Long-term follow-up of the impact of brief sleep and lifestyle interventions in infancy on BMI z-score at 11 years of age: The POI randomized controlled trial.

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To determine whether BMI differences observed at 5 years of age, from early intervention in infancy, remained apparent at 11 years. Participants (n = 734) from the original randomized controlled trial (n = 802) underwent measures of body mass index (BMI), body composition (DXA), sleep and physical activity (24-h accelerometry, questionnaire), diet (repeated 24-h recalls), screen time (daily diaries), wellbeing (CHU-9D, WHO-5), and family functioning (McMaster FAD) around their 11th birthday. Following multiple imputation, regression models explored the effects of two interventions ('Sleep' vs. 'Food, Activity and Breastfeeding' [FAB]) using a 2 × 2 factorial design. Five hundred twelve children (48% female, mean [SD] age 11.1 [0.1] years) returned for the 11-year assessment (63% of original sample). Significant differences in BMI z-score (mean difference; 95% CI: -0.16; -0.41, 0.08) or the risk of overweight (including obesity) (odds ratio; 95% CI: 0.85; 0.56, 1.29) were no longer observed between children who had received the sleep intervention compared with those who had not. By contrast, children who had received the FAB intervention had greater BMI z-scores (0.24; 0.01, 0.47) and a higher risk of obesity (1.56; 1.03, 2.36) than children not enrolled in FAB. No significant differences were observed in any lifestyle variables nor wellbeing measures across all groups. Sustained reductions in BMI and obesity risk from an early sleep intervention were not apparent 9 years later, whereas a more traditional lifestyle intervention resulted in increased rates of obesity, not explained by any differences in lifestyle behaviours measured. ClinicalTrials.gov number NCT00892983, https://clinicaltrials.gov/study/NCT00892983.