Year 5. May 4. Interactions That Have Meaning

“The best doctor I have ever had in my entire life”: Alaní Estrella, MD Receives Outstanding Patient Review 

Many of our patients at UCLA come to us from communities that are often marginalized, with limited access to consistent health care in a fragmented health care environment. Some of them have bounced from one provider to another with little continuity. Unfortunately, the physicians that they may see episodically might, for various reasons, have incomplete access to their history and treatment, and sometimes might not even remember their names. This compounds the lack of trust these patients have in the health care system — and can make it less likely for them to seek out the care they need in the future.

These realities make it all the more special when our outstanding clinical faculty or trainees make such a great impression on a vulnerable patient that they are moved to share their experience. Such was the case for third-year internal medicine resident Alaní Estrella, MD, who currently sees patients at the Simms-Mann Health and Wellness Center at Venice Family Clinic, a federally qualified health center. When the residency program collected patient feedback earlier this year, a patient shared the following statement about Dr. Estrella:

"I came in for a routine check-up, because I also take a large amount of psychiatric medication through Edelman Mental Health Care in Culver City. So, it means I need to be physically examined more than once a year. I actually look forward to my appointments with Dr. Estrella. In the medical field and social services some people don't care that much and then on the flip side is a great person like Dr. Estrella. Months ago, he actually took the time to call my psychiatrist at Edelman to make sure and update how I was doing. No one has ever done that for me before. I was actually crying from happiness when I was told that he called. I think all doctors (mental and physical) should have an open conversation with each other regarding their patients. Truly, Dr. Alaní Estrella is the best doctor I have ever had in my entire life. He is my best doctor ever because he actually listens to me, and cares to know how I can feel better. He also notices things that I might miss or disregard. Also, because of Dr. Estrella I have finally decided to get my long, long overdue colonoscopy. I wish he could be my doctor for life. I wish him all the success in the future. Dr. Estrella is going to be one the greatest doctors ever!"

What a fantastic review! Dr. Estrella said that the feedback warmed his heart. On top of the typical challenges with care continuity for under-resourced populations, the nature of internal medicine residency means trainees frequently move from one service to another, with little time to form strong relationships with patients. The Simms-Mann Clinic is one of the few exceptions.

“If you’re able to step back and take the 30,000-foot view, you’re able to see that of course the work you do matters — you’re getting people mammograms, you’re getting people ultrasounds, you’re helping them with important things. But it’s rare that we get specific feedback that we’ve been impactful,” he said. “That was really special. It’s what we all strive for — to be helpful on these patients’ journeys, answer their questions and help them feel comfortable seeking care.”

Dr. Estrella’s interest in the patient experience is partly what drove him to become a doctor in the first place. At age 14, he had a major abdominal surgery in the Dominican Republic, where his father is from, and struggled in recovery despite speaking fluent Spanish and having the support of family nearby. These memories remained with him throughout his time in college, when he became seriously interested in pursuing the sciences as a career. Even as he conducted basic science research, he found himself thinking about the experience of the patient who would ultimately benefit from the discoveries made in the lab.

“I thought to myself, ‘Is this going to be something the patient can actually use?’” he recalled. “And obviously now, being on the inside is really interesting, because there are all these pressures to see enough people, and often, my goals are different than the patient’s goals. You’re also balancing past patient traumas.”

Dr. Estrella had been working for some time with the patient who left the stellar review to make him feel more comfortable with medicine. He does the same for all of his patients at the clinic, leveraging his bilingual background to give the many patients who speak Spanish, linguistically and culturally concordant care.

“I've always been very eager to help kind of bridge the gap for populations that have less access to care,” Dr. Estrella said. “Especially at Simms-Mann, when most of my panel is Spanish-speaking and everyone has difficulties with access to care, I think it's especially great when I can make an impact.” 

We are thrilled that Dr. Estrella will be staying on at UCLA as a nocturnist — a hospitalist who works exclusively overnight — when he graduates from residency in a couple of months. Thank you, Alaní, for being an inspiring example of exemplary high-quality patient care!

Amier Haidar, MD, MPH Demonstrates Link Between Ultra-Processed Foods and Cardiovascular Disease 

The research that our trainees begin while they are here at UCLA often continues to influence their field after they move on to the next phase of their careers. Such is the case with a recent study first authored by Amier Haidar, MD, MPH, a 2025 graduate of the UCLA Internal Medicine Residency Program who is now a cardiology fellow at the University of Texas – Houston. This impactful work — which was published March 17 in JACC Advances — reveals a strong link between the consumption of ultra-processed foods (UPFs) and the development of cardiovascular disease, and demonstrates the intersectionality of socioeconomics, race, access and disease. 

“This specific project was something I developed toward the end of residency, as part of growing interest in how ultra-processed foods may impact cardiometabolic health,” Dr. Haidar said. “It represents a continuation of that work, combining my clinical training with population-based research to better understand how everyday dietary patterns influence long-term heart health.”

Dr. Haidar noted that while there have been many studies internationally that investigate the relationship between UPFs and cardiovascular disease, they typically do not include large, diverse populations like the ones that characterize the U.S. He has worked in nutrition research for nearly 10 years, starting when he was an undergraduate at the University of Texas at Austin. His research mentor there, Deanna Hoelscher, PhD, served on the U.S. Department of Health and Human Services 2025 Dietary Guidelines Committee; one of the major takeaways from her work was the need for more studies about the health impacts of UPFs within heterogeneous U.S. communities.

Given how prevalent UPFs are within the standard U.S. diet — especially among historically marginalized racial and ethnic groups — Dr. Haidar saw an opportunity to fill a crucial knowledge gap.

“That really shaped how I thought about this research,” Dr. Haidar said.

Dr. Haidar undertook the study under the mentorship of Karol E. Watson, MD, PhD, director of the UCLA Women’s Cardiovascular Health Center. Their team analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) to see if they could find a relationship between cardiovascular disease and intake of UPFs, which are generally defined as foods that are processed with the use of artificial ingredients such as colors, flavors and emulsifiers. 

Their results revealed a striking link between consumption of UPFs and cardiovascular disease, one that remained even after the researchers accounted for overall diet quality, total calories consumed and traditional cardiometabolic risk factors like obesity. That suggests that the effect might not be about fat, sugar or calories alone, but instead about the degree of processing itself.

Dr. Haidar and his team were particularly struck by the magnitude of the association. Each additional serving of UPFs was associated with an average 5.1% increased risk of an atherosclerotic cardiovascular disease-associated (ASCVD) event across all races. Participants with the highest levels of UPF consumption — 9 servings per day — had a 66.8% higher risk compared to the lowest quintile, about a serving a day.

“We were struck by the magnitude of the association,” Dr. Haidar said. “Given how common UPFs are in the diet, seeing that level of risk has important public health implications.”

The researchers also observed a distinct connection between race, UPF consumption and cardiovascular disease. Black participants had 6.1% higher risk of ASCVD events per serving of UPFs — nearly twice that of than non-Black participants, who had a 3.2% increased risk. 

Dr. Haidar explained that this discrepancy is likely the consequence of systemic and structural factors rooted in historic racism and not any inherent biological difference. Racial and ethnic differences are largely driven by socioenvironmental determinants of health; as studies have shown, Black individuals in the U.S. are more likely to live in neighborhoods with limited access to healthy food options and are disproportionately burdened by unhealthy nutrition environments. They are also more likely to be targeted by food and beverage companies for unhealthy products.

“These disparities are rooted in historical racial segregation and community disinvestment, which have shaped the built environment and contributed to inequities in access to healthy food,” Dr. Haidar said. “Together, these reinforce and perpetuate existing cardiovascular health disparities and likely explain the findings observed in our study.”

Although Dr. Haidar came to UCLA with a demonstrated interest in nutrition and public health — he graduated medical school with a dual MD/MPH degree — his experiences in the UCLA Internal Medicine Residency Program helped refine and deepen his interest. He was particularly affected by his experience caring for patients with advanced cardiovascular disease, many of whom had modifiable risk factors.

“It became clear that while we are very effective at treating disease once it develops, there is a significant opportunity to intervene earlier,” Dr. Haidar said. His academic and research work alongside Dr. Watson and another mentor, UCLA Health Women’s Cardiovascular Center Co-Director Tamara Horwich, MD, gave him the opportunity to study the questions that arose from his clinical experiences more rigorously using large cohort data.

“That combination of seeing the clinical impact firsthand, working to prevent it in clinic and having the tools to study it, ultimately solidified my decision to focus on cardiovascular disease prevention,” Dr. Haidar said.

In the course of talking about his path to this study, Dr. Haidar also had a lot of great advice for trainees. For current residents who are in the process of refining their own career paths in clinical and academic research, he recommended being intentional with their time and priorities. The rapid pace of residency makes it impossible to do everything, making it crucial to focus on areas of genuine interest that align with long-term goals.

“Early on, you may find yourself meeting with a lot of people and being offered different projects. That’s a great opportunity, but it’s also important to learn how to say no to things that don’t truly align with your interests,” Dr. Haidar said. “Being selective allows you to invest more deeply in the work that matters most to you.” 

He added that trainees should seek out mentors who are committed to their growth and who give both guidance and the freedom to explore ideas. Additionally, when it comes to balancing research and clinical work, he suggested starting small and staying consistent.

“Some of the best research questions come directly from what you’re seeing at the bedside, so try to connect your clinical experiences with your academic work. And just as important be someone who follows through,” he said. “In a busy environment, being reliable, producing high-quality work and doing it in a timely manner really sets you apart and builds trust with mentors and collaborators.” 

Finally, trainees should give themselves time to figure things out. Dr. Haidar did not start his project until halfway through his third year of residency. 

“You don’t need to have everything decided early on,” he said. “Stay curious, stay open and pay attention to what excites you that’s usually a good signal for where you should go.”

Congratulations, Amier, on this important and impactful study that received extensive coverage in the global media!

Saya Yusa, MD and Daniel Kozman, MD Present Study of UCLA Safety Net Partnerships at Social Mission Alliance Conference

The DoM's safety net partnerships provide a uniquely community-partnered avenue for us to provide exceptional care to the most vulnerable members of our communities. Through agreements with multiple hospitals and federally qualified health centers — which accept patients regardless of whether or not they have insurance — UCLA faculty are positioned with paid protected time to directly provide care on site at these critical points of access to healthcare.

New research presented in late March at the annual Social Mission Alliance (SMA) Conference by preventive medicine fellow Saya Yusa, MD, MS and DoM Director of Health Equity Partnerships Daniel M. Kozman, MD, MPH shows that these partnerships are good for our faculty, too, and builds on the feedback the DoM Office of Wellness received during last year’s annual wellness survey.

“It was very clear from our findings that working in safety net settings helped our faculty feel that their work was more meaningful and allowed them to work with a patient population they otherwise would not encounter,” Dr. Yusa said. “They felt that this part of their work allowed them to connect back to the root and the mission of why they’re in medicine to begin with.”

To better understand the symbiotic relationships of our safety net partnerships and their impact on our faculty and patient care, Dr. Yusa, Dr. Kozman and public health and health services researcher Nina T. Harawa, PhD, MPH, who was also involved in the study, conducted 13 qualitative interviews — 11 with UCLA safety net faculty and two with executives at the safety net institutions. They also added three questions to the 2025 wellness survey that were specifically for faculty at safety net institutions and had 27 respondents.

As their poster showed, their results revealed strong positive sentiment from both our faculty and safety net executives about the impact of our partnered work. In addition to increasing access to more timely primary and specialty care in under-resourced settings, Dr. Yusa noted that working in a safety net setting also had unique benefits for faculty who conducted research or precepted. It gave close proximity to the patient populations they typically study and allowed trainees to work in safety-net settings.

“It really grounded them,” Dr. Yusa said. “It made the work feel more fulfilling and sustainable because of its meaningfulness.”

Importantly, this kind of work also appears to be an antidote against burnout. Dr. Yusa noted that the results complement and can help inform other efforts led by current Chief Wellness Officer Joshua N. Khalili, MD and former Chief Wellness Officer Sun Yoo, MD began to improve our retention. Ensuring that our people remain strongly connected to the core mission of why they entered the medical field is key to helping UCLA Health improve retention — a key return on investment in reducing the high cost of healthcare workforce turnover.

She added that our safety net partnerships are also a major draw for trainees who hope to work with underserved populations — and for people from those communities, as our community investment is increasingly demonstrated and trust grows.

“These partnerships reflect well on UCLA Health because they make it feel like less of an ivory tower of academic medicine,” she said.

Great work, Dr. Yusa, Dr. Kozman and Dr. Harawa! I encourage everyone to take a look at the team’s poster. It is motivating to see the wide-ranging impact of our safety net partnerships!

Kaitlyn Fruin, MD to Develop Homeboy Gym with AHA Social Enterprise Funding Award 

I am proud to share that the fantastic community engagement work already being done at Homeboy Industries by internist Kaitlyn Michelle Fruin, MD is set to expand thanks to a Career Development Award from the American Heart Association (AHA). Dr. Fruin will use the funds to develop and measure the impact of a new multi-use fitness facility — dubbed Homeboy Gym — on Homeboy’s campus, along with other programs focused on improving heart health.

“I was thrilled to learn that the AHA recognized the life-changing work of our partners at Homeboy Industries and were willing to invest in our collaboration advancing Homeboy’s healing mission,” Dr. Fruin said. “This award gives me the structured mentorship, protected time and training I need to grow into an independent physician-investigator.”

For Dr. Fruin, the award gives her a unique opportunity to build expertise across four areas: community-engaged qualitative methods, implementation science, clinical nutrition and social entrepreneurship.

“That last one might surprise people, but it’s central to my vision,” Dr. Fruin said. “One of the hardest problems in community-engaged research is sustainability — partnerships built with real trust and real commitment can fall apart when grant funding ends.”

She added that the goal isn’t just to generate evidence about the existence of a problem, but to build community-based health infrastructure that lasts. Her experience collaborating on VeggieRx, CommunityRx, and her medical school’s Anchor Mission strategy in Chicago taught her that real sustainability requires revenue models, not just grant cycles. Homeboy has already proven this at scale, with over $10 million in annual social enterprise revenue.

“The way I see it, grants build the evidence, social enterprise sustains the work and we use the data to advocate for policies that create durable funding for community-based health-promoting services,” Dr. Fruin said. “All three are necessary — and this award is helping me develop the skills to pursue all three.”

Meanwhile, for Homeboy members, the fitness center will offer much more than weights: It will expand on the organization’s whole-person healing model, giving them the opportunity to take part in breathwork and yoga in addition to strength training.

Dr. Fruin noted that mass incarceration is devastating both for those who are incarcerated as well as their families and communities, and that while health interventions for the formerly incarcerated do exist, they are typically in clinical settings — places that people from this population access at low rates. 

“Our partnership with Homeboy asks a different question: Can we meet people where they already are, in organizations that they already trust?” Dr. Fruin said. “If we can demonstrate that community-based organizations are viable and effective sites for health intervention, we also open the door to sustainable funding models that allow organizations like Homeboy to continue offering life-changing services.”

Dr. Fruin is most looking forward to learning even more from Homeboy’s leadership and trainees, who have a deep understanding of what healing looks like for formerly gang-involved and incarcerated individuals — one that health systems too often overlook. 

“I see this project as an opportunity to listen deeply and let that understanding reshape how we think about care,” Dr. Fruin said. She plans to share the project’s findings with healthcare systems, policymakers and the Global Homeboy Network, a community composed of hundreds of nonprofits that work to advance health for marginalized populations. 

“We want to meet our most vulnerable community members where they are. That means designing trauma-informed community-based care that reaches our patients and neighbors who may never seek out traditional primary care and sustaining the community partners who are already showing up for them. Because, as Father Greg Boyle reminds us, 'we belong to each other — no exceptions,” she said.

Dr. Fruin has worked with Homeboy since her time as a resident and is grateful for the DoM’s sustained support of our partnership with the organization. She feels that the Bruin Scholar Award she received in 2025 was a pivotal catalyst for her work, as it helped Homeboy launch the Homeboy Gym and develop the programming that now forms the basis of her AHA funding.

“I’m deeply grateful to my mentors and to the entire department for the encouragement, resources and trust that have allowed this collaboration to grow into what it is today,” Dr. Fruin said. She is especially thankful to her Career Development Award mentorship team in the DoM and at Homeboy, including faculty members Arleen F. Brown, MD, PhD, Alejandra Casillas, MD, MSHS, Alice A. Kuo, MD, PhD, MBA and Zhaoping Li, MD, PhD, along with Homeboy Vice President of Wellness and Community Care and Director of Legal Services Donna Harati, JD and Vice President of Operations Jose Arellano.

LIFT-UP Scholar Débora Sobreira, PhD Wins Award for Presentation at BRIDGES Consortium 

Next, I would like to shine the spotlight on Debora Sobreira, PhD, vice chair of biological chemistry at UCLA, whose lab studies the functional impact of non-coding genes. Dr. Sobreira recently won an excellence award for an oral presentation that she gave at the in-person meeting of the BRIDGES Consortium, where she shared with the audience a fascinating glimpse into her team’s work on a stem cell model to dissect how specific genetic variants influence susceptibility to obesity and modulate individual responses to pharmacological treatments.

“I was truly honored,” Dr. Sobreira said. “Being recognized among such outstanding scientists is incredibly humbling, and being able to represent UCLA in this context makes it even more meaningful. It is a wonderful reminder of why we do this work and the incredible community we are part of.”

The research Dr. Sobreira shared in her award-winning presentation, is a step toward understanding why some people respond better to obesity medications, like GLP-1 receptor agonists, than others. The model her team developed prompts human-derived induced pluripotent stem cells (iPSCs) to differentiate into cell types that are implicated in obesity, including fat cells, or adipocytes, and brain cells found in a region called the hypothalamus, or hypothalamic neurons. Hypothalamic neurons are linked to feeding behavior, making them a common target for popular obesity drugs like GLP-1 receptor agonists, which include semaglutide (the generic name for Wegovy and Ozempic).

Dr. Sobreira showed in her presentation how the model can be manipulated, such as for screening different obesity drugs to see how effective they are in individuals with certain genotypes, or to simply observe metabolic differences.

“With this model we can test in a controlled system and interpret the results of different drugs or understand genetically why one individual’s cells are more metabolically healthier than another’s,” she explained. 

Dr. Sobreira is a scholar in the UCLA Leveraging Institutional Support for Talented, Upcoming Physicians and/or Scientists (LIFT-UP) program, a network of promising post-docs, junior and mid-level faculty members who are studying nutrition, obesity, diet and similar fields. We are one of four institutions who have LIFT-UP programs; all of them are funded under the banner of the BRIDGES Consortium, an initiative sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institutes of Health (NIH) Office of Nutrition Research, the NIH Office of Disease Prevention, the NIH Office of Behavioral and Social Sciences Research and the NIH Chief Officer for Scientific Workforce Diversity Office to advance the careers of promising early-career scientists. The UCLA LIFT-UP program is led by multiple faculty in the DoM under the overall leadership of Kenrick Duru, MD, MS, professor in the Division of General Internal Medicine and Health Services Research.

“LIFT-UP is an amazing program because it guides your transition from being a post-doc to becoming a faculty member, which is quite a challenge,” Dr. Sobreira explained. “As post-docs, we all know how to do science, but running a lab is like running a small business — you have to manage your people, your time, your money and find opportunities to apply for grants.” 

The program provides financial assistance for launching a lab and pilot projects, the results of which can be used to apply for more funding from federal agencies and other organizations. It also offers extensive mentoring and plentiful networking opportunities. 

“The pipeline that LIFT-UP establishes has, at least for me, worked super well,” Dr. Sobreira said. “It helps you start your academic life, and the networking they provide is very important.”

Dr. Sobreira is especially grateful to the mentors she has met through the program. 

“Having mentors and colleagues who believe in your work makes an enormous difference” she said. “Their encouragement and scientific feedback push me to think bigger and aim higher, that kind of support is what sustains you through the challenges of an academic career."

Congratulations, Debora!

Julie Friedman Honored with 2026 City of West Hollywood Women in Leadership Award 

I am thrilled to share that Iris Cantor-UCLA Women’s Health Education & Research Center Director Julie Friedman, MPH was recently presented with a 2026 City of West Hollywood Women in Leadership Award, a special honor granted to four outstanding women and sponsored by the West Hollywood Women’s Advisory Board and the West Hollywood Chamber of Commerce. The awards ceremony took place on March 25 at the Andaz West Hollywood.

Julie said she was surprised and honored to receive the award, which recognized her work in managing the LA County Sexual and Gender Diverse Women’s Health Collaborative (SGDWHC). The Iris Cantor-UCLA Women’s Health Center serves as the lead agency for the collaborative alongside the city of West Hollywood. Dr. Pregler shared that, when giving Julie her award, West Hollywood City Councilmember John M. Erickson recalled his first day as an intern for the West Hollywood City Council back in 2010, when he was asked to take notes at a meeting chaired by Julie.

“He commented on her extraordinary commitment to vulnerable women over 15 years of collaboration as an ally to the LGBTQ+ community,” Janet P. Pregler, MD, director of the Iris Cantor-UCLA Women’s Health Center, said.

When reflecting on her work with the SGDWHC — which trains health care providers and social workers to provide inclusive, culturally-sensitive care to LGBTQ+ women — Julie said that she had learned the importance of checking assumptions and deferring to content experts with lived expertise to lead the collaborative’s work.

“I take my lead from the members and try to actualize their ideas and vision,” Julie said. “I pride myself in leading from being in the background to facilitate and streamline the work of the collaborative members.” 

This approach is rooted in Julie's philosophy about the qualities that make an effective leader. She believes that capable leaders create nurturing, safe environments to move out of their own comfort zones and stretch their skills, as well as learn from mistakes to gain autonomy in decision making and problem solving.

“Giving others the limelight to gain visibility and recognition for their work that contributed to all our successes is essential to being an effective leader,” Julie said.

Julie’s favorite part about her role with the collaborative is the chance to learn from the wide range of organizations she has worked with so far, including the Trans Latino Coalition, the LA County Sheriff’s Department, HealthRight 360, the city of West Hollywood, Inner City Struggle, the LA County Department of Public Health Office of Women’s Health and many others. She has been most enlightened by the community-based participatory research the collaborative conducts.

“Working with collaborative members in designing and implementing the Collaborative’s allyship training program, ‘Caring for Sexual and Gender Diverse Women’s Health,’ was most educational and a true team effort,” Julie added. “Seeing how the training participants valued learning how to deliver inclusive care, build trust to promote disclosure and create welcoming and supportive office environments was most rewarding.” 

Julie is grateful to the collaborative for all of its support and was thrilled to have so many collaborative members cheer her on at the awards ceremony! Congratulations from all of us in the DoM too, Julie — we are lucky to call you our colleague!