Stories about: David Ludwig

Low-carb diets make us burn more calories, finds largest, longest feeding trial to date

Low carb diet helps us burn calories faster, supporting the Carbohydrate-Insulin Model of obesity
Supporting the Carbohydrate-Insulin Model of obesity, a new study finds that low-carb diets increase our energy expenditure.

Most people who diet to lose weight regain the pounds within a year or two, in part because the body adapts by slowing down metabolism and burning fewer calories. A new study known as the Framingham State Food Study, or (FS)2, suggests that low-carb diets can help people keep the weight off, showing that eating fewer carbohydrates increases the number of calories burned. The findings, published today in the BMJ, could help make obesity treatment more effective.

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Very-low-carb diet can safely curb blood sugar in type 1 diabetes, study suggests

very-low-carb diet shows promise in type 1 diabetes

David Ludwig, MD, PhD, an endocrinologist at Boston Children’s Hospital, has written popular books espousing a low-glycemic, low-carbohydrate diet for weight control. He has argued that high-glycemic diets are contributing to the epidemic of type 2 diabetes.  But he hadn’t given much thought to carbohydrate restriction for type 1 diabetes until 2016.

At a conference, Ludwig met a surgeon with type 1 diabetes who maintains normal hemoglobin A1c levels (indicating high blood sugar control) on a very-low-carbohydrate diet. This surprised and impressed him: he had never seen any patient with type 1 diabetes able to completely normalize their hemoglobin A1cs. Moreover, most diabetes experts discourage very-low-carb diets, believing they pose a risk for hypoglycemia, or a dangerous drop in blood sugar.

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News Note: More evidence that high-glycemic diets cause obesity

a high-glycemic diet

A large genetic analysis lends credence to the idea that insulin spikes after eating high-glycemic foods promote weight gain. People genetically predisposed to produce higher than normal levels of insulin after eating processed carbohydrates — “bad carbs” like white bread, potatoes and refined sugar — were more likely to be obese, the study found.

The researchers, led by David Ludwig, MD, PhD, of Boston Children’s Hospital, Joel Hirschhorn, MD, PhD, of Boston Children’s and the Broad Institute, and Jose Florez, MD, PhD, of the Broad Institute and Massachusetts General Hospital, tapped a collection of large-scale genome-wide association studies. Analyzing data from more than 26,000 people who had glucose challenges, they identified genetic variants linked with high insulin levels 30 minutes after the challenge.

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Q+A: The economic case for obesity treatment

medical costsCan putting a price tag on childhood obesity propel treatment and prevention efforts into comprehensive action? Perhaps, says David Ludwig, MD, PhD, of Boston Children’s Hospital.

Although the U.S. Task Force on Childhood Obesity set a goal of dropping obesity prevalence among youth to 5 percent by 2030, efforts have failed to make a significant dent. Recent data indicate only slight dips in obesity prevalence among 6- to 19-year-olds in some states. And other data show that the prevalence of extreme obesity in children continues to rise.

With nearly 20 percent of U.S. children tipping the scales as obese, policymakers need not only to act but also to justify the investment in childhood obesity treatment and prevention programs.

Duke University researchers offered a helping hand in a review article in the April 7 online Pediatrics, estimating the incremental lifetime direct medical cost of childhood obesity. Their economic model showed a $19,000 incremental lifetime medical cost of an obese child relative to a normal-weight youth.

Ludwig, who directs the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital, provides insights into the next steps.

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Preschool obesity is down, but Feds need to do more

Young child on scale ShutterstockThe scales may not be tipping up quite so precipitously for some low-income preschoolers. So says a recent report from the Centers for Disease Control and Prevention (CDC). Bucking the previous trend, 19 states saw small decreases in obesity rates among preschoolers between 2008 and 2011, while rates held steady in another 20 states. Is this cause for celebration, cautious optimism or concern?

Perhaps all of the above, says David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital. “The report is a small, but encouraging, sign after nearly half a century of bad news.”

The latest data, along with several other reports, are raising hopes that the era of continually rising obesity rates may be drawing to a close. But most epidemics aren’t halted by a small crook in the prevalence curve. In fact, containing the obesity curve will require more muscle from federal decision makers, Ludwig contends.

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For overweight adolescents, health begins at home

(Flickr/Anonymous Account)
(Flickr/Anonymous Account)

This post is third in a series on obesity. Read last week’s posts on food addiction and what it means to define obesity as a disease.

The goal of any community health intervention is for individuals to achieve daily lifestyle goals in a way that realistically takes into account their cultural backgrounds, neighborhoods, families and home lives. For overweight or obese adolescents, these intimate surroundings play a pivotal role in allowing healthful behaviors to take root.

Research teams at Boston Children’s Hospital and suburban affiliate Wareham Pediatrics are conducting a study that lets adolescents collaborate with their doctors online to improve their weight. Videoconferencing technology, provided by Boston Children’s Telehealth Program, brings services directly to subjects in their homes.

“We’re bringing high-quality interventions directly to kids in the community where they live and simultaneously learning about the community itself,” says Cara Ebbeling, PhD, associate director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, and one of the leading researchers. “For example, we are looking at what grocery stores are located in the community and what opportunities exist for physical activity.”

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This is your brain on a high-glycemic diet

Are sugary foods fueling addiction?(Incase/Flickr)
Are sugary foods fueling addiction?(Incase/Flickr)

Is there such a thing as food addiction? A study using brain imaging suggests that high-glycemic foods may trigger the same brain mechanism tied to substance addiction.

A team led by David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, found that consuming highly processed, rapidly digested carbohydrates can cause excess hunger and stimulate brain regions involved in reward and cravings. These findings suggest that limiting such “high-glycemic index” foods could help obese individuals avoid overeating.

Published this week in The American Journal of Clinical Nutrition, the study investigated how food intake is regulated by dopamine-containing pleasure centers of the brain.

“Beyond reward and craving, this part of the brain is also linked to substance abuse and dependence, which raises the question as to whether certain foods might be addictive,” says Ludwig.

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Eating for two, the low-glycemic way

Low-GL food pyramid

When a woman goes into pregnancy already carrying excess weight, she’s at particular risk for metabolic and hormonal abnormalities that boost her odds for diabetes, preterm delivery and, ultimately, cardiovascular disease. And increasing evidence suggests that obesity creates a toxic in-utero environment that increases the baby’s birth weight and affects its development and future health.

So a big focus for obstetricians is to minimize weight gain during the pregnancy. Now, a small but intriguing randomized trial suggests that a low-glycemic-load diet is the best way to do that.

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