Mustila Taina, Raitanen Jani, Keskinen Päivi, Saari Antti, Luoto Riitta
Department of Pediatrics, Central Hospital of Seinäjoki, Seinäjoki, Finland.
BMJ Open. 2012 Feb 3;2(1):e000624. doi: 10.1136/bmjopen-2011-000624. Print 2012.
To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life.
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).
The participants (N=89) were mothers of infants aged 2-10 months.
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.
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.
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).
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.
Current Controlled Trials ISRCTN21512277.
探讨针对婴儿母亲强化生活方式咨询对其子女4岁前体重发育的影响。
对2004年至2006年芬兰初级保健儿童健康诊所的一项整群随机对照试验进行随访。参与者在2010年接受了关于其子女体重和身高测量的随访调查。整群数为6个，随访应答率为71.9%（N = 64/89）。
参与者（N = 89）为2至10个月婴儿的母亲。
干预包括在婴儿2至10个月大时进行饮食和体育活动的个人咨询，以及参加有监督的团体锻炼课程的选项。
作者分析了干预研究的次要结局：子女的体重发育情况。主要结局是此前报道的产后10个月恢复到孕前体重的女性比例。
多水平混合效应非线性回归模型纳入了分组、儿童年龄以及分组与儿童年龄之间的交互作用。与对照组相比，干预组子女在24至48个月期间BMI z评分的增加较慢（-0.034至-0.002，p = 0.028）。分析0至48个月期间，身长/身高别体重的z评分在两组间无差异（p = 0.23），但在24至48个月期间，组间差异显著（p = 0.012）。
在孩子出生第一年针对母亲进行生活方式咨询可能有效减缓子女直到4岁时的体重增加。然而，需要更大规模的研究来证实这些发现，这些发现可能在对抗肥胖流行方面具有潜力。
Current Controlled Trials ISRCTN21512277
