Home visiting by trained nurses decrease BMI in young children

A home based intervention program, teaching mums about healthy eating and the importance of physical activity, has been effective in reducing the Body Mass Index (BMI) of their young children at age 2 years. The randomized controlled trial, undertaken in south western Sydney by researchers from the University of Sydney was published in the British Medical Journal.

Childhood obesity is a growing problem with about one in five Australian preschoolers being overweight. As overweight in the preschool years can lead to overweight in later life, the need for this  to be addressed early is important. The study, which was part of the Healthy Beginnings Trial, aimed to measure whether a home based intervention could be effective in reducing the BMI of children at age 2 years.

667 first time infants and their mothers were enrolled before birth. They were divided into 2 groups - 225 in an intervention group  and 242 in the control group. The intervention group was visited by trained community nurses at home once before birth and then 7 times after birth when the baby was 1,3,5,9,12. 18 and 24 months. During these visits the main messages given were:- breast is best, no solids until 6 months, eat a variety of fruits and vegetables daily, have water only in a cup and be part of an active family. The control group was not visited at home but visited their local community nurse at their various locations. The child's weight, length, TV viewing times, eating habits including junk food consumption and physcial activity patterns were recorded.

The study found at the end of the 2 years intervention, the intervention group compared to the control group had:-

• Lower BMI ( 16.43 vs 16.82)
• Ate more serves of vegetables
• less likely to be given food as a reward
• less likely to eat in front of the TV
• less likely to watch more than 1 hour of TV a day
• Mothers from the intervention group also ate more vegetables and were more physically active

The groups did not differ  significantly in their fruit or junk food intake or time spent playing outdoors.

The study shows that a home based intervention strategy by trained health professionals during the first 2 years of life is an effective strategy for helping to reduce childhood overweight /obesity and can have a positive impact on eating habits and activity patterns. Further long term followup and measures of cost effectiveness are needed.

Reference:

Ming Wen L, Baur L et al. Effectiveness of home based early intervention on children's BMI at age 2: randomized controlled trial. BMJ2012;344:e3732