Prevention of Overweight in Infancy

Conditions

Growth, Obesity, Sleep

Keywords

Obesity, Sleep, Physical activity, Breast feeding, Depression

Brief summary

Obesity is one of the biggest threats to health in the 21st century. Rapid weight gain in the first year of life tends to lead to overweight in children, which in turn leads to overweight in adults. This rapid early weight gain occurs most often at weaning when eating patterns emerge. Infant sleep problems also appear to be associated with the risk of becoming overweight, and contribute to maternal post-natal depression. We propose to undertake a 4-arm randomised controlled trial to determine whether extra education and support for families around weaning and development of early food and activity habits, with or without intervention to improve infant sleep, will decrease the current risk patterns of rapid excessive early childhood weight gain in New Zealand. This would provide strong evidence for the value of such a strategy in the long term control of the obesity epidemic and its consequent complications. This is a two-year intervention with follow-ups at 3.5, 5 and 11 years of age.

Detailed description

We plan on undertaking a 4-arm randomised controlled trial to test the following hypotheses: 1. That anticipatory guidance and extra education and support in infancy around weaning and decreasing/avoiding television watching will delay the timing of introduction of solid foods, will be associated with more successful introduction of nutrient dense foods with appropriate portion size and decrease small screen exposure leading to a lower number of children with excessive weight velocity in infancy and early childhood. 2. That anticipatory guidance, education and extra support around the early development of infant sleeping patterns will decrease sleep problems, increase infant sleeping time, decrease arousals at night and lower sleep latency which will in turn influence rate of early infant weight gain. 3. That interventions 1 and 2 will interact additively with regard to infant and early childhood weight gain. 4. That intervention 2 will lead to lower rates of maternal depression and increased family well being.

Rachael W. Taylor, Barbara C. Galland, Anne‐Louise M. Heath, Andrew Gray, Kim Meredith‐Jones et al. (11 authors)

Pediatric Obesity2025-01-17

10.1111/ijpo.13204

Associations between activity, sedentary and sleep behaviours and psychosocial health in young children: a longitudinal compositional time-use study.

Taylor RW, Haszard JJ, Meredith-Jones KA, Azeem AA, Galland BC, Heath AM, Taylor BJ, Healey D.

2023-01-035 citations

10.1186/s44167-022-00011-3

Adherence to 24-h movement behavior guidelines and psychosocial functioning in young children: a longitudinal analysis

Rachael W. Taylor, Jillian J. Haszard, Dione Healey, Kim Meredith‐Jones, Barry Taylor et al. (6 authors)

International Journal of Behavioral Nutrition and Physical Activity2021-08-2530 citations

10.1186/s12966-021-01185-w

Long-Term Follow-Up of a Randomized Controlled Trial to Reduce Excessive Weight Gain in Infancy: Protocol for the Prevention of Overweight in Infancy (POI) Follow-Up Study at 11 Years

Taiwo O Adebowale, Barry Taylor, Andrew Gray, Barbara C. Galland, Anne‐Louise M. Heath et al. (11 authors)

JMIR Research Protocols2020-11-035 citations

10.2196/24968

Using compositional principal component analysis to describe children's gut microbiota in relation to diet and body composition.

Leong C, Haszard JJ, Heath AM, Tannock GW, Lawley B, Cameron SL, Szymlek-Gay EA, Gray AR, Taylor BJ, Galland BC, Lawrence JA, Otal A, Hughes A, Taylor RW.

2020-01-0121 citations

10.1093/ajcn/nqz270

24-h movement behaviors from infancy to preschool: cross-sectional and longitudinal relationships with body composition and bone health

Rachael W. Taylor, Jillian J. Haszard, Kim Meredith‐Jones, Barbara C. Galland, Anne‐Louise M. Heath et al. (10 authors)

International Journal of Behavioral Nutrition and Physical Activity2018-11-2674 citations

10.1186/s12966-018-0753-6

Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: follow-up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y.

Taylor RW, Gray AR, Heath AM, Galland BC, Lawrence J, Sayers R, Healey D, Tannock GW, Meredith-Jones KA, Hanna M, Hatch B, Taylor BJ.

2018-08-0160 citations

10.1093/ajcn/nqy090

Three-year follow-up of a randomised controlled trial to reduce excessive weight gain in the first two years of life: protocol for the POI follow-up study.

Taylor RW, Heath AL, Galland BC, Cameron SL, Lawrence JA, Gray AR, Tannock GW, Lawley B, Healey D, Sayers RM, Hanna M, Meredith-Jones K, Hatch B, Taylor BJ.

2016-08-1118 citations

10.1186/s12889-016-3383-4

Impact of an early-life intervention on the nutrition behaviors of 2-y-old children: a randomized controlled trial.

Fangupo LJ, Heath AL, Williams SM, Somerville MR, Lawrence JA, Gray AR, Taylor BJ, Mills VC, Watson EO, Galland BC, Sayers RM, Hanna MB, Taylor RW.

2015-07-2946 citations

10.3945/ajcn.115.111823

Lactation Consultant Support from Late Pregnancy with an Educational Intervention at 4 Months of Age Delays the Introduction of Complementary Foods in a Randomized Controlled Trial.

Cameron SL, Heath AL, Gray AR, Churcher B, Davies RS, Newlands A, Galland BC, Sayers RM, Lawrence JA, Taylor BJ, Taylor RW.

2015-05-2011 citations

10.3945/jn.114.202689

Prevention of Overweight in Infancy (POI.nz) study: a randomised controlled trial of sleep, food and activity interventions for preventing overweight from birth.

Taylor BJ, Heath AL, Galland BC, Gray AR, Lawrence JA, Sayers RM, Dale K, Coppell KJ, Taylor RW.

2011-12-1982 citations

10.1186/1471-2458-11-942

The Early Prevention of Obesity in CHildren (EPOCH) Collaboration--an individual patient data prospective meta-analysis.

Askie LM, Baur LA, Campbell K, Daniels LA, Hesketh K, Magarey A, Mihrshahi S, Rissel C, Simes J, Taylor B, Taylor R, Voysey M, Wen LM, EPOCH Collaboration Group.

2010-11-2537 citations

10.1186/1471-2458-10-728

Interventions

BEHAVIORALFAB

Standard well child care plus 7 extra parent contacts for augmented education and support around breast feeding, food and activity with 1 before birth and then at 1-2 weeks, and 3, 4, 7, 9, 13, and 18 months post-partum.

BEHAVIORALSleep

Standard well child care plus 2 extra contacts focussed on Sleep with 1 before birth (anticipatory guidance), and sleep problem prevention at 3 weeks. A sleep problem intervention starting at 6 months was possible for those indicating their child had a sleep problem at 6 months of age. Main prevention advice focussed on placing baby to sleep awake, maximising night-day differences and use of sleep place in parents bedroom for first 6 months. Intervention after 6 months uses preferentially a technique called parental presence, and if this does not fit family a technique called camping out and finally, if neither of the first two fit family, controlled crying.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

16 Years to 55 Years

Healthy volunteers

Yes

Inclusion criteria

* Mothers booked for delivery in Dunedin, New Zealand

Exclusion criteria

* Women booked after 34 weeks gestation, * Identified congenital abnormality likely to affect feeding and/or growth * Home address outside of metropolitan Dunedin or Invercargill, * Families who are likely to shift out of metropolitan Dunedin or Invercargill in the next 2 years. * Unable to communicate in English or te reo Maori.

Design outcomes

Primary

Measure	Time frame	Description
BMI z score	24 months (end of intervention)	BMI z score derived from ht and weight and using World Health Organisation (WHO) growth standards

Secondary

Measure	Time frame	Description
Television viewing	24 months (end of intervention) and 60 months (end of follow-up)	Hours of screen use by parental questionnaire
Major/ Moderate sleep problems	24 months (end of intervention)	Parents indicate presence of sleep problems in child
Physical activity (PA)	24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)	PA measured using actical accelerometry over 5-7 days
Duration of exclusive and any breast feeding	24 months	Measured by repeated questionnaire
Dietary intake	24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)	Dietary information (foods, food groups, nutrients) via food frequency questionnaire
Sleep	24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)	Measured by questionnaire and accelerometry at multiple timepoints
Number of night awakenings	24 months (end of intervention) and 60 months (end of follow-up)	Measured by questionnaire and accelerometry at multiple timepoints
Self-regulation	42 and 60 months	Measured by questionnaire and laboratory based measures at follow-up only
Body composition	60 months and 11 years (further follow-up)	Measured by dual-energy x-ray absorptiometry at follow-up only
Parental depression score	Measured at multiple timepoints between pregnancy and 24 months (end of intervention) and 60 months (end of follow-up)	Edinburgh Postnatal Depression questionnaire

Countries

New Zealand

Outcome results

None listed