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A community-randomized controlled trial against sugary snacking among infants and toddlers
Simin Z Mohebbi1, Jorma I Virtanen, Miira M Vehkalahti
1Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. smohebbi@tums.ac.ir
Insights
Educational interventions significantly reduced sugary snacking in infants and toddlers. Health staff providing oral health education with reminders proved effective in lowering unhealthy eating habits.
Area of Science:
- Public Health
- Pediatric Nutrition
- Behavioral Science
Background:
- Sugary snacking in infants and toddlers is a growing concern with implications for long-term oral and overall health.
- Understanding the impact of targeted educational interventions is crucial for developing effective public health strategies.
- Maternal dietary habits often influence children's eating behaviors, highlighting the importance of family-centered approaches.
Purpose of the Study:
- To evaluate the effectiveness of educational interventions aimed at reducing sugary snack consumption in young children.
- To assess the impact of different intervention strategies (pamphlet and reminder vs. pamphlet only) compared to a control group.
- To explore the role of socioeconomic factors in the success of these interventions.
Main Methods:
- A 6-month intervention study involving 242 infants (12-15 months) and their mothers in Tehran, Iran.
- Participants were assigned to three groups: pamphlet and reminder, pamphlet only, or control.
- Data on sugary snacking frequency were collected at baseline and follow-up; statistical analyses included Spearman correlation, Mann-Whitney test, and logistic regression.
Main Results:
- The intervention group receiving pamphlets and reminders showed the highest positive outcome rate (62%) in reducing children's sugary snacking.
- Significant reductions in snacking frequency were observed in the intervention groups compared to the control group.
- Maternal and child snacking habits at baseline were correlated, and socioeconomic status did not significantly affect intervention outcomes.
Conclusions:
- Oral health education delivered by general health staff, incorporating reminders for mothers, is an effective strategy for reducing sugary snacking in young children.
- This approach is particularly valuable in countries with developing oral health systems.
- Interventions targeting maternal education can lead to positive changes in infant and toddler dietary habits.
Objectives:
We evaluated the impact of educational interventions on sugary snacking in infants and toddlers in Tehran, Iran.
Methods:
A 6-month intervention was integrated into health staff duties. We assigned 12- to 15-month-olds (n = 242) and their mothers attending the vaccination offices of 18 randomly selected public health centers into the following groups: pamphlet and reminder (A), pamphlet only (B), and one control group (C). The mothers were interviewed at baseline and after follow-up. We recorded the frequency of sugary snacking for both the children and their mothers and calculated changes over 6 months. A reduction in the children's snacking frequency indicated a positive outcome. The family's residential area (affluent/nonaffluent) indicated its socioeconomic level. Associations between the children's and their mothers' snacking frequency were assessed by means of Spearman correlation. The outcomes of each intervention group were compared separately to those of the control group by means of the Mann-Whitney test. In addition, we performed intention to treat analysis. Factors related to a positive outcome were explained by means of logistic regression models.
Results:
In all groups, the child's and mother's snacking at baseline correlated (r = 0.4). A positive outcome was found for 62% of the children in group A and for 49% and 32% in groups B and C, respectively. In group A, a reduction in the children's snacking frequency was found despite their residential area (P < 0.05). Controlling for intervention effects, the logistic regression model showed that residential area was unrelated to the positive outcome.
Conclusions:
Oral health education with reminders provided to mothers by general health staff is a valuable tool for reducing sugary snacking in infants and toddlers in a country with developing oral health systems.
