Interventions for Childhood Obesity in the First 1,000 Days A Systematic Review

Abstract

Context The “first 1,000 days”—conception through age 24 months—are critical for the development and prevention of childhood obesity. This study systematically reviews existing and ongoing interventions during this period, identifies gaps in current research, and discusses conceptual frameworks and opportunities for future interventions. Evidence acquisition PubMed, Embase, Web of Science, and Clinicaltrials.gov were searched to identify completed and ongoing interventions implemented during pregnancy through age 24 months that aimed to prevent overweight/obesity between age 6 months and 18 years. English-language, controlled interventions published between January 1, 1980, and December 12, 2014, were analyzed between December 13, 2014, and March 15, 2015. Evidence synthesis Of 34 completed studies from 26 unique identified interventions, nine were effective. Effective interventions focused on individual- or family-level behavior changes through home visits, individual counseling or group sessions in clinical settings, a combination of home and group visits in a community setting, and using hydrolyzed-protein formula. Protein-enriched formula increased childhood obesity risk. Forty-seven ongoing interventions were identified. Across completed and ongoing interventions, the majority target individual- or family-level changes, many are conducted in clinical settings, and few target early-life systems and policies that may impact childhood obesity. Conclusions Obesity interventions may have the greatest preventive effect if begun early in life. Yet, few effective interventions in the first 1,000 days exist and many target individual-level behaviors of parents and infants. Interventions that operate at systems levels and are grounded in salient conceptual frameworks hold promise for improving future models of early-life obesity prevention.

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

“…3 Although preschool initiatives have shown some success, 4 relatively few studies exist in children aged <2 years. 5 Three Australian studies have modified some obesity-related behaviors in toddlers and parents, 6 -8 but only 1 study has significantly affected BMI at 2 years of age. 6 Early-life obesity prevention has typically focused on encouraging healthy eating and increasing physical activity, with surprisingly inconsistent results, 4,5 thus prompting interest in assessing other behaviors (including sleep).…”

“…5 Three Australian studies have modified some obesity-related behaviors in toddlers and parents, 6 -8 but only 1 study has significantly affected BMI at 2 years of age. 6 Early-life obesity prevention has typically focused on encouraging healthy eating and increasing physical activity, with surprisingly inconsistent results, 4,5 thus prompting interest in assessing other behaviors (including sleep). 9 Observational studies support a strong inverse association between sleep duration and obesity in childhood, 10 and plausible biological mechanisms (eg, changes to eating/ activity habits or appetite-regulating hormones) exist to explain this relationship.…”

Ontogenesis and Dysontogenesis of the Gut Microbiota in Young Children: a Trigger Mechanism of Child Health Disorders

“…РОЛЬ ИЗМЕНЕННОЙ КИШЕЧНОЙ МИКРОБИОТЫ В ПАТОГЕНЕЗЕ ОЖИРЕНИЯ Распространение метаболических заболеваний, в т. ч. ожирения, в большинстве промышленно развитых стран предопределило необходимость углубленных исследо-ваний этиопатогенетических факторов этой патологии [25,26]. С одной стороны, были установлены вариан-ты генотипов, способствующие манифестации наруше-ний обмена [27].…”

Reducing childhood obesity: opportunities to influence transitional infant feeding

“…188 While behaviour change of parents and infants were the basis for these successful interventions, the author argued the need for a systematic approach, 189 ground in theoretical frameworks.…”

“…195 many early childhood obesity prevention interventions lack these guiding frameworks. 188 The theoretical constructs used in early childhood obesity prevention studies vary widely, though many are grounded in the Health Belief Model which relies on the existence of parental concern and belief that following health advice will reduce obesity at an acceptable cost. 196 Some also consider the aspect of self-efficacy in that parents feel confident to implement and maintain behaviour change as reflected in the Social Cognitive Model.…”