Q&A with Dr. Julie Lumeng

Published: October 2, 2019

This Friday, the 4th annual Philip R. Nader Legacy of Health Lectureship will take place at the UTHealth School of Public Health in Houston, Texas. The goal of this lectureship is to provide a place where multi-disciplinary collaboration is welcomed in order to mobilize communities to address chronic disease, especially in younger populations. This year’s keynote address comes from Dr. Julie Lumeng, the Director for the Center for Human Growth and Development at the University of Michigan. In her lecture, Dr. Lumeng will address topics surrounding childhood obesity, psychosocial factors of chronic disease, and public health.

On top of her work at the CHGD, Dr. Lumeng is also a professor in both the Department of Pediatrics and the Department of Nutritional Sciences at U of M. She is the Thomas P. Borders Family Research Professor of Child Behavior and Development, and serves as a reviewer and editor for many peer-reviewed journals, including but not limited to Appetite, the American Journal of Epidemiology, and JAMA (the Journal of the American Medical Association). Before her lecture this weekend, we reached out to Dr. Lumeng to have her answer some questions she might not be able address directly during her talk. Keep reading to learn more!

How did your interest in public health begin? Relatedly, what path did your research take? Did you always think you’d be studying pediatric nutritional patterns and eating behaviors?

I have always enjoyed writing, analytic thinking, and creative problem solving. I also enjoy working with teams of people to solve problems. I decided to go to medical school because it seemed likely to offer a life that integrated helping people with the opportunity to tackle some of society’s most challenging problems. I was drawn to pediatrics because witnessing the parent-child relationship in action was extremely compelling to me, and I was motivated by the opportunity to help children and their parents in ways that could impact well-being for years to come. One night while working the overnight shift in the emergency room as a pediatric resident, there was a lull in patients. I opened the journal Pediatrics at 3am and came across a now classic article on the development of eating behavior in childhood. I found it so fascinating. At the time, the childhood obesity epidemic was starting to receive a great deal of attention. Obesity runs in my family and I have witnessed the struggles with obesity in my family throughout my life. I started doing research on this topic as a fellow in developmental and behavioral pediatrics and just have never stopped. With teams of people from other disciplines, we are always coming up with new questions that I think are really interesting and that if we could answer them, maybe we could make a real difference in people’s lives. 

What large-scale public health problems do you see in Michigan? Are they similar or different to what the nation as a whole sees, on average? 

As with most states in the nation, we see many challenges with obesity among children and families in our state. Michigan in particular took a substantial hit during the economic downturn 10 years ago and its impact on the auto industry. The Flint water crisis has also been a big public health challenge. The community has really struggled over the last 20 years as jobs have left the region. These psychosocial stressors have had a big impact on families. In some sense, Michigan is a microcosm of the challenges we face as a nation.

How do you encourage health promotion and increasing health literacy in the work you do?

One of the issues I am extremely passionate about is preventing bias and stigma against individuals with overweight and obesity, and their parents. We know that once an adult has developed obesity, the likelihood that that adult can lose 10% of their body weight and keep it off is less than 5%.  When children develop overweight or obesity, society is very quick to judge parents as being at fault. Although certainly parenting is important, I believe there is a big biological component. I think there may be value to reframing how we think about childhood obesity to be similar to how we think about parenting other health conditions.  For example, when children have asthma or attention deficit hyperactivity disorder, we generally don’t frame the situation as those conditions being the parents’ fault or due to suboptimal parenting.  Instead, we think of these conditions as something the child was born with, and that the parent’s task is then to parent their child with these conditions to optimize the child’s health and well-being.  Similarly, I think some children are born with a very strong biological predisposition to obesity, and parents strive to do their best with promoting the child’s health and well-being in a very stigmatizing environment. In the 1950’s, medicine thought that autism was caused by poor mothering. Medicine and science tend to blame conditions we don’t understand on personal responsibility or poor parenting. Just as we now understand that autism has a biological basis, and we strive to support parents in their goals of parenting their child with autism, I think we need to be cautious as a field about attributing obesity to “poor parenting” when scientists are still struggling to understand the underlying mechanisms of behavior. In our work, we have found that most parents have internalized the pervasive public health messaging about nutrition and exercise, and that health literacy about obesity is less the problem than grappling with how to manage the stigma when a child is still overweight or obese despite usual “good parenting”.

Do you have a favorite research project that you’ve worked on, or one that stands out to you?

I have really enjoyed working on our ABC studies.  ABC stands for Appetite, Behavior, and Cortisol. Science knew that stress alters cortisol, and that cortisol increases appetite. We were interested in understanding whether, among populations experiencing psychosocial stress, if there could be a biological pathway linking psychosocial stress to weight gain – through cortisol and increased appetite, even in very young children.  We found some evidence for this, and also found the opposite direction – that there is some evidence that obesity predicts alterations in the biological stress response pathways. There is much additional work to be done in sorting out these relationships. 

Do you have any advice for those pursuing a career in nutrition, pediatrics, or public health?

I use as a constant refrain, “Maybe it is a disciplinary difference.” By that, I mean that sometimes people from different disciplinary backgrounds are talking about a problem using very different languages or lenses. I think it is so important to be patient in trying to understand those different lenses, even though it may take a little more time, because when we integrate those different lenses we can really make progress. I also feel strongly that people bring different cognitive strengths to a team – some people are really creative, some people are great organizers, some people are great analytically and with statistics, some are amazing writers with flawless spelling and grammar, and some have amazing insights into other people’s behavior.  Progress is made best when we can capture and engage each person’s unique strengths, and not worry about areas in which they may be weaker – because there are plenty of people at the table on a team who can compensate for that.  I also think it is so important to remember that for most of us, our work is funded by taxpayers or by donors to philanthropic causes. It is a tremendous privilege and responsibility to be a steward of those funds – ensuring those funds are used absolutely as well as possible to improve the human condition is the primary goal and drives our work every day. Finally, there was a fabulous quote on twitter recently, in which someone commented, “Don’t attempt to distinguish yourself by being smart. Distinguish yourself by being kind.” 

For more information about the Philip R. Nader Legacy of Health Lectureship or to register, please visit our website.