Long-Term Effects of Childhood Obesity Prevention Program | Journal Scan

Study Questions:

Can a home-based early intervention to prevent elevated body mass index (BMI) in children be effective in the long-term?

Methods:

The present study examined long-term outcomes of a home-based intervention on children’s BMI among participants of the Healthy Beginnings Trial. This trial was conducted between March 2011 and June 2014, in 465 mothers who consented to follow-up at 3 years after the intervention, when their children were 5 years old. Participants were from economically disadvantaged areas of Sydney, Australia. The original intervention included home visits from community nurses at 8 time points (antenatal period and 1, 3, 5, 9, 12, 18, and 24 months after birth). No further visits were performed after that. The primary outcomes of interest were the children’s BMI and BMI z score. Secondary outcomes included dietary behaviors, quality of life, physical activity, and TV viewing time of children and their mothers.

Results:

A total of 369 mother/child participants were included in the follow-up study, for a completion rate of 80.9% for the intervention group and 77.7% for the control group. At age 2 years, the difference (intervention minus control) in BMI (calculated as weight in kilograms divided by height in meters squared) was −0.41 (95% confidence interval [CI], −0.71 to −0.10; p = 0.009). At 5 years, the difference between the intervention group and control group was similar and not significant (0.03 [95% CI, −0.30 to 0.37]). In terms of secondary outcomes, the intervention group and the control group were similar for dietary behaviors, quality of life, physical activity, and TV viewing time at 5 years.

Conclusions:

The investigators concluded that an early life home-visit intervention did not influence childhood BMI in the long-term. Obesity programs are recommended to continue during childhood to be effective in prevention of obesity.

Perspective:

The investigators are to be congratulated for looking at long-term outcomes. These findings highlight the need for research related to long-term sustainable interventions. Determining whether brief ongoing visits or use of other types of interventions would be effective in maintaining a healthy BMI for this population needs to be examined.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Diet

Keywords: Body Mass Index, Body Weight, Child, Diet, Early Intervention (Education), House Calls, Metabolic Syndrome X, Mothers, Motor Activity, Obesity, Parturition, Primary Prevention, Quality of Life, Control Groups, Follow-Up Studies


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