Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity

Mina Nicole Händel, Sofus Christian Larsen, Jeanett Friis Rohde, Maria Stougaard, Nanna Julie Olsen, Berit Lilienthal Heitmann, Mina Nicole Händel, Sofus Christian Larsen, Jeanett Friis Rohde, Maria Stougaard, Nanna Julie Olsen, Berit Lilienthal Heitmann

Abstract

Background: There is limited evidence to support the effectiveness of primary interventions aiming to prevent excess weight gain among young children. Evaluating behavioral changes, such as physical activity (PA), may add to future development of efficient interventions. The objective was to evaluate the effect on PA outcomes of the 15 month Healthy Start intervention that focused on changing diet, PA, sleep and stress management among normal weight but obesity-prone preschool children. Children were defined as obesity-prone if they had a birth weight > 4,000 g, mothers with a pre-pregnancy body mass index of > 28 kg/m2, or mothers with ≤ 10 years of schooling.

Method: From a baseline study population of 635 normal weight 2-6 year old preschool children from the greater Copenhagen area, parents of 307 children had given information on PA at both the baseline and follow-up examinations. PA was obtained from a 7 days recording in the Children's Physical Activity Questionnaire. Time used for sport activities were combined with outdoor playing time to achieve a proxy of total PA level of moderate to vigorous intensity.

Results: Linear regression analyses revealed that at follow-up the intervention group spent more time on sports and outdoor activities combined per week than the control group (ITT analyses: intervention: 400 min/week; 95% confidence interval (CI): 341, 459 versus control: 321 min/week; 95% CI: 277, 366; p = 0.02), although no significant intervention effects were seen for each of the subcategories, e.g. sports participation, outdoor activities, screen time, or commuting frequency.

Conclusion: Our results suggest that the overall time spent on sports and outdoor activities combined was increased at follow-up among normal weight obesity-prone children, as a result of the Healthy Start intervention.

Trial registration: ClinicalTrials.gov NCT01583335.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow chart of the study…
Fig 1. Flow chart of the study population.

References

    1. Wold Health Organization (2016) Obesity and overweight.
    1. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y et al. (2011) Interventions for preventing obesity in children. Cochrane Database Syst Rev 12: CD001871 doi:
    1. Yavuz HM, van Ijzendoorn MH, Mesman J, van d V (2015) Interventions aimed at reducing obesity in early childhood: a meta-analysis of programs that involve parents. J Child Psychol Psychiatry 56: 677–692. doi:
    1. Ling J, Robbins LB, Wen F (2016) Interventions to prevent and manage overweight or obesity in preschool children: A systematic review. Int J Nurs Stud 53: 270–289. doi:
    1. Showell NN, Fawole O, Segal J, Wilson RF, Cheskin LJ, Bleich SN et al. (2013) A systematic review of home-based childhood obesity prevention studies. Pediatrics 132: e193–e200. doi:
    1. Blake-Lamb TL, Locks LM, Perkins ME, Woo Baidal JA, Cheng ER, Taveras EM (2016) Interventions for Childhood Obesity in the First 1,000 Days A Systematic Review. Am J Prev Med 50: 780–789. doi:
    1. Seburg EM, Olson-Bullis BA, Bredeson DM, Hayes MG, Sherwood NE (2015) A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions. Curr Obes Rep 4: 157–173. doi:
    1. Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O et al. (2015) What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev 16: 547–565. doi:
    1. Olsen NJ, Mortensen EL, Heitmann BL (2012) Predisposition to Obesity: Should We Target Those Most Susceptible? Curr Obes Rep 1: 35–41. doi:
    1. The Danish Board of Technology (2011) Targeted prevention of obesity—more effect for the money.
    1. Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ (2005) Interventions for preventing obesity in children. Cochrane Database Syst Rev CD001871 doi:
    1. Mahoney JL, Vest AE (2012) The Over-Scheduling Hypothesis Revisited: Intensity of Organized Activity Participation During Adolescence and Young Adult Outcomes. J Res Adolesc 22: 409–418. doi:
    1. Janz KF, Letuchy EM, Eichenberger Gilmore JM, Burns TL, Torner JC, Willing MC et al. (2010) Early physical activity provides sustained bone health benefits later in childhood. Med Sci Sports Exerc 42: 1072–1078. doi:
    1. Morris JN, Hardman AE (1997) Walking to health. Sports Med 23: 306–332.
    1. Kjonniksen L, Anderssen N, Wold B (2009) Organized youth sport as a predictor of physical activity in adulthood. Scand J Med Sci Sports 19: 646–654. doi:
    1. Washington RL, Bernhardt DT, Gomez J, Johnson MD, Martin TJ, Rowland TW et al. (2001) Organized sports for children and preadolescents. Pediatrics 107: 1459–1462.
    1. Biddle SJ, Pearson N, Ross GM, Braithwaite R (2010) Tracking of sedentary behaviours of young people: a systematic review. Prev Med 51: 345–351. doi:
    1. Telama R, Yang X, Leskinen E, Kankaanpaa A, Hirvensalo M, Tammelin T et al. (2014) Tracking of physical activity from early childhood through youth into adulthood. Med Sci Sports Exerc 46: 955–962. doi:
    1. Francis SL, Stancel MJ, Sernulka-George FD, Broffitt B, Levy SM, Janz KF (2011) Tracking of TV and video gaming during childhood: Iowa Bone Development Study. Int J Behav Nutr Phys Act 8: 100 doi:
    1. Jones RA, Hinkley T, Okely AD, Salmon J (2013) Tracking physical activity and sedentary behavior in childhood: a systematic review. Am J Prev Med 44: 651–658. doi:
    1. Carver A, Timperio AF, Hesketh KD, Ridgers ND, Salmon JL, Crawford DA (2011) How is active transport associated with children's and adolescents' physical activity over time? Int J Behav Nutr Phys Act 8: 126 doi:
    1. Herrington S, Brussoni M (2015) Beyond Physical Activity: The Importance of Play and Nature-Based Play Spaces for Children's Health and Development. Curr Obes Rep 4: 477–483. doi:
    1. Olsen NJ, Buch-Andersen T, Handel MN, Ostergaard LM, Pedersen J, Seeger C et al. (2012) The Healthy Start project: a randomized, controlled intervention to prevent overweight among normal weight, preschool children at high risk of future overweight. BMC Public Health 12: 590 doi:
    1. [Anonymous] (2011) Physical activity—manual on disease prevention and treatment [Fysisk aktivitet—håndbog om forebyggelse og behandling]. 1–480.
    1. Rollnick S (1996) Behaviour change in practice: targeting individuals. Int J Obes Relat Metab Disord 20 Suppl 1: S22–S26.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320: 1240–1243.
    1. Corder K, van Sluijs EM, Wright A, Whincup P, Wareham NJ, Ekelund U (2009) Is it possible to assess free-living physical activity and energy expenditure in young people by self-report? Am J Clin Nutr 89: 862–870. doi:
    1. Ottosen MH, Andersen D, Dahl KM, Hansen AT, Lausten M et al. (2014) Børn og unge i Danmark. Velfærd og trivsel 2014 1–243.
    1. Lachin JM (2000) Statistical considerations in the intent-to-treat principle. Control Clin Trials 21: 167–189.
    1. Royston P (2004) Multiple imputation of missing values. Stata Journal 4: 227–241.
    1. Taber DR, Stevens J, Murray DM, Elder JP, Webber LS, Jobe JB et al. (2009) The effect of a physical activity intervention on bias in self-reported activity. Ann Epidemiol 19: 316–322. doi:
    1. Dennison BA, Russo TJ, Burdick PA, Jenkins PL (2004) An intervention to reduce television viewing by preschool children. Arch Pediatr Adolesc Med 158: 170–176. doi:
    1. Fitzgibbon ML, Stolley MR, Dyer AR, VanHorn L, KauferChristoffel K (2002) A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr. Prev Med 34: 289–297. doi:
    1. Fitzgibbon ML, Stolley MR, Schiffer LA, Braunschweig CL, Gomez SL, Van HL et al. (2011) Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: postintervention results. Obesity (Silver Spring) 19: 994–1003. doi:
    1. Harvey-Berino J, Rourke J (2003) Obesity prevention in preschool native-american children: a pilot study using home visiting. Obes Res 11: 606–611. doi:
    1. Reilly JJ, Kelly L, Montgomery C, Williamson A, Fisher A, McColl JH et al. (2006) Physical activity to prevent obesity in young children: cluster randomised controlled trial. BMJ 333: 1041 doi:
    1. Chillon P, Evenson KR, Vaughn A, Ward DS (2011) A systematic review of interventions for promoting active transportation to school. Int J Behav Nutr Phys Act 8: 10 doi:
    1. Corder K, Crespo NC, van Sluijs EM, Lopez NV, Elder JP (2012) Parent awareness of young children's physical activity. Prev Med 55: 201–205. doi:
    1. Sarker H, Anderson LN, Borkhoff CM, Abreo K, Tremblay MS, Lebovic G et al. (2015) Validation of parent-reported physical activity and sedentary time by accelerometry in young children. BMC Res Notes 8: 735 doi:
    1. Peirson L, Fitzpatrick-Lewis D, Morrison K, Ciliska D, Kenny M, Usman AM et al. (2015) Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis. CMAJ Open 3: E23–E33. doi:
    1. Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y et al. (2011) Interventions for preventing obesity in children. Cochrane Database Syst Rev CD001871 doi:
    1. Janssen I, Leblanc AG (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 7: 40 doi:

Source: PubMed

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