Childhood adiposity, overweight, and obesity, arising from maternal undernutrition, gestational diabetes, and impaired intrauterine and early-life development, are strong predictors of poor health trajectories and increased risk of non-communicable diseases. LYN-1604 ic50 In Canada, China, India, and South Africa, a significant portion, ranging from 10 to 30 percent, of children aged 5 to 16 years are classified as overweight or obese.
The principles of developmental origins of health and disease provide a groundbreaking approach to preventing overweight and obesity, reducing adiposity, and integrating interventions throughout the lifespan, commencing before conception and extending into early childhood. The Healthy Life Trajectories Initiative (HeLTI) was created in 2017 by a unique collaboration of national funding agencies spanning Canada, China, India, South Africa, and the WHO. HeLTI seeks to measure the consequences of a unified four-phase intervention, starting pre-conceptionally and extending throughout pregnancy, infancy, and early childhood, in its aim to reduce childhood adiposity (fat mass index), overweight and obesity, while simultaneously optimizing early childhood development, nutrition, and the establishment of healthy behaviours.
Across Canada, as well as in Shanghai, China, Mysore, India, and Soweto, South Africa, approximately 22,000 women are currently being recruited. Future mothers, numbering an anticipated 10,000, and their progeny will be tracked until the child turns five years old.
HeLTI has implemented a standardized approach to the intervention, metrics, instruments, biological specimen acquisition, and analytical procedures for the trial spanning four countries. An intervention addressing maternal health behaviors, nutrition, weight, psychosocial support to alleviate maternal stress and prevent mental illness, optimization of infant nutrition, physical activity, and sleep, and promotion of parenting skills will be evaluated by HeLTI to determine if it reduces intergenerational risks of excess childhood adiposity, overweight, and obesity across diverse environments.
In the context of research institutions, we find the Canadian Institutes of Health Research, the National Science Foundation of China, the Department of Biotechnology in India, and the South African Medical Research Council.
Prominent organizations in the global science community include the Canadian Institutes of Health Research; the National Science Foundation of China; the Department of Biotechnology, India; and the South African Medical Research Council.
Unfortunately, the prevalence of ideal cardiovascular health is worryingly low among Chinese children and adolescents. We sought to determine if a school-focused lifestyle intervention for obesity would enhance indicators of optimal cardiovascular health.
We conducted a cluster-randomized, controlled trial, encompassing schools situated in seven different regions of China, randomly assigning them to intervention or control groups based on stratification by province and school grade (grades 1-11; ages 7-17). Randomization was conducted under the supervision of an independent statistician. An intervention lasting nine months for a specific group involved promoting better diets, exercise, and self-monitoring of behaviors related to obesity. The control group did not receive any of these interventions. Ideal cardiovascular health, a key outcome assessed at both baseline and nine months, comprised six or more ideal cardiovascular health behaviors (e.g., non-smoking, BMI, physical activity, and diet), along with factors such as total cholesterol, blood pressure, and fasting plasma glucose. Multilevel modeling was incorporated into our intention-to-treat analysis methodology. Peking University's ethics committee in Beijing, China, reviewed and approved this study (ClinicalTrials.gov). NCT02343588's implications for medical research require thorough analysis.
A review of follow-up cardiovascular health measures involved 30,629 students in the intervention group and 26,581 students in the control group, taken from 94 participating schools. Results from the follow-up assessment indicated 220% (1139 out of 5186) of the intervention group and 175% (601 out of 3437) of the control group met the criteria for ideal cardiovascular health. In conclusion, while the intervention was associated with ideal cardiovascular health behaviors (three or more; odds ratio 115; 95% CI 102-129), it had no effect on other ideal cardiovascular health metrics after controlling for potential influencing factors. The intervention demonstrably enhanced ideal cardiovascular health practices among primary school children, aged seven to twelve, (119; 105-134) outperforming secondary school students aged thirteen to seventeen (p<00001), without any discernible gender variation (p=058). LYN-1604 ic50 The intervention's benefit for senior students aged 16-17 in terms of reducing smoking (123; 110-137) was coupled with a positive impact on the ideal physical activity levels of primary school students (114; 100-130). However, a negative association was found for ideal total cholesterol in primary school boys (073; 057-094).
The school-based intervention, concentrating on diet and exercise, proved effective in enhancing ideal cardiovascular health behaviors for Chinese children and adolescents. Life-long cardiovascular health could potentially benefit from early interventions.
Grant funding for this project includes the Special Research Grant for Non-profit Public Service, provided by the Ministry of Health of China (201202010), and the Guangdong Provincial Natural Science Foundation (2021A1515010439).
Dual funding for the project came from the Special Research Grant for Non-profit Public Service from the Ministry of Health of China (201202010) and the Guangdong Provincial Natural Science Foundation (2021A1515010439).
The existing evidence for effective early childhood obesity prevention is minimal and concentrated on interventions involving direct interaction. Unfortunately, the COVID-19 pandemic led to a substantial decrease in the implementation of face-to-face healthcare programs on a global scale. A telephone-based intervention's contribution to lessening the likelihood of obesity in young children was scrutinized in this study.
A pragmatic, randomized controlled trial, employing a pre-pandemic study protocol, was conducted between March 2019 and October 2021. The trial enrolled 662 women with two-year-old children (mean age 2406 months, standard deviation 69) and extended the initial 12-month intervention period to 24 months. The intervention, tailored to the needs of the participants, included five telephone support sessions plus text message communication over a 24-month timeframe, encompassing child ages 24-26 months, 28-30 months, 32-34 months, 36-38 months, and 42-44 months. The intervention group (331 individuals) benefited from staged telephone and SMS support addressing healthy eating, physical activity, and COVID-19. A retention strategy was implemented for the control group (n=331), involving four mailings concerning topics unrelated to obesity prevention, such as toilet training, language development, and sibling relations. Telephone interviews, supplemented by surveys, were utilized at 12 and 24 months after the initial assessment (age 2) to evaluate the intervention's effect on BMI (primary outcome), eating habits (secondary outcome), and perceived co-benefits. The Australian Clinical Trial Registry possesses the record of this trial, identifiable through registration number ACTRN12618001571268.
Out of a total of 662 mothers, 537 (81%) completed the follow-up assessment at the 3-year mark, and a further 491 (74%) successfully completed the follow-up assessment at the four-year point. Analysis via multiple imputation methods demonstrated no substantial difference in average BMI levels amongst the respective groups. For low-income families (those with annual household incomes below AU$80,000) at age three, the intervention was substantially linked to a reduced average BMI (1626 kg/m² [SD 222]) in the intervention group when contrasted with the control group (1684 kg/m²).
The difference between groups was -0.059, which was statistically significant (p=0.0040) and had a 95% confidence interval of -0.115 to -0.003. Television-related eating habits differed significantly between intervention and control groups, with the intervention group displaying a substantially reduced likelihood of consuming meals in front of the TV, indicated by adjusted odds ratios (aOR) of 200 (95% CI 133-299) at age three and 250 (163-383) at age four. In a qualitative study of 28 mothers, the intervention was found to bolster awareness, confidence, and motivation for implementing healthy feeding practices, particularly within families with culturally diverse backgrounds (i.e., families where a language other than English is spoken).
Mothers in the study expressed positive feedback regarding the telephone-based intervention. Children from low-income families could experience a reduction in their BMI as a result of the intervention. LYN-1604 ic50 The current disparity in childhood obesity rates among low-income and culturally diverse families might be lowered by telephone-based support programs.
The trial was financed through a combination of grants, namely, the NSW Health Translational Research Grant Scheme 2016, grant number TRGS 200, and a partnership grant from the National Health and Medical Research Council (number 1169823).
Funding for the trial comprised the NSW Health Translational Research Grant Scheme 2016 (grant TRGS 200) and a separate National Health and Medical Research Council Partnership grant (number 1169823).
Healthy infant weight gain might be influenced by nutritional interventions undertaken throughout pregnancy and before, although clinical proof is scarce. To this end, we evaluated the potential effects of pre-pregnancy conditions and prenatal nutritional intake on the bodily size and growth of children during their first two years.
Community-based recruitment of women in the UK, Singapore, and New Zealand, before conception, resulted in their random allocation to one of two groups: an intervention group (myo-inositol, probiotics, and additional micronutrients) or a control group (standard micronutrient supplement), stratified by geographical location and ethnicity.