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Interventions commenced by early infancy to prevent childhood obesity—The EPOCH Collaboration: An individual participant data prospective meta‐analysis of four randomized controlled trials
Author(s) -
Askie Lisa M,
Espinoza David,
Martin Andrew,
Daniels Lynne A,
Mihrshahi Seema,
Taylor Rachael,
Wen Li Ming,
Campbell Karen,
Hesketh Kylie D,
Rissel Chris,
Taylor Barry,
Magarey Anthea,
Seidler Anna Lene,
Hunter Kylie E,
Baur Louise A
Publication year - 2020
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12618
Subject(s) - medicine , breastfeeding , randomized controlled trial , psychological intervention , childhood obesity , body mass index , confidence interval , screen time , pediatrics , obesity , early childhood , intervention (counseling) , physical therapy , overweight , developmental psychology , psychiatry , psychology , surgery , pathology
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.