Professor William Philip Trehearne James, FRSE FMedSci CBE (1938–2023)

Philip (Phil) James who died in London in October 2023 was a major figure in human nutrition, both nationally and internationally. Indeed, he was one of the giants of the field over the past half century. Born in Liverpool in 1938, he was brought up in Bala, North Wales, the only boy in a family of four children. Both his parents were teachers and his father, a conscientious objector in the First World War, was head of the local Boy’s Grammar School and died when Philip was only 7 years old. Most of the family were Quakers and after attending primary school in Bala he went to Ackworth School in Yorkshire, a coeducational Quaker boarding school.

He flourished at school after which he went to University College London to study medicine, his acceptance into the Medical School being distinctly unusual. There had been an administrative error about the date of the interview so that when he arrived and the mistake was realised, he found himself being interrogated at short notice by an ad hoc group of what he discovered were three Nobel Prize winners. During the discussion, they were highly impressed that he had rewired a burnt-out Rolls Royce car and he was readily admitted. While still a medical student he met and married Jean Moorhouse, who was also a former Ackworth School pupil. As he has pointed out, getting married whilst still a student was almost unheard of then⁽¹⁾. His life expectancy at the time had been predicted to be limited as a consequence of bronchiectasis linked to pneumonia that he had contracted when aged 9.

After graduation, he entered the training posts customary for medicine, and the clinician’s perspective that he gained during that period stayed with him throughout the rest of his career. In 1965, he was recruited by John Waterlow to work in the Medical Research Council (MRC) Tropical Metabolism Research Unit in Jamaica. Malnutrition in children was the focus of the Unit, and he began research there on albumin metabolism⁽²⁾ and intestinal function⁽³⁾. The period in Jamaica was followed by a year at the Massachusetts General Hospital in the USA as a Wellcome Trust Fellow. He then spent a year at the MRC Gastroenterology Unit in London before taking up a Senior Lectureship at the London School of Hygiene & Tropical Medicine. At the London School, with which he was associated in different ways for much of the rest of his life, he was involved in the traditional combination of teaching, research and clinical work.

His initial research on malnutrition in children and in gastroenterology was what brought him into the field of nutrition. This was further cemented when in 1974 he moved to the MRC Dunn Nutritional Laboratory in Cambridge as Deputy Director. The Dunn was a highly prestigious research centre and at the time one of the largest of the MRC’s establishments. It had been set-up in 1927 when Sir Frederick Gowland Hopkins (who won the Nobel Prize for the discovery of vitamins) was Professor of Biochemistry at Cambridge. My own association with Philip, spanning almost 50 years, began at the Dunn when in 1975 I was one of his first appointments to the group that he was establishing on energy metabolism and obesity. Our close professional link continued at the Rowett Research Institute in Aberdeen, to which I moved as Head of the Division of Biochemical (later Biomedical) Sciences when he was Director.

Philip began to come to national and international prominence at the Dunn, having established what became two renowned research groups – the one on energy metabolism and obesity and the other on dietary fibre. With considerable tenacity and entrepreneurial flair, he established a major clinical nutrition research facility – Dunn Clinical – which included metabolic facilities and human calorimetry, at the Old Addenbrooke’s Hospital site in central Cambridge. In so doing, he had to overcome considerable obstacles.

His own research interests at the Dunn (and thereafter) centred on obesity and a major thrust of these studies, both in humans and in laboratory animals, was on the concept that the obese had a higher efficiency of energy utilisation than lean individuals. This ran counter to the somewhat Puritan ethos at the time, which emphasised ‘gluttony and sloth’ as the causes of obesity. The focus on energy efficiency led to an interest in adaptive heat production and the role of brown adipose tissue in energy metabolism – areas for which he and the group became world-leading. One of the key early observations from the human studies was that the obese have a higher, not lower, energy expenditure than lean individuals⁽⁴⁾. Several of the major studies from both the energy and the dietary fibre groups under Philip’s overall direction were published in ‘Nature’, reflecting the quality and innovation of the work being undertaken. A number of those working with him during the time at the Dunn subsequently took up senior positions elsewhere, both in the UK and internationally.

Philip could be iconoclastic, relishing taking a dissident view. Indeed, the autobiographical article that he wrote in 2021 for the ‘Annual Review of Nutrition’ is titled ‘A Dissenter’s Journey’⁽¹⁾. An example of this comes from some of the early work that he spearheaded at the Dunn on fat cells⁽⁵⁾. A dominant idea at the time was that obesity was caused by having too many adipocytes (white). In 1977, he submitted a paper for the 2^nd International Congress on Obesity, held in Washington USA, under the provocative title ‘The Myth of Adipocyte Hypercellularity’. His talk was scheduled for presentation towards the end of the Congress, and the lecture room was packed to hear someone opposing what was the prevailing idea of some of the most powerful obesity specialists in the USA. The presentation proved to be very well-received, but fearing that this might not be case we had arranged that I would wait outside with a taxi for us to go immediately to the airport for the return flight to the UK. We joked en route about keeping a lookout to see whether anyone was on Philip’s tail, which happily they were not.

One of the features of the time in Cambridge was the bringing of the work to a wide audience through television, demonstrating Philip’s ability to connect at multiple levels. The BBC Horizon team approached him to do a programme on the then emerging excitement about obesity being linked to brown fat. Philip was asked to narrate the programme – ‘The Fat in the Fire’ – in addition to being a key scientist within it. At that time he still saw patients as a clinician and in the programme is shown talking earnestly and sympathetically to a lady who was telling him that if she ate more than 600 calories a day she put on weight. His response epitomised the sensitive and concerned physician. However, a few weeks later at the preview of the programme when this section came up, he roared with laughter and cried ‘I don’t believe her!’.

After the Dunn and Cambridge, in 1982 he took on the role of Director of the Rowett Research Institute in Aberdeen. The Rowett was then a highly prestigious Institute, the founding Director Lord Boyd Orr having received the Nobel Peace Prize, and it was widely regarded as the ‘Jewel in the Crown’ of the Scottish Agricultural Research System. Moving to such an Institute was, of course, a radical departure for someone whose interests lay firmly in human nutrition, but it reflected a proper desire that agriculture should be closely linked to actual human nutritional requirements. There was, in addition, the view at a Governmental level that enhancing agricultural production and efficiency per se was no longer a priority. I recall Philip describing his initial exploratory visit to the Rowett. The incumbent Director, Sir Kenneth Blaxter, showed him a series of barns filled with pigs, sheep and cattle. Philip was bemused – what was he, who had always been involved in human studies, supposed to do with them? The species perspective of the Rowett at the time was undoubtedly a benign version of ‘four legs good, two legs bad’.

But one of Philip’s greatest successes at the Rowett was the development of a Human Nutrition Centre, alongside the traditional agricultural work. This shift in emphasis was what was needed, and despite some hesitation the Scottish Office (as it then was) supported the development of human nutrition. Indeed, they continued to strongly support the Rowett during Philip’s Directorship such that from the mid 1980s to the mid 1990s there was scarcely a week when ‘Nature’ did not include an advertisement for an appointment at the Institute.

He was very much in the vanguard with two specific innovations at the Rowett which subsequently became standard in other research institutions. One was the introduction of an external funding unit, Rowett Research Services, to facilitate interaction with industrial partners and to commercialise work undertaken at the Institute. The other was the founding of a crèche for staff members, and which was to be run by the mothers who used it. As an indication of how innovative that was, I remember a meeting where BBSRC officials came up from the Head Office in Swindon to inform the Scottish Institutes of new policy developments that were to be introduced. They unveiled one particular initiative that everyone agreed was an excellent development – that Institutes should establish a workplace crèche. However, when I pointed out that it had already been done at the Rowett and indeed was fully functioning, they were perplexed and very reluctant to believe it. How was it possible to have done such a thing if they had only just defined the policy?

From early in his career, Philip had had a commitment to public health and policy matters. As his reputation grew, his input and advice was increasingly sought by major international organisations, especially the WHO, FAO of the UN and the European Union, as well as by a number of national Governments. An early example of his ability to crystallise considerable amounts of information and articulate policies is the report that he compiled in 1976 for the MRC and the DHSS (Department of Health & Social Security), as it then was, on ‘Research in Obesity’⁽⁶⁾. Another is the report on ‘Human Energy Requirements. A guide for Planners and Nutritionists’ for FAO in 1990⁽⁷⁾. The external policy roles expanded greatly during his years at the Rowett and became essentially full-time following his formal retirement.

Philip, of course, never really retired, and into his early 80’s the annual newsletter that accompanied the family Christmas card always contained a remarkable list of the places that he had been to, and the organisations with which he had been involved, that year. His input was sought on issues spanning malnutrition, nutritional quality, healthy eating and obesity, with his expertise encompassing physiology and metabolic systems, epidemiology and public health policy. The range of reports for Government Ministers and International Organisations for which he was responsible was illustrated in a ‘Perspectives’ article (‘A clinical nutritionists experience and expectations’) in the European Journal of Clinical Nutrition in 2017⁽⁸⁾. One aspect of his public health focus was trenchant criticism, from time to time, of parts of the food industry.

Among the most notable of his many policy contributions was the blueprint for the establishment of the Food Standards Agency in the UK which he produced in the late 1990s at the request of Tony Blair. In the initial period of the Blair Government, Philip was consulted on an almost daily basis by the then Minister of Health. He played a similar important role in relation to food safety for the European Commission in Brussels, initially in response to the concern with BSE (bovine spongiform encephalopathy), which had, of course, started in the UK and with which Philip had been involved earlier at a policy level.

A major development was the International Obesity Task Force which he originally set-up in 1995 as a policy and advocacy think-tank on the disorder. The International Obesity Task Force was his key focus when he and his wife Jean moved from Aberdeen to London on his official retirement from the Rowett. His formal links with obesity organisations culminated in the Presidency of the International Association for the Study of Obesity (now World Obesity). In these external roles, as in everything he did professionally, there was throughout the devoted and unfailing support of Jean. Together, they hosted, and befriended, many of the national and international visitors and students who came to consult, or work with, Philip.

He received a number of honours and awards including Fellowship of the Royal Society of Edinburgh (Scotland’s National Academy), Fellowship of the Academy of Medical Sciences, Honorary Fellowship of the Nutrition Society and a CBE. In 2020, in recognition of his contributions to obesity the World Obesity Federation instituted the ‘William Philip T James Award’ to ‘acknowledge outstanding achievement in the field of obesity surveillance, prevention and management’.

Those who knew Philip well were conscious of his Quaker background and of his roots in North Wales. Of his many qualities, for those who had worked closely with him, the one that I remember most of all comes from the time in Cambridge; it was his remarkable ability to inspire. He made us feel that we were doing the most important thing in the world in the most important place in the world. That ability to inspire is something that I have never personally forgotten and which has influenced my own world-view.

Philip James was a giant of nutrition and a remarkable man. He is survived by Jean, to whom he was married for more than 60 years, his daughter Claire, son Mark and by four grandchildren.