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A Review of Registered Randomized Controlled Trials for the Prevention of Obesity in Infancy
Seema Mihrshahi1,2,3, Danielle Jawad3, Louise Richards3
1Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
Insights
Preventing childhood obesity is crucial. This review of 29 randomized controlled trials (RCTs) found many interventions improved healthy practices, but more data is needed to confirm long-term weight outcomes.
Area of Science:
- Public Health
- Pediatrics
- Preventive Medicine
Background:
- Childhood overweight and obesity represent a significant global public health challenge.
- Early childhood is a critical period for establishing lifelong health behaviors.
- Identifying effective interventions for obesity prevention in young children is essential.
Purpose of the Study:
- To systematically describe planned, ongoing, and completed randomized controlled trials (RCTs) focused on preventing obesity in early childhood.
- To analyze the characteristics and methodologies of these interventions.
- To assess the current evidence base for early childhood obesity prevention strategies.
Main Methods:
- Searched two major clinical trial registries: WHO International Clinical Trials Registry Platform and ClinicalTrials.gov.
- Included RCTs with a primary aim of preventing childhood obesity and child weight-related outcomes.
- Defined interventions as starting within the first two years of life, lasting at least 6 months postnatally, including lifestyle/behavioral components, and with a minimum 2-year follow-up.
Main Results:
- Identified 29 unique RCTs implemented since 2008, predominantly in high-income countries.
- Interventions encompassed a wide range of strategies including diet, activity, sleep, emotion regulation, parenting education, home visits, and group sessions.
- Eleven trials reported child weight-related outcomes, but most lacked sufficient power for significant effect detection. However, many showed improvements in practices like breastfeeding, screen time, and physical activity.
Conclusions:
- Numerous RCTs are investigating early childhood obesity prevention, employing diverse lifestyle and behavioral interventions.
- While improvements in healthy practices are observed, conclusive evidence on long-term weight-related outcomes is limited due to power and follow-up constraints.
- Continued follow-up of ongoing trials is necessary to fully evaluate the long-term effectiveness of these early childhood obesity prevention strategies.
Abstract:
Childhood overweight and obesity is a worldwide public health issue. Our objective was to describe planned, ongoing and completed randomized controlled trials (RCTs) designed for the prevention of obesity in early childhood. Two databases (World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov) were searched to identify RCTs with the primary aim of preventing childhood obesity and at least one outcome related to child weight. Interventions needed to start in the first two years of childhood or earlier, continue for at least 6 months postnatally, include a component related to lifestyle or behaviours, and have a follow up time of at least 2 years. We identified 29 unique RCTs, implemented since 2008, with most being undertaken in high income countries. Interventions ranged from advice on diet, activity, sleep, emotion regulation, and parenting education through to individual home visits, clinic-based consultations, or group education sessions. Eleven trials published data on child weight-related outcomes to date, though most were not sufficiently powered to detect significant effects. Many trials detected improvements in practices such as breastfeeding, screen time, and physical activity in the intervention groups compared to the control groups. Further follow-up of ongoing trials is needed to assess longer-term effects.
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