The TrimTots programme for prevention and treatment of obesity in preschool children: evidence from two randomised controlled trials

Lanigan, Julie; Collins, Sarah; Birbara, Toni; Kokoreli, Maria; Singhal, Atul

doi:10.1016/s0140-6736(13)62483-6

Cited by 15 publications

(42 citation statements)

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“…35-37 There have been several studies published in the past 8 years specifically focusing on reduction of obesity in the preschool age group. 38-43 Most of these have been comprehensive, family-centered interventions which have demonstrated modest improvements in BMI that have been sustained over 12 months. Although family-based interventions (aimed at both children and their parents) are most common, some investigators have popularized an approach in which parents are the exclusive agents of change, thereby conserving the human resource required to intervene.…”

Section: Discussionmentioning

confidence: 99%

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children

Wald

Ewing

Moyer

et al. 2017

Clin Pediatr (Phila)

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This prospective, randomized, controlled trial for parents of overweight and obese 3- to 7-year-olds was performed to assess the feasibility of a program promoting healthy eating and lifestyle by targeting parents as agents of change. The intervention was composed of 6-in-person group sessions and a customized website over 12 months. The control group received customary care. The primary outcome was feasibility of the intervention to promote healthy behavior change measured by attendance. The secondary outcome was effectiveness assessed by attaining reduced body mass index (BMI) z scores, healthy behavior changes and increased parent self-efficacy. Seventy-three child-parent dyads were enrolled; 14 parents never attended any sessions. Participation in follow-up assessments did not meet the hypothesized level. Ultimate BMI z scores did not differ between control and intervention groups. Parenting skills did not improve in the intervention group. This intervention to achieve healthy lifestyle changes in children via their parents as "change agents" was unsuccessful.

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Section: Discussionmentioning

confidence: 99%

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children

Wald

Ewing

Moyer

et al. 2017

Clin Pediatr (Phila)

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“…The inconsistency of the conclusions may result from the variation in study characteristics (study population, age, gender, and sample size), study design, intervention duration, strategies, etc. For instance, the TrimTots programme, involving randomized controlled trials (RCTs) of PA interventions in preschool and primary school age children, indicated a significant reduction in obesity risk after a long term follow-up [ 28 ]; while the results from the ECLS-K study, an earlier childhood longitudinal study in primary school, demonstrated that physical education has no significant impact on BMI if the students had a normal weight/overweight status [ 29 ]. A recently published systematic review by the Cochrane Collaboration demonstrated the positive impact of school-based PA interventions on students’ behavior and on physical measurements [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of long-term school-based physical activity interventions on body mass index of primary school children – a meta-analysis of randomized controlled trials

et al. 2016

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BackgroundPhysical activity (PA) intervention is a commonly recommended strategy to combat childhood obesity. However, its effectiveness has long been controversial. This paper aims to examine the effectiveness of long-term (≥12 months) school-based PA interventions on body mass index (BMI) in primary school children, who are gaining BMI.MethodsOriginal papers were retrieved from PubMed, Google Scholar, the Cochrane Library and Web of Science, published between 1990 and 2015. The inclusion criteria were those research studies that were: randomized controlled trials (RCTs), conducted in primary school settings, had valid data on BMI at baseline and at the final follow up (or on BMI changes), and involved PA intervention that lasted for at least 12 months.ResultsOut of 11,158 potentially eligible articles, 18 papers were included in the analysis, involving 22,381 primary school children with intervention durations ranging from 12 to 72 months. Compared to the control groups, the BMI increment was 2.23 kg/m2 less in the intervention groups (p < 0.05). The heterogeneity was high across the studies (99.8 %), but declined after sub-group analyses. The intervention type, intervention duration, and weekly PA intervention time were among the factors leading to the heterogeneity.ConclusionLong-term school-based interventions containing PA as a core component appear to be effective in achieving healthier BMI. However, the results should be interpreted with caution due to the high heterogeneity among the studies. More high quality school-based RCTs among diverse populations are needed to improve the homogeneity and to yield a more robust conclusion.

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“…The National Institute for Health and Care Excellence recommends that interventions should include advice on achieving a healthy diet, encourage physical activity and incorporate strategies for behaviour change. However, there are currently no full reports and only one published abstract ( 94 ) of successful interventions for the prevention of obesity in preschool children that meet these guidelines in the UK. Multi-component interventions in other countries, based on similar guidance to the National Institute for Health and Care Excellence, have reported some success as reviewed by Ling et al ( 84 ) .…”

Section: Interventions In Preschool Childrenmentioning

confidence: 99%

“…BMI was lower in children after participation in the programme compared with baseline (mean difference in BMI z -score: −0·3, 95 % CI −0·6, −0·1, P = 0·007). In trial 2, BMI was lower in the intervention group compared with controls immediately following participation (mean difference in BMI z -score: −0·3; 95 % CI −0·8, 0·3, P = 0·3) ( 94 ) .…”

Section: Interventions In Preschool Childrenmentioning

confidence: 99%

Prevention of overweight and obesity in early life

Lanigan

2018

Proc. Nutr. Soc.

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Childhood obesity is a serious challenge for public health. The problem begins early with most excess childhood weight gained before starting school. In 2016, the WHO estimated that 41 million children under 5 were overweight or obese. Once established, obesity is difficult to reverse, likely to persist into adult life and is associated with increased risk of CVD, type 2 diabetes and certain cancers. Preventing obesity is therefore of high importance. However, its development is multi-factorial and prevention is a complex challenge. Modifiable lifestyle behaviours such as diet and physical activity are the most well-known determinants of obesity. More recently, early-life factors have emerged as key influencers of obesity in childhood. Understanding risk factors and how they interact is important to inform interventions that aim to prevent obesity in early childhood. Available evidence supports multi-component interventions as effective in obesity prevention. However, relatively few interventions are available in the UK and only one, TrimTots, has been evaluated in randomised controlled trials and shown to be effective at reducing obesity risk in preschool children (age 1-5 years). BMI was lower in children immediately after completing TrimTots compared with waiting list controls and this effect was sustained at long-term follow-up, 2 years after completion. Developing and evaluating complex interventions for obesity prevention is a challenge for clinicians and researchers. In addition, parents encounter barriers engaging with interventions. This review considers early-life risk factors for obesity, highlights evidence for preventative interventions and discusses barriers and facilitators to their success.

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The TrimTots programme for prevention and treatment of obesity in preschool children: evidence from two randomised controlled trials

Cited by 15 publications

References 0 publications

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children

The impact of long-term school-based physical activity interventions on body mass index of primary school children – a meta-analysis of randomized controlled trials

Prevention of overweight and obesity in early life

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