Impact of an early-life intervention on the nutrition behaviors of 2-y-old children: a randomized controlled trial

Fangupo, Louise J.; Heath, Anne‐Louise M; Williams, Sheila; Somerville, Megan R; Lawrence, Julie; Gray, Andrew; Taylor, Barry; Mills, Virginia C; Watson, Emily O.; Galland, Barbara; Sayers, Rachel; Hanna, Maha; Taylor, Rachael W.

doi:10.3945/ajcn.115.111823

Cited by 50 publications

(83 citation statements)

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“…We have previously reported that there were no differences in food and nutrient intake at 24 months. 20 There were a few differences in activity-related behaviors: children in the FAB and combination groups spent more time active outside than the control group at 12 months (both, P ≤ .022), and the amount of time spent watching television was lower in the FAB (P = .014) and combination (P < .001) groups compared with the control group at 6 months.…”

Section: Resultsmentioning

confidence: 88%

“…18 Dietary intake was assessed by using a validated food frequency questionnaire 26 at 12 and 24 months. 20 Parents indicated how many minutes per week their child spent playing actively outside and inside and watching television at multiple time points. Sleep duration was assessed according to questionnaire responses (parents indicated bed and wake times) and accelerometric findings (24 months only).…”

Section: Discussionmentioning

confidence: 99%

“…However, the high prevalence of overweight and obesity in young New Zealand children (29.6% at 2-4 years of age) 17 illustrates the urgent need for additional assistance over and above well-child care. Why it appears to be so difficult to influence nutrition 20 or activity 34 behaviors at this age is uncertain, but other health priorities such as infant crying 35 and sleep problems 36 may take precedence for parents. It is also well recognized that parents underestimate their child's weight status, 37 particularly during infancy, 38 a time when weight gain is often equated with good parenting.…”

Section: Discussionmentioning

confidence: 99%

“…19 Families in the intervention groups received additional guidance and support ( Fig 1). Those in the FAB group received 8 parent contacts, 20 including 3 from an international board-certified lactation consultant promoting breastfeeding and delaying the introduction of solids until 6 months. 21 Trained researchers (nurses, dietitians, and nutrition graduates) discussed with parents (predominantly mothers) nutrition behaviors believed to affect weight in face-to-face individual sessions at 7, 13, and 18 months of age.…”

Section: Methodsmentioning

confidence: 99%

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Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT

et al. 2017

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The few existing early-life obesity prevention initiatives have concentrated on nutrition and physical activity, with little examination of sleep. METHODS:This community-based, randomized controlled trial allocated 802 pregnant women (≥16 years, <34 weeks' gestation) to: control, FAB (food, activity, and breastfeeding), sleep, or combination (both interventions) groups. All groups received standard well-child care. FAB participants received additional support (8 contacts) promoting breastfeeding, healthy eating, and physical activity (antenatal-18 months). Sleep participants received 2 sessions (antenatal, 3 weeks) targeting prevention of sleep problems, as well as a sleep treatment program if requested (6-24 months). Combination participants received both interventions (9 contacts). BMI was measured at 24 months by researchers blinded to group allocation, and secondary outcomes (diet, physical activity, sleep) were assessed by using a questionnaire or accelerometry at multiple time points. RESULTS:At 2 years, 686 women remained in the study (86%). No significant intervention effect was observed for BMI at 24 months (P = .086), but there was an overall group effect for the prevalence of obesity (P = .027). Exploratory analyses found a protective effect for obesity among those receiving the "sleep intervention" (sleep and combination compared with FAB and control: odds ratio, 0.54 [95% confidence interval, 0.35-0.82]). No effect was observed for the "FAB intervention" (FAB and combination compared with sleep and control: odds ratio, 1.20 [95% confidence interval, 0.80-1.81]). CONCLUSIONS:A well-developed food and activity intervention did not seem to affect children's weight status. However, further research on more intensive or longer running sleep interventions is warranted. Departments of a the Dean, Dunedin School of Medicine, b Preventive and Social Medicine, c Women's and Children's Health, d Human Nutrition, and e Medicine, University of Otago, Dunedin, New ZealandProf B Taylor is the co-principal investigator of the Prevention of Overweight in Infancy (POI) study, contributed to study design, co-led the sleep intervention, co-wrote the manuscript, and directed the statistical analyses; Mr Gray contributed to study design, designed and completed all statistical analyses, and wrote the relevant sections of the manuscript; Dr Galland contributed to study design, co-led the sleep intervention, and reviewed and revised the manuscript; Dr Heath contributed to study design, co-led the FAB (food, activity, and breastfeeding) intervention, and reviewed and revised the manuscript; Dr Lawrence contributed to study design, coordinated and led the management of the study, and reviewed and revised the manuscript; Ms Sayers delivered the sleep intervention, and reviewed and revised the manuscript; Drs Cameron, Hanna, and Dale contributed to data collection, and reviewed and revised the manuscript; Dr Coppell contributed to study design, and reviewed and revised the manuscript; and Prof R Taylor is the co-principal inves...

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Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT

et al. 2017

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“…117 Like the Australian trials, the POI trial improved infant feeding practices but had limited impact on child intake and BMI at 2 years of age. 193,194 Eating meals within a family meal setting, reducing screen time, being physically active and achieving adequate sleep (also associated with feeding 131,156 ) are also important determinates of childhood obesity 68 and have been considered in some of the obesity prevention interventions. 195 many early childhood obesity prevention interventions lack these guiding frameworks.…”

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confidence: 99%

Reducing childhood obesity: opportunities to influence transitional infant feeding

Harrison¹

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Capacity for Regulation of Energy Intake in Infancy

et al. 2023

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ImportanceThe capacity for regulation of energy intake (REI) to match energy needs is thought to contribute to differences in weight gain, and preventing excess infant weight gain is a priority.ObjectiveTo determine capacity for REI across infancy.Design, Setting, and ParticipantsFor this cohort study, a convenience sample of mother-infant dyads was recruited from the community in Michigan between 2015 and 2019. Inclusion criteria were healthy, full-term infants with weight appropriate for gestational age; biological mothers who were 18 years or older, English speaking, and a legal and custodial guardian; and infant having had consumed 2 oz or more in 1 feeding from an artificial nipple at least once per week. Infants were followed in the home setting with staff support for up to 12 months.InterventionsMother-infant dyads participated at infant age 1, 2.5, 5, 7, 10, and 12 months. In the intervention condition, mothers offered a feeding every hour for 6 hours. In the control condition, mothers fed infants as they typically would for 6 hours. Intake was recorded and kilocalories calculated.Main Outcomes and MeasuresCapacity for REI was indexed as the difference in intake in kilocalories per kilogram of body weight (intervention minus control condition); a value of 0 indicated perfect REI. Maternal and infant characteristics were obtained by questionnaire, and anthropometry was measured. Using multiple imputation, the intercept and slope for difference in kilocalories per kilogram across the 6 age points were estimated using mixed models accounting for repeated measures within participants. Statistical analyses were conducted between September 2021 and February 2023.ResultsThe sample included 175 infants (87 [49.71%] female, 88 [50.29%] male; 494 pairs of intervention and control conditions and 4630 feedings). The mean (SD) 12-month weight-for-age z score was 0.1 (0.8). Mean (SD) gestational age as 39.55 (1.05) weeks, and mean (SD) birth weight was 3.43 (0.41) kg. Mean (SD) breastfeeding duration for those who reported stopping by 12 months was 17.83 (12.03) weeks. As designed, the intervention (compared with control) condition included more feedings at shorter intervals. After collapsing the data across age points in a mixed model accounting for repeated measures within participants, the REI estimate at 1 month differed from 0. On average, infants ate 5.21 kcal/kg (95% CI, 2.89-7.54 kcal/kg) more in the frequent feeding intervention condition than in the ad lib feeding control condition. This difference did not significantly change over 12 months of infancy (REI slope = −0.01 kcal/kg per month; 95% CI, −0.02 to 0.03 kcal/kg per month).Conclusions and RelevanceThe study’s findings suggested that, on average, when offered more frequent feedings, healthy, full-term infants may overeat. The results provide support for responsive feeding as a strategy for preventing excess infant weight gain.

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Impact of an early-life intervention on the nutrition behaviors of 2-y-old children: a randomized controlled trial

Abstract: Additional education and support for parents from birth did not improve nutrition behaviors in this population at 2 y of age. This trial was registered at clinicaltrials.gov as NCT00892983.

Cited by 50 publications

References 39 publications

Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT

Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT

Reducing childhood obesity: opportunities to influence transitional infant feeding

Capacity for Regulation of Energy Intake in Infancy

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