Early Obesity Prevention: A Randomized Trial of a Practice-Based Intervention in 0-24-Month Infants

Abstract

Objective: A pediatric office-based intervention was implemented following a randomized, controlled design, aimed at improving child feeding practices and growth patterns and ultimately reducing risk for overweight and obesity later in life.

Methods: Four clinics (232 infants) were randomized to control or intervention (I), the latter delivered by health care provider at each of 7-9 well-baby visits over 2 years, using a previously developed program (Growing Leaps and Bounds) that included verbal, visual, and text advice and information for parents.

Results: The I group offered significantly less soda (p = 0.006), sweetened tea (p = 0.01), punch (p = 0.02) and/or cow's milk (p = 0.001) to infants and delayed the introduction of drink/food other than breast milk (p < 0.05). Parents in the I group had a higher perceived parental monitoring (p = 0.05) and restriction (p = 0.01) on infant feeding. While the I group exhibited at baseline more adverse socioeconomic indicators than the control group, growth trajectory or body size indices did not significantly differ between groups.

Conclusions: Education provided by health care providers in addition to follow-up monthly phone calls may help modify parental behaviors related to child feeding and increase parental sense of responsibility toward child eating behaviors.

Figure 1

Growth trajectory (height) by geographic location for boys and girls.

Figure 2

Liquids other than breast milk or formula offered to infants. ^∗Soda: p < 0.006, cow's milk: p < 0.001, sweetened tea: p < 0.014, and punch: p < 0.021.

Figure 3

Age of infant at introduction of food/drink other than breast milk. ^∗ p < 0.051. n = 82 (control = 37, intervention = 45), considering only caregivers who ever breastfed.