Armenian American famous nutrition specialist Caroline Apovian is the Director of the Partnership Program between the Boston University and Yerevan State Medical University after Mkhitar Heratsi. She is also interested in doing research around the farmlands in Armenia because those children are not growing properly, they are not getting enough protein.
Caroline Apovian is Professor of Medicine and Pediatrics, in the Section of Endocrinology, Diabetes and Nutrition at Boston University School of Medicine, USA. She is also Director of the Center for Nutrition and Weight Management at Boston Medical Center, USA. Dr. Apovian is a nationally and internationally recognized authority on nutrition and has been in the field of obesity and nutrition since 1990. Her current research interests are in: weight loss and its effects on endothelial cell function, adipose cell metabolism and inflammation, research in the bariatric surgery population, and novel pharmacotherapeutic antiobesity agents. She is also an expert in the technique for subcutaneous adipose tissue biopsies, and has been performing these biopsies on research subjects for over 10 years.
Dr. Apovian was a recipient of the Physician Nutrition Specialist Award given by the American Society of Clinical Nutrition. This was for her work on developing and providing nutrition education, to medical students and physicians in training at Boston University School of Medicine. She has published over 200 articles, chapters, and reviews on the topics of: obesity, nutrition and the relationship between adipose tissue and risk of developing cardiovascular disease. Dr. Apovian has written the popular books “The Overnight Diet”, “The ALLI Diet Plan” and “The Age-Defying Diet”.
Dr. Apovian has been a member of The Obesity Society since 1992, and has served on the Clinical Committee as well as Secretary/Treasurer and the Executive Committee from 2005 to 2008. She has been a faculty speaker and has presented papers at several of the Society's Annual Scientific Meeting, and until recently she served as Associate Editor for the Society's journal, Obesity. Now she is the President of the U.S. Obesity Society.
- Dr. Apovian, what are you occupied with right now? What kind of new projects are you implementing?
We are doing a lot of research. We are doing Zoom meetings, lecturing; all of our activities were put on video. I did a conference on obesity course in May in New York, but I was in Boston, 750 doctors from around the world joined. We are also doing a lot of research on COVID-19, we have seen a lot of COVID-19 cases in Boston, and we are reviewing records to try to look at reasons why people got sick. We are also talking to patients on the phone, and there are many people who need to come to the hospital, so we have to make sure they get to the hospital. I am not on the front line, I am not taking care in the hospital, but many of my patients have been getting sick because of obesity. So, I need to make sure they are okay.
- Are you planning to visit Armenia when the situation with COVID-19 ends?
Well, I am the Director of the Armenia Partnership Program between the Boston University and Yerevan State Medical University. So I have been going to Armenia up until a few years ago. And I would like to go back to Armenia at some point to continue our partnership: we send medical students to Armenia, and students come here to learn our new practices in medical education. So that is ongoing. I was also interested in doing research around the farmlands in Armenia because those children are not growing properly, they are not getting enough protein, they get malnutrition, and I want to know why. Because my background is in nutrition, I try to help children in the villages of Armenia. I would like to work with nutrition specialists in Yerevan to try to study what is going on in Armenia so that we can try to help and prevent the malnutrition that is happening. And I think there is not enough protein to eat. I think the problem is that the farmers are sending good food to the city for people to buy it, not leaving enough good food for their own children. These children are also overweight, but malnourished, they eat chips and packages of food without protein. That is the problem.
Last time I went to Armenia, I tried to work on this, and what we need is funding. We asked USAID in Armenia to start a project like this, and they said: “The money was just cut”. So, we do not have enough funding to do this. We need to raise money.
Professor of Medicine and Pharmacology at the College of Physicians & Surgeons, Columbia University, Dr. John Bilezikyan is my cousin. I used to go to Armenia with him almost every year in October. But in 2017 I stopped going because I became President of United States Obesity Society, and there was a lot of work. So, instead of going to Armenia I started going to Oman. The U.S. Department of State sent me to Oman to try to help them with their obesity problem.
- What do you miss about Armenia there, in the United States?
I think I miss fresh food. Food is so good in Armenia. The lavash and the beauty of Armenia – the beautiful hills, and the people are so genuine and friendly, and I miss the Republic Square, the dry fruits and nuts in “Vernisazh” market. And there was a bread made with some greens – “Jengyalov hac” which I tried in Artsakh Republic.
- Let’s pass to COVID-19. How would you describe this virus in general? Why isn’t it possible to find a vaccine against it?
Because it has enough ways to get into the cells. It gets into the lung tissue through the ACE2 receptor. Every cell in a lung has an ACE2 receptor. It gets in the air, and it multiplies. It gets into the fat cells because fat cells have ACE2 receptors as well. So, it gets into our cells in a unique way. There are these receptors in liver, in kidney and in heart. Once it gets in, it’s very difficult because it can cause more severe problems with obesity because they have a lot of fat tissues. And our immune cells are having a hard time fighting it, especially people who are older, because they have older immune cells.
- What is the difference between COVID-19 and other pandemics?
You know the 1918 pandemic killed many people, that was a very serious disease. But this one is more problematic, because it can be more severe, and it’s more contagious. You know Ebola kills you, but it’s not easy to get infected with Ebola. So the difference is that you can have this virus and not know you have it and give it to many-many people before even you get sick. It is contagious, and it kills, so that’s the problem. In Boston we got hit very badly because a number of investigators from all over the world, but, in particular, from China, came to Boston to a hotel, and then everybody got sick. Nobody knew that they were sick.
- Could you mention any state or states that effectively struggle against COVID-19?
Yes, South Korea did well. Everybody there wear a mask. They made everybody wear a mask, and they made everybody listen. Because of the strict Government, everybody listened. The problem with places like the United States and Armenia is that people want their freedom, but sometimes their freedom hurts other people. Public health is very important measure to ensure that people stay alive so they can enjoy freedom. South Korea did a great thing. We all have to look at what they did.
- What would say about the situation in Armenia?
Stay home, wear a mask, exercise and eat protein – chicken, fish, stake.
- What would be your call to people in Armenia who still do not believe that this virus exists?
In the United States, for example, the doctors and nurses came out on video and talked to the public, saying: “This is real”. In New York City they were taking pictures and videos of the bodies taken out of the hospital and put bodies on bodies. All you have to do is to look at this and realize – people are dying. Don’t believe it, take them to the hospital and make them watch what’s happening there. I remember my brave grandmother who had seen all her family beheaded in front of her eye during the Armenian Genocide. Whenever I had a problem, I would go to my grandmother and talk to her, she would say: “That’s not a problem”. So, COVID-19 is not a problem, stay home, wear a mask, and we will bit the virus.
Author: Tatevik Ghazaryan