Preventing Obesity during Infancy: A Pilot Study

Paul, Ian M.; Savage, Jennifer S.; Anzman, Stephanie L.; Beiler, Jessica S.; Marini, Michele; Stokes, Jennifer L.; Birch, Leann L.

doi:10.1038/oby.2010.182

Cited by 221 publications

(272 citation statements)

References 64 publications

(63 reference statements)

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“…All targeted first-time mothers. Paul et al 49 reported a significant effect on weight-for-length percentiles at 12 months of age (33rd vs 50th, retention 69%; n = 22 vs 30) of an intervention comprising 3 nurse home visits targeting soothing strategies and process of solid introduction. Two other large Australian trials 47,48 have reported outcomes at ∼2 years of age.…”

Section: Figurementioning

confidence: 99%

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An Early Feeding Practices Intervention for Obesity Prevention

et al. 2015

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OBJECTIVE: Report long-term outcomes of the NOURISH randomized controlled trial (RCT), which evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on "protective" complementary feeding practices that were hypothesized to reduce childhood obesity risk. METHODS:The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed 5 times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear mixed models evaluated intervention (group) effect across time.RESULTS: Retention at age 5 years was 61%. Across ages 2 to 5 years, intervention mothers reported less frequent use of nonresponsive feeding practices on 6 of 9 scales. At 5 years, they also reported more appropriate responses to food refusal on 7 of 12 items (Ps # .05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P = .06) or the prevalence of overweight/obesity (control 13.3% vs intervention 11.4%, P = .66).CONCLUSIONS: Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to 5 years of age and were paralleled by a nonsignificant trend for lower child BMI Z-scores at all postintervention assessment points.WHAT'S KNOWN ON THIS SUBJECT: "Protective" complementary feeding practices that promote self-regulation of intake and development of healthy food preferences have been positively associated with healthy child eating patterns and growth. There are few high-quality trials evaluating feeding practice interventions; none has reported long-term outcomes. WHAT THIS STUDY ADDS:This large randomized controlled trial demonstrates that anticipatory guidance on the "how" of complementary feeding resulted in more protective feeding practices. These intervention effects were sustained for 3 years and translated into commensurate trends in obesity risk. Dr Daniels conceived the study; led the design, successful funding applications, and overall implementation of the study; and wrote the first draft of the paper; Dr Mallan undertook the statistical analysis and drafted the Results and Methods sections; Dr Nicholson contributed to funding applications, intervention development, and design of outcome assessments; Dr Thorpe contributed to funding application and measure development; Dr Nambiar coordinated study implementation and contributed to data collection and entry; Ms Mauch contributed to the design and delivery of the intervention modules and data collection; Dr Magarey contributed to the design, funding applications, developme...

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Section: Figurementioning

confidence: 99%

“…Since the Ciampa review, 24 only 3 [47][48][49] RCTs have reported weight status after an obesity prevention intervention commencing in infancy. All targeted first-time mothers.…”

Section: Figurementioning

confidence: 99%

An Early Feeding Practices Intervention for Obesity Prevention

et al. 2015

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“…This focus for obesity prevention has gained considerable currency since this study commenced, with 1 published protocol, 28 2 pilot studies, 29,30 and 1 additional RCT published. 31 Data from the pilots and RCTs, targeting mothers and infants ,6 months of age, provide additional support for a focus on early childhood with 1 nonrandomized trial (n = 80) reporting a trend to reductions in television viewing 30 and another (n = 110) reporting a lower weight-forlength percentile in intervention children (P = .009).…”

Section: 14)mentioning

confidence: 99%

“…31 Data from the pilots and RCTs, targeting mothers and infants ,6 months of age, provide additional support for a focus on early childhood with 1 nonrandomized trial (n = 80) reporting a trend to reductions in television viewing 30 and another (n = 110) reporting a lower weight-forlength percentile in intervention children (P = .009). 29 Wen' s RCT intensive home visiting intervention 31 targeting families living in socially and economically disadvantaged areas of Sydney, Australia (n = 667), reports lower BMI and improvements in some obesitypromoting behaviors at age 2 years in the intervention compared with the control group. The previously mentioned RCT in a Cochrane review 4 (n = 43) reported evidence of lower child energy intake in the intervention group (P = .06) but no differences in BMI.…”

Section: 14)mentioning

confidence: 99%

A Parent-Focused Intervention to Reduce Infant Obesity Risk Behaviors: A Randomized Trial

Campbell¹,

Lioret²,

McNaughton³

et al. 2013

Pediatrics

238

375

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WHAT'S KNOWN ON THIS SUBJECT: While obesity-promoting eating, sedentary and physical activity behaviors, and increased prevalence of adiposity are evident from early life, few highquality studies have evaluated interventions that seek to influence the development of these behaviors in very early childhood. WHAT THIS STUDY ADDS:This study highlights the receptivity of first-time parents to interventions focused on their new infant' s eating and active play and provides evidence of effectiveness on some obesity-promoting behaviors in very early childhood. abstract OBJECTIVE: To assess the effectiveness of a parent-focused intervention on infants' obesity-risk behaviors and BMI.METHODS: This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitiandelivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes; all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 3 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age. RESULTS:Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = -4.45; 95% confidence interval [CI]: -7.92 to -0.99; P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48; 95% CI: 0.24 to 0.95; P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = -3.69; 95% CI: -6.41 to -0.96; P = .008) and viewed fewer daily minutes of television (mean difference = -15.97: 95% CI: -25.97 to -5.96; P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity.

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“…While Guidelines knowledge in this study was related to the delay in the introduction of solids, the use of 'food to soothe' infant distress and promote sleep and growth is prominent in the literature, and another key modifiable obesity risk factor to address. 133,134,203,[293][294][295] Fruit and vegetable intake are fundamental indicators of a healthy diet and early exposure during infancy is associated with higher intakes during childhood. 179 Our findings that both feeding confidence and maternal self-efficacy directly affected infant fruit and vegetable intake builds on the limited studies on this relationship.…”

Section: Discussionmentioning

confidence: 99%

Reducing childhood obesity: opportunities to influence transitional infant feeding

Harrison¹

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Preventing Obesity during Infancy: A Pilot Study

Cited by 221 publications

References 64 publications

An Early Feeding Practices Intervention for Obesity Prevention

An Early Feeding Practices Intervention for Obesity Prevention

A Parent-Focused Intervention to Reduce Infant Obesity Risk Behaviors: A Randomized Trial

Reducing childhood obesity: opportunities to influence transitional infant feeding

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