Effect of a Child Care Center-Based Obesity Prevention Program on Body Mass Index and Nutrition Practices Among Preschool-Aged Children

Abstract

This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group.

Obesity prevention interventions in early childhood education and care settings with parental involvement: a systematic review

“…Four studies addressed all seven targeted outcomes (De Coen et al, 2012;Natale et al, 2014;Puder et al, 2011;Story et al, 2012) in both the home and ECEC settings. Capacity building of centre staff and directors was a high priority in the majority of studies (Bayer et al, 2009;Bock et al, 2010;Cespedes et al, 2013;De Coen et al, 2012;de Silva-Sanigorski et al, 2011;Hu et al, 2010;Natale et al, 2014;Puder et al, 2011;Reilly et al, 2006;Story et al, 2012;Yin et al, 2012;Zask et al, 2012), and every parent received some form of educational material to read or interact with.…”

“…A table was also created to show the main outcome variables in each study (see Table 4). Fifteen studies were included from a number of high-and middle-income countries around the world including Australia (de Zask, Adams, Brooks, & Hughes, 2012), Switzerland (Puder et al, 2011), USA (Dennison, Russo, Burdick, & Jenkins, 2004;Fitzgibbon et al, 2005Fitzgibbon et al, , 2006Natale, Lopez-Mitnik, Uhlhorn, Asfour, & Messiah, 2014;Story et al, 2012;Yin et al, 2012), Belgium (De Coen et al, 2012), Germany (Bayer et al, 2009;Bock, Fischer, Hoffmann, & Renz-Polster, 2010), China (Hu et al, 2010), Columbia (Cespedes et al, 2013) and Scotland (Reilly et al, 2006). Two studies have multiple papers explaining the study Notes: 1, yes; 0, no; 0*, unable to determine.…”

“…One study was omitted due to its use of the same data from another study that is included (Burgi et al, 2012). Most studies were RCTs (Dennison et al, 2004;Fitzgibbon et al, 2005;Natale et al, 2014), several were cluster or group RCT (Fitzgibbon et al, 2006;Story et al, 2012) (Bayer et al, 2009;Bock et al, 2010;Cespedes et al, 2013;De Coen et al, 2012), with two studies defining their design as single blinded (Puder et al, 2011;Reilly et al, 2006). Three studies utilised a quasi-experimental design Yin et al, 2012;Zask et al, 2012).…”

“…and evaluation; one of these studies has different first authors (Adams, Zask, & Dietrich, 2009;Zask et al, 2012) and the other has the same first author (Natale et al, 2013(Natale et al, , 2014. The intervention with multiple papers and different first authors will be referenced using the paper with the evaluation data (Zask et al, 2012).…”

Increasing water intake in pre-school children with unhealthy drinking habits: A year-long controlled longitudinal field experiment assessing the impact of information, water affordance, and social regulation

“…Based on the recruitment timing and research budget, the final recruited sample reached 439 children. This sample size is comparable to other recent nutritional intervention trials aiming to prevent obesity in similar-aged children which also used a multi-component approach combining environmental, educational, and parental aspects and included aspects on water intake (Natale, Lopez-Mitnik, Uhlhorn, Asfour, & Messiah, 2014;Story, et al, 2012). Natale et al aimed to examine the effect of an early childhood obesity prevention program on changes in BMI z-score and nutrition practices over 6 months in 307 children aged 2 to 5 years.…”