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David Ludwig

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.

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Should the state intervene on behalf of morbidly obese children?

by Tripp Underwood on July 13, 2011

When we think of child abuse and neglect, we think of burns and bruises and children left unattended. We don’t think of obesity. But maybe, in some cases, we should.

In a recent commentary in the Journal of the American Medical Association (JAMA), 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.

Children in this highest BMI category are at great risk for many serious health complications. We all know that childhood obesity can lead to life-long health complications, but in extreme cases it can be life-threatening in the short term. For example, type 2 diabetes, which is being seen in younger and younger patients as the childhood obesity epidemic continues, can cause very serious complications and even be fatal. Sleep apnea, which often occurs in obese children, can lead to very dangerous heart problems.

Because of these dangers Ludwig says the most severe instances of childhood obesity may justify a child’s removal from the home because of imminent health risks to the child and the parents’ continued failure to address those problems. Full story »

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AAP comes out strongly against sugary sports drinks

by Claire McCarthy on June 1, 2011

David Ludwig, MD, PhD, director of the Boston Children's/New Balance Foundation Center for Obesity Prevention.

The American Academy of Pediatrics (AAP) sent a strongly worded message to parents this week: your children should not drink sports drinks or energy drinks.

The ads for these drinks are full of athletes exercising and the message is clear: sports drinks will help us be faster and stronger. More than that, the message is that we need them for exercise, because they replace the fluid we lose in sweat. “Energy and sports drinks are marketed in a way that imbues them with a healthy halo,” says David Ludwig, MD, PhD, director of the New Balance Center for Obesity Prevention at Children’s Hospital Boston.

“Over the last decade, many studies have highlighted the adverse effects of the traditional sugar-sweetened soda,” says Ludwig. With declining consumption rates of these drinks, the food industry has tried to create a submarket of alternative beverages. Sports drinks are still sugar-sweetened, but they typically have about 25 percent less sugar and some electrolytes. Full story »

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Parade.com talks healthy eating

by Tripp Underwood on April 11, 2011

It’s no secret that most kids aren’t exactly crazy about healthy eating. Many growing taste buds prefer pizza to carrots, leaving plenty of parents and educators at a loss for how to get the children in their lives to eat better. From hip marketing campaigns to health food product placement— not too mention good, old-fashioned trickery— there are plenty of way to try to get kids to eat right, but there isn’t a sure fire method that’s proven to work.

To help parents in their quest for healthier kids, David Ludwig, MD, PhD, director of Children’s Hospital Boston’s Optimal Weight for Life program, recently spoke with Parade magazine, offering practical advice on ways parents can drive home the importance of a well balanced diet. Here’s an excerpt:

“Young children are like ducks: They do what their parents do,” says Harvard endocrinologist Dr. David Ludwig, director of the Optimal Weight for Life program at Children’s Hospital Boston. If you eat junk food instead of fruits and vegetables, they will too.”

A University of Tennessee study reports that mothers usually refrain from offering babies foods they themselves dislike—so if you hate fava beans, chances are that your child has never tried them. Still, says Dr. Ludwig, it’s never too late to become a good role model. Explain to children that real foods—like fruits, vegetables, nuts, berries, beans, fish and meat—come from nature. Dr. Ludwig recommends that obese children keep food diaries, recording all of the sugary drinks and factory-processed junk foods they eat in a day. They’ll be astonished at how many they consume. Kids may moan, but they’ll get hungry and learn to replace cheese puffs with low-fat cheese.

For great advice on other ways parents can make healthy eating easier, check out the entire article here.

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Children’s in the news

by Tripp Underwood on February 12, 2011

Susanah Huh, MD, MPH

Children’s Susanna Huh, MD, MPH, speaks with ABC News about a new study she co-authored that published in Pediatrics that found infants raised on formula who are fed solid foods before they are 4 months old have a six times higher risk of becoming obese by age 3 than those starting later. The study found no association between the timing of solid-food introduction and obesity in breast-fed infants. Star Telegram, The Washington Post’s “The CheckUp” Blog, NPR, CBSNews.com and The Los Angeles Times also reported on Huh’s findings.

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Restaurant Nutrition Draws Focus of First Lady

The New York Times reports that a team of advisors for First Lady Michelle Obama has been holding private talks over the past year with the National Restaurant Association in a bid to get restaurants to adopt her goals of smaller portions and children’s meals that include healthy offerings like carrots, apple slices and milk instead of French fries and soda. Children’s David Ludwig, MD, PhD, speaks about the importance of being vigilant when forming partnerships with the food industry and whether the food industry can play a responsible role in the obesity epidemic.

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In the battle against childhood obesity, start young(er than you think)

by Claire McCarthy on February 8, 2011

Dr. Claire McCarthy is a primary care physician and the Medical Communications Editor at Children’s Hospital Boston. Along with her blogs here on Thriving, you can find her at the Huffington Post and Boston.com. Follow her on Twitter @drClaire.

Claire McCarthy, MD

We all know that prevention is the best way to deal with any public health problem. With obesity being an increasingly, um, huge problem in our society, we need to do everything we can to prevent it. And to do so we need to start in—infancy?

That’s the message in the study by Children’s Hospital Boston researchers in this week’s journal Pediatrics. As described yesterday in Tripp Underwood’s Thrive post, the study, led by Susanna Huh, MD, MPH, and Sheryl Rifas-Shiman, MPH, showed that when parents of formula-fed infants started solid foods before 4 months of age, the infants were six times more likely to be obese at age 3.

Why do we care? Three is very far from adulthood. There’s still plenty of time to lose the baby fat. Right? Full story »

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Children’s in the news

by Tripp Underwood on February 5, 2011

Here at Children’s Hospital Boston, our staff prides itself on providing world-class care for every patient that comes through our doors. But when they’re not busy performing surgeries, setting bones or caring for patients, many of our clinicians are doing research that will shape the future of pediatrics, or discussing how those changes will impact everyday care for thousands of people. Here’s a quick round up of what Children’s employees have been discussing with the media this past week.

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A safer and earlier way to determine if a fetus has Down syndrome is being studied

An article in The Los Angeles Times discusses new technology soon to be available that will allow women to know early in their pregnancy whether they are carrying a fetus with Down syndrome. Children’s Brian Skotko, MD, MPP, speaks with the paper about the new tests – which are noninvasive and will pose fewer risks to the mother and fetus than current prenatal testing—and the questions they raise.

Dr. Skotko wrote a similar piece for Thrive last week and has opened a wide debate on the subject of prenatal testing.

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