Lifestyle counselling targeting infant's mother during the child's first year and offspring weight development until 4 years of age: a follow-up study of a cluster RCT

Abstract

Objective: To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life.

Design and setting: Follow-up of a cluster-randomised controlled trial in primary care child health clinics during 2004-2006 in Finland. Participants received a follow-up survey during 2010 concerning weight and height measurements of their offspring. Number of clusters was six and the response rate to the follow-up 71.9% (N=64/89).

Participants: The participants (N=89) were mothers of infants aged 2-10 months.

Intervention: The intervention included individual counselling on diet and physical activity when the infant was 2-10 months of age and an option to attend supervised group exercise sessions.

Primary and secondary outcome measures: The authors analysed the secondary outcome of the intervention study: the weight development of the offspring. The primary outcome was the proportion of women returning to their prepregnancy weight by 10 months post partum, reported earlier.

Results: Multilevel mixed effect non-linear regression models included group, age of the child and interaction between group and age of the child. The increase of BMI z-score between 24 and 48 months was slower among the intervention group offspring (-0.034 to -0.002, p=0.028) as compared with control group. Z-scores for weight-for-length/height did not differ between groups when the period 0-48 months was analysed (p=0.23) but for the period of 24-48 months, between-group differences were significant (p=0.012).

Conclusions: Lifestyle counselling targeting mothers during the child's first year may be effective in slowing offspring weight gain until 4 years of age. However, larger studies are needed to confirm the findings which may have the potential in combatting the obesity epidemic.

Trial registration number: Current Controlled Trials ISRCTN21512277.

Figure 1

Original sample and the follow-up of the offspring, respondents and non-respondents.

Figure 2

Growth trajectories by gender, exact age of the child and weight from birth to age of 48 months.

Figure 3

Weight-for-height from 0 to 48 months and BMI z-scores from 24 to 48 months. p Values denote for the significance of intervention effects (interaction between group and child's age at months). Non-linear model including age of the child and interaction between group × age. Obs., observed; est., estimated.