Interventions commenced by early infancy to prevent childhood obesity-The EPOCH Collaboration: An individual participant data prospective meta-analysis of four randomized controlled trials.

Lisa M Askie, David Espinoza, Andrew Martin, Lynne A Daniels, Seema Mihrshahi, Rachael Taylor, Li Ming Wen, Karen Campbell, Kylie D Hesketh, Chris Rissel, Barry Taylor, Anthea Magarey, Anna Lene Seidler, Kylie E Hunter, Louise A Baur

Journal: Pediatric obesity 2020;15(6):e12618

PMID: 32026653

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Abstract

BACKGROUND

Childhood obesity is a significant global problem. Childhood obesity prevention interventions may be more effective when started very early in life before metabolic and behavioural patterns are established.

METHODS AND FINDINGS

A prospectively planned, individual participant data meta-analysis of four randomized controlled trials. Participants were first-time mothers of term infants. Trial interventions commenced during pregnancy or early infancy and comprised education and support delivered via group sessions and/or home visits. Control group families accessed existing local well-child health care. The primary outcome was body mass index (BMI) z score at 18 to 24 months; 2196 mother-child dyads were available for analysis. Intervention children had lower BMI z scores at 18 to 24 months than control children (-0.12 adjusted mean; 95% confidence interval, -0.22 to -0.02, P = .017). There was some evidence that the BMI z score reduction was greater in settings with limited well-child health care programmes (interaction P value = .03). Improvements were also detected in television viewing time, feeding practices, and breastfeeding duration.

CONCLUSIONS

Parent-focused intervention programmes that commence by early infancy and which aim to establish a trajectory of healthy lifestyle behaviours produced a modest but statistically significant reduction in BMI z score, which if replicated on a wider scale may have important public health implications.

Address: NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.; Center Child Health Research, School Exercise Nutrition Sciences, Queensland University Technology, Brisbane, Queensland, Australia.; School of Public Health, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia.; Department of Medicine, University of Otago, Dunedin, New Zealand.; Health Promotion Unit, Sydney Local Health District, School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.; Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.; School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.; Dunedin School of Medicine, Office of the Dean, University of Otago, Dunedin, New Zealand.; Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Discipline of Child and Adolescent Health, University of Sydney, Clinical School, The Children's Hospital at Westmead, Camperdown, New South Wales, Australia.

DOI: 10.1111/ijpo.12618

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MeSH Terms: Body Mass Index, Child, Child, Preschool, Female, Healthy Lifestyle, Humans, Infant, Intersectoral Collaboration, Male, Pediatric Obesity, Pregnancy, Prospective Studies, Randomized Controlled Trials as Topic