Impaired growth during gestation and early life, coupled with maternal undernutrition and gestational diabetes, often lead to childhood adiposity, overweight, and obesity, which increase the risk for unfavorable health trajectories and non-communicable diseases. AGI-6780 In Canada, China, India, and South Africa, a significant portion, ranging from 10 to 30 percent, of children aged 5 to 16 years are classified as overweight or obese.
The application of developmental origins of health and disease principles leads to a unique approach to tackling overweight and obesity, reducing adiposity, and implementing integrated interventions across the entire life cycle, starting from the period before conception and throughout early childhood. National funding agencies in Canada, China, India, South Africa, and the WHO joined forces in 2017 to establish the Healthy Life Trajectories Initiative (HeLTI). To quantify the effectiveness of a complete four-phase intervention, beginning before conception and extending through pregnancy, infancy, and early childhood, is the purpose of HeLTI. This intervention is intended to reduce childhood adiposity (fat mass index) and overweight/obesity and to improve early child development, nutrition, and other healthy behaviours.
Approximately 22,000 women are being recruited in the provinces of Canada, as well as Shanghai, China; Mysore, India, and Soweto, South Africa. Prospective mothers, expected to number 10,000, and their children will be observed until the children reach their fifth birthday.
HeLTI has established consistent protocols for the intervention, measurements, tools, biological samples, and data analysis components of the trial across the four countries. HeLTI will investigate whether an intervention designed to address maternal health behaviours, nutrition, weight, psychosocial support, optimizing infant nutrition, physical activity, and sleep, and fostering parenting skills can reduce the incidence of intergenerational childhood overweight, obesity, and excess adiposity across various contexts.
The Canadian Institutes of Health Research, the National Science Foundation of China, the Department of Biotechnology in India, and the South African Medical Research Council.
The National Science Foundation of China, the Canadian Institutes of Health Research, the Department of Biotechnology in India, and the South African Medical Research Council each play vital roles in their respective scientific communities.
Chinese children and adolescents are exhibiting an unacceptably low rate of ideal cardiovascular health. An examination was conducted to assess the effectiveness of a school-based lifestyle program in improving cardiovascular health parameters related to obesity.
A cluster-randomized controlled trial was implemented, selecting schools from China's seven regions for random assignment to either an intervention or a control group, stratified by province and grade level (grades 1-11; ages 7-17). The randomization was carried out by a separate, independent statistician. During a nine-month period, an intervention group was subjected to educational campaigns on diet, exercise, and self-monitoring for obesity-related behaviors; conversely, the control group had no such promotional campaigns. Ideal cardiovascular health (defined by six or more ideal cardiovascular health behaviours – non-smoking, BMI, physical activity, diet – and factors – total cholesterol, blood pressure, fasting plasma glucose) was the primary outcome, assessed at both baseline and nine months. Intention-to-treat analysis and multilevel modeling formed the backbone of our study. This research project was authorized by the ethics review board at Peking University, Beijing, China, (ClinicalTrials.gov). In-depth scrutiny of the NCT02343588 clinical trial is essential.
94 schools, encompassing 30,629 intervention group and 26,581 control group students, were assessed for any follow-up cardiovascular health measures. Subsequent assessments revealed that 220% (1139 out of 5186) of the intervention group and 175% (601 out of 3437) of the control group achieved ideal cardiovascular health. Although the intervention showed a strong association with ideal cardiovascular health behaviors (three or more; odds ratio 115; 95% CI 102-129), it did not manifest a similar effect on other indicators of cardiovascular health when accounting for related factors. The intervention demonstrably enhanced ideal cardiovascular health practices among primary school children, aged seven to twelve, (119; 105-134) outperforming secondary school students aged thirteen to seventeen (p<00001), without any discernible gender variation (p=058). AGI-6780 The intervention successfully prevented senior students (16-17) from smoking (123; 110-137) and promoted favorable physical activity among primary school students (114; 100-130), yet it was inversely linked to lower ideal total cholesterol levels in primary school boys (073; 057-094).
Ideal cardiovascular health behaviors in Chinese children and adolescents were positively impacted by a school-based intervention program centered on diet and exercise. The potential for enhancing cardiovascular health throughout a person's life is present with early interventions.
The Ministry of Health of China's Special Research Grant for Non-profit Public Service (201202010), and the Guangdong Provincial Natural Science Foundation (2021A1515010439) are funding this project.
The research was supported by two grants: the Special Research Grant for Non-profit Public Service of the Ministry of Health of China (201202010) and the Guangdong Provincial Natural Science Foundation (2021A1515010439).
A lack of substantial evidence underscores the effectiveness of early childhood obesity prevention programs, whose impact is primarily measured through face-to-face interventions. However, global face-to-face health programs were substantially reduced in scope as a consequence of the COVID-19 pandemic. This study explored the influence of a telephone-based intervention on reducing the chance of obesity in young children.
We adjusted a pre-pandemic study protocol and implemented a pragmatic randomized controlled trial among 662 women with children aged 2 years (mean age 2406 months [SD 69]) across March 2019 and October 2021. The initial, 12-month intervention period was extended to 24 months. Five telephone support sessions, supplemented by text messaging, formed the core of the 24-month adapted intervention, targeting children at specific age intervals: 24-26 months, 28-30 months, 32-34 months, 36-38 months, and 42-44 months. Regarding healthy eating, physical activity, and COVID-19 information, the intervention group (n=331) received staged telephone and SMS support. The control group (n=331) received four distinct mail-outs concerning topics not pertaining to obesity prevention, such as toilet training, language development, and sibling dynamics, acting as a retention mechanism. At 12 and 24 months post-baseline (age 2), surveys and qualitative telephone interviews assessed intervention effects on BMI (primary outcome), eating habits (secondary outcome), and perceived co-benefits. Registration of the trial with the Australian Clinical Trial Registry is evident by the unique identifier ACTRN12618001571268.
In a group of 662 mothers, 537, or 81%, completed the follow-up assessment at three years of age. Importantly, 491, representing 74%, successfully completed the follow-up assessment at four years of age. The results of the multiple imputation analysis did not reveal a meaningful distinction in average BMI between the experimental and control groups. In the intervention group of low-income families (annual household income less than AU$80,000) at age three, the mean BMI was significantly lower (1626 kg/m² [SD 222]) than that of the control group (1684 kg/m²).
A statistically significant difference of -0.059 was found (95% confidence interval: -0.115 to -0.003; p=0.0040). The intervention group displayed a notable reduction in the frequency of children eating in front of the television, compared to the control group, as measured by adjusted odds ratios (aOR) of 200 (95% CI 133-299) at age three and 250 (163-383) at age four. Through qualitative interviews with 28 mothers, the intervention's impact was revealed: increased awareness, amplified confidence, and strengthened motivation to execute healthy feeding practices, especially for families with cultural diversity (such as those who speak languages other than English at home).
Maternal participants in the study reported a positive experience with the telephone-based intervention. The intervention could potentially decrease the BMI of children originating from low-income families. AGI-6780 The current disparity in childhood obesity rates among low-income and culturally diverse families might be lowered by telephone-based support programs.
Funding for the trial came from the NSW Health Translational Research Grant Scheme 2016 (grant TRGS 200) and a Partnership grant (number 1169823) from the National Health and Medical Research Council.
The trial's funding sources included the NSW Health Translational Research Grant Scheme 2016 (grant number TRGS 200) and a National Health and Medical Research Council Partnership grant (grant number 1169823).
Nutritional strategies implemented throughout pregnancy and before conception may positively influence infant weight gain; however, conclusive clinical studies are rare. Based on this, we investigated if preconception factors and maternal supplements during pregnancy could modify the bodily proportions and growth rate of children during their initial two years of life.
Recruiting women from communities in the UK, Singapore, and New Zealand before conception, they were randomly assigned to receive either a specialized intervention (myo-inositol, probiotics, additional micronutrients), or a control regimen (standard micronutrient supplement), the assignment was stratified by location and ethnic background.