Intense nutrition training does not prevent obesity in toddlers

Clinical Question

Can intense nutrition training with a focus on motivational interviewing prevent obesity in toddlers and their mothers?

Bottom Line

Extensive nutrition training, using the tenets of motivational interviewing and delivered with the best educational bells and whistles, was ineffective in preventing obesity in toddlers and their mothers. Motivational interviewing may be better at treating, rather than preventing, obesity in children (Pediatrics 2015;135(4):649-657). (LOE = 1b)

Reference

Doring N, Ghaderi A, Bohman B, et al. Motivational interviewing to prevent childhood obesity: A cluster RCT. Pediatrics 2016;137(5):e20153104.  [PMID:27244793]

Study Design

Randomized controlled trial (nonblinded)

Funding

Government

Setting

Population-based

Synopsis

This study was conducted in Sweden at 59 child health care centers as part of their regular child health preventive services. A total of 1355 families with 1369 infants between the ages of 9 months and 10 months were randomly assigned (allocation concealment uncertain) to receive either usual care or a series of 1 group session, 6 individual sessions, and 2 individual telephone sessions with nurses trained in motivational interviewing, focusing on healthful food habits and physical activity. This was a heavy-duty intervention and the nurses who delivered the content received 5 days of training on nutrition, physical activity, motivational interviewing, learning theory, and the principles of cognitive behavior therapy. The training was conducted by a nutritionist, psychologists, and motivational interviewing experts. Analysis was by intention to treat and the study was powered at 90% to find a mean difference in body mass index of 0.3 kg/m^2. Alas, the intervention didn't work. At age 4 years, there were no statistically different changes in the children's or their mothers' body mass index, waist circumference, or likelihood of being overweight. Physical activity was not affected, either. Healthful food habits were slightly improved among children and mothers.

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