About

Dr. Kenneth B. Christopher is an Assistant Professor at Harvard Medical School and an Associate Physician at Brigham and Women's Hospital. His research focuses on Critical Care Outcomes, metabolomics, and clinical trials. He is the Faculty Director for Global Education at Harvard Medical School, where he directs clinical research, leadership, and education training courses across multiple countries including the UK, Malaysia, India, Japan, and China. At Brigham and Women’s Hospital, he serves as Director of the Nathan E. Hellman Memorial Laboratory studying Critical Illness outcomes, and as Assistant Program Director of the Internal Medicine Residency Training Program. Dr. Christopher provides consultative inpatient care in Renal Medicine and Nutrition Support. He studied Epidemiology at the T.H. Chan Harvard School of Public Health and was a Harvard Macy Scholar in Medical Education. He is an author of numerous research articles, a frequent international speaker, and has received multiple awards including the Annual Scientific Award from the Society of Critical Care Medicine, a Promising Investigator Award from the American Society for Parenteral and Enteral Nutrition, and grant funding from the National Institute of Health.

Research topics

• Computer Science
• Political Science
• Medicine
• Internal medicine
• Intensive care medicine
• Pathology
• Family medicine
• Pediatrics
• Gerontology
• Library science

Selected publications

• Toward Precision in Nutrition Therapy

  Critical Care Medicine · 2024-12-17 · 20 citations

  reviewOpen access

  Precision in critical care nutrition is paramount, as it focuses nutrition interventions on those patients most likely to benefit, or those who might potentially be harmed. Critical care nutrition must therefore be tailored to individual metabolic needs as determined by factors that control the capacity for tissue homeostasis and anabolic responses. This ideally involves the accurate and timely assessment of macronutrient and micronutrient requirements, a careful evaluation of metabolic response mechanisms and the identification of circumstances that might interfere with the productive utilization of dietary substrates. Specific surrogate markers of metabolic response, such as blood glucose levels, urea levels, or nitrogen balance, might be used to evaluate the metabolic readiness for nutrition and to establish the timing, nature, and clinical effectiveness of nutrition interventions. Despite the pressing need to further develop more targeted approaches in critically ill patients, indices of immediate metabolic responses that correlate with favorable clinical outcomes are lacking. In addition, the development of precision approaches might address timely adjustments in protein, energy, or micronutrient supplementation based on evolving clinical conditions. Here, we review why precision tools are needed in critical care nutrition, our progress thus far, as well as promising approaches and technologies by which multidisciplinary healthcare teams can improve quality of care and clinical outcomes by individualizing nutrition interventions.

  PublisherDOI

• Associations Between Dietary Patterns and Kidney Health Assessed in the Population-Based CHRIS Study Using Reduced Rank Regression

  Journal of Renal Nutrition · 2024-03-21 · 6 citations

  articleOpen access

  OBJECTIVE: While diet plays a key role in chronic kidney disease (CKD) management, the potential for diet to impact CKD prevention in the general population is less clear. Using a priori knowledge, we derived disease-related dietary patterns (DPs) through reduced rank regression (RRR) and investigated associations with kidney function, separately focusing on generally healthy individuals and those with self-reported kidney diseases, hypertension, or diabetes mellitus. METHODS: Eight thousand six hundred eighty-six participants from the population-based Cooperative Health Research in South Tyrol study were split into a group free of kidney disease, hypertension and diabetes (n = 6,133) and a group with any of the 3 conditions (n = 2,553). Diet was assessed through the self-administered Global Allergy and Asthma Network of Excellence food frequency questionnaire and DPs were derived through RRR selecting food frequency questionnaire-derived sodium, potassium, phosphorus, and protein intake as mediators. Outcomes were creatinine-based estimated glomerular filtration rate, urinary albumin-to-creatinine ratio, CKD and microalbuminuria. Multiple linear and logistic models were used to assess associations between RRR-based DPs and kidney outcomes separately in the 2 analytic groups. RESULTS: We identified 3 DPs, where high adherence reflected high levels of all nutrients (DP1), high potassium-phosphorus and low protein-sodium levels (DP2), and low potassium-sodium and high protein-phosphorus levels (DP3), respectively. We observed heterogeneous associations with kidney outcomes, varying by analytic group and sex. Kidney outcomes were much more strongly associated with DPs than with single nutrients. CONCLUSION: RRR is a feasible approach to estimate disease-related DPs and explore the combined effects of nutrients on kidney health. Heterogeneous associations across kidney outcomes suggest possible specificity to kidney function or damage. In individuals reporting kidney disease, hypertension or diabetes, specific dietary habits were associated with better kidney health, indicating that disease-specific dietary interventions can be effective for disease control.

  PublisherDOI

• The Effect of COVID-19 on Middle-Aged Adults’ Mental Health: A Mixed-Method Case–Control Study on the Moderating Effect of Cognitive Reserve

  Healthcare · 2024-01-10 · 2 citations

  articleOpen accessSenior author

  The COVID-19 pandemic has increased the vulnerability of adults to mental health effects, and the study of protective factors has become crucial. Cognitive reserve (CR) is a well-known protective factor against cognitive decline and several health factors; however, its protective effect on mental health during the pandemic has been rarely addressed. Thus, this study explored, through a mixed-method design, the effect of CR on perceived distress and PTSD-like symptoms in middle-aged participants who have survived severe COVID-19 and a matched control group. A total of 432 participants filled out self-report measures of CR, PTSD, depression, and anxiety, and were also asked to provide narration about their COVID-19-related experience. COVID-19 significantly affected the chances of reporting different mental health symptoms; levels of CR played a protective role in reducing their severity. Moreover, adults with higher CR seemed to be more realistic, focusing less on positive emotions, and elaborating more on the sense of anxiety when describing their experience: this might be an indication of a lower use of suppression to regulate emotions. Practical implications of these findings and future directions have been also discussed.

  PublisherOA PDFDOI

• What do we know about micronutrients in critically ill patients? A narrative review

  Journal of Parenteral and Enteral Nutrition · 2024-11-18 · 11 citations

  reviewOpen access

  Abstract Micronutrient (MN) status alterations (both depletion and deficiency) are associated with several complications and worse outcomes in critically ill patients. On the other side of the spectrum, improving MN status has been shown to be a potential co‐adjuvant therapy. This review aims to collect existing data to better guide research in the critical care setting. This narrative review was conducted by the European Society of Intensive Care Medicine Feeding, Rehabilitation, Endocrinology, and Metabolism MN group. The primary objective was to identify studies focusing on individual MNs in critically ill patients, selecting the MNs that appear to be most relevant and most frequently investigated in the last decade: A, B 1 , B 2 , B 3 , B 6 , folate, C, D, E, copper, iron, selenium, zinc, and carnitine. Given the limited number of interventional studies for most MNs, observational studies were included. For each selected MN, the review summarizes the main form and functions, special needs and risk factors, optimal treatment strategies, pharmacological dosing, and clinical implications all specific to critically ill patients. A rigorous rebalancing of research strategies and priorities is needed to improve clinical practice. An important finding is that high‐dose monotherapy of MNs is not recommended. Basal daily needs must be provided, with higher doses in diseases with known higher needs, and identified deficiencies treated. Finally, the review provides a list of ongoing trials on MNs in critically ill patients and identifies a priority list of future research topics.

  PublisherOA PDFDOI

• Metabolic phenotypes and vitamin D response in the critically ill: A metabolomic cohort study

  Clinical Nutrition · 2024-09-19 · 3 citations

  articleSenior author
  PublisherDOI

• The value of prospective metabolomic susceptibility endotypes: broad applicability for infectious diseases

  EBioMedicine · 2023-09-19 · 5 citations

  articleOpen access

  BACKGROUND: As new infectious diseases (ID) emerge and others continue to mutate, there remains an imminent threat, especially for vulnerable individuals. Yet no generalizable framework exists to identify the at-risk group prior to infection. Metabolomics has the advantage of capturing the existing physiologic state, unobserved via current clinical measures. Furthermore, metabolomics profiling during acute disease can be influenced by confounding factors such as indications, medical treatments, and lifestyles. METHODS: We employed metabolomic profiling to cluster infection-free individuals and assessed their relationship with COVID severity and influenza incidence/recurrence. FINDINGS: ). We observed similar severity associations when recapitulating this susceptibility endotype using metabolomics from individuals during and after acute COVID infection. We demonstrate the value of using metabolomic endotyping to identify a metabolically susceptible group for two-and potentially more-IDs that are driven by increases in specific amino acids, including microbial-related metabolites such as tryptophan, bile acids, histidine, polyamine, phenylalanine, and tyrosine metabolism, as well as carbohydrates involved in glycolysis. INTERPRETATIONS: These metabolites may be identified prior to infection to enable protective measures for these individuals. FUNDING: The Longitudinal EMR and Omics COVID-19 Cohort (LEOCC) and metabolomic profiling were supported by the National Heart, Lung, and Blood Institute and the Intramural Research Program of the National Center for Advancing Translational Sciences, National Institutes of Health.

  PublisherDOI

• Issue Information

  Journal of Parenteral and Enteral Nutrition · 2023-07-01 · 1 citations

  paratextOpen access

  and Rest of World), €670 (Europe), £560 (UK

  PublisherOA PDFDOI

• Current practice of gastric residual volume measurements and related outcomes of critically ill patients: A secondary analysis of the intestinal‐specific organ function assessment  study

  Journal of Parenteral and Enteral Nutrition · 2023-03-28 · 18 citations

  articleOpen access

  BACKGROUND: Gastric residual volume (GRV) measurement to detect gastrointestinal (GI) dysfunction is a common diagnostic procedures in critical care, albeit still not well standardized being operator-, patient-, and tube-dependent. Our aim was to describe current practice of GRV measurements and its association with clinical outcomes in critically ill patients. METHODS: This was a secondary analysis of an international prospective observational cohort study (intestinal-specific organ function assessment). Eligibility criteria were defined as ≥1 GRV measurement during the 7-day study period. Data collection included GRV measurement practices, tube diameters and volumes, symptoms of GI dysfunction, and clinical outcomes. The primary aim was to describe current practices of GRV measurements, and the secondary aim was to test the association of high (>200 ml) vs. low GRV with symptoms of GI dysfunction and clinical outcomes using generalized linear regression and survival models. RESULTS: Two hundred fifty-eight patients with 2422 GRV measurements on 875 study days were analyzed. GRV was mainly measured via passive drainage twice daily using large diameter tubes. There was no significant association between tube size or measurement technique and high GRV. High GRV occurred in 34% of patients and was associated with other GI symptoms and with increased disease severity but not with 28-day or 90-day mortality, intensive care unit-free and ventilator-free days. CONCLUSION: There was substantial variability of GRV measurement techniques, but this had no impact on the amount of GRV. High GRV was not associated with mortality or ventilator-free days but may serve as a marker of GI dysfunction and disease severity.

  PublisherOA PDFDOI

• Issue Information

  Journal of Parenteral and Enteral Nutrition · 2023-05-01 · 1 citations

  paratextOpen access

  and Rest of World), €670 (Europe), £560 (UK

  PublisherOA PDFDOI

• Toward a higher‐quality <i>JPEN</i>

  Journal of Parenteral and Enteral Nutrition · 2023-07-06

  editorialOpen access1st authorCorresponding

  The author declares no conflicts of interest.

  PublisherOA PDFDOI

Recent grants

• Pharmacokinetics and metabolomics of vitamin D supplementation in critical illness

  NIH · $940k · 2016–2021

• NIH Grant K08AI060881

  NIH · $621k · 2011

Frequent coauthors

• Fiona K. Gibbons

  Massachusetts General Hospital

  94 shared

• Mallika L. Mendu

  Inspira Medical Center Vineland

  46 shared

• Takuhiro Moromizato

  Gunma Children's Medical Center

  34 shared

• Angela J. Rogers

  33 shared

• Augusto A. Litonjua

  Golisano Children's Hospital

  31 shared

• Sowmya Chary

  Biogen (United States)

  30 shared

• Augustine M.K. Choi

  Cornell University

  29 shared

• Rebecca M. Baron

  National Heart Lung and Blood Institute

  29 shared

Education

• SM, Epidemiology

  Harvard University T H Chan School of Public Health

  2015

• MD

  New York Medical College

  1997

• BS, Biochemistry Molecular Biology

  University of California San Diego

  1993

• BA, Cognitive Science

  University of California San Diego

  1993

• Special Student

  Dartmouth College

  1991

Awards & honors

• Annual Scientific Award twice from the Society of Critical C…
• Promising Investigator Award from the American Society for P…