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Childhood obesity

How would you support a child trying to live healthier?

by Tripp Underwood on February 3, 2012

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. Full story »

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Step up to the plate

by Tripp Underwood on January 4, 2012

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.

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Fighting childhood obesity: SNAP v. soda

by Tripp Underwood on September 27, 2011

In the mid 20th century, hunger was a major concern for America’s poor. To better support malnourished families living below the poverty line, the federal government created the Food Stamp Act in 1964 to help provide healthy food to people in need.

America’s nutritional landscape has changed a lot over the past 50 years. Malnourishment is still a big problem in America, but in a much different way than it was back then.

Because of their lower prices and mass availability, unhealthy foods and drinks have become a staple in the diets of millions of Americans. Obesity rates in this country have grown to epidemic levels, with impoverished communities being hit especially hard. In low-income homes across the country, overweight and obese children now outnumber underweight kids by a ratio of seven to one.

To combat this epidemic, many states are trying to change what type of items people can buy via the Supplemental Nutrition Assistance Program (SNAP-formerly know as food stamps). Because sugar-sweetened beverages have no nutritional value and have been closely linked with obesity, nine states, including Illinois, Nebraska, Texas and most recently New York, have tried to have these drinks barred from being bought with SNAP money. In each case the US Department of Agriculture (USDA) has said no. Full story »

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Apples vs. Oz

by Tripp Underwood on September 16, 2011

In many cases jucies aren't much of a healthier alternative to soda

By now you’ve probably heard about Dr. Oz’s war against apple juice. The doctor/TV personality recently made claims that many brands of apple juice contain too much arsenic, a known cancer-causing agent found in many pesticides.

The Food and Drug Administration was quick to respond to Oz’s study, saying that any trace levels of arsenic found in apple juice sold in the US was perfectly safe, and statements to the contrary were “irresponsible and misleading.”

Inflammatory or not, Oz’s attack on apple juice seems to have gotten the public’s attention. But as many people consider the hidden ingredients in their kids’ favorite drink, they seem to be ignoring a far more obvious problem with many popular juices: Large amounts of sugar. Full story »

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Children’s in the news

by Tripp Underwood on August 25, 2011

Have you heard about the new kids’ book, “Maggie Goes on a Diet”? It’s basically a retelling of the age-old ugly ducking fable, but with a modern twist. In this reenactment, the duckling is a 14-year-old girl who goes on a diet, and with a little hard work goes from being an overweight, self-conscious kid to a star soccer player and the most popular girl in school.

The book may stress the importance of healthful eating and exercise, but many people are finding fault with the author’s emphasis on the thin = happy storyline, instead of focusing on the importance of health.

Among the critics is our own Dr. Claire, who was on New England Cable News this morning to talk about Maggie, childhood obesity and how to send kids the right message about health and weight.

Full story »

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Greenwashing your kids: Advertisers target green parents

by Tripp Underwood on August 16, 2011

Cigarette manufacturer Reynolds American Inc. recently released a new ad campaign for its American Spirit line, touting the eco-friendliness of the brand. The ads boast that the company uses recycled paper, electric hand dryers and ceramic mugs instead of paper towels and disposables cups. It even goes as far as to point out that their sales team drives hybrids. Thankfully it stops short of saying that America Spirits are a healthier cigarette than non-green alternatives, but the message is pretty clear: if you smoke and care about the environment, American Spirit is the brand for you.

Hopefully most people will recognize these ads for what they are, a green tinted smoke screen devised to push an otherwise unhealthy product. But regardless of the campaign’s success, the fact that these ads exist at all says a lot about how the eco movement influences people’s buying habits. If something as unhealthy as tobacco is rebranding itself as green, then it’s safe to assume that phony green marketing has infiltrated other markets as well. Full story »

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Food for thought: The war against childhood obesity

by Tripp Underwood on August 10, 2011

Daivd Ludwig, MD, PhD

For David Ludwig, MD, PhD, one of health’s most fundamental truths can be traced back to a 2,000-year-old quote from Hippocrates, the father of modern medicine: “Let food be thy medicine and let medicine be thy food.”

It’s a simple but powerful philosophy, and when combined with current research in obesity prevention, it’s one of the cornerstones of Children’s Hospital Boston’s Optimal Weight for Life (OWL) Clinic. “Hippocrates was right, nutrition really is the foundation for health and well-being,” says Ludwig. “He understood that intuitively, without access to the modern science and technology.”

Founded by Ludwig in 1996, OWL is a multidisciplinary clinic with a staff that includes physicians, nurses, dietitians and experts in child behavior. With Ludwig at the helm, OWL has spent the past decade and a half researching childhood obesity while serving over 1,500 patients a year, making it one of the largest and most respected childhood obesity clinics in America. Now, thanks to a $7 million grant provided by the New Balance Foundation, Ludwig and his team will be able to expand their clinical research, patient care and community health programs. The newly created New Balance Foundation Obesity Prevention Center will bring Ludwig’s message to even more children and communities struggling with weight issues.

Since he was 8 years old, Ludwig has been captivated by the inner workings of the human body. By the time he finished the fourth grade he had read every physiology book on the shelves of his local library.

That fascination stayed with him throughout his education. When he began his pediatric endocrinology fellowship at Children’s, he focused his studies on diet and weight, researching how brain function affects body size, as well as the role genetics plays in why some people become obese and others do not.

But with childhood obesity already reaching epidemic status by the mid-1990s, Ludwig felt a more preventive approach was needed to remedy the mounting health problems that overweight children would face in the future.

“Our genes, though important, haven’t caused the epidemic—so we need to look to the environment for the answers,” he says. Full story »

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Boston Globe comments on state intervention for morbidly obese children

by Tripp Underwood on July 25, 2011

Headlines like “Should Parents Lose Custody of Super-Obese Kids?’’ and “The War on Bad Parenting” conjure up some pretty strong mental images. Outrage and fear may sell newspapers and attract web traffic, but according to Boston Globe columnist Joanna Weiss, sensationalist journalism can also detract from the issues at hand.

“Maybe we tune out the headlines and the fear-mongering and find a way to talk about health issues quietly, one on one,” she wrote in an Op-Ed piece in Sunday’s Boston Globe, commenting on the explosive media coverage of a recent article in the Journal of the American Medical Association (JAMA). The controversial piece, written by David Ludwig, MD, PhD, director of the Optimal Weight for Life (OWL) Program at Children’s Hospital Boston, argues that life-threatening obesity—where a child’s body mass index (BMI) is beyond the 99 percentile and multiple attempts to help the child lose weight have failed—could call for state intervention, and in extreme cases foster care.

The following is an excerpt from Weiss’s editorial, including quotes from an interview she conducted with Ludwig after the JAMA commentary first attracted attention.

“Most people would be horrified if a child were systematically underfed, began to starve, and the state refused to help,’’ Ludwig said. “Why is that fundamentally different from a child who is so overfed that their life is now in danger?’’

It’s a reasonable question, but those have become increasingly hard to ask; you can’t suggest a modest solution to the obesity epidemic without facing a fiery backlash. People howl when Michelle Obama suggests they should eat more vegetables. They cry “nanny state’’ when Mayor Menino bans sugary drinks from vending machines.

And if we can’t agree on small steps, what do we do about these rare, extreme cases when a child’s life is at stake?

To read the full article, please click here.

Full story »

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