The Healthy Start Project: Primary Prevention of Overweight in Preschool Children Susceptible to Future Overweight
Condition: Overweight; Obesity
MeSH terms: Obesity; Overweight
Study type: Interventional

Summary: 
      Obesity prevention should remain a priority, although there is some evidence of a possible
      leveling off in some age groups across European countries and in USA, Japan and Australia.
      Besides adult health problems such as type-2 diabetes and cardiovascular diseases, obesity in
      childhood is associated with psychological and social problems, low self-esteem,
      stigmatization and being teased and bullied by friends. Danish research suggests that the
      causes behind the increase in obesity occurrence are present already in early childhood, and
      that prevention of obesity therefore has to start early. Research has suggested that at least
      three sub-groups can be considered susceptible to develop obesity: Children with obesity
      among their 1st degree relatives; children with a high birth weight or children coming from
      socially disadvantaged families (low socioeconomic status). Earlier intervention programs has
      showed little effect in preventing excessive weight gain and knowledge on how to develop
      effective intervention programs that reduce overweight and obesity remains limited. It has
      been suggested that future prevention programs may be more successful if specifically
      targeting groups that are at high risk, as mention above, of excessive weight gain.

      Based on these suggestions, the "Sund Start" project was initiated. The purpose of the study
      was to determine whether aiming prevention towards 2-6 years old Danish children who were yet
      normal weight, but were considered susceptible to develop overweight or obese could prevent
      later on risk of becoming overweight or obese. Furthermore, to investigate if it was possible
      to improve diet habits, increase physical activity, reduce stress and improve sleeping habits
      among children at high risk for later on overweight and obesity.

      The "Sund Start" project will contribute with knowledge about whether targeting normal
      weight, predisposed children is effective in preventing overweight and obesity, and if
      reduced stress and improved sleep, should be considered important new obesity prevention
      tools. Moreover, the project will contribute with knowledge about how to change lifestyle and
      its effects on development of overweight and obesity in high risk Danish preschool children.
    

Detailed description: 
      In 2009, data on all births between 2004 and 2007 in 11 selected municipalities from the
      greater Copenhagen area was obtained from the Danish national birth register at the National
      Board of Health. This register contains information on all births, whether at hospital or
      home, on factors such as birth weight and length, height and pre-pregnant weight of the
      mother, parity, and Central Personal Registry number (CPR-number). Data on socioeconomic
      status was obtained from the administrative birth forms. This was done manually using the
      CPR-numbers obtained from the birth register.

      After selection of the children eligible for participation, the children were allocated to
      three groups, (intervention group, control group, shadow group) using computer based
      randomization. All siblings were allocated to the same group. After the random allocation,
      children from the intervention group and the control group were sent a letter with an
      invitation to participate in the project. Children from the shadow group were also
      identified, and their general practitioners were contacted and asked for information on each
      child's height and weight.
    

Intervention name(s): Lifestyle habits, including sleep and stress
Intervention type(s): Behavioral
Intervention description(s): The intervention group was offered up to 10 individual consultations focusing on improving diet, physical activity and sleep habits and reducing stress. Moreover, the intervention group was offered participation in monthly cooking classes and playing arrangements
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Overweight; Obesity; Susceptibility; Prevention; Diet; Physical activity; Sleep; Family stress