Early prevention of obesity in children

One in five children and adolescents in Australia are either overweight or obese, and globally in 2014, 41 million children under the age of five were overweight or obese. Our project team is collaborating with the NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood to tackle this global epidemic.

Effectiveness of interventions

We are developing new tools to monitor obesity-related behaviours in the first five years of life, to understand changes in obesity risk.

To determine whether interventions are effective, we plan to analyse data from intervention trials conducted nationally and internationally and identify factors that promote successful implementation of obesity programs.

The economics of interventions

Furthermore, very few obesity interventions in early childhood have been subjected to economic evaluation. Since information on cost-effectiveness, equity, affordability, implementation feasibility, acceptability, sustainability and scalability are all vital to decisions about program implementation, we will assess the economic implications of different early childhood interventions.

We are evaluating obesity interventions in early childhood to ascertain whether there are effective programs to reduce obesity in the first five years of life, and onwards through generations to follow.

Through this project collaboration we aim to reduce the prevalence of obesity and obesity-related behaviours in the first five years of life, impacting both current young people and their subsequent generations.

The research impact will also extend to national policy, scaling up programs and translating research into practice requires an understanding of the policy context, available policy levers, and how to engage practitioners and consumers in this process.

Evidence of effectiveness

• We have undertaken the first prospectively planned individual participant data meta-analysis, involving four landmark early childhood obesity prevention RCTs from Australasia (total n=2,196 mother-child dyads, where children were 0-2 years old): Healthy Beginnings, INFANT, Nourish and Prevention of Obesity in Infancy. Using the innovative design of prospective meta-analysis, and by pooling data to increase power, we were the first in the world to show early childhood obesity prevention interventions (influencing early feeding, activity, screen time and sleep) lead to a clinically significant decrease in overweight/obesity prevalence in children at age 2. 

Large scale implementation

Two founding studies within our collaboration have received separate NHMRC Partnership Grants to evaluate the large scale implementation of two effective early childhood obesity prevention interventions. These are now well underway.

• Healthy Beginnings (USYD, NHMRC Partnership grant #1169823, CIs Wen, Hayes and Baur, AIs Rissel and Taki). Healthy Beginnings originally delivered through staged home visits by community nurses, led to significantly reduced early risk factors for childhood obesity and mean BMI of children at age 2y; in the scaled up version it is being implemented through text messages and telephone support (known as CHAT).
• INFANT (Deakin, NHMRC Partnership grant #1161223, Also includes investigators from USYD - Elizabeth Denney-Wilson, Sarah Taki. INFANT used dietitian-delivered sessions through established new parent groups, achieved high acceptance and positive and sustained (up to 5y) impacts on diet quality and TV viewing, and has been modified for implementation through Victorian local governments.

Evaluation of health care costs

A/Prof Alison Hayes published the first economic evaluation of an early childhood obesity prevention program and was then the first to use big data to show that children with obesity have higher healthcare costs in the first 5 years of life 

Publications

• Askie L, Espinoza D, Martin A, Daniels L, Mihrshahi S, Taylor R, Wen LM, Campbell K, Hesketh K, Rissel C, Taylor B, Magarey A, Seidler A, Hunter K, Baur L. Interventions commenced by early infancy to prevent childhood obesity – The EPOCH Collaboration:  an individual participant data prospective meta-analysis of four randomized controlled trials.  Pediatr Obesity 2020:e12618. doi: 10.1111/ijpo.12618. 
• Hayes A, Chevalier A, D’Souza M, Baur L, Wen LM, Simpson K. Early childhood obesity: association with healthcare expenditure in Australia. Obesity 2016; 24:1752-8.  

Internal collaborators

• Associate Professor Lisa Askie
• Professor Adrian Bauman
• Professor Louise Baur (Project Node Leader)
• Professor Tim Gill
• Associate Professor Alison Hayes
• Professor Chris Rissel
• Clinical Associate Professor Li Ming Wen

External collaborators

• Associate Professor Karen Campbell, Deakin University
• Professor Lynne Daniels, Queensland University of Technology
• Dr Rebecca Golley, University of South Australia
• Associate Professor Kylie Hesketh, Deakin University
• Professor Marj Moodie, Deakin University
• Associate Professor Rachael Taylor, Otago University
• Professor Stewart Trost, Queensland University of Technology