Abstract
BackgroundRapid weight gain during the first three years of life predicts child and adult obesity, and also later cardiovascular and other morbidities. Cross-sectional studies suggest that infant diet, activity and sleep are linked to excessive weight gain. As intervention for overweight children is difficult, the aim of the Prevention of Overweight in Infancy (POI.nz) study is to evaluate two primary prevention strategies during late pregnancy and early childhood that could be delivered separately or together as part of normal health care.Methods/DesignThis four-arm randomised controlled trial is being conducted with 800 families recruited at booking in the only maternity unit in the city of Dunedin, New Zealand. Mothers are randomised during pregnancy to either a usual care group (7 core contacts with a provider of government funded "Well Child" care over 2 years) or to one of three intervention groups given education and support in addition to "Well Child" care: the Food, Activity and Breastfeeding group which receives 8 extra parent contacts over the first 2 years of life; the Sleep group which receives at least 3 extra parent contacts over the first 6 months of life with a focus on prevention of sleep problems and then active intervention if there is a sleep problem from 6 months to 2 years; or the Combination group which receives all extra contacts. The main outcome measures are conditional weight velocity (0-6, 6-12, 12-24 months) and body mass index z-score at 24 months, with secondary outcomes including sleep and physical activity (parent report, accelerometry), duration of breastfeeding, timing of introduction of solids, diet quality, and measures of family function and wellbeing (parental depression, child mindedness, discipline practices, family quality of life and health care use). This study will contribute to a prospective meta-analysis of early life obesity prevention studies in Australasia.DiscussionInfancy is likely to be the most effective time to establish patterns of behaviour around food, activity and sleep that promote healthy child and adult weight. The POI.nz study will determine the extent to which sleep, food and activity interventions in infancy prevent the development of overweight.Trial RegistrationClinical Trials NCT00892983Prospective meta-analysis registered on PROSPERO CRD420111188. Available from http://www.crd.york.ac.uk/PROSPERO
Highlights
Rapid weight gain during the first three years of life predicts child and adult obesity, and later cardiovascular and other morbidities
Aim The aim of this study is to evaluate the effect on weight velocity and body mass index at 24 months of age of two early childhood obesity prevention interventions delivered to parents in late pregnancy and the first 2 years of their infant’s life: anticipatory guidance, extra education and support to encourage (a) positive diet and physical activity behaviours, or (b) appropriate sleeping patterns, or (c) both interventions combined
This study looks directly at modifying growth in early infancy–a time when it is likely to be easiest to set up patterns of behaviour around food, activity and sleep that appear to be associated with healthier child and adult weight
Summary
Rapid weight gain during the first three years of life predicts child and adult obesity, and later cardiovascular and other morbidities. Cross-sectional studies suggest that infant diet, activity and sleep are linked to excessive weight gain. In response to convincing evidence that early growth sets the pattern for future growth and predicts both childhood and adult obesity, as well as later cardiovascular morbidity and mortality [7,8,9], there has been an increasing focus on preventive interventions during infancy. In designing interventions for the primary prevention of excessive weight gain in infancy, it appears logical to begin with the most obvious determinants of energy balance–energy intake (breastfeeding, complementary feeding, and infant diet) and energy expenditure (activity and sedentary behaviours).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
