Louise A Baur, Professor of Pediatrics and Child Health at the University of Sydney’s Medical School in Australia presented one of the world’s first studies that examined obesity risk factors in very young children at the 19th European Congress on Obesity in Lyon, France.
The study demonstrated that mothers were able to reduce their child’s body-mass index (BMI), TV-viewing time and improve their child’s vegetable intake by the age of 2 years by participating in a nurse-led, home-based intervention.
In light of the well known fact that people in socially and economically disadvantaged parts of developed countries have a higher risk of obesity, and given that only few early childhood obesity prevention programs have been evaluated so far, the researchers decided to conduct a randomized controlled trial, called “Healthy Beginnings” in disadvantaged parts of Sydney between 2007 and 2010 and recruited a total of 667 first-time mothers and their infants.
The mothers and infants were split equally into an intervention and control group. Those in the intervention received eight home visits from specially trained community nurses who delivered a staged home-based intervention that started during the antenatal period, with the remaining seven to follow at 1, 3, 5, 9, 12, 18 and 24 months after the child was born, whilst those in the control group received no home visits. The timing of the visits was designed to coincide with early childhood developmental milestones, for instance introducing solid foods and transition to family meals.
The primary outcomes were determined as the children’s BMI, infant feeding practices, and TV viewing time at the age of 2 years. The BMI was established by the community nurses, whilst the mothers of the children self-measured the other outcomes.
The researchers observed at the 12-month follow-up that the children in the intervention group were breastfed for a considerably longer amount of time and were also introduced to solids later as compared with those in the control group. At 24 months, the children in the intervention group showed a substantial improvement in vegetable consumption and in food not being used as a reward, as well as less TV viewing time. The average BMI was also considerably lower in the intervention group with 16.49 kg/m2 compared to 16.87 kg/m2 in the control group, a reduction of 0.38 kg/m2.
The researchers conclude:
“The home-based early intervention delivered by trained community nurses significantly reduced mean BMI and TV viewing time and improved vegetable intake for children at age 2 years.”
Professor Baur adds:
“Obesity is a major public health problem in many countries, and this is associated with a rise in overweight and obesity in children in the preschool age group. A sizeable minority of children in westernized countries is already affected by the time they start school. This highlights the importance of having effective obesity prevention programs in place early in life. But we need good evidence as to what sort of prevention programs work at this stage of life, especially in those who are most vulnerable for excess weight gain.”
At present, the researchers are conducting a follow-up of the children and their families who participated in the Healthy Beginnings Trial until the children are 5 years old. The team is working in collaboration with other teams who are conducting three other early intervention trials in Australia and New Zealand so the data of all four separate trials can be combined.
Written By Petra Rattue