Interventions that prevent or reduce obesity in children from birth to five years of age: A systematic review.
Katia Narzisi, Joan Simons
PMID 32295414WHAT IT FOUND
Some home, childcare and clinic programmes lowered BMI or improved feeding in children under five, but effects were inconsistent and often faded.
The evidence does not show a reliable long-term obesity prevention programme.
Key findings
01Thirty studies involving 23,185 children reported mixed weight outcomes: some interventions lowered BMI or zBMI, while others showed no significant effect.
02Nurse-delivered home visiting lowered mean BMI, and a dietitian-led infant feeding programme lowered BMI z-scores at 13 months, but the latter effect was not sustained at age two years.
03Multicomponent community, childcare and clinic programmes sometimes improved diet, activity or weight, but several had no significant BMI change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The review could miss relevant preschool studies because the age at which children start school varies by country. The evidence base is limited: there were only 22 randomised controlled trials, 8 quasi-experimental studies and 7 pilot studies among the 30 included studies. Some positive findings were not sustained, and follow-up ranged from none to four years. Some studies had no control group, so changes cannot be attributed to the intervention. The search was limited to English-language articles and six databases, so studies in other languages or settings may be missing. Deprived families were sometimes not recruited as planned, limiting usefulness for high-risk groups.
Declared interests
The authors declared no conflicts of interest and received no financial support for the research, authorship or publication.
The easy way to misread this
Do not conclude that any programme reliably prevents obesity in under-fives. Many positive findings were small, inconsistent, not sustained, or came from pilots without control groups.