Candice: As a child, I had a huge sweet tooth. In fact, there was a time when I didn’t enjoy drinking water (my dad eventually nipped that in the bud, as we say).  Between the ages of 9 and 11, I was overweight and snuck extra helpings of desserts.  One day my dad said to me, “If you keep eating like that you’re doing to get diabetes”.  At the time, I didn’t know anyone with diabetes, although I did know that it was a growing problem in my community.  I was also the type to never believe by heresy; I need to read and investigate to figure it out for myself.  That moment [paired with my love of science] sparked my interest in a career in scientific research.  In 7^th grade, I stopped drinking sodas and never looked back.  After graduate school, I wanted to get back to the reason I became interested in scientific research, which was to understand the impact of sugar on health disparities in African-American communities.

Candice: I actually entered graduate school with the plan that my research focus would be more translational, assisting with clinical intervention studies in a cohort of primarily African-American children aiming to reduce obesity and type 2 diabetes risk factors. Instead, when I arrived on campus, I was thrown into animal research. In all honesty, I sort of fell into basic research by accident. I wanted to find my way back to the root of my interest in research, which has always been to conduct more translational research that tied my bench skills into human trials that would lead to public health knowledge and change. Thanks to my graduate school mentor, I managed to do just that, later pursuing two postdoctoral fellowships that were primarily clinical research focused on nutrition, obesity, and insulin resistance.

My basic science training paired with a translational and public health mindset provided me the skills to approach research with a broader lens. I constantly strive to incorporate interdisciplinary research questions and methodologies into my core research and am able to grasp concepts from new fields (e.g. microbiome and epigenetics) relatively quickly. The skill of grasping new concepts and communicating science to different audiences is a critical skill not just when speaking with other scientists but when I am out in the community educating others in lay language.I think it’s a skill all scientists should have if they want to make a more direct impact on human health.

Candice: Since the day I applied to graduate school, my goal as a scientist has always been to conduct research that impacts the lives of African-Americans both in the lab and outside the lab.  That is, I wanted to take what I learned in the lab and teach the Black community the science behind obesity and type 2 diabetes development and steps that we can take to prevent these diseases. My research primarily focuses on understanding the impact of sugar-sweetened beverages on the health of Black women, which is so relevant to the Black community which disproportionately consumes more sugar-sweetened beverages than other race/ethnic groups in the U.S.  Unfortunately, so much of what we understand about the link between obesity, nutrition and cardiometabolic disease (T2D and CVD) largely stems from research conducted in primarily Caucasian participants.  My goal is to conduct studies that bring a more personalized, evidence-based approach to public health education specific to the Black community.  I have recently expanded my research to begin investigating the impact of increased access to sugar-sweetened beverages in countries in Africa with the hopes that my research can aid in preventing the impact of high sugar consumption in Black populations around the world.

Candice: My primary research investigates how high consumption of sugar-sweetened beverages (SSBs) impacts insulin sensitivity [how our bodies respond to insulin] and risk factors of cardiovascular disease (cholesterol, triglycerides, LDL-cholesterol) in Black women.  I am also investigating the epigenetic effects of high SSB consumption, that is, how high SSB consumption alters the expression of genes, and the role of the gut microbiome in SSB-induced metabolic dysregulation.  If funding were not an obstacle, my ideal study would be to conduct a multi-site SSB intervention study in different regions of the U.S. in Black men, women and children within the same household to measure the effects of high SSB consumption on genes and risk factors of cardiometabolic disease.  This type of study would help us to understand the impact of the environment and genes on the body’s response to high sugar consumption.

Candice: One of the most important findings from a small study I conducted demonstrated that BMI and percent body fat were not predictive of whole-body insulin sensitivity in Black women, but as expected, this was not the case in white women. However, visceral fat, which tends to be lower in Black women, was as equally related to insulin sensitivity in Black as in white women.  This suggests that simple metrics of obesity like BMI and even percent body fat, may not be reliable indicators of insulin resistance (the precursor to type 2 diabetes in Black women) in Black women, specifically.  It also suggests, that although visceral fat tends to be lower in Black women, it should not be ruled out as an important risk factor in this population. Instead, additional research is required to understand its role in insulin resistance development in this population. Importantly, metrics that can better determine fat distribution (since visceral fat is expensive to measure by current reliable methods) are needed to better assess cardiometabolic disease risk in Black women. 

Candice: First, I’ll speak to the general population of future researchers.  Be strategic in who you choose to be your mentors, especially those of you applying/starting graduate school.  A research mentor during this time can make or break your experience/success.  If your needs aren’t being met, don’t be afraid to seek additional mentorship from others (including your peers and those outside of your department).  Stay the course. We all have obstacles on this road towards becoming a researcher.  This path is like riding a roller coaster, but eventually, you find your way to level ground. Find your niche and become an expert in that area.  Then leverage your expertise to find collaborations with others to expand your research questions to be more interdisciplinary.  No human health problem can be solved by looking at one factor.  Poor health outcomes are multifaceted and require collaboration with those outside of your field. 

For those of you that find yourselves as the “only one” in your department, it can be especially challenging.  Find a group of peers going through similar experiences. Create yourself a mentorship team, including a mentor that is either not in your department or not at your institution that can simply be there to support you as a scholar and provide career guidance.  Don’t be afraid to reach out to someone whose work you admire or career path you could learn from, even [and especially] if they’re not at your institution.  Take the leap and introduce yourself.  Take advantage of as many career development opportunities as you can, particularly those focused on underrepresented individuals.

Lastly, when times get hard, remind yourself why you chose this path.  Remind yourself of what you hope to accomplish in this career to give yourself the motivation to keep going.

Candice: A book could be written to answer this question. African-Americans (adults and adolescents) consume far too much sugar, with Hispanics/Latinos in a close second. Why is this? It’s all a result of structural racism. The sugar-sweetened beverage industry targets the advertisement of sugar-sweetened beverages to Black and Hispanic adolescents at a disproportionately greater rate than to white adolescents. TV ads of high-sugar and high-fat beverages and foods activate visual cues to want to satisfy our rewards regions in the brain to consume high-sugar.In the case of sugar-sweetened beverages, this promotes greater consumption of high-sugar beverages in black and brown communities. Due to the structural racism, many of these adolescents are watching more tv, which further increases their exposure to these ads. They’re watching more tv because it may not be safe to go outside, or perhaps they live in a single-parent household and are required to stay inside to remain safe while their parent is at work. Or perhaps, they simply do not have the opportunity to participate in sports and other after school activities because their school’s budgets were cut and their parent cannot afford off-campus sports clubs (growing up, only rich kids played club sports). This scenario becomes exacerbated during the summer months when children are not in school. Racist housing policies designed to segregate housing have placed their families in marginalized neighborhoods where the value of housing has decreased, matched by poorer school systems, a plethora of fast-food chains, and liquor stores, but few grocery stores. Therefore, not only is there an increase in targeted food and beverage marketing in these communities, but there is greater access to these unhealthy foods and lower access to healthier alternatives. The one thing we can do as a community to combat the industry and our harmful food environments is to educate ourselves. I hope that I can become a leader in working with community members to teach them what we know about how sugar-sweetened beverages affect our health and the role of the industry in targeting our communities.

I focus specifically on Black women because Black women in the U.S. are more likely than any other race and more likely than Black men to die of cardiovascular disease, in part because they have the highest prevalence of hypertension in the world and over 80% of us are overweight or obese. These are all health risks associated with regular sugar-sweetened beverage consumption. Furthermore, intervention studies in Black adolescents have shown lower improvements in physical activity [and thus less weight-loss success] in girls. This points to a need for more creative intervention in girls to improve health outcomes at a young age. Importantly, if Black girls are consuming high amounts of sugar-sweetened beverages and having less physical activity, this further perpetuates the growth in cardiometabolic-health disparities amongst Black women.