Personalized web-based advice in combination with well-child visits to prevent overweight in young children: Cluster randomized controlled trial

Background: Overweight is a major health issue, and parent-targeted interventions to promote healthy development in children are needed. Objective: The study aimed to evaluate E-health4Uth Healthy Toddler, an intervention that educates parents of children aged 18 to 24 months regarding health-related behaviors, as compared with usual care. The effect of this intervention on the following primary outcomes was evaluated when the children were 36 months of age: health-related behaviors (breakfast daily, activity and outside play, sweetened beverage consumption, television (TV) viewing and computer time), body mass index (BMI), and the prevalence of overweight and obesity. Methods: The BeeBOFT (acronym for breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing) study is a cluster randomized controlled trial involving 51 Youth Health Care (YHC) teams. In total, 1094 parents participated in the control group, and 1008 parents participated in the E-health4Uth Healthy Toddler intervention group. The intervention consisted of Web-based personalized advice given to parents who completed an eHealth module and discussion of the advice during a regular well-child visit. In this study the eHealth module was offered to parents before two regular well-child visits at 18 and 24 months of age. During the well-child visits, the parents’ personalized advice was combined with face-to-face counseling provided by the YHC professional. Parents in the control group received usual care, consisting of the regular well-child visits during which general information on child health-related behavior was provided to parents. Parents completed questionnaires regarding family characteristics and health-related behaviors when the child was 1 month (inclusion), 6 months, 14 months, and 36 months (follow-up) of age. The child’s height and weight were measured by trained health care professionals from birth through 36 months of age at fixed time points. Multilevel linear and logistic regression models were used to evaluate the primary outcomes at 36 months of age. Results: At 36 months, we observed no differences between health-related behaviors of children, BMI or the percentage of children having overweight or obesity in the control and intervention group (P>.05). An analysis of the intervention effect revealed that boys benefited from eating breakfast daily, non-Dutch children spent more time being active or playing outdoors, children of low-educated parents and of overweight and obese mothers spent less time watc

Primary prevention of overweight in preschool children, the BeeBOFT study (breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing): Design of a cluster randomized controlled trial

Background: Two overweight prevention interventions were developed to be offered by preventive Youth Health Care (YHC) in addition to the currently applied overweight prevention protocol to parents of 0-3 year old children. The two interventions aim to support parents of preschool children to realize healthy child nutrition and activity behaviors of their young child. The aim of this study is to assess the effects of the two overweight prevention interventions with regard to child health behaviors and child Body Mass Index. Methods/Design. A cluster randomized controlled trial was conducted among parents and their preschool children who attend one of 51 participating YHC teams. The teams were randomly allocated to one of the two intervention groups, or to the control group (care as usual).The 'BBOFT+' intervention focuses on effective child rearing by parents from birth onwards by enlarging parental skills concerning healthy behavioural life-style habits. Parents who are allocated to the 'E-health4Uth Healthy toddler' intervention group, at the child age of circa 18 and 24 months old, are invited to complete an online E-health module providing tailored health education regarding healthy child nutrition and activity behaviors. The E-health messages are discussed and reinforced during the subsequent regularly scheduled visits by YHC professionals, and were repeated after 4 weeks.The primary outcome measures at child age 3 years are: overweight inducing/reducing behaviors, (for 'BBOFT+' only) healthy sleep, Body Mass Index and prevalence of overweight and obesity. Secondary outcome measures are attitudes and other cognitive characteristics of the parents regarding the overweight-related behaviors of their child, parenting styles and practices, and health-related quality of life of the children. Discussion. We hypothesize that the use of the additional interventions will result in a healthier lifestyle of preschool children and an improved BMI and less development of overweight and obesity compared to usual care. Trial registration. Nederlands Trial Register NTR1831

El entrenamiento integrado en edades tempranas

La característica principal de los alumnos en edades tempranas es su carácter notablemente activo, lo que nos lleva a los adultos formadores en la educación física y/o deportiva del niño que el trabajo que se presente, de entrenamiento o de formación física, sea llevadera, variada y atractiva pues la demanda de atención para que sea efectivo el trabajo físico es de gran magnitud. Este entrenamiento nos aportará la ventaja de acercarnos con la mayor similitud posible a la realidad. Durante el aprendizaje el proceso de transferencia entre habilidades e iniciación deportiva será más eficaz. También, la mejora y percepción global de las situaciones lúdicas de entre compañeros dará respuestas reales a situaciones reales en el mismo momento. También economizamos tiempo de cara a grupos numerosos, tocando en menos tiempo más aspectos de interés general. A nivel socio-afectivo es fácil vislumbrar que la relación entre participantes va aportar una gran riqueza no tan sola deportiva sino también humana y personal. Por todo ello he aquí la siguiente exposición de la importancia del entrenamiento con aspectos integrados en el deporte a edades tempranas de nuestros alumnos y/o jugadores.The main characteristic of the students in early ages is its notably active character, what takes us to the mature formations in the boy’s physical and sport education that the work that is presented, of training or of physical formation, be bearable, varied and attractive because the demand of attention so that it is effective the physical work is of great magnitude. This training will contribute us the advantage of coming closer with the biggest similarity possible to the reality. During the learning the transfer process between abilities and sport initiation will be more effective. Also, the improvement and global perception of the games situations of among partners he will give real answers to real situations in the same moment. We also economize time of face to numerous groups, playing in less time more aspects of general interest. At partner-affective level it is easy to glimpse that the relationship among participants goes to not contribute a great wealth so alone sport but also human and personal. For everything there is it here the following exhibition of the importance of the training with aspects integrated in the sport to our students’ early ages and players.Facultad de Educación y Humanidades - Campus de Melilla (Universidad de Granada

Sleep and body mass index in infancy and early childhood (6-36mo): a longitudinal study

Summary Background: Relatively, few longitudinal studies have evaluated the association between sleep and body mass index (BMI) among younger children. In addition, few studies have evaluated the bidirectional longitudinal association between sleep duration and child BMI. Objective: The objective of the study is to determine in children aged 6 to 36 months (1) the cross‐sectional association of sleep duration and sleep problems with child BMI z score, (2) whether sleep duration predicts changes in child BMI z score, and (3) and whether BMI z score can predict changes in child sleep duration. Methods: This study used longitudinal data from the BeeBOFT study (N = 2308). Child sleep duration and sleep problems (indicated by night awakenings and sleep‐ onset latency) were parent reported, and child BMI was measured using a standardized protocol by trained healthcare professionals at approximately 6, 14, and 36 months of age. Linear mixed models and linear regression models were applied to assess the cross‐sectional and bidirectional longitudinal associations between sleep and BMI z scores. Results: Cross sectionally, shorter sleep duration was associated with higher BMI z scores at 14 (β = −0.034, P < 0.05) and 36 months (β = −0.045, P < 0.05). S

Factors associated with early introduction of complementary feeding and consumption of non-recommended foods among Dutch infants: the BeeBOFT study

The present study aimed to investigate the factors associated with early introduction of complementary feeding (i.e., before age 4 months), and factors associated with infants consumption of non-recommended foods, including sweet beverages and snack foods. Methods: This study used cross-sectional data from the BeeBOFT study (n = 2157). Data on complementary feeding practices and potential determinants were obtained by questionnaire at infant’s age of 6 months. Logistic regression models were used to investigate factors associated with early introduction of complementary feeding and infants’ consumption of non-recommended foods. Results: 21.4% of infants had received complementary feeding before 4 months of age. At the age of 6 months, 20.2% of all infants were consuming sweet beverages daily and 16.5% were consuming snack foods daily. Younger maternal age, lower maternal educational level, absence or shorter duration of breastfeeding, parental conviction that “my child always wants to eat when he/she sees someone eating” and not attending day-care were independently associated with both early introduction of complementary feeding and the consumption of non-recommended foods. Higher maternal pre-pregnancy BMI and infant postnatal weight gain were associated only with early introduction of complementary feeding. Conclusions: We identified several demographical, biological, behavioral, psychosocial, and social factors associated with inappropriate complementary feeding practices. These findings are relevant for designing intervention programs aimed at educating parents

Parenting support to prevent overweight during regular well-child visits in 0-3 year old children (BBOFT+ program), a cluster randomized trial on the effectiveness on child BMI and health behaviors and parenting

BACKGROUND: Prevention of overweight during early childhood seems promising. OBJECTIVE: To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). METHODS: A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI. RESULTS: No differences were found in weight status at 36 months between intervent