W. Philip T. James
CBE, FRSE, MD, DSc. Hon. Prof. Nutrition. London School of Hygiene and Tropical Medicine. London. United Kingdom.
A brief summary of his career:
Born 1938 and educated in North Wales as a child and then in Yorkshire before studying physiology and biochemistry and then medicine at University College/ Hospital (UCH), London. After graduating he undertook the extra training in paediatrics, general medicine and surgery, cardiology and respiratory disease before starting his research career in the UK Medical Research Council’s (MRC) Tropical Metabolism Research Unit, Jamaica where he acted as the paediatrician running the clinical unit for malnourished children. After a year at the Massachusetts General Hospital, Boston he worked at the MRC Gastroenterology Unit, Central Middlesex Hospital London before becoming Senior Lecture in Nutrition at the London School of Hygiene and Tropical Medicine (LSHTM) and Honorary Consultant Physician at the Tropical Diseases Hospital and UCH. He ran the postgraduate nutrition course at LSHTM and dealt with malnourished surgical patients and began an obesity clinic. He was then invited to become the Assistant Director at the MRC Dunn Nutrition Unit in Cambridge and established a whole body calorimeter/metabolic unit at Addenbrooke’s Hospital, a clinical metabolism facility and an obesity clinic. He initiated the first modern UK approach to nutritional public health with the NACNE report. After 8 years he was then invited to become the Director of the Rowett Research Institute in Aberdeen, Scotland then a world famous centre for animal nutrition research. For 17 years he led a transformation of the institute to deal with nutritional aspects of the whole food chain and human nutrition and collaborations in 60 countries. Was asked by the UK government to serve on numerous committees dealing with the food chain. He then led the first integrated 1988 WHO analysis of the 53 European states’ nutritional state and policy needs before establishing, chairing and writing the 2000 WHO 797 report on an integrated approach to global nutritional deficiencies and the nutritional basis for the non – communicable diseases. He chaired and led the first Scottish diet report with a new perspective on the historical basis for the severe public health problems in Scotland and proposed remedies. This then led to the Scottish Diet Action plan that became the prototype for WHO action on nutritional public health in Europe. He also helped lead the WHO initiative to counter the Sarayevo siege in the Bosnian war. He subsequently chaired the Millennium Commission for the UN’s SCN. He also developed the plan for a Food Standards Agency in the UK for tony Blair, the need for a European Health Division in Brussels for President Delors of the European Commission and the need for a European Food Safety Authority. Having established the International Obesity Task Force (IOTF) to help WHO develop its global obesity strategy he left the Rowett to run the IOTF in London and then helped establish the societies for global obesity research and policy (now the World Obesity Federation) and its European branch. He continues as Hon. Prof at the LSHTM working with WHO Europe and for the last 6 years for the WHO Eastern Mediterranean region.
Degrees and awards.
BSc Honours in Physiology, M.B.B.S. Honours London with Distinctions, Gold and Silver Medals in Medicine, Pathology, Clinical Biochemistry, Obstetrics and Gynaecology. Postgraduate degrees: MRCP, MD and DSc London. M.A., Cambridge. Fellowships of the Royal College of Physicians, London and Edinburgh, of the Royal College of General Practitioners, Royal College of Arts, Institute of Biology, UK Nutrition Society and Association of Nutritionists. Founding Fellow UK Academy of Medical Sciences. Fellow of the Royal Society of Edinburgh. Honorary DScs from Universities of the City of London, Buckinghamshire and Aberdeen. Hon. Member UK Faculty of Public Health and UK Dietetic Society. Sir David Cuthbertson’s prize for distinguished research in metabolic medicine, Sir Alistair McIntyre Distinguished Award, University of the West Indies, for outstanding services internationally in the field of medicine, Sebrell Prize for contributions to the understanding of obesity; Commander of the British Empire (CBE) for Services to Science, WHO Europe prize for services to public health.
Main research initiatives, findings and policy developments.
In Jamaica at the UK‘s Medical Research Council’s (MRC’s) Tropical Metabolism Research Unit it was shown that in protein- energy malnutrition (PEM) albumin levels are a poor index of nutritional deprivation. This analysis was undertaken with help from Andrew Hay: there is a complex metabolic adjustment with the contraction of extravascular albumin and the preservation of circulating levels with lower protein intakes. The assessment used iodinated albumin and whole body beta counting with mathematical modelling showing extracellular albumin mass contractions and therefore that falls in circulating albumin concentrations are late developments when intakes are poor.
Malnourished children’s diarrhoea is a reflection of severe gut atrophy with the loss of disaccharide levels and malabsorption which can only be overcome by providing the appropriate combination of monosaccharides and sodium solutions in non- hyperosmolar terms. Severe diarrhoeas, however, may reflect a toxic secretion from the small intestine induced by viral or bacterial infections but this can be counteracted by conjoint frequent glucose/saline input. This work led, with the parallel findings in Puerto Rica and the Dhaka Cholera unit, the Dhaka Unit to drive the introduction of a standard glucose/saline therapeutic solution which is now saving millions of lives a year. Disaccharidase deficiencies, poor digestibility and malabsorption can recover on treatment but pancreatic insulin secretion on glucose challenge, then measured by the new insulin assay by Hal Coore, seems permanently impaired with enormous implications for a future propensity to type 2 diabetes in adulthood. The demand for high kcalories and nutritionally complete food is very high only after the first few days of precarious electrolyte imbalance when excess intake is lethal: the control of appetite during recovery is exquisite with usually an immediate shut-off the day the child recovers their normal weight for height despite persistent stunting.
These analyses and concepts of appropriate weight for height and the separate consideration of wasting and stunting in sick children allowed the recognition, with Bike Aksu, that stunting rather than wasting was the dominant nutritional problem in lower income countries after our survey for the UK Government’s Department for Overseas Development of school children in Montserrat in 1971. This became the Waterlow classification of malnutrition and the principles behind current WHO distinctions between stunting and wasting in PEM. In London with Andrew Tomkins at the London School of Hygiene and the Hospital for Tropical Medicine it was shown that tropical sprue was an intrinsic gut mucosal folate deficiency mediated problem with jejunal folate deficiency in facilitating methylation of uracil to thymidine. Also developed the concept of using C1 labelled leucine for determining protein turnover in children and adults with Peter Garlick to amplify Prof. John Waterlow’s interest in protein turnover.
Analyses for the UK government and MRC in 1971 established the optimum BMIs for adults based on old USA Metropolitan Life Insurance statistics of body weights and mortality as part of a new look at the problem of obesity for the UK Government’s Department of Health and MRC. Then established and directed the MRC Dunn Clinical Nutrition Centre in Cambridge and set up a national referral centre for obese patients at the hospital. Developed whole body calorimetry with Joy Dauncey using Peter Murgatroyd’s construction and control skills and new approaches to energy balance evaluation and the importance of independent measures of body composition and energy expenditure by the D2O18 technique. Identified the need for biomarkers for food intake as intake measures often misleading. Then with Paul Trayhurn, Prakash Shetty, Roland Jung and Mike Lean showed thermogenic defects potentially associated with brown fat metabolism in familial obesity and the adaptive hypothalamic responses to weight gain in obesity that then neuro-hormonally defends the higher body weights and biologically resists attempts to slim. Helen Dallosso showed smokers have elevated basal metabolic rates (BMRs) and cigarette induced thermogenesis but appetite effects dominate the explanation for smokers being slimmer than non - smokers. Also established in the metabolic unit with whole body calorimetry that fat overfeeding induced very modest thermogenesis signifying ready body fat accretion. Christine Zed then found responses to fat feeding were higher in lean than obese subjects as was the response to adrenergic blockade – again consistent with a reduced action of brown adipose tissue in obese individuals with a strong family history of obesity. Johanna Bisdee also showed the marked menstrual cyclic variation in BMR in young women and the much greater response to overfeeding with carbohydrate than fat when assessed by whole body calorimetry. The new whole body calorimetric analyses showed the exquisite control of energy metabolism with a variation in 24 hour expenditure of only 0.7% including instrumental error and the robustness of BMR measures allowed the recognition clinically that obese patients often mislead themselves about their true intake. This was helpful when assessing obese patients in the newly established national referral centre. With Prakash Shetty it was also recognised that “Third World” studies apparently showing extraordinary energetic adaptation to poor food intakes (especially in women) were bogus: measures of expenditure were far more reliable. This led to a complete re-evaluation of the world’s food needs as Chair of the energy sub- group in the WHO/FAO/UNU’s 1981 reanalysis of protein and energy needs in FAO, Rome. Then with Claire Schofield international reference BMRs and evaluations of physical activity levels (PALs) for global use were developed. A new FAO approach for evaluating food needs for communities and countries was also developed with help provided to governments of many lower income countries across the world. A little later a further FAO report with Prakash Shetty set out the value of using BMI as a reference point for assessing overall national food supply (FAO Food and Nutrition Paper 56) and proved fundamental in determining national food needs and the standard FAO approach to assessing the global millions of undernourished which FAO publishes every year.
John Cummings and Sheila Bingham used dietary fibre specially prepared with special arrangements by Unilever who very rapidly froze a ton each of different freshly picked vegetables and then performed Southgate style extraction of fibre in a specially commissioned industrial distillery normally used for industrial scale perfume production. The metabolic studies established at the DCNC showed non-starch polysaccharides’ physiological effects and these underlay the specification of appropriate fibre intakes later for the 2000 WHO 797 Diet and public health report. Hans Englyst with John Cummings also developed the new methods and definitions of fibre including resistant starch and with Ian McNeil it was shown that fibre derived volatile fatty acids were absorbed from the colon. New metabolic markers were also developed e.g. para-amino-butyric acid for completeness of urine collections in Sheila Bingham’s studies. Claudia Sanchez-Castillo then helped develop the novel lithium technique (now the gold standard method) for analysing the food sources of salt; new standards for assessing food intakes were also set in studies of cancer with John Cummings and Sheila Bingham.
The complete physiological re-evaluation of different nutrients’ effects metabolically and clinically led to the then highly controversial proposal for a new public health nutrition initiative in the UK when asked to Chair the UK National Advisory Committee for Nutrition Education (NACNE). This specified the need for a transformed approach to national nutritional policy making in the UK to combat nutritional deficiencies but also stroke, heart disease, obesity diabetes and cancers. A TV series on short family related programmes dealing with food purchases and cooking for the BBC also led to major national food initiatives with more correspondence to the BBC than they had ever received since World War II.
At the Rowett, as well as the Directorial work and expanding human nutrition, new or amplified research programmes were started e.g. on zinc, selenium, bone metabolism, energy balance, indices of oxidative damage and of mutational change. A PhD programme was started and increased to an average of 60 in on-going research programmes and a new MSc course in Human Nutrition was established led by Peter Aggett and later Geraldine McNeil with up to 40 students undertaking shorter term research projects at the Rowett. A new approach was introduced with Mike Lean for dietary management of the obese and those with diabetes involving prescribing individually a 500-600kcals/d-deficit diet to reduce weight but limit the reactive drive to eat. This became the norm for a huge range of major international weight reduction controlled trials in Europe and elsewhere and was applied first to test the value of orlistat and then of sibutramine as aids to weight loss. When conducted by fully trained physicians/dieticians there was a remarkably coherent and effective response. Sibutramine was later tested in the 16-country six–year SCOUT trial that led to the withdrawal of sibutramine because of cardiovascular side effects in already cardiovascularly compromised patients. James Stubbs, who had worked in calorimetry at the MRC Dunn, continued his approach to dietary and behavioural factors affecting energy balance at the Rowett. Internationally with Anna Ferro-Luzzi a new analysis was developed of what was termed adult “chronic energy deficiency” with a broadening of the specification of the normal BMI to 18.5-24.9. Below that level work capacity studies in Latin America and Africa was reduced with preliminary evidence of a curvilinear increase in mortality as BMIs fall below 18.5 as well as clear evidence from Africa and Asia of intercurrent infections affecting work ability below BMIs of 17.0. A marked increase in mortality risk was also evident below a BMI of16.0. A conjoint placebo controlled double blind trial with Prakash Shetty in Bangalore and Anna Ferro-Luzzi of the impact of micronutrients supplementation on haematological and immunological status was conducted in very poor Indian villagers and showed marked improvements in immunological function in the micro-supplemented group.
Then in the challenge of nutritional policy making for WHO Europe (WHO 1988 EURO report 24) with Anna Ferro-Luzzi, Bjorn Isaksson and Wiktor Szostak we had to cope with the paucity of good data on nutritional status in so many poor Eastern European Countries e.g. in the Baltic States, the Caucuses and the Asian Republics. This led to Vilius Grabauskas of Lithuania as WHO ADG for Non – Communicable Diseases (including mental health and nutrition) in WHO Geneva, asking for a fresh approach to global nutrition policy making to encompass malnutrition, other nutritional deficiencies and the adult chronic disease. This involved creating drafts of new integrated and novel approaches with the generation of integrated data and policies addressing different ministries with a range of new strategies and then chairing the WHO technical Expert Committee to produce integrated analyses and proposals for the 1990 WHO 797 report. WHO emergencies sometimes arose, however, as in the Bosnian war when it became clear that Sarajevo was on the brink of starvation. So with Aileen Robertson, seconded from the Rowett’s Postgraduate Nutrition and Dietetic Centre to WHO in Zagreb, we avoided mass starvation in the Bosnian war by transferring by satellite data on adult and children’s anthropometry from “Sniper’s Alley” in Sarajevo and from elsewhere in Bosnia to the Rowett for immediate calculation. The priority requirements for distribution of food by the UNHCR, WFP and major international charities to different areas and selected Bosnian towns was then organised within 24 hrs. based on satellite exchanges of data on changing children’s anthropometry. The UK government was also persuaded to ask their army engineers to create immediately a new road over the mountains to Sarajevo (which became the main access route) with 200 new trucks to supply food.
Later the International Obesity Task Force (IOTF) was established to collate the rapidly accumulating evidence that poor countries were now beginning to have a major problem of obesity so all the evidence was collated and presented to WHO which convened another Expert Technical Report, that was eventually published as the 2000 WHO TRS 894 report. Then chairing the special UN Millennium Commission on global issues relating to Nutrition up to 2020 led to a change in policy relating to low birth weight as in South East Asian infants and children were often stunted but nationally this prevalence related to lower birth weights so maternal nutrition had to be a much higher priority than hitherto. A new life – cycle approach to nutritional analyses and policy-making emerged with its concept of intergenerational persistence or enhancement of problems.
In the UK Tony Blair, as incoming Prime Minster, suddenly required a new approach to cope with the crises in food safety and the novel emergence of bovine spongiform encephalitis (BSE) presumably from bovine products contaminated with the infective BSE prions. Cases of the new human form of Creutzfeldt-Jacob Disease had recently emerged in the UK as well as further E. Coli outbreaks. So within 6 weeks with Karen McColl’s help a restructuring of the UK government with the extraction of different segments of the Ministries of Health and Agriculture was proposed with the formation of an independent UK Food Standards Agency. This dealt not only with food safety but also with nutrition and with formal deliberative sessions open to the public. When implemented this proved a national and international success with new analyses and policies on the deleterious impact of marketing to children and the introduction of traffic light nutritional labelling of foods which we had produced as a proposal with a suggested scheme some years earlier in the Coronary Prevention Group which I chaired. The Food Standards Agency proposal immediately stimulated President Delors of the European Commission to ask for help with European issues. The formation of a new EC division for health was proposed which became DG SANCO with a top level Scientific Committee of 8 independent scientists from different European countries with a further 8 chairs of different independent committees dealing with a huge range of issues from nutrition to animal health, plant science and other biological scientific problems. Then as one of the 8 scientists a solution to the European BSE crisis had been proposed by the first committee meeting involving shutting down all the cattle, sheep and goat industries in Europe to prevent a major epidemic of BSE in Europe and the possible emergence of the novel Creutzfeldt-Jacob Disease (n CJD) in humans across Europe. Already up to a maximum of 8 million young people in the UK alone were predicted to be liable to this appalling fatal disease. As the solo objector to this radical approach a new strategy had to be devised within 6 weeks with a scheme involving discriminating different national risks of animal feed contamination, post-mortem checks on animal tissue and brain pathology, new slaughtering practices and tissue restrictions for human consumption in every assessed country globally supplying food to Europe. New approaches to tissues available for human consumption and a huge range of industrial processes e.g. gluten production for pills used in the pharmaceutical industry had to be introduced. This not only proved successful in rapidly arresting the BSE epidemic but also no cases of nCJD emerged in Europe. A major trade war with the USA was also avoided. However, it required a new industrial approach across the whole of Europe with the re-education of policy makers in many parts of the world.
Then having moved to London in the new Millennium with IOTF, a completely new approach to a whole range of nutrition policies was required including an analysis of the appropriate measures for children’s normal growth, a fresh approach to analysing the community, national and international drivers of the change in the food systems and how to rectify its defects. The importance of physical activity in combatting coronary heart disease was reaffirmed with James Erlichman and an international group of the top global physical activity experts but with the additional need to restrict saturated fat; combatting obesity required longer, albeit less intense, activity daily combined with food energy restriction. Analyses of a large individual database then showed that there was an Asian propensity to diabetes on modest weight gain. This collaboration with Rachel Huxley of the George Institute, Sydney and Tim Gill from the Nutrition Department of Sydney University compared different Asian groups with Australasians. Then together with Claudia Sanchez- Castillo parallel studies were initiated with the Mexican Government that demonstrated the same sensitivity to diabetes on weight gain in a country with a long-standing reputation for admirable work combatting widespread PEM in infants and children. The type 2 sensitivity on weight gain was therefore considered to reflect poor early maternal nutrition with foetal epigenetic changes as well as the previously impact of PEM (as shown in Jamaica) in inducing a seemingly permanently reduced capacity for insulin secretion. Now the same feature of diabetes sensitivity has been found in the Eastern Mediterranean region of WHO when helping the Regional Director, Ala Alwan in Cairo with the overwhelming nutritional problems of the region. The region continues to have maternal and childhood malnutrition but extraordinary levels of obesity, diabetes, cardiovascular disease and cancers. So over the last 6 years WHO proposals for new industrial approaches needed for salt reduction to combat hypertension have been developed and now are being implemented. Industrially produced trans fat in the Gulf States have also been banned as well as changes in government fiscal policies with a progressive elimination of vegetable oil and sugar subsidies and now additional fiscal policies to improve the nutritional quality of the whole food chain. Analyses and publications on their impact are still in progress. Additional help has been provided for WHO in Geneva on global food policies with a reappraisal, with the late Aubrey Sheiham, of his original WHO 1990 analyses of the need for sugar restriction to 10% to limit dental caries. After our detailed reanalysis of the original 2nd World War Japanese data and a wealth of new global data WHO recently accepted that a 5% sugar limit would often be considered preferable to 10%. We had specified minimal levels and only 2-3% average intakes as the maximum average levels to limit dental caries provided there was additional water fluoridation and dental care. Work with WHO Europe has also helped develop new approaches to maternal nutrition and inter-sector policies for improving maternal and childcare.
Books and Technical reports:
1. James WPT.(Compiler) Research on obesity . A report of the DHSS/MRC group. HMSO 1976
2. James W.P.T, Theander O. (eds.) Methods for the measurement of dietary fibre, Marcel Dekker, New York. 1981
3. Cioffi L.A, James W.P.T, Van Italliee T.B. (eds.). The Body Weight Regulatory System: Normal and Disturbed Mechanisms, Raven Press, New York. 1981
4. A discussion paper on proposals for nutritional guidelines for health education in Britain. (1983). National Advisory Committee on Nutrition Education, Chairman James, W.P.T. The Health Education Council. See Nutrition: the changing scene1983.. Extracts from NACNE report. Lancet 1983: II: 719-721, 782-784, 835-838, 902-905.
5. Obesity: A report of the Royal College of Physicians. Journal of the Royal College of Physicians of London, 1983;17: 4-58. Secretary and Author: James, WPT. Chair of Advisory Committee: Sir Douglas Black, President of the Royal College.
6. James W.P.T. (ed.) Clinics in Endocrinology and Metabolism: Obesity, W.B. Saunders Company, London. 1984
7. James W.P.T, Parker S.W. (eds.) Current Approaches: Obesity, Duphar Laboratories Limited, Southampton. 1988
8. James W.P.T. in collaboration with Ferro Luzzi A, Isaksson B, Szostak W.B. (eds.). Healthy nutrition: Preventing nutrition related diseases in Europe, WHO Regional Publications, European Series, 1988.No. 24.
9. James W.P.T, Schofield E.C. Human Energy Requirements: A Manual for Planners and Nutritionists, Published by arrangement with the Food and Agriculture Organization of the United Nations by Oxford University Press. (1990). Oxford UK.
10. James W.P.T. Chair and prime author: Diet, Nutrition and the Prevention of Chronic Diseases. WHO Technical Report, Series 797. Geneva, WHO1990.
11. Garrow J.S, James W.P.T. (later edition Ralph A) Editors: Human Nutrition and Dietetics. (9th and 10th edition) Churchill Livingstone, London. 1993 and 2000
12. Shetty P.S, James, W.P.T. (1994). Body Mass Index. A measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56, FAO, Rome.
13. James, W.P.T, Muir, C.S., Tunstall -Pedo E,H., Lean, M.E., Cockburn F, Foster A., Maclennan W.J, Robertson A. (1994). Scotland's Health, a challenge to us all. The Scottish Diet. (Report of a Working Party to the Chief Medical Officer for Scotland). Scottish Home and Health Department, Edinburgh.
14. James, W.P.T. & Ralph A. (Eds.) (1994). The Functional Significance of Low Body Mass Index. Proceedings of an IDECG Workshop, Rome, November 1992. Macmillan Press, Basingstoke.
15. Chesson, A., Collins, A.R., Dutta-Roy, A.K., James, W.P.T., Provan, G.J., Pusztai, A., Ralph, A. & Stewart, C.S. (1995). Compounds of Dietary Origin Protective of Human Health. MAFF, London1995.,
16. Obesity. Reversing the increasing problem of obesity in England. (1995) A report from the Nutrition and Physical Activity Task Forces. Department of Health, London.
17. Obesity in Scotland. Integrating Prevention with Weight Management. (1996) A National Clinical Guideline recommended for use in Scotland by the Scottish Intercollegiate Guidelines Network (SIGN). Chairman: James, W.P.T
18. Ferro-Luzzi, A and James WPT (1997) Diet and Health in Scientific and Technological Options Assessment (STOA) Nutrition in Europe. Report to the European Parliament, PE Number 166.481. European Union, Directorate General for Research. 1997
19. James WPT and McColl K. (1997) A Food Standards Agency for the UK. A report for the Prime Minister, Mr Tony Blair.
20. James WPT (Chair) Ending Malnutrition by 2020: An Agenda for Change in the Millennium. Food & Nutrition Bulletin 2000, Vol 21, No.3s.). UN International Nutrition Foundation, Boston, MA, USA
21. Robertson A, Tirado C, Lobstein T, Jermini M, Knai C,. Jensen J H, Ferro-Luzzi A and James WPT. Food and Health in Europe: A new basis for action. WHO Regional Publications, European Series, 2004. No 96. Copenhagen.
22. Alwan A, Al–Jawaldeh A, James WPT, MacGregor G. Policy statement and recommended actions to lower national salt intakes and lower death rates from high blood pressure and strokes in the Eastern Mediterranean Region. 2015 see WHO EMRO website
23. 2016 Breda J, Galea G, Lazdane G, Schumann NL, Robertson A, Sørensen TB, James P, Lobstein T. Maternal Nutrition: the best start in life. WHO EURO. European Series Report. 2016
24. Alwan A, McColl. K, Al–Jawaldeh A, James WPT. Proposed policy priorities for preventing obesity and diabetes in the Eastern Mediterranean Region Report for the WHO Regional Office for the Eastern Mediterranean23 January 2017. (in press on WHO EMRO website)
A selection of the 530 or so papers published over the last 50 years:
25. Waterlow J.C, Alleyne G.A.O, Chan H, Garrow J.S, Hay A, James W.P.T, Picou D, Stephen J.M.L. (1966) Observations on the mechanisms of adaptation to low protein intakes. Arch. Lationoamericanos de Nutricion, XVI, 175 200.
26. James W.P.T. (1968) Intestinal absorption in protein calorie malnutrition. Lancet, 1, 333 335.
27. James W.P.T. (1968) Jejunal biopsy modified for paediatric use. Lancet, 1, 795 796.
28. Ashworth A, Bell R, James W.P.T, Waterlow J.C. (1968) Calorie requirements of children recovering from protein calorie malnutrition. Lancet, 2, 600 603.
29. James W.P.T, Hay A.M. (1968) Albumin metabolism: effect of the nutritional state and the dietary protein intake. Journal of Clinical Investigation, 47, 1958 1972.
30. James W.P.T, Coore, H.G. (1970) Persistent impairment of insulin secretion and glucose tolerance after malnutrition. American Journal of Clinical Nutrition, 23, 386 389.
31. James W.P.T. (1970) Sugar absorption and intestinal motility in children when malnourished and after treatment. Clinical Science, 39, 305 318.
32. James W.P.T. (1971) Jejunal disaccharidase activities in children with marasmus and with kwashiorkor: the response to treatment. Archives Diseases of Childhood, 46, 218 220.
33. James W.P.T, Drasar B.S, Miller C. (1972) Physiological mechanism and pathogenesis of weanling diarrhoea. American Journal of Clinical Nutrition, 25, 564 571.
34. James W.P.T. (1972) Comparison of three methods used in assessment of carbohydrate absorption in malnourished children. Archives of Diseases of Childhood, 47, 531 536..
35. Cummings J.H, James W.P.T, Wiggins H.S. (1973) Role of the colon in ileal resection diarrhoea. Lancet, 1, 344 347.
36. Garlick P.J, Millward D.J, James W.P.T. (1973) The diurnal response of muscle and liver protein synthesis in vivo in meal fed rats. Biochemical Journal, 136, 935 945..
37. Tomkins A.M, James W.P.T, Walters J.H, Cole A.C.E. (1974) Malabsorption in overland travellers to India. British Medical Journal, 3, 380 384.
38. O'Keefe S.J.D, Sender P.M, James W.P.T. (1974) "Catabolic" loss of body nitrogen in response to surgery. Lancet, 2, 1035 1038.
39. James W.P.T, Sender P.M, Garlick P.J, Waterlow J.C. (1975) The choice of label and measurement technique in tracer studies of body protein metabolism in man. I.A.E.A. Symposium on Dynamic Aspects of Isotope Technique in Man, pp.461 472.
40. Garlick P.J, Millward D.J, James W.P.T, Waterlow J.C. (1975). The effect of protein deprivation and starvation on the rate of protein synthesis in tissues of the rat. Biochimica Biophysica Acta, 414, 71 84.
41. Tomkins A.M, Drasar B.S, James W.P.T. (1975) Bacterial colonisation of jejunal mucosa in acute tropical sprue. Lancet, 1, 59 62.
42. Tomkins AM, Badcock J, James WP. Altered morphology and pathways of DNA synthesis in small Intestinal epithelium in dietary folate deficiency. Proc Nutr Soc. 1976 Dec;35(3):144A
43. James W.P.T, Garlick P.J, Sender P.M, Waterlow J.C. (1976) Studies of amino acid and protein metabolism in normal man with U 14C L Tyrosine. Clinical Science and Molecular Medicine, 50, 525 532.
44. James W.P.T, Trayhurn P. (1976) An integrated view of the metabolic and genetic basis for obesity. Lancet, 2, 770 773.
45. James W.P.T. (1977) Dietary fibre, transit time, faecal bacteria, steroids, and colon cancer in two Scandinavian populations. Report from the International Agency for Research on Cancer Intestinal Microecology Group. Lancet, 2, 207 211.
46. Trayhurn P, Thurlby PL. James WPT. (1977). Thermogenic defect in pre obese ob/ob mice. Nature, 266, 60 62.
47. Cummings J.H, Southgate DAT, Branch W, Houston H, James WPT. (1978) Colonic response to dietary fibre from carrot, cabbage, apple, bran and guar gum. Lancet, 1, 5 9.
48. James WPT, Davies HL, Bailes J, Dauncey MJ. (1978). Elevated metabolic rates in obesity. Lancet, 1, 1122 1125.
49. Jung RT, Gurr MI, Robinson MP, James WPT. (1978). Does adipocyte hypercellularity in obesity exist? British Medical Journal, 2, 319 321.
50. McNeil NI, Cummings JH, James WPT. (1978) Short chain fatty acid absorption by the human large intestine. Gut 19 819-822
51. Shetty P.S., Jung, R.T. & James, W.P.T. (1979). Effect of catecholamine replacement with Levodopa on the metabolic response to semi starvation. Lancet, 1, 77 79.
52. Jung, R.T., Shetty, P.S., James, W.P.T., Barrand, M.A. & Callingham, B.A. (1979). Reduced thermogenesis in obesity. Nature, 279, 322 323.
53. Shetty P.S., Watrasiewicz, K.E., Jung, R.T. & James, W.P.T. (1979). Rapid turnover transport proteins: an index of subclinical protein energy malnutrition. Lancet, 2, 230 232.
54. McNeil N.I., Cummings J.H. & James W.P.T. (1979). Rectal absorption of short chain fatty acids in the absence of chloride. Gut, 20, 400 403.
55. Bingham S, Williams D.R.R., Cole R.J. & James, W.P.T. (1979). Dietary fibre and regional large bowel cancer mortality in Britain. British Journal of Cancer, 40, 456.
56. Jung R.T., Shetty P.S. & James, W.P.T. (1980). The effect of beta adrenergic blockade on metabolic rate and peripheral thyroid metabolism in obesity. European Journal of Clinical Investigation, 10, 179 182.
57. Jung, R.T., Shetty, P.S, James, W.P.T. (1980) The effect of refeeding after semi starvation on catecholamine and thyroid metabolism. International Journal of Obesity, 4, 95 100.
58. Shetty, P.S., Jung, R.T., James, W.P.T., Barrand, M.A., Callingham, B.A. (1981) Postprandial thermogenesis in obesity. Clinical Science, 60, 519 525.
59. James, W.P.T., Shetty, P.S. (1982). Metabolic adaptation and energy requirements in developing countries. Human Nutrition:Clinical Nutrition, 36C, 331 336.
60. Jung, R.T., Shetty, P.S., James, W.P.T., Barrand, M.A. Callingham, B.A. (1982) Plasma catecholamines and autonomic responsiveness in obesity. International Journal of Obesity, 6, 131 141.
61. Gurr, M.I., Jung, R.T., Robinson, M.P.,James, W.P.T. Adipose tissue cellularity in man: the relationship between fat cell size and number, the mass and distribution of body fat and the history of weight gain and loss. International Journal of Obesity, 1982; 6, 419 436.
62. Jung, R.T., Campbell, R.G., James, W.P.T., Callingham, B.A. Altered hypothalamic and sympathetic responses to hypoglycaemia in familial obesity. Lancet,1982; 1, 1043 1046.
63. Bingham, S., Wiggins, H.S., Englyst, H., Seppanen, R., Helms, P., Strand, R., Burton, R., Jorgensen, I.M., Poulsen, L., Paerregaard, A., Bjerrum, L. James, W.P.T. Methods and validity of dietary assessments in four Scandinavian populations. Nutrition and Cancer,1982; 4, 23 33.
64. Lean, M.E.J., Branch, W.J., James, W.P.T., Jennings, G.. Ashwell, M. Measurement of rat brown adipose tissue uncoupling protein by radio immunoassay: increased concentration after cold acclimation. Bioscience Reports, 1983; 3, 61 71.
65. Lean, M.E.J., James, W.P.T. Uncoupling protein in human brown adipose tissue mitochondria. Isolation and detection by specific antiserum. FEBS 1983; 163, 235 240.
66. Klein, P.D., James, W.P.T., Wong, W.W., Irving, C.S., Murgatroyd, P.R., Cabrera, M., Dallosso, H.M., Klein, E.R. & Nichols, B.L. Calorimetric validation of the double labelled water method for determination of energy expenditure in man. Human Nutrition: Clinical Nutrition, 1984; 38C, 95 106.
67. Dallosso, H.M. James, W.P.T. Whole body calorimetry studies in adult men. 1. The effect of fat over feeding on 24 h energy expenditure. British Journal of Nutrition.1984; 52, 49 64.
68. Dallosso, H.M., James, W.P.T. The role of smoking in the regulation of energy balance. International Journal of Obesity, 1984; 8, 365 375.
69. Schofield, W.N., Schofield C, James, WPT. Basal metabolic rate Review and prediction, together with an annotated bibliography of source material. Human Nutrition: Clinical Nutrition, 1985; 39C(Suppl 1), 1 96.
70. Lean, MEJ, James, WPT. Diabetes: Prescription of diabetic diets in the 1980s. Lancet, 1986; 1, 723 725.
71. Lean M.E.J., James W.P.T., Jennings, G, Trayhurn, P. Brown adipose tissue uncoupling protein content in human infants, children and adults. Clinical Science, 1986; 71, 291 297.
72. Lean ME, James WP Prescription of diabetic diets in the 1980s Lancet. 1986 Mar 29;1(8483):723-5
73. Zed, C. James, W.P.T. Dietary thermogenesis in obesity: fat feeding at different energy intakes. International Journal of Obesity, 1986;10, 375 390.
74. Sanchez Castillo, C.P., Branch, W.J, James, W.P.T. A test of the validity of the lithium marker technique for monitoring dietary sources of salt in man. Clinical Science, 1987;72, 87 94.
75. James, W.P.T., Ralph, A., Sanchez Castillo, C.P. The dominance of salt in manufactured food in the sodium intake of affluent societies. Lancet, 1987;1, 426 429.
76. James, W.P.T., Ferro Luzzi, A. Waterlow, J.C. Definition of chronic energy deficiency in adults. Report of a Working Party of the International Dietary Energy Consultative Group. European Journal of Clinical Nutrition, 1988; 42(12), 969 981.
77. Lean, M.E.J., James, W.P.T. Metabolic effects of isoenergetic nutrient exchange over 24 hours in relation to obesity in women. International Journal of Obesity, 1988; 12, 15 27.
78. Bisdee, J.T., James, W.P.T, Shaw, M.A. Changes in energy expenditure during the menstrual cycle. British Journal of Nutrition, 1989; 61, 187 199.
79. Bisdee, J.T., Garlick, P.J. James, W.P.T. Metabolic changes during the menstrual cycle. British Journal of Nutrition, 1989; 61, 641 650.
80. Ferro Luzzi, A., Sette, S., Franklin, M, James, W.P.T. A simplified approach of assessing adult chronic energy deficiency. European Journal of Clinical Nutrition, 1992; 46, 173 186.
81. James, W.P.T., Mascie-taylor, G.C.N., Norgan, N.G., Bistrian, B.R., Shetty, P.S. Ferro-Luzzi, A. The value of arm circumference in assessing chronic energy deficiency in Third World adults. European Journal of Clinical Nutrition, 1994;48(no 12), 883-894.
82. Shetty, P.S., James W.P.T, Ferro-Luzzi, A Malnutrition and the immune response. 1.Malnutrition in the community; recent concepts. Transactions of the Royal Society of Tropical Medicine and Hygiene . 1994; 88 612-614.
83. Francois, P.J., James W.P.T. An assessment of nutritional factors affecting the BMI of a population. European Journal of Clinical Nutrition, 1994; 48(Suppl 3): S110-S114
84. James, W.P.T, Francois, P.J. The choice of cut-off point for distinguishing normal body weights from underweight or "chronic energy deficiency" in adults. European Journal of Clinical Nutrition, 1994; 48(Suppl 3), S179-S184
85. Shetty P.S., Soares M.J, James, W.P.T. Body mass index: its relationship to basal metabolic rates and energy requirements. European Journal of Clinical Nutrition, 1994; 48 (Suppl 3), S28-S38.
86. Sanchez-Castillo, C.P., Dewey, P.J.S., Solarno, M.de L., Tucker, M, James, W.P.T. The non-starch polysaccharides in Mexican pulses and cereal products. Journal of Food Composition and Analysis, 1995; 7, 260-281.
87. Sanchez-Castillo, C.P., Dewey, P.J.S., Solarno M de L., Finney,S., James, W.P.T. The dietary fiber content (non starch polysaccharides) of Mexican fruit and vegetables. Journal of Food Composition and Analysis . 1995; 8: 284-294.
88. James, W.P.T. The International Obesity Task Force: obesity at the World Health Organization. Nutrition, Metabolism and Cardiovascular Disease, .1996); 6 (Suppl to no 1): 11-13.
89. Ferro-Luzzi, James, W.P.T. Adult malnutrition: simple assessment techniques for use in emergencies. British Journal of Nutrition, 1996; 75: 3-10.
90. Ferro-Luzzi, A, James, W.P.T. Anthropometric indicators in nutritional surveillance: adult BMI as a discriminator for targeting aid programmes - micronutrient status and immunocompetence. 1997 WHO, Geneva.
91. Robertson, A, James, W.P.T. War in the former Yugoslavia; coping with nutritional issues. In: Essentials of Human Nutrition, (Mann, J.I. & Truswell, S., eds.) Oxford University Press. 1998; 557-574
92. James WPT. The Role of the Food Standards Agency in the UK. 1998;Eurohealth 4 9-10
93. Sanchez-Castillo CP, Grubb D., Solano M. De L., Franklin MF, James W.P.T. Non-starch polysaccharide intakes in Mexican villagers and residents of Mexico City. British Journal of Nutrition, 1997; 77, 345-357.
94. James W.P.T., Ralph A., Nelson M., Leather S. The contribution of nutrition to inequalities in health. British Medical Journal, 1997; 314, 1545-1549.
95. Sanchez – Castillo C.P., Dewey P.J.S., Finnie S., Solano, M.de L., James W.P.T. (1997). The starch and total sugar content of Mexican fruit and vegetables: preliminary data. Archivos Latinamericanos de Nutrition, 47, 168-172
96. Stubbs R.J., Prentice A.M., James W.P.T. (1997). Carbohydrates and energy balance. Annals of the New York Academy of Sciences 819, 44-67
97. James WPT, Astrup A, Finer N, Hilsted J, Kopelman P, Rössner S, Saris WHN, Van Gaal LF. A two year sibutramine trial of obesity reduction and maintenance (STORM). The Lancet, 2000; 356:2119-2125.
98. Finer N, James WP, Kopelman PG, Lean ME, Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor. Int J Obes Relat Metab Disord. 2000 Mar;24(3):306-13.
99. James WPT, Aksu B, Ferro-Luzzi A. (2000) Assessing the nutritional status of children and adults In: Nutrient metabolism and Malnutrition: A festschrift for John Conrad Waterlow Ed: Prakash Shetty Chapter 14, pp 117-128 Smith-Gordon, London.
100. James WPT, Norum K, Smitasiri S, Swaminathan MS, Tagwirye J, Uauy R, Ul Haq M. 2000. Ending Malnutrition by 2020: an Agenda for Change in the Millennium. Final Report to the ACC/SCN by the Commission on the Nutrition Challenges of the 21st Century. Supplement to the Food and Nutrition Bulletin, September/October 2000. (Food & Nutrition Bulletin, Vol 21, No.3s, Sept. 2000.) UNU International Nutrition Foundation, USA.
101. Sanchez-Castillo CP, Velasquez-Monroy O, Lara-Esqueda A, Berber A, Sepulveda, J, Tapia-Conyer R, James WP. Diabetes and hypertension increases in a society with abdominal obesity: results of the Mexican National Health Survey 2000. Public Health Nutr. 2005 ;8:53-60
102. Ferro-Luzzi A, James WP, Kafatos A. The high-fat Greek diet: a recipe for all? Eur J Clin Nutr 2002 Sep;56(9):796-809.
103. Erlichman J., Kerbey A L, James WPT. Physical activity and its impact on health outcomes. Paper1: the impact of physical activity on cardiovascular disease and all - cause mortality: an historical perspective. Obesity Reviews 2002, 3: 257-271.
104. Erlichman J., Kerbey A L, James WPT. Physical activity and its impact on health outcomes. Paper 2: prevention of unhealthy weight gain by physical activity: an analysis of the evidence. Obesity Reviews 2002 3:273-287.
105. Swinburn BA, Caterson I, Seidell JC and James WPTJ Diet, nutrition and the prevention of excess weight gain and obesity,. Public Health Nutrition 2004, 7,123-146
106. Darnton-Hill I, Nishida C, James WP. A life course approach to diet, nutrition and the prevention of chronic diseases. Public Health Nutr. 2004 ;7:101-21
107. James WPT, Jackson-Leach R, Ni Mhurchu C, Kalmara E, Shayeghi M, Rigby NJ, Nishida C, Rodgers A. Overweight and obesity (high body mass index). In: (Eds. Ezzati M, Lopez AD, Rodgers A, Murray CJL). Comparative Quantification of Health Risks. Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, Chapter 8, Volume 1. World Health Organization, Geneva, 2004
108. Rigby NJ, Kumanyika S, James WPT. Confronting the epidemic: the need for global solutions. J Public Health Policy. 2004;25(3-4):418-34.
109. Ezzati M, Hoorn SV, Lawes CMM, Leach R, James WPT, Lopez AD, Rodgers A and Murray CJL. Rethinking the "diseases of affluence" paradigm: Economic development and global patterns of nutritional risks obesity and other cardiovascular risk factors 2005 in relation to economic development. PLoS Medicine, 2005; Vol.2, No.5, E133, 0404-0412.
110. James WP The policy challenge of coexisting undernutrition and nutrition-related chronic diseases. Matern. Child Nutr. 2005 Jul;1(3):197-203
111. James P. Marabou 2005: nutrition and human development. Nutr Rev. 2006 May;64(5 Pt 2):S1-11
112. James WPT and Rigby NJ. Nutrition policy: national strategies for dietary change. In: Coronary Heart Disease Epidemiology. From etiology to public health, 2nd edition. (Eds. Marmot M and Elliott P). Oxford University Press, Oxford, 2005, pp 805-818.
113. Zimmett P and James WPT The unstoppable obesity and diabetes juggernaut. What should politicians do? Australian Medical Journal 2006, 185:187-8
114. Lozada M, Sánchez-Castillo CP, Cabrera GA, Mata II, Pichardo-Ontiveros E, Villa AR, James WP School food in Mexican children Public Health Nutr. 2007 17;:1-10
115. James WPT The fundamental drivers of the obesity epidemic. Obesity Reviews 2008;9: Suppl 1 6-13,
116. Huxley R, James WPT, Barzi F, Patel JV, Lear SA, Suriyawongpaisal P, Janus E, Caterson I, Zimmet P, Prabhakaran D, Reddy S, Woodward M, on behalf of the Obesity in Asia Collaboration. Ethnic comparisons of the cross-sectional relationships between measures of body size with diabetes and hypertension Obesity Reviews 2008; 9 Suppl 1 53-61.
117. James WPT The epidemiology of obesity: the size of the problem. J Int Med 2008 ; 263: 336–352.
118. Bauman A, Allman-Farinelli M, Huxley R, James WP. Leisure-time physical activity alone may not be a sufficient public health approach to prevent obesity--a focus on China. Obes Rev. 2008 Mar;9 Suppl 1:119-26
119. James WP. The fundamental drivers of the obesity epidemic. Obes Rev. 2008 Mar;9 Suppl 1:6-13. Review.
120. James WP, Lobstein T. BMI screening and surveillance: an international perspective. Pediatrics. 2009 Sep;124 Suppl 1:S42-9
121. James WP, Caterson ID, Coutinho W, Finer N, Van Gaal LF, Maggioni AP,Torp-Pedersen C, Sharma AM, Shepherd GM, Rode RA, Renz CL; SCOUT Investigators. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. NEJM 2010..363:905-17
122. James WPT, Gaza C. The human microbiome: an expanding digestive, physiological and metabolic role. Summary. Nutrition Reviews 2012. 2012 ;70 Suppl 1:S87-94. doi:10.1111/j.1753-4887
123. James WPT .UK Post-war Nutrition. Sustaining a nation. World Nutrition 2013;4;8; 609-617.(October – December.
124. James WPT. Conflicts of interest in NCD prevention – an issue for medical leaders in the Middle East?. Eastern Mediterranean Health Journal 2014.20.653-655
125. James WPT. World Agriculture, food and nutrition policy. Government for the people. [As I see it]. World Nutrition 2013; 4, 6(June - July): 342-358
126. Sheiham A, James WP. A new understanding of the relationship between sugars, dental caries and fluoride use: implications for limits on sugars consumption. Public Health Nutr. 2014; 17 : 2176-84.:
127. Sheiham A, James WP. A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake. BMC Public Health. 2014 Sep 16;14:863. doi:10.1186/1471-2458-14-863. PubMed PMID: 25228012; PubMed Central PMCID: PMC4168053
128. Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, James WP, Wang Y, McPherson K. Child and adolescent obesity: part of a bigger picture. Lancet. 2015 Feb 18. pii: S0140-6736(14)61746-3. doi: 10.1016/S0140-6736(14)61746-3.
129. Nolte-'t Hoen EN, Van Rooij E, Bushell M, Zhang CY, Dashwood R, James WP, Harris C, Baltimore D. The role of microRNA in nutritional control. J Intern Med. 2015 Apr 2. doi: 10.1111/joim.12372. [Epub ahead of print] PubMed PMID: 25832550.
130. Sheiham A , James WPT. Diet and dental caries - the pivotal role of free sugars reemphasized. J.Dental Research.2015. 94:1341-7.
131. Zomer E, Gurusamy K, Leach R, Trimmer C, LobsteinT, Morris S, James W P, Finer N, Interventions that cause weight loss and the impact on cardiovascular risk factors: a systematic review and meta-analysis. Obesity Reviews 2016. June doi: 10.1111/obr.12433.
132. James WPT and Breda J. Government's evolving role in obesity: nutrition, education, regulation, monitoring and research. In Handbook of Obesity Eds. Bray GA, Bouchard C Fourth Edition Vol. 2, Clinical Applications. 2016 pp 471
133. Zomer E, Leach R, Trimmer C, Lobstein T, Morris S, James WP, Finer N. Effectiveness and cost-
effectiveness of interventions that cause weight loss and reduce the risk of cardiovascular disease. Diabetes, Obesity and Metabolism 2017; 9(1):118-124
134. James WPT. The challenge of diabetes in Asia. European Journal of Clinical Nutrition. 2017;71:803-804
135. James WPT. A clinical nutritionist's experience and expectations. Eur J Clin Nutr. 2017 Aug;71(8):915-918