The effectiveness of interventions during the first 1,000 days to improve energy balance‐related behaviors or prevent overweight/obesity in children from socio‐economically disadvantaged families of high‐income countries: a systematic review

Abstract

Summary This narrative systematic review examined effectiveness of interventions during pregnancy and up to 2 years of age in improving energy balance‐related behaviors or prevent overweight/obesity in children from families experiencing socio‐economic disadvantage. We identified 24 interventions, from 33 articles, since 1990. Overall, despite their heterogeneity and variability in internal and external validity, there was some evidence of beneficial impact of interventions on obesity risk (4/15), and associated behaviors, e.g.: breastfeeding (9/18), responsive feeding (11/16), diet (7/8), sedentary (1/3) and movement (4/7) behaviors, and sleep (1/2). The most effective interventions aimed at promoting breastfeeding commenced antenatally; this was similar for the prevention of obesity, provided the intervention continued for at least 2 years postnatally and was multi‐behavioral. Effective interventions were more likely to target first‐time mothers and involve professional delivery agents, multidisciplinary teams and peer groups. Among ethnic/racial minorities, interventions delivered by lay agents had some impact on dietary behavior but not weight outcomes. Co‐creation with stakeholders, including parents, and adherence to theoretical frameworks were additional ingredients for more pragmatic, inclusive, non‐judgmental, and effective programs. The growing body of evidence on obesity prevention interventions targeting families experiencing socio‐economic disadvantage is promising for reducing early inequalities in obesity risk.

Lifestyle patterns in European preschoolers: Associations with socio‐demographic factors and body mass index

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Social patterning of childhood overweight in the national ELFE cohort

“…Another recent systematic review found that interventions delivered by lay agents among ethnic/racial minorities had some effect on lifestyle behaviors and obesity risk; additional factors for creating more effective, pragmatic, inclusive, and non-judgmental programs were to engage stakeholders, including users, in their development and adhering to theoretical frameworks. 50…”

Understanding risk and causal mechanisms for developing obesity in infants and young children: A National Institutes of Health workshop

“…Family‐based interventions and those conducted in the home setting appeared to be most effective. In a narrative review of interventions to prevent overweight obesity in children from families experiencing socio‐economic disadvantage, only 4 of 11 trials examining growth beyond birth impacted risk of overweight/obesity or growth at 24 months or 2 years 246 . Effective interventions were more likely to begin antenatally; promote healthy feeding practices and energy balance‐related behaviors such as diet, sedentary behaviors, physical activity, and sleep; and include professionals, multidisciplinary teams, and peers.…”