Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT

• Published in: Pediatrics (Evanston) Vol. 139; no. 3
• Main Authors: Taylor, Barry J, Gray, Andrew R, Galland, Barbara C, Heath, Anne-Louise M, Lawrence, Julie, Sayers, Rachel M, Cameron, Sonya, Hanna, Maha, Dale, Kelly, Coppell, Kirsten J, Taylor, Rachael W
• Format: Journal Article
• Language: English
• Published: United States 01.03.2017
• Subjects: Adult; Breast Feeding; Child, Preschool; Diet; Exercise; Female; Humans; Infant; Infant, Newborn; New Zealand; Pediatric Obesity - prevention & control; Pregnancy; Sleep; Sleep Hygiene
• ISSN: 1098-4275
• DOI: 10.1542/peds.2016-2037

The few existing early-life obesity prevention initiatives have concentrated on nutrition and physical activity, with little examination of sleep. This community-based, randomized controlled trial allocated 802 pregnant women (≥16 years, <34 weeks' gestation) to: control, FAB (food, activity, and breastfeeding), sleep, or combination (both interventions) groups. All groups received standard well-child care. FAB participants received additional support (8 contacts) promoting breastfeeding, healthy eating, and physical activity (antenatal-18 months). Sleep participants received 2 sessions (antenatal, 3 weeks) targeting prevention of sleep problems, as well as a sleep treatment program if requested (6-24 months). Combination participants received both interventions (9 contacts). BMI was measured at 24 months by researchers blinded to group allocation, and secondary outcomes (diet, physical activity, sleep) were assessed by using a questionnaire or accelerometry at multiple time points. At 2 years, 686 women remained in the study (86%). No significant intervention effect was observed for BMI at 24 months ( = .086), but there was an overall group effect for the prevalence of obesity ( = .027). Exploratory analyses found a protective effect for obesity among those receiving the "sleep intervention" (sleep and combination compared with FAB and control: odds ratio, 0.54 [95% confidence interval, 0.35-0.82]). No effect was observed for the "FAB intervention" (FAB and combination compared with sleep and control: odds ratio, 1.20 [95% confidence interval, 0.80-1.81]). A well-developed food and activity intervention did not seem to affect children's weight status. However, further research on more intensive or longer running sleep interventions is warranted.