Robert P Heaney

BMJ 2016; 354 doi: (Published 22 September 2016) Cite this as: BMJ 2016;354:i5111
  1. Ned Stafford
  1. Hamburg

Vitamin D advocate and a “Legend of Osteoporosis,” who led the Omaha Nuns Study to investigate the bone biology of ageing women

In the mid-1960s Robert Heaney, an endocrinologist at Creighton University in Omaha in the US, made contact with six Catholic motherhouses. Heaney, a bone and calcium expert, explained to the nuns his plans for a long term study to try to unlock the secrets of osteoporosis. For the study he would need lots of healthy women under the age of 45, willing to—as he later put it—go “under a microscope.”1

His sales pitches worked.

The Omaha Nuns Study

Late one day in 1967, some 168 nuns arrived, suitcases in hand, at the metabolic research unit of Creighton’s old St Joseph Hospital. The nuns would stay at the hospital for the next eight days. They would repeat the monitoring process every five years until 1992, allowing Heaney and his colleagues to study the women—and their bones—as they aged.

At the time, Heaney was already an osteoporosis expert.2 He hatched the plan for the nuns study after realising that he and other researchers had been focusing only on treatments for osteoporosis. He hoped that his study would help develop strategies to prevent it.

From that point, for the rest of his life, Heaney would focus his research on disease prevention and maintaining optimal health. In the early 2000s Heaney—known as “Bob” to friends and colleagues—would become a leading advocate of the potentially wide ranging health benefits of higher doses of vitamin D supplements.

“Bob was one of the drivers of this new perspective on vitamin D,” says Martin Hewison, of the Institute of Metabolism and Systems Research at the University of Birmingham in the UK. “Bob was held in the highest regard by everyone in the field, even molecular researchers like myself.”

But in 1967, when what is now called the “Omaha Nuns Study” began, Heaney’s focus was on calcium. He and colleagues meticulously noted every gram of food and every drop of liquid consumed by the nuns during their time at the hospital. Study participant Sister Rosalima Wilkinson in 2007 told a reporter for the Omaha World-Herald: “Everything you took in they calculated and everything that came out of you.” The then 77 year old Sister Rosalima added: “Everything, dear.”1

Indeed, the research team chemically analysed every gram of excreta. They took blood samples at regular intervals. They monitored hormones. They monitored flows of calcium into and out of the body—and between blood and bone. Most of the nuns returned every five years for eight days under the microscope. They were joined by 24 additional nuns in 1977.

The study—supported by the National Institutes of Health (NIH)—yielded a huge unique database that, according to Creighton University, continues to provide the scientific community with the most complete mapping of the calcium economy of midlife women that is available anywhere.

Heaney’s first paper from the study was published in 1975.3 Since then nearly three dozen additional papers based on the study have been published. The study was a primary source for current calcium intake recommendations from the NIH; the National Osteoporosis Foundation; and the National Academies of Sciences, Engineering, and Medicine. Creighton’s metabolic research unit of 1967 was transformed into what is now the highly regarded Osteoporosis Research Center, which is led by Robert Recker—a mentee of Heaney’s who had also been involved in the nuns study.

In a 1986 article noting “booming” sales of calcium supplements, the New York Times described Heaney as “the physician who set off the calcium craze.”4 Heaney told the newspaper that food was the best source of calcium, but added, “It’s better taking (calcium) pills than not getting sufficient amounts.”

Career and hobby

Robert Proulx Heaney was born on 10 November 1927 in Omaha. His affiliation with Creighton University, a Jesuit, Catholic institution, began in 1941 when he attended Creighton Preparatory School, a high school for boys. Heaney graduated with a degree in chemistry from Creighton University in 1947.

After receiving his medical degree from Creighton in 1951, Heaney trained in internal medicine at St Louis City Hospital in Missouri, and completed a research fellowship at the Oklahoma Medical Research Foundation in Oklahoma City. In 1955 he moved to the National Institutes of Health in Bethesda, Maryland, as a clinical associate; his work included using radioactive calcium tracers to learn how the body uses calcium.5

A devout Catholic, Heaney returned to Creighton in 1957, to become a professor of medicine and remained there for the rest of his life. Over the years he held several administrative positions, including chair of the department of internal medicine and vice president for health sciences.

He loved research so much that he never stopped. He remained active even after being diagnosed with an incurable, malignant brain tumour in May 2015 at the age of 87. Nearly half of his more than 400 research papers were published after he turned 72 in 1999.

“Dr Heaney was passionate about all aspects of research, and research was not only his career, but it might be seen as his hobby,” says Joan M Lappe, who co-authored dozens of papers with Heaney and is associate dean for research at Creighton. “He was a consummate thinker and loved intellectual challenges. Work was fun for him.”

Lappe says that Heaney had a long term interest in vitamin D in relation to skeletal health, but that his interest skyrocketed in 2002 when he read a paper about cancer mortality and inadequate doses of solar ultraviolet B radiation.6 From that point on, Heaney wrote nearly 90 papers on vitamin D.

“Bob was the master of providing insights into the roles of vitamin D and calcium on bone health,” says Michael F Holick, professor of physiology and biophysics at Boston University School of Medicine. Holick says that two of Heaney’s studies—both published in 2003 with Heaney as lead author—are examples that “epitomise his many outstanding scientific contributions in the area of vitamin D and calcium and bone metabolism.”

The first study was used by the Endocrine Society to recommend that the blood level of 25-hydroxyvitamin D should be at least 30 ng/ml.7 The second study “provided important information that dispelled the notion that vitamin D was extremely toxic,” Horlick says.8

A “Legend of Osteoporosis”

In his last years, Heaney collaborated closely with the public health promotion group GrassrootsHealth. In 2015 the group argued that the National Academy of Sciences’ recommended dietary allowance for vitamin D had been miscalculated and could be increased by a factor of 10.9 10

Heaney’s honours include being named in 2008 a “Legend of Osteoporosis” by the National Osteoporosis Foundation. He served on the editorial boards of all the major scientific publications in the area of bone biology.

In 2011 Heaney endowed an academic chair at Creighton—not in science, but in pastoral liturgical theology—in memory of his wife of 55 years, Barbara Reardon Heaney, a psychiatrist who died in 2006. “Dr Heaney was a very spiritual person, actively involved in his Catholic faith,” says Lappe. “He was a strong advocate for social justice.”

Hewison adds, “He was a very civil and polite researcher, who had an extremely humanitarian view of his research: could simple changes in the use of vitamin D have profound effects on the health of the nation?”

In his final months, Heaney was open about his impending death from brain cancer. He talked about it in the local newspaper.11 He wrote about it in Creighton Magazine, saying he was thankful that he would not—like so many others—die a violent and unexpected death: “I had been given the rare opportunity to wrap things up. I had a chance to say goodbye to friends and family.”12

Heaney leaves his second wife, Janet Barger Heaney, to whom he had been married for eight years; two sons; and five daughters from his first marriage.

Robert P Heaney (b 1927; q Creighton University, Nebraska, US, 1951), died from brain cancer on 6 August 2016.


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