The effects of hypothetical behavioral interventions on the 13-year incidence of overweight/obesity in children and adolescents

被引:5
作者
Boernhorst, C. [1 ]
Pigeot, I. [1 ,2 ]
De Henauw, S. [3 ]
Formisano, A. [4 ]
Lissner, L. [5 ]
Molnar, D. [6 ]
Moreno, L. A. [7 ,8 ]
Tornaritis, M. [9 ]
Veidebaum, T. [10 ]
Vrijkotte, T. [11 ]
Didelez, V. [1 ,2 ]
Wolters, M. [1 ]
机构
[1] Leibniz Inst Prevent Res & Epidemiol, BIPS, Achterstr 30, D-28359 Bremen, Germany
[2] Univ Bremen, Inst Stat, Fac Math & Comp Sci, Bremen, Germany
[3] Univ Ghent, Dept Publ Hlth & Primary Care, Ghent, Belgium
[4] CNR, Inst Food Sci, Avellino, Italy
[5] Univ Gothenburg, Inst Med, Sahlgrenska Acad, Sch Publ Hlth & Community Med, Gothenburg, Sweden
[6] Univ Pecs, Med Sch, Dept Pediat, Pecs, Hungary
[7] Univ Zaragoza, Inst Agroalimentario Aragon IA2, Inst Invest Sanitaria Aragon IIS Aragon, Fac Hlth Sci,GENUD Growth Exercise Nutr & Dev Res, Zaragoza, Spain
[8] Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr C, Madrid, Spain
[9] Res & Educ Inst Child Hlth, Strovolos, Cyprus
[10] Estonian Ctr Behav & Hlth Sci, Natl Inst Hlth Dev, Tallinn, Estonia
[11] Univ Amsterdam, Amsterdam Univ Med Ctr Amsterdam UMC, Dept Publ & Occupat Hlth, Amsterdam, Netherlands
基金
欧盟地平线“2020”;
关键词
Causal inference; Childhood obesity; IDEFICS/I.Family cohort; Modifiable risk factor; Observational data; Parametric g-formula; OBESITY PREVENTION PROGRAM; CORONARY-HEART-DISEASE; LIFE-STYLE FACTORS; CHILDHOOD OBESITY; PHYSICAL-ACTIVITY; CONSENSUS STATEMENT; RECOMMENDED AMOUNT; AMERICAN ACADEMY; SLEEP; RISK;
D O I
10.1186/s12966-023-01501-6
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background In view of the high burden of childhood overweight/obesity (OW/OB), it is important to identify targets for interventions that may have the greatest effects on preventing OW/OB in early life. Using methods of causal inference, we studied the effects of sustained behavioral interventions on the long-term risk of developing OW/OB based on a large European cohort.Methods Our sample comprised 10 877 children aged 2 to < 10 years at baseline who participated in the well-phenotyped IDEFICS/I.Family cohort. Children were followed from 2007/08 to 2020/21. Applying the parametric g-formula, the 13-year risk of developing OW/OB was estimated under various sustained hypothetical interventions on physical activity, screen time, dietary intake and sleep duration. Interventions imposing adherence to recommendations (e.g. maximum 2 h/day screen time) as well as interventions 'shifting' the behavior by a specified amount (e.g. decreasing screen time by 30 min/day) were compared to 'no intervention' (i.e. maintaining the usual or so-called natural behavior). Separately, the effectiveness of these interventions in vulnerable groups was assessed.Results The 13-year risk of developing OW/OB was 30.7% under no intervention and 25.4% when multiple interventions were imposed jointly. Meeting screen time and moderate-to-vigorous physical activity (MVPA) recommendations were found to be most effective, reducing the incidence of OW/OB by -2.2 [-4.4;-0.7] and -2.1 [-3.7;-0.8] percentage points (risk difference [95% confidence interval]), respectively. Meeting sleep recommendations (-0.6 [-1.1;-0.3]) had a similar effect as increasing sleep duration by 30 min/day (-0.6 [-0.9;-0.3]). The most effective intervention in children of parents with low/medium educational level was being member in a sports club; for children of mothers with OW/OB, meeting screen time recommendations and membership in a sports club had the largest effects.Conclusions While the effects of single behavioral interventions sustained over 13 years were rather small, a joint intervention on multiple behaviors resulted in a relative reduction of the 13-year OW/OB risk by between 10 to 26%. Individually, meeting MVPA and screen time recommendations were most effective. Nevertheless, even under the joint intervention the absolute OW/OB risk remained at a high level of 25.4% suggesting that further strategies to better prevent OW/OB are required.
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页数:17
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