Over the past 2-3 decades numerous obesity prevention studies have been conducted among children and their results summarised by the Cochrane group and by several more recent reviews. Common to the conclusions from these reviews is that intervention effects were modest if at all evident, and that positive intervention outcomes were seen in <25% of all published trials. This is contrasted by the positive results from obesity treatment studies that generally produce significant and clinically meaningful weight reductions in overweight/obese children. Surprisingly, none of the previous prevention interventions were restricted to healthy weight children but were conducted among mixed groups of normal- and overweight children. Recent evidence suggests that in mixed groups an overall primary preventive effect cannot be observed in healthy weigh children, while children with existing overweight/obesity may benefit with weight loss without being specifically targeted.
The Danish Sundstart randomised controlled intervention is the first RCT to specifically target healthy weight young children and aimed at preventing initial excessive weight and fat gain. Families to normal weight, and obesity susceptible, children aged 2-6 years were invited to participate. Children were identified from national registries and considered obesity susceptible if they were born with a high birth weight, or their mother had overweight prior to pregnancy or low education. The intervention delivered guidance for improvements in diet and physical activity and sleep quantity and quality, and reduction of stress based on individual needs and capabilities of each individual family. In total 553 children were randomised and 365 completed the study. The average intervention lasted 1.3 years. Intention-to-treat analyses indicated no differences in weight gain in intervention compared to control group, but an underlying lower gain in percentage fat mass and a higher gain in lean mass. The results of the Sundstart Intervention will be discussed during the presentation.