Daivd Ludwig, MD, MPH

Every month the Journal of the American Medical Association (JAMA) publishes an article called Clinical Crossroads, where a patient case is presented and medical professionals are invited to share their thoughts on how they might treat that person. A few weeks later the case is presented again, this time with commentary from an expert who specializes in the medical condition profiled in the article.

The most recent Clinical Crossroads was written by David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital. Ludwig’s case focuses around Ms K, a 14 year-old girl struggling to lose weight.

Unlike typical medical case studies that focus on diagnosis and treatment of acute illness, Clinical Crossroads often takes into account the ethical, emotional and economic issues related to the patient’s health and treatment. All three of these elements figure heavily in Ms K’s story, making it ideal for the Clinical Crossroads treatment.

But as Ludwig himself would tell you, overcoming childhood obesity isn’t just the job of pediatricians and their patients; parents play a vital role in helping children achieve and maintain a healthy weight and lifestyle too. With that in mind, we are presenting Dr. Ludwig’s Clinical Crossroads piece to you on Thriving and asking for your input as parents.

Given the following situation, what are some ways Ms K and her parents could work as a team to help her live healthier? If you were her mother or father, what would you do to support her efforts?

Ms K is an obese 14-year-old girl who is struggling with weight loss. She lives in the greater metropolitan Boston area. Ms K began to gain weight at age 8 years. Over the past 7 years, her weight has gone up by 20 to 30 lb annually … She reports trying various weight loss programs but either she did not follow through or they did not work. She has never lost more than 5 lb with any focused effort.

On a typical day, Ms K skips breakfast, so her school lunch is her first meal of the day. She eats whatever is served there, often something “greasy,” with a small salad and chocolate milk. When she comes home from school, she begins to snack on “good” junk food. Over the course of the afternoon, she might have several of the following: baked chips, a cereal bar or 2, 2 or more “100-calorie packs,” a glass of (1%) milk, crackers, or pasta with cheese. She eats dinner with her parents, which is often fried chicken, pasta with cheese, or a hamburger. There are rarely vegetables on the plate. After dinner, she will routinely eat more, ingesting 1 to 3 snacks while working on her computer. She does not routinely eat dessert at dinner and does not drink sugar-sweetened beverages. She does not watch television regularly. She used to ride a horse several times a week but has not done so in several years. Her only regular activity is walking home from school, about mile daily.

Ms K was told by her pediatrician that she needed to lose weight or she might develop diabetes. She has experienced harassment at school and online related to her obesity. There has also been significant tension between Ms K and her parents—especially her mother—about her eating habits and progressive weight gain.

   Ms K’s mother was interviewed for the piece, and said the following:

“Probably the biggest challenge that my husband and I have had is backing off. I constantly watch her, correct her, and stop her from doing things. I am almost obsessive about what she eats, what she doesn’t eat. My husband and I went to a counselor locally, and he was the one to tell us we need to back off because it is making things worse. That’s been the biggest challenge. I think I feel like I am the food police sometimes.”

Please share your ideas with us on how families can work together to improve eating habits by commenting on the blog, leaving a message on our Facebook wall or connecting with us @ThrivingKids on Twitter.

To speak with a member of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital please visit their website.

Have you seen the anti-childhood obesity ads from Georgia?

With 40% of the kids in Georgia overweight or obese (only Mississippi is worse), health advocates decided that it was time for “a wake-up call.”  So the Strong4Life campaign and Children’s Healthcare of Atlanta have released print and TV ads with obese kids and slogans like “It’s hard to be a little girl when you’re not.”

Ouch. I mean, really. Imagine being on a playground and having some kid point at you and say, “You look like the fat girl on TV!”  What were they thinking?

Actually, I get what they were thinking. It’s a desperate-times-call-for-desperate-measures thing.

We do need a wake-up call. It’s not like Georgia is the only place with a childhood obesity problem. Nationwide, a third of US kids are overweight or obese, and studies show that overweight kids tend to grow up into overweight adults. Being overweight brings with it a higher risk of health, emotional, and even financial problems. That’s not what we want for our children—of course it’s not.

So we just tell people to eat less and exercise more, right? After all, weight gain or loss is an energy equation. If you take in more calories than you burn off you gain weight—take in fewer calories or burn off more of them, you lose weight. Simple stuff, no problem, right?

Wrong. Big problem.

I’ve been doing primary care pediatrics for twenty years now. I have helped all sorts of kids with all sorts of problems get better.  But obesity is one problem I can’t seem to make better. I’ve been feeling pretty desperate myself.

I’ve tried everything. We talk in detail about foods they should and shouldn’t eat and drink. I give them recipes and shopping lists. We make specific diet plans. We make specific plans for exercise, thinking together about what’s easiest and most fun. I try to make all the plans with them instead of for them, setting small goals, so that everything I ask them to do is realistic. We talk a lot about why it’s important to be at a healthy weight, and why being overweight is bad for them. I connect them to nutritionists, weight loss programs, community resources, exercise programs, psychologists and anyone else who might help. I see them regularly to check on their progress and try out new ideas.

And for the most part, I get nowhere. Really. It’s amazingly discouraging. I feel like a failure as a doctor—and I feel desperate about the future of my patients.

Part of the problem (by no means the whole problem!) is that many families don’t take things seriously enough, no matter what I say. They think it’s baby fat that the kids will grow out of. Or they don’t even think the kids are overweight, often because the entire family is overweight; it seems normal to them. I guess it’s this stuff that the folks in Georgia were trying to tackle with the ad campaign, and I applaud them for trying to do something.

But no solution should involve shaming children.  That’s taking desperation too far.

People say it’s like the gross pictures on the cigarette labels, meant to shake people up and make them rethink their habits. But the ones who really need to rethink things are the parents. Maybe pictures of obese adults, with captions like: “this is your kid in 10 years if you don’t start making changes now,” would be better. Same message, no shaming of children.

These really are desperate times, and we really do need desperate measures. We desperately need more safe outdoor and indoor spaces for exercise.  We desperately need affordable healthy foods. We desperately need more afterschool programs and other supports for families who are working so hard to make ends meet that they truly don’t have time to take their kids to the park or make healthy home-cooked meals. We desperately need to get people to shut off TV’s and other screens. We desperately need fast food to be healthier (we can’t stop people from buying quick, cheap food). There is so much we desperately need.

We do not, however, desperately need to make children feel shamed.

For information on what Children’s Hospital Boston is doing to fight childhood obesity, visit the website of the Optimal Weight for Life (OWL) Program and read about the Fitness in the City program as well as about our advocacy efforts, such as working for better school nutrition.

The New Balance Foundation Obesity Prevention Center Boston Children’s Hospital recently hosted a symposium for nutritionists, medical professionals and community leaders to discuss the USDA’s current dietary guidelines and new MyPlate icon. Here’s a brief video recapping this exciting meeting of these respected and nutritionally-sound minds:

To learn more about the symposium, which featured award winning chef and famed restaurateur Jody Adams, Sam Kass, assistant White House chef and senior policy advisory for Healthy Food Initiatives at the White House, and a host of other important speakers, check out this blog chronicling the whole talk. If you’d like to learn more about childhood obesity or talk to one of our experts, please contact the obesity prevention center.

Boston Magazine recently released its 2011 Top Doc list, made up of the best 650 physicians in the Hub. Seeing as Boston is home to some of the greatest medical minds on the planet, the list reads like a prestigious who’s-who roster of talent; a medical dream team spanning every aspect of treatment, from surgery to research and innovation.

Broken into 57 different specialties, doctors included on the list are voted for by fellow medical professionals, meaning that the Top Docs have not only gained the respect of the public and media, but of their peers as well.

Children’s Hospital Boston is proud to announce that over 10 percent of the entire list was made up of our staff, many of whom will be familiar to Thriving readers.

David Ludwig, MD, PhD

As director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital, David Ludwig, MD, PhD, is a respected leader in childhood obesity research and prevention, as well as a regular Thriving contributor and interviewee. In a recent post Ludwig explains why he supports legislation that would restrict the amount of junk food available through public assistance programs. For more blogs on Dr. Ludwig’s work, click here.

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In 2004 Children’s Chief of Cardiac Surgery, Pedro del Nido, MD, was the first person to use the da Vinci surgical robot to fix a defect in a child’s heart, using child-sized tools of his own design. Read about another family whose child was also saved by Dr. del Nido’s surgical expertise and steady hands.

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Mininder Kocher, MD, MPH

Mininder Kocher, MD, MPH, associate director of Children’s Division of Sports Medicine, helps many young athletes work through their sports related injuries. Most recently Dr. Kocher and one of his patients was featured on ABC World News, a segment that included a guest appearance by Patriots quarterback Tom Brady.

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David Hunter, MD, PhD

David Hunter, MD, PhD, Ophthalmologist-in-Chief at Children’s Hospital Boston’s Department of Ophthalmology has spent years helping young people see better. In this recent blog post, Dr. Hunter weighs in on new research that indicates that the amount of time a toddler spends outside could have a direct, positive relationship on his developing eyesight.

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Lisa Diller, MD

Lisa Diller, MD is the clinical director of the Dana-Farber/Children’s Hospital Cancer Center (DF/CHCC), where she works as part of a multi-disciplinary team devoted to curing pediatric cancers. But as science is now discovering, the therapies that are so effective at saving children’s lives can also occasionally lead to problems down the road (called the late effects of cancer treatment.) Some of the more common concerns surrounding late effects of cancer treatment have to do with its effects on fertility, and in this blog post, Dr. Diller describes the great lengths doctors are now going to in order to help preserve the fertility of young patients with cancer.

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Norman Spack, MD

Norman Spack, MD, is an endocrinologist and a leading expert in gender identity disorder in children and adolescents. Spack co-launched the interdisciplinary Gender Management Service (GeMS) Clinic at Children’s—the first pediatric academic program in the Western Hemisphere to evaluate and medically treat young transgender people. In this blog you’ll meet a family that says with Spack’s help their transgender daughter has been given the opportunity to “live her dreams.”

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Marc Laufer, MD

As Chief of Gynecology and Associate in Surgery, Marc Laufer, MD has conducted novel research in adolescent medicine that has greatly improved treatments for female patients with reproductive conditions. For 13 years, he has also been the Co-Director of the Center for Young Women’s Health, which brings adolescent health education online. Learn how a conference run by Laufer and his team has changed a young woman’s life.

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As director of Children’s Advanced Fetal Care Center, Russell Jennings, MD, is no stranger to high tech surgical suites. But his affinity for technology doesn’t end there. In a recent blog post, Jennings talks at length about how he believes doctors can use social media like Facebook to interact with patients, making it a powerful tool for spreading factual medical information.

 

Congratulations to all our staff on the Top Doc list:

Adolescent Medicine

Sara F. Forman, MD

Rebecca F. O’Brien, MD

Elizabeth R. Woods, MD, MPH

Allergy and Immunology

Lynda C. Schneider, MD

Frank J. Twarog, MD, PhD

Dale T. Umetsu, MD, PhD

Child Neurology

Blaise Bourgeois, MD

Basil T. Darras, MD

Scott L. Pomeroy, MD, PhD

Mustafa Sahin, MD, PhD

Joseph J. Volpe, MD

Robert R. Wolff, MD

Clinical Genetics

Mira B. Irons, MD

Dermatology

Stephen Gellis, MD

Kay S. Kane, MD

Diagnostic Radiology

Roy G. McCauley, MD

Hand Surgery

Peter M. Waters, MD

Internal Medicine

Matthew Gillman, MD

Neonatal-Perinatal Medicine

John P. Cloherty, MD

Ivan D. Frantz III, MD

DeWayne M. Pursley, MD, MPH

Linda J. Van Marter, MD, MPH

John A. Zupancic, MD, ScD

Neurology

H. Royden Jones, MD

Neurosurgery

Ossama Al-Mefty, MD

Liliana C. Goumnerova, MD

Joseph R. Madsen, MD

Obstetrics/Gynecology

Marc. R. Laufer, MD

Ophthalmology

David G. Hunter, MD, PhD

Orthopedic Surgery

Mark C. Gebhardt, MD

Daniel J. Hedequist, MD

James R. Kasser, MD

Mininder S. Kocher, MD, MPH

Pain Medicine/ Palliative Care

Charles B. Berde, MD, PhD

Pediatric Cardiology

Peter Lang, MD

James E. Lock, MD

Jane W. Newburger, MD, MPH

Edward P. Walsh, MD

Pediatric Endocrinology

Catherine M. Gordon, MD, MSc

David S. Ludwig, MD, PhD

Norman P. Spack, MD

Pediatric Gastroenterology

Maureen M. Jonas, MD

Alan Leichtner, MD, FAAP

Pediatric Hematology/Oncology

Amy L. Billett, MD

Lisa R. Diller, MD

Eva C. Guinan, MD

Mark W. Kieran, MD, PhD

Stephen E. Sallan, MD

Pediatric Nephrology

William E. Harmon, MD

Michael J. Somers, MD

Pediatric Otolaryngology

Michael J. Cunningham, MD, FACS

Trevor J. McGill, MD, FACS

Dennis Poe, MD, FACS

Pediatric Pulmonology

Henry L. Dorkin, MD

Pediatric Surgery

Russell W. Jennings, MD

Craig W. Lillehei, MD

Robert C. Shamberger, MD

Pediatrics

Carolyn H. Bridgemohan, MD

Margaret W. Manion, MD (Longwood Pediatrics)

Judith S. Palfrey, MD

Leonard A. Rappaport, MD, MS

Plastic Surgery

Elof K. Eriksson, MD

John G. Meara, MD, DMD, MBA

John B. Mulliken, MD

Sports Medicine

Lyle J. Micheli, MD

Thoracic Surgery

Pedro J. Del-Nido, MD

John E. Mayer Jr., MD

Urology

Stuart B. Bauer, MD

Claire McCarthy, MD

A week or so ago, the American Academy of Pediatrics came out with a report entitled “Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents.” It’s a 44-page report full of evidence-based recommendations for preventing kids from getting heart disease when they grow up.

I wasn’t going to write about it. After all, it seems like everyone’s eyes glaze over when I talk to them about diet and exercise; why should I waste the time writing something people likely won’t read? And even if they read it, chances are they won’t follow the recommendations. I know I sound cynical, but that comes from years of talking to families about healthy habits with really minimal results.

But here’s the thing: cardiovascular disease is the leading cause of death in the United States. And the risk factors and risky behaviors that lead to cardiovascular disease can and usually do start in childhood. I can’t really call myself a good doctor if I don’t talk about this stuff. I just wish I was more effective.

Look, I get it. I’ve done my share of cajoling/begging/yelling to get my kids to eat vegetables, with variable results. I know what it’s like to try to get a kid who has absolutely no interest in exercising to exercise (especially when it involves me exercising too—just kicking them outside, like our parents did, doesn’t always work out). We are all short on time and would prefer to keep negative interactions with our family to a minimum. Especially when it’s all about something that won’t happen for years (if at all).

Also tough: keeping our kids healthy means taking a long hard look at our own health and habits—because whether it’s the food we serve or the example we set, we have an impact.  It means eating better, not smoking, exercising, going to the doctor regularly, watching our weight and our blood pressure…ah! The eyes are really glazing over now. I can see it. Denial is way more comfy.

It’s not like we never make our kids do things for their future good. We push them to do well in school, we help them make choices that might help them get into a good college, even if they don’t like doing homework or aren’t interested in sports and clubs. (Maybe this is easier because we don’t have to change our habits.) But they aren’t going to get much out of being a doctor or lawyer if they die at 45 of a heart attack.

Like I said, the recommendations go on for 44 pages.  But here are the bottom lines, so to speak:

• Family history matters when it comes to heart disease. Know your own cholesterol values.  Find out what Uncle Jimmy died of so young. If there is a change in your health or the health of a close relative, let your child’s doctor know.
• Don’t smoke, or let your kids be around people who do—and do everything you can to stop them from smoking as teens. If you smoke, talk to your doctor about smoking cessation program.
• Baby fat and kid fat turn into adult fat. Know your child’s Body Mass Index (BMI).  If it’s over the 85^th percentile, take action. Don’t ignore it.
• Make sure your child’s blood pressure is taken at every checkup from age 3 on, and talk to your doctor about when to do a blood test to check for hyperlipidemia (all children should be checked at age 9-11 and 18-21, but some might need it earlier or more frequently).
• Eat healthy. This means:
• Breastfeed for at least the first 6 months, if possible
• Keep portion sizes reasonable
• Serve whole grains, lean meats, and lots of fruits and vegetables
• No sugar-sweetened beverages—and preferably no juice.  Low-fat unsweetened milk and water should be all anybody drinks.
• Try to keep fat and cholesterol to a minimum (including fast food)
• Shut off the TV and get your kids (and everyone) moving for an hour a day.

I know, you’ve heard all of this before. We all have. But here’s why: because it’s important.  It could literally save your child’s life.

It makes me sad every day that I can’t seem to make significant changes with my patients when it comes to diet and exercise and weight and smoking and everything else. I try to work with families and understand their individual lives and needs, but it’s not enough. My friend and fellow doctor-blogger Wendy Sue Swanson is asking her readers for their perspectives and practical suggestions—maybe that’s what all of us doctors should be doing.

So if your eyes haven’t totally glazed over, chime in. Why aren’t we doctors more effective? What should we be doing differently? What makes it hard? What has worked, or might work, for you?

This was my breakfast last Friday.

As a black coffee and dry toast kind of guy, I have to admit I was skeptical when I first laid eyes on the plate. Roasted red peppers, kale sautéed in garlic and olive oil, black beans, cheese and smoked salmon isn’t exactly my traditional 8 AM fare.

But after a few bites I was sold; at some point it seems my tastes had changed without me knowing, which I was about to learn was a very good thing.

“When it comes to food, it’s OK to break the rules,” said award winning chef and famed restaurateur Jody Adams, as she addressed a packed house of nutritionists, medical professionals and community leaders who gathered at Children’s Hospital Boston to discuss the USDA’s current dietary guidelines and new MyPlate icon.

“In fact, if we are going to be successful in our mission to reduce and prevent childhood obesity in this country, more than a few rules are going to have to be broken. We need to change the way we think about a lot of foods,” she said.

Adams, along with Sam Kass, assistant White House chef and senior policy advisory for Healthy Food Initiatives at the White House,  spoke Friday morning at Step Up to the Plate, a panel discussion hosted by the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital. In addition to Kass and Adams, the panel included Boston Public Health Commission Director Barbara Ferrer PhD, MPH, MEd , Cara Ebbeling, PhD, Associate Director of Research and Training at the Center and Eric Rimm, ScD, Associate Professor of Epidemiology and Nutrition at Harvard; each bringing a unique vision about how the USDA’s dietary guidelines can be utilized to help American kids eat and live better.

As a recognized leader in the fight against childhood obesity, Center director David Ludwig, MD, PhD, was the esteemed host of the event, but the real star of the show was MyPlate, the color-coded icon that recently replaced the Food Pyramid as the government’s visual representation of a balanced diet.

“MyPlate is a key component of what First Lady Michelle Obama is trying to do with the Let’s Move campaign,” Kass says. “One of the pillars of our goal to better serve the community is empowering parents with the information they need to make the best choices for their families. MyPlate is a simple tool or guide that can help them do just that.”

But healthy eating is a daily balancing act, and too complex a task to be fully expressed with a single image. Kass, Adams and their Step Up to the Plate colleagues stressed that MyPlate was a good starting point for parents looking to feed their families better, but to be truly successful it takes commitment, a willingness to learn and a little creativity.

When using MyPlate as a guide, Ludwig and his team suggest stocking up on foods like vegetables, fruits, beans and whole, minimally processed grains because they have a low glycemic index (GI). Foods with a low GI have carbohydrates that break down slowly, gradually releasing glucose into the bloodstream, which makes the eater feel full for a longer period of time.

Here are a few more key points the speakers made that parents should remember when using MyPlate to plan their own menus.

Vegetables. There are so many varieties of vegetables grown in the world, but far too many people stick only to the classics. When filling the vegetable portion of your children’s plates, try to incorporate new types and cooking methods. The variety will help kids avoid ‘veggie fatigue’ and they may even find a new favorite. (For instance, did you know that roasting almost any vegetable often brings out their natural sugar and adds a little sweetness? Kids that hate sautéed Brussels sprouts or cauliflower may love them roasted.) As a rule, dark green vegetables like spinach, kale and broccoli provide the most nutrients so use them often, and try to limit overly starchy foods like pumpkin, potatoes or corn, which should be considered more of a grain than a vegetable.

Protein.  Go lean with protein! When meeting a child’s protein quota, parents are wise to pick lean options like chicken, seafood or turkey over red meat. Also, don’t forget that meat is not the only food with protein in it. Soy, beans, peas, cheese and many other vegetarian options contain plenty of protein; try incorporating them into your meals as you would meats. To limit the amount of saturated fat in your child’s diet, it’s recommended that they get no more than two servings of red meat a week.

Dairy. Milk is the undisputed king of healthy drinks at many family dinner tables. And while milk is an excellent source of calcium and vitamins A and D, not all milk is created equal in terms of health benefits. As a rule kids should drink low fat or 1% milk, and if they are struggling with weight it’s suggested they have no more than three servings a day. Contrary to popular belief, milk is NOT essential to a healthy diet for toddlers and older children. Kids can receive their dairy requirements from cheeses or naturally sweetened yogurts, and calcium from leafy greens. In most cases water is a healthy substitute for milk.

Not all grain products are the same. Whole grains are a healthier option than refined grain products

Grain. At least half of all grains that you serve your children should be of the whole grain, non-refined variety, like brown rice, traditional steel-cut oats, or stone-ground breads. Though they technically fall into the grain category, white bread, sugary breakfast cereals and most processed snacks are packed with refined carbohydrates that promote weight gain and increase risk for diabetes and heart disease.

Fruit. Like its cousin the vegetable, fruit gets a lot more respect and prominence in the MyPlate era. Together fruits and vegetables should cover half of the plate at every one of your child’s meals, so serving a wide variety is going to be important in keeping kids interested. Take advantage of fruits’ naturally bright colors and many shapes, which are often intriguing to young eaters. Also, just because a bottle of fruit juice has a picture of an apple or grape on the label, doesn’t mean it has the same nutritional value as whole fruit. For the most part, commercial fruit juices marketed to children have more sugar and preservatives than health benefits and should be given to kids sparingly.

In the end, Step Up to the Plate reminded me that getting kids to eat better should be thought of as a marathon, not a race. Instilling better eating habits in kids takes time, practice and endurance. There will be fights about junk food, wrinkled noses and furrowed brows when you offer new things and maybe even a tantrum or two. It may not always be easy, but as Ludwig and his Step up to the Plate colleagues are quick to remind us, if you’re patient, stick to your guns and model the right eating behaviors for your family, the kids will come around. Who knows? They may even thank you for it one day.

Dr. Ludwig is Children’s obesity expert and considered a pioneer in the fight against childhood obesity because of his innovative approach to obesity treatment and prevention. From soda taxes to questioning whether or not the state has a right to intervene in the care of severely obese children, Dr. Ludwig is at the forefront of the national discussion about the obesity epidemic. To learn more about his work please visit the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital website.

How big a role does sun light paly in strengthening young eyes?

As a kid, my mother was always shooing my brother and me outside to play. ‘Get outdoors and get some fresh air’ was more than a suggestion in the Underwood household—it was a parental mandate. The forced backyard time didn’t do much for my budding videogame skills, but it’s possible that it did wonders for my eyes.

Studies recently presented at a American Academy of Ophthalmology meeting suggests that kids who spend more time outdoors are less likely to suffer from myopia, also known as nearsightedness. Could playing outside really improve eyesight in kids?

For years outdoor play has been celebrated as a free and effective weapon in the war against childhood obesity, but it rarely gets much press as an eyesight enhancer. But according to a new analysis of eight eye health studies, which pools data on more than 10,400 children, there is a correlation between people who spend less time in the sun and nearsightedness.

The findings should be a red flag for parents because for the past three decades myopia cases have been rising among children. If a strong connection between a lack of sunlight and nearsightedness can be proven it may be helpful in reducing those numbers, and offer parents another reason to encourage more outdoor play.

“When I see a young child who is just developing myopia the first question parents ask is ‘how can we stop it,’” says David Hunter, MD, PhD, Ophthalmologist-in-Chief at Children’s Hospital Boston’s Department of Ophthalmology. “My suggestion usually is getting outside more might make a difference.”

[Watch a video of Dr. Hunter treating a vision condition known as Duane syndrome.]

David Hunter, MD, PhD

More work needs to be done before science can establish a concrete cause and effect relationship between sun exposure and stronger eyes, but the initial findings are pretty convincing. Research shows that as little as one extra hour of outdoor time per week could reduce the chance of myopia by as much two percent. And of the thousands of children studied, nearsighted kids spent three and a half hours less time outside per week than their peers with typical vision.

The studies also noted that today’s kids spend a lot of time doing near work, or the act of looking at objects close up, like handheld video games or computer screens. Because near work is more common today than in pervious generations many people think it too could be a contributing factor to nearsightedness, but at the moment only sunlight has been connected to a rise in myopia.

“We know that being outside more has positive effect on vision,” Hunter says. “Now we need to tease out why that is, figure out how much a factor near work or sunlight or fresh air play into the picture and let parents know how to best use that information.”

The people who will benefit most from that advice are younger children and their parents. Most vision problems tend to develop around the ages of 9 through 12, usually right around a child’s first growth spurt. So if being indoors too much really is a trigger of myopia, how a child spends his or her time in the preschool to preteen years is going to be important in helping prevent nearsightedness later in life.

In the meantime, Hunter says parents should encourage outdoor play whenever possible, because even if a stronger link between sun and eyesight is never discovered, increased outdoor time already has several other proven health benefits.

And for what it’s worth, it’s been decades since my mom made go outside to play, and I still don’t own a pair of glasses.

To learn more about the work Dr. Hunter does with young eyes, check out this video about the pediatric vision scanner he helped design, which can catch vision problems before the child is even old enough to talk. It uses laser technology to scan the eye and identify amblyopia (lazy eye) and strabismus (misaligned eyes) in young children using a non-invasive, rapid diagnostic test.

David Ludwig, MD, PhD

David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center and the Optimal Weight for Life (OWL) Program at Children’s Hospital Boston, was recently featured in the annual medical issue of the Boston Globe Magazine. Ludwig was profiled for his leadership role in the war on childhood obesity.

 “Ludwig, who holds a chair in pediatric endocrinology at Harvard and directs the Optimal Weight for Life (OWL) program at Children’s Hospital, is arguably the nation’s leading crusader in the battle against childhood obesity. With nearly a third of US children and teens overweight, and fully 17 percent obese, Ludwig believes this battle is one we cannot afford to lose.”

(For the full article click here, subscription required.)

Clearly Dr. Ludwig’s message is an important one. In an effort to share his research with a broader audience, Children’s has partnered with The New Balance Foundation to create the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital. Thanks to a generous donation from the charitable arm of New Balance, Children’s can now do even more to transform the lives of overweight and obese children nationwide and turn the tide against childhood obesity.

Thanks to a donation from the New Balance Foundation Ludwig and his team can take OWL to more people

Keeping with that theme, the Center recently launched a website, with obesity prevention information aimed at parents, kids and medical professionals. Here’s a quick sample of some of the great tools you’ll find there:

• Healthy recipes for both meals and snacks.
• Advice on ensuring your home is a healthy, food safe environment.
•  Fun and easy exercise routines.
• Tips on how to talk about sensitive, weight-related issues with your kids.
• Patient success stories to inspire your own efforts.
• A list of Online sources to better support your family’s efforts.

Still need convincing? If so meet Delroy, an OWL success story who personifies Ludwig’s message that with the proper direction and a little bit of hard work we all can make a difference in reducing childhood obesity.