Integrating executive function training with health behavior intervention for preschool obesity prevention in China:...

Area of Science:

• Childhood Obesity Prevention
• Executive Function (EF) Development
• Public Health Interventions

Background:

• Preschool is a critical period for obesity prevention.
• Few interventions integrate executive function (EF) enhancement with health behavior promotion.
• Real-world multilevel interventions are needed for early obesity prevention.

Purpose of the Study:

• To evaluate a multilevel kindergarten-family intervention for obesity prevention in preschoolers.
• To assess the intervention's impact on Body Mass Index z-score (BMIz), executive function (EF), and health behaviors.
• To determine the feasibility and potential promise of integrating EF activities with health promotion.

Main Methods:

• Cluster-randomized controlled trial involving 26 kindergartens in Wuhan, China.
• Intervention included health education, EF-enhancing activities, environmental modifications, and family engagement over three semesters.
• Linear mixed models and cluster-robust sensitivity analyses were used to evaluate outcomes.

Main Results:

• BMIz gain was smaller in the intervention group compared to controls (MD, -0.08; P=0.043).
• Significant improvements were observed in executive function (EF) tests (Digit Span, Corsi Block Tapping) and healthy dietary consumption scores.
• Exploratory analyses suggested potential heterogeneity by kindergarten tier and sex.

Conclusions:

• The kindergarten-family intervention demonstrated potential for early obesity prevention with modest EF improvements.
• Effects on BMIz gain were directionally favorable but statistically uncertain after small-sample correction.
• Larger trials are necessary to confirm effectiveness, durability, and equity across diverse settings.