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Lifestyle counselling targeting infant's mother during the child's first year and offspring weight development until 4 years of age: a follow-up study of a cluster RCT [with consumer summary]
Mustila T, Raitanen J, Keskinen P, Saari A, Luoto R
BMJ Open 2012 Feb;2(1):e000624
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life. DESIGN AND SETTING: Follow-up of a cluster randomised controlled trial in primary care child health clinics during 2004 to 2006 in Finland. Participants received a follow-up survey during 2010 concerning weight and height measurements of their offspring. Number of clusters was six and the response rate to the follow-up 71.9% (n = 64/89). PARTICIPANTS: The participants (n = 89) were mothers of infants aged 2 to 10 months. INTERVENTION: The intervention included individual counselling on diet and physical activity when the infant was 2 to 10 months of age and an option to attend supervised group exercise sessions. PRIMARY AND SECONDARY OUTCOME MEASURES: The authors analysed the secondary outcome of the intervention study: the weight development of the offspring. The primary outcome was the proportion of women returning to their prepregnancy weight by 10 months post partum, reported earlier. RESULTS: Multilevel mixed effect non-linear regression models included group, age of the child and interaction between group and age of the child. The increase of BMI z-score between 24 and 48 months was slower among the intervention group offspring (-0.034 to -0.002, p = 0.028) as compared with control group. Z-scores for weight-for-length/height did not differ between groups when the period 0 to 48 months was analysed (p = 0.23) but for the period of 24 to 48 months, between-group differences were significant (p = 0.012). CONCLUSIONS: Lifestyle counselling targeting mothers during the child's first year may be effective in slowing offspring weight gain until 4 years of age. However, larger studies are needed to confirm the findings which may have the potential in combatting the obesity epidemic. TRIAL REGISTRATION NUMBER: Current Controlled Trials ISRCTN21512277.
Reproduced with permission from the BMJ Publishing Group.

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