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ObesityPOInzNCT00892983

Prevention of Overweight in Infancy

A study testing FAB and Sleep in people with Obesity and Growth, run by University of Otago at 1 site in New Zealand.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Obesity is one of the biggest threats to health in the 21st century. Rapid weight gain in the first year of life tends to lead to overweight in children, which in turn leads to overweight in adults. This rapid early weight gain occurs most often at weaning when eating patterns emerge. Read more about this study

Who is it for?
Ages 16 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Obesity, Growth, Sleep
What is being tested?
FAB and Sleep
Could I receive a placebo?
No, everyone receives an active treatment
How many people
802 participants
Where
1 siteNew Zealand
Study dates
May 2009to Apr 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 55 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Mothers booked for delivery in Dunedin, New Zealand

Who cannot join

  • Women booked after 34 weeks gestation,
  • Identified congenital abnormality likely to affect feeding and/or growth
  • Home address outside of metropolitan Dunedin or Invercargill,
  • Families who are likely to shift out of metropolitan Dunedin or Invercargill in the next 2 years.
  • Unable to communicate in English or te reo Maori.

Trial locations and contacts

1 site in 1 country.

New Zealand1 site
  • University of Otago

    Dunedin, South Island, 9013

Other trials in New Zealand

About this study

Official title: Primary Prevention of Rapid Weight Gain in Early Childhood: a Randomised Controlled Trial

Obesity is one of the biggest threats to health in the 21st century. Rapid weight gain in the first year of life tends to lead to overweight in children, which in turn leads to overweight in adults. This rapid early weight gain occurs most often at weaning when eating patterns emerge. Infant sleep problems also appear to be associated with the risk of becoming overweight, and contribute to maternal post-natal depression. We propose to undertake a 4-arm randomised controlled trial to determine whether extra education and support for families around weaning and development of early food and activity habits, with or without intervention to improve infant sleep, will decrease the current risk patterns of rapid excessive early childhood weight gain in New Zealand. This would provide strong evidence for the value of such a strategy in the long term control of the obesity epidemic and its consequent complications.

This is a two-year intervention with follow-ups at 3.5, 5 and 11 years of age.

Read the detailed description

We plan on undertaking a 4-arm randomised controlled trial to test the following hypotheses:

  1. That anticipatory guidance and extra education and support in infancy around weaning and decreasing/avoiding television watching will delay the timing of introduction of solid foods, will be associated with more successful introduction of nutrient dense foods with appropriate portion size and decrease small screen exposure leading to a lower number of children with excessive weight velocity in infancy and early childhood.
  2. That anticipatory guidance, education and extra support around the early development of infant sleeping patterns will decrease sleep problems, increase infant sleeping time, decrease arousals at night and lower sleep latency which will in turn influence rate of early infant weight gain.
  3. That interventions 1 and 2 will interact additively with regard to infant and early childhood weight gain.
  4. That intervention 2 will lead to lower rates of maternal depression and increased family well being.
Conditions
Obesity, Growth, Sleep
Being tested
FAB, Sleep
Keywords
Obesity, Sleep, Physical activity, Breast feeding, Depression
Medical subject headings
Obesity, Motor Activity, Breast Feeding, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FABBehavioural

    Standard well child care plus 7 extra parent contacts for augmented education and support around breast feeding, food and activity with 1 before birth and then at 1-2 weeks, and 3, 4, 7, 9, 13, and 18 months post-partum.

  • SleepBehavioural

    Standard well child care plus 2 extra contacts focussed on Sleep with 1 before birth (anticipatory guidance), and sleep problem prevention at 3 weeks. A sleep problem intervention starting at 6 months was possible for those indicating their child had a sleep problem at 6 months of age. Main prevention advice focussed on placing baby to sleep awake, maximising night-day differences and use of sleep place in parents bedroom for first 6 months. Intervention after 6 months uses preferentially a technique called "parental presence", and if this does not fit family a technique called "camping out" and finally, if neither of the first two fit family, controlled crying.

Study groups in NCT00892983
Study groupRoleWhat they receive
Standard well child careNo interventionStandard Well Child Care (SWCC) - 8 Core visits at 2-4 weeks, 6 weeks, 3, 5, 8-10 and 15 months, 2 and 3 years.
Food Activity Breast feeding supportExperimentalFAB (Food Activity Breast feeding support) 8 extra parent contacts for augmented education and support around breast feeding, food and activity
Receives: Behavioral: FAB
SleepExperimentalPrevention of sleep problems in first 6 months and then active early intervention for sleep problems from 6 months to 24 months
Receives: Behavioral: Sleep
FAB + SleepExperimentalcombination of interventions used in arms 2 and 3
Receives: Behavioral: FAB; Behavioral: Sleep

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. BMI z score

    BMI z score derived from ht and weight and using World Health Organisation (WHO) growth standards

    Measured: 24 months (end of intervention)

  2. BMI z score

    BMI z score derived from ht and weight and using WHO growth standards

    Measured: 60 months of age (followup at 5 years of age)

  3. BMI z score

    BMI z score derived from height and weight and using WHO reference data

    Measured: Follow-up at 11 years of age

Secondary outcomes (10)
  1. Dietary intake

    Dietary information (foods, food groups, nutrients) via food frequency questionnaire

    Measured: 24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)

  2. Television viewing

    Hours of screen use by parental questionnaire

    Measured: 24 months (end of intervention) and 60 months (end of follow-up)

  3. Major/ Moderate sleep problems

    Parents indicate presence of sleep problems in child

    Measured: 24 months (end of intervention)

  4. Physical activity (PA)

    PA measured using actical accelerometry over 5-7 days

    Measured: 24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)

  5. Duration of exclusive and any breast feeding

    Measured by repeated questionnaire

    Measured: 24 months

  6. Parental depression score

    Edinburgh Postnatal Depression questionnaire

    Measured: Measured at multiple timepoints between pregnancy and 24 months (end of intervention) and 60 months (end of follow-up)

  7. Sleep

    Measured by questionnaire and accelerometry at multiple timepoints

    Measured: 24 months (end of intervention) and 60 months (end of follow-up) and 11 years (further follow-up)

  8. Number of night awakenings

    Measured by questionnaire and accelerometry at multiple timepoints

    Measured: 24 months (end of intervention) and 60 months (end of follow-up)

  9. Self-regulation

    Measured by questionnaire and laboratory based measures at follow-up only

    Measured: 42 and 60 months

  10. Body composition

    Measured by dual-energy x-ray absorptiometry at follow-up only

    Measured: 60 months and 11 years (further follow-up)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 May 2009 (estimated)
  2. Study startMay 2009
  3. Primary completionApr 2016
  4. Study completionApr 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
802 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00892983
Sponsor's protocol ID
105891.01.P.NH
Other IDs
HRC 08/374
Acronym
POInz
Status last verified
Jul 2020
First submitted
3 May 2009
Last updated
8 Jul 2020
Results posted
No
Data monitoring committee
Yes

Publications

  • Taylor RW, Heath AL, Galland BC, Cameron SL, Lawrence JA, Gray AR, Tannock GW, Lawley B, Healey D, Sayers RM, Hanna M, Meredith-Jones K, Hatch B, Taylor BJ. Three-year follow-up of a randomised controlled trial to reduce excessive weight gain in the first two years of life: protocol for the POI follow-up study. BMC Public Health. 2016 Aug 11;16(1):771. doi: 10.1186/s12889-016-3383-4.

    PubMed 27514714
  • Taylor RW, Iosua E, Heath AM, Gray AR, Taylor BJ, Lawrence JA, Hanna M, Cameron SL, Sayers R, Galland B. Eating frequency in relation to BMI in very young children: a longitudinal analysis. Public Health Nutr. 2017 Jun;20(8):1372-1379. doi: 10.1017/S1368980017000143. Epub 2017 Feb 27.

    PubMed 28238299
  • Galland BC, Sayers RM, Cameron SL, Gray AR, Heath AM, Lawrence JA, Newlands A, Taylor BJ, Taylor RW. Anticipatory guidance to prevent infant sleep problems within a randomised controlled trial: infant, maternal and partner outcomes at 6 months of age. BMJ Open. 2017 Jun 2;7(5):e014908. doi: 10.1136/bmjopen-2016-014908.

    PubMed 28576897
  • Moir C, Meredith-Jones K, Taylor BJ, Gray A, Heath AM, Dale K, Galland B, Lawrence J, Sayers RM, Taylor RW. Early Intervention to Encourage Physical Activity in Infants and Toddlers: A Randomized Controlled Trial. Med Sci Sports Exerc. 2016 Dec;48(12):2446-2453. doi: 10.1249/MSS.0000000000001055.

    PubMed 27471782
  • Fangupo LJ, Heath AL, Williams SM, Somerville MR, Lawrence JA, Gray AR, Taylor BJ, Mills VC, Watson EO, Galland BC, Sayers RM, Hanna MB, Taylor RW. Impact of an early-life intervention on the nutrition behaviors of 2-y-old children: a randomized controlled trial. Am J Clin Nutr. 2015 Sep;102(3):704-12. doi: 10.3945/ajcn.115.111823. Epub 2015 Jul 29.

    PubMed 26224299
  • Cameron SL, Heath AL, Gray AR, Churcher B, Davies RS, Newlands A, Galland BC, Sayers RM, Lawrence JA, Taylor BJ, Taylor RW. Lactation Consultant Support from Late Pregnancy with an Educational Intervention at 4 Months of Age Delays the Introduction of Complementary Foods in a Randomized Controlled Trial. J Nutr. 2015 Jul;145(7):1481-90. doi: 10.3945/jn.114.202689. Epub 2015 May 20.

    PubMed 25995280
  • Meredith-Jones K, Haszard J, Moir C, Heath AL, Lawrence J, Galland B, Taylor B, Gray A, Sayers R, Taylor R. Physical activity and inactivity trajectories associated with body composition in pre-schoolers. Int J Obes (Lond). 2018 Sep;42(9):1621-1630. doi: 10.1038/s41366-018-0058-5. Epub 2018 Mar 15.

    PubMed 29717271
  • Taylor RW, Haszard JJ, Meredith-Jones KA, Galland BC, Heath AM, Lawrence J, Gray AR, Sayers R, Hanna M, Taylor BJ. 24-h movement behaviors from infancy to preschool: cross-sectional and longitudinal relationships with body composition and bone health. Int J Behav Nutr Phys Act. 2018 Nov 26;15(1):118. doi: 10.1186/s12966-018-0753-6.

    PubMed 30477518
  • Taylor RW, Gray AR, Heath AM, Galland BC, Lawrence J, Sayers R, Healey D, Tannock GW, Meredith-Jones KA, Hanna M, Hatch B, Taylor BJ. Sleep, nutrition, and physical activity interventions to prevent obesity in infancy: follow-up of the Prevention of Overweight in Infancy (POI) randomized controlled trial at ages 3.5 and 5 y. Am J Clin Nutr. 2018 Aug 1;108(2):228-236. doi: 10.1093/ajcn/nqy090.

    PubMed 30101329
  • Hatch B, Galland BC, Gray AR, Taylor RW, Sayers R, Lawrence J, Taylor B. Consistent use of bedtime parenting strategies mediates the effects of sleep education on child sleep: secondary findings from an early-life randomized controlled trial. Sleep Health. 2019 Oct;5(5):433-443. doi: 10.1016/j.sleh.2019.03.002. Epub 2019 May 20.

    PubMed 31122876
  • Leong C, Haszard JJ, Heath AM, Tannock GW, Lawley B, Cameron SL, Szymlek-Gay EA, Gray AR, Taylor BJ, Galland BC, Lawrence JA, Otal A, Hughes A, Taylor RW. Using compositional principal component analysis to describe children's gut microbiota in relation to diet and body composition. Am J Clin Nutr. 2020 Jan 1;111(1):70-78. doi: 10.1093/ajcn/nqz270.

    PubMed 31711093
  • Meredith-Jones K, Galland B, Haszard J, Gray A, Sayers R, Hanna M, Taylor B, Taylor R. Do young children consistently meet 24-h sleep and activity guidelines? A longitudinal analysis using actigraphy. Int J Obes (Lond). 2019 Dec;43(12):2555-2564. doi: 10.1038/s41366-019-0432-y. Epub 2019 Sep 2.

    PubMed 31477783
  • Askie LM, Espinoza D, Martin A, Daniels LA, Mihrshahi S, Taylor R, Wen LM, Campbell K, Hesketh KD, Rissel C, Taylor B, Magarey A, Seidler AL, Hunter KE, Baur LA. 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 Obes. 2020 Jun;15(6):e12618. doi: 10.1111/ijpo.12618. Epub 2020 Feb 6.

    PubMed 32026653
  • Roy M, Haszard JJ, Savage JS, Yolton K, Beebe DW, Xu Y, Galland B, Paul IM, Mindell JA, Mihrshahi S, Wen LM, Taylor B, Richards R, Te Morenga L, Taylor RW. Bedtime, body mass index and obesity risk in preschool-aged children. Pediatr Obes. 2020 Sep;15(9):e12650. doi: 10.1111/ijpo.12650. Epub 2020 May 6.

    PubMed 32372572
  • Taylor BJ, Gray AR, Galland BC, Heath AM, Lawrence J, Sayers RM, Cameron S, Hanna M, Dale K, Coppell KJ, Taylor RW. Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT. Pediatrics. 2017 Mar;139(3):e20162037. doi: 10.1542/peds.2016-2037.

    PubMed 28242860

Questions about this trial

What is this clinical trial studying?

A study testing FAB and Sleep in people with Obesity and Growth, run by University of Otago at 1 site in New Zealand.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in New Zealand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

BMI z score (time frame: 24 months (end of intervention)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00892983, which also lists 22 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jul 2020.

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