Selective primary obesity prevention in children

BACKGROUND AND OBJECTIVE: Obesity in children is characterized by a rapid gain of weight starting at an age of 4 to 5 years. We investigated whether low threshold prevention prevented a further increase of the Standard-Deviation-Score of the BMI (BMI SDS) in children with impending obesity. PATIENTS AND METHODS: The network CrescNet collected data from more than 300,000 children. We selected 365 children with impending obesity (age 4 to 7 years). After randomisation the study population was divided into an intervention group (180 children) and a control group (185 not informed children). The paediatrician carried out a low threshold intervention consisted of an age-adapted nutrition and exercise program to inspire the awareness of the adequate nourishment and motion. RESULTS: 59 children of the intervention group opted for a participation and 49 of them took part to the end of the study. This study population stabilized their BMI SDS (p < 0.025). The children randomised in the intervention group who were not interested to participate, and the children of the control group increased their BMI SDS within the observation period of one year (p < 0.001, p = 0.002). According to nutrition diaries a decrease energy intake of the participants of the intervention group was detected. The percentage of protein intake was particularly remarkable, amounting to 363 % fulfillment of demand at the beginning of the study and 274 % at the end. A regression analysis suggests that an intervention and also the approval to take part in the study had a significant influence on changes in BMI SDS. CONCLUSION: A low threshold intervention in early childhood could successfully prevent an increase of obesity.