Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity: outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules

Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4–6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Design: Randomised controlled trial of a community-based early feed...

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Published inInternational Journal of Obesity Vol. 36; no. 10; pp. 1292 - 1298
Main Authors Daniels, L A, Mallan, K M, Battistutta, D, Nicholson, J M, Perry, R, Magarey, A
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.10.2012
Nature Publishing Group
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Online AccessGet full text
ISSN0307-0565
1476-5497
1476-5497
DOI10.1038/ijo.2012.96

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Abstract Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4–6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Design: Randomised controlled trial of a community-based early feeding intervention. Subjects and methods: Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. Results: There were no differences according to group allocation on key maternal and infant characteristics. At follow-up ( n =598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P =0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1–2.1, P =0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P =0.001) or using games (67% vs 29%, P <0.001). Conclusions: These results provide early evidence that anticipatory guidance targeting the ‘when, what and how’ of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
AbstractList To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Randomised controlled trial of a community-based early feeding intervention. Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001). These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
International Journal of Obesity (2012) 36, 1292-1298; doi: 10.1038/ijo.2012.96; published online 19 June 2012
To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Randomised controlled trial of a community-based early feeding intervention. Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001). These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
OBJECTIVE: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. DESIGN: Randomised controlled trial of a community-based early feeding intervention. SUBJECTS AND METHODS: Six hundred and ninety-eight first-time mothers (mean age 30 ±5 years) with healthy term infants (51% male) aged 4.3 ± 1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7 ± 1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of > + 0.67. Maternal feeding practices were assessed via self-administered questionnaire. RESULTS: There were no differences according to group allocation on key maternal and infant characteristics. At follow- up (n = 598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42 [+ or -]0.85 vs 0.23 ± 0.93, P = 0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR) = 1.5, confidence interval (CI) 95% = 1.1-2.1, P = 0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P = 0.001) or using games (67% vs 29%, P < 0.001). CONCLUSIONS: These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained. International Journal of Obesity (2012) 36, 1292-1298; doi: 10.1038/ijo.2012.96; published online 19 June 2012 Keywords: childhood obesity; randomised controlled trial; infant; feeding practices
Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline.Design:Randomised controlled trial of a community-based early feeding intervention.Subjects and methods: Six hundred and ninety-eight first-time mothers (mean age 30 plus or minus 5 years) with healthy term infants (51% male) aged 4.3 plus or minus 1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7 plus or minus 1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. Results: There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42 plus or minus 0.85 vs 0.23 plus or minus 0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001). Conclusions: These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline.OBJECTIVETo evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline.Randomised controlled trial of a community-based early feeding intervention.DESIGNRandomised controlled trial of a community-based early feeding intervention.Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire.SUBJECTS AND METHODSSix hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire.There were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001).RESULTSThere were no differences according to group allocation on key maternal and infant characteristics. At follow-up (n=598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P=0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1-2.1, P=0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P=0.001) or using games (67% vs 29%, P<0.001).These results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.CONCLUSIONSThese results provide early evidence that anticipatory guidance targeting the 'when, what and how' of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4–6 months, using outcome data assessed 6 months after completion of the first of two intervention modules and 9 months from baseline. Design: Randomised controlled trial of a community-based early feeding intervention. Subjects and methods: Six hundred and ninety-eight first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over 3 months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) of >+0.67. Maternal feeding practices were assessed via self-administered questionnaire. Results: There were no differences according to group allocation on key maternal and infant characteristics. At follow-up ( n =598 (86%)), the control group infants had higher BMI-for-age z-score (BMIZ) (0.42±0.85 vs 0.23±0.93, P =0.009) and were more likely to show rapid weight gain from baseline to follow-up (odds ratio (OR)=1.5, confidence interval (CI) 95%=1.1–2.1, P =0.014). Mothers in the control group were more likely to report using non-responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, P =0.001) or using games (67% vs 29%, P <0.001). Conclusions: These results provide early evidence that anticipatory guidance targeting the ‘when, what and how’ of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.
Audience Academic
Author Nicholson, J M
Battistutta, D
Perry, R
Mallan, K M
Magarey, A
Daniels, L A
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  fullname: Nicholson, J M
  organization: Parenting Research Centre, Centre for Learning Innovation, Queensland University of Technology
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  surname: Perry
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  fullname: Magarey, A
  organization: School of Exercise and Nutrition Sciences, Queensland University of Technology, Department of Nutrition and Dietetics, Flinders University
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ContentType Journal Article
Copyright Macmillan Publishers Limited 2012
2015 INIST-CNRS
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Issue 10
Keywords randomised controlled trial
infant
feeding practices
childhood obesity
Human
Evaluation
Obesity
Prognosis
Nutrition
Nutrition disorder
Metabolic diseases
Infant
Feeding
Prevention
Randomization
Professional practice
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Clinical trial
Evolution
Child
Age
Nutritional status
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Snippet Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4–6 months, using outcome data assessed 6 months after...
To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after completion of the...
OBJECTIVE: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after...
International Journal of Obesity (2012) 36, 1292-1298; doi: 10.1038/ijo.2012.96; published online 19 June 2012
Objective: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6 months after...
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SubjectTerms 692/308/409
692/699/1702/393
692/700/1720
692/700/459
Australia - epidemiology
Biological and medical sciences
Body Mass Index
Breast Feeding - methods
Breast Feeding - statistics & numerical data
Care and treatment
Eating behavior
Education
Epidemiology
Feeding
Feeding Behavior
Female
Follow-Up Studies
General aspects
Health Education
Health Promotion and Disease Prevention
Humans
Infant
Infant Food
Infant Nutritional Physiological Phenomena
Infant, Newborn
Infants
Internal Medicine
Intervention
Male
Maternal-Child Health Centers
Medical sciences
Medicine
Medicine & Public Health
Metabolic Diseases
Mother-Child Relations
Nutrition
Obesity
Obesity - epidemiology
Obesity - prevention & control
Obesity in children
original-article
Pregnancy
Prevention
Prevention and actions
Primary Prevention
Program Evaluation
Public Health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk factors
Satiety Response
Surveys and Questionnaires
Weight Gain
Title Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity: outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules
URI https://link.springer.com/article/10.1038/ijo.2012.96
https://www.ncbi.nlm.nih.gov/pubmed/22710926
https://www.proquest.com/docview/1095258822
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https://www.proquest.com/docview/1113218972
Volume 36
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