Early-life intervention can prevent childhood overweight, obesity

An intervention delivered through primary care offices providing nutrition education and parenting support beginning in a woman’s third trimester of pregnancy and continuing through her child’s fourth year can mitigate against early childhood obesity, according to study results presented at ObesityWeek.

“Pregnancy and early infancy are promising times in the lifestyle for child obesity prevention,” presenter Mary Jo Messito, MD, clinical associate professor of pediatrics and associate director of the General Academic Pediatric Fellowship at NYU School of Medicine and director of the Pediatric Obesity Treatment Program at Bellevue Hospital Center, told Endocrine Today. “Excess weight gain begins in early infancy and increases life-long risk for obesity.”

Messito and colleagues randomly assigned 533 pregnant women (29% with obesity) to enrollment in a program for Hispanic families designed to prevent early childhood obesity (the Starting Early Program, or StEP) or to standard care. The groups were well matched for mother and infant baseline characteristics. The StEP group received nutrition counseling and group support for nutrition and parenting that were coordinated with their primary care visits; eight sessions were available to parents of children aged 1 to 12 months, and 7 sessions were available to parents of children aged 1 to 3 years. Children’s weight and length were recorded at well-child visits, and 393 had data available at 18 months. Researchers used linear regression, adjusted for birth weight, to assess weight and height at ages 6, 12 and 18 months.

During the first year, participants attended a mean 5.5 sessions; topics included how to soothe the baby without feeding, the value of “tummy time” and preparation of healthy solid foods, among others. Weight-for-length z scores were significantly lower for the StEP group compared with the standard care group at 12 months (0.45 vs. 0.65; P = .02) and at 18 months (0.74 vs. 1.00; P = .02), and growth rates remained stable from 12 to 18 months. Children of participants who attended at least five sessions during the first year had weight-for-length z scores a mean 0.66 lower than those of children of StEP parents who attended fewer than five sessions in the first year (P = .001).

“Increased intervention dose led to greater impact on weight-for-length z score, and we had overall strong participation in this intervention for an underrepresented, difficult-to-follow group,” Messito said. — by Jill Rollet


Messito MJ. T-OR-LB-2081. Presented at: ObesityWeek 2017; Oct. 29-Nov. 2, 2017; Washington, D.C.

Disclosure: Messito reports no relevant financial disclosures.

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