The effects of hypothetical behavioral interventions on the 13-year incidence of overweight/obesity in children and adolescents

International Journal of Behavioral Nutrition and Physical Activity

Research

D. Molnár¹  S. De Henauw²  T. Vrijkotte³  L. A. Moreno⁴  A. Formisano⁵  C. Börnhorst⁶  M. Wolters⁶  V. Didelez⁷  I. Pigeot⁷  T. Veidebaum⁸  M. Tornaritis⁹  L. Lissner^1,10 

[1] Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary;Department of Public Health and Primary Care, Ghent University, Ghent, Belgium;Department of Public and Occupational Health, Amsterdam University Medical Center (Amsterdam UMC), University of Amsterdam, Amsterdam, The Netherlands;GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain;Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Madrid, Spain;Institute of Food Sciences, National Research Council, Avellino, Italy;Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany;Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany;Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany;National Institute for Health Development, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia;Research and Education Institute of Child Health, Strovolos, Cyprus;School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;

关键词: Causal inference;    Childhood obesity;    IDEFICS/I.Family cohort;    Modifiable risk factor;    Observational data;    Parametric g-formula;   

DOI  :  10.1186/s12966-023-01501-6

 received in 2023-04-05, accepted in 2023-08-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn view of the high burden of childhood overweight/obesity (OW/OB), it is important to identify targets for interventions that may have the greatest effects on preventing OW/OB in early life. Using methods of causal inference, we studied the effects of sustained behavioral interventions on the long-term risk of developing OW/OB based on a large European cohort.MethodsOur sample comprised 10 877 children aged 2 to < 10 years at baseline who participated in the well-phenotyped IDEFICS/I.Family cohort. Children were followed from 2007/08 to 2020/21. Applying the parametric g-formula, the 13-year risk of developing OW/OB was estimated under various sustained hypothetical interventions on physical activity, screen time, dietary intake and sleep duration. Interventions imposing adherence to recommendations (e.g. maximum 2 h/day screen time) as well as interventions ‘shifting’ the behavior by a specified amount (e.g. decreasing screen time by 30 min/day) were compared to ‘no intervention’ (i.e. maintaining the usual or so-called natural behavior). Separately, the effectiveness of these interventions in vulnerable groups was assessed.ResultsThe 13-year risk of developing OW/OB was 30.7% under no intervention and 25.4% when multiple interventions were imposed jointly. Meeting screen time and moderate-to-vigorous physical activity (MVPA) recommendations were found to be most effective, reducing the incidence of OW/OB by -2.2 [-4.4;-0.7] and -2.1 [-3.7;-0.8] percentage points (risk difference [95% confidence interval]), respectively. Meeting sleep recommendations (-0.6 [-1.1;-0.3]) had a similar effect as increasing sleep duration by 30 min/day (-0.6 [-0.9;-0.3]). The most effective intervention in children of parents with low/medium educational level was being member in a sports club; for children of mothers with OW/OB, meeting screen time recommendations and membership in a sports club had the largest effects.ConclusionsWhile the effects of single behavioral interventions sustained over 13 years were rather small, a joint intervention on multiple behaviors resulted in a relative reduction of the 13-year OW/OB risk by between 10 to 26%. Individually, meeting MVPA and screen time recommendations were most effective. Nevertheless, even under the joint intervention the absolute OW/OB risk remained at a high level of 25.4% suggesting that further strategies to better prevent OW/OB are required.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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