Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood Sydney School of Public Health, The University of Sydney, Sydney, NSW 2109, Australia.
Int J Environ Res Public Health. 2021 Mar 2;18(5):2444. doi: 10.3390/ijerph18052444.
Childhood overweight and obesity is a worldwide public health issue. Our objective was to describe planned, ongoing and completed randomized controlled trials (RCTs) designed for the prevention of obesity in early childhood. Two databases (World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov) were searched to identify RCTs with the primary aim of preventing childhood obesity and at least one outcome related to child weight. Interventions needed to start in the first two years of childhood or earlier, continue for at least 6 months postnatally, include a component related to lifestyle or behaviours, and have a follow up time of at least 2 years. We identified 29 unique RCTs, implemented since 2008, with most being undertaken in high income countries. Interventions ranged from advice on diet, activity, sleep, emotion regulation, and parenting education through to individual home visits, clinic-based consultations, or group education sessions. Eleven trials published data on child weight-related outcomes to date, though most were not sufficiently powered to detect significant effects. Many trials detected improvements in practices such as breastfeeding, screen time, and physical activity in the intervention groups compared to the control groups. Further follow-up of ongoing trials is needed to assess longer-term effects.
儿童超重和肥胖是一个全球性的公共卫生问题。我们的目的是描述为预防儿童早期肥胖而计划、正在进行和已完成的随机对照试验(RCT)。我们在两个数据库(世界卫生组织国际临床试验注册平台、ClinicalTrials.gov)中搜索了以预防儿童肥胖为主要目标的 RCT,并至少有一个与儿童体重相关的结果。干预措施需要在儿童生命的头两年或更早开始,在出生后至少持续 6 个月,包括与生活方式或行为相关的组成部分,并至少有 2 年的随访时间。我们确定了 29 项自 2008 年以来实施的独特 RCT,其中大多数在高收入国家进行。干预措施从饮食、活动、睡眠、情绪调节和育儿教育方面的建议,到个体家访、诊所咨询或小组教育课程,不一而足。目前已有 11 项试验公布了与儿童体重相关的结果数据,但大多数试验的样本量不足以检测到显著效果。与对照组相比,许多试验发现干预组在母乳喂养、屏幕时间和体育活动等方面的做法有所改善。需要对正在进行的试验进行进一步随访,以评估长期效果。