Projecting the impact of hypothetical early life interventions on adiposity in children living in low‐income households. Issue 5 (10th June 2016)

• Record Type: Journal Article
• Authors: Nianogo, Roch A.; Wang, May C.; Wang, Aolin; Nobari, Tabashir Z.; Crespi, Catherine M.; Whaley, Shannon E.; Arah, Onyebuchi A.
• Is Part Of: Pediatric obesity. Volume 12:Issue 5(2017:Oct.)
• Page Start: 398
• Page End: 405
• Publication Date: 2016-06-10
• Subjects: adiposity -- breastfeeding -- causal inference -- childhood obesity; Obesity in children -- Periodicals; Obesity in adolescence -- Periodicals; Obesity -- Periodicals; Overweight children -- Periodicals; 618.92398
• DOI: 10.1111/ijpo.12157
• Languages: English
• ISSNs: 1747-7174

Abstract

Summary: Background: It is difficult to evaluate the effectiveness of interventions aimed at reducing early childhood obesity using randomized trials. Objective: To illustrate how observational data can be analysed using causal inference methods to estimate the potential impact of behavioural 'interventions' on early childhood adiposity. Methods: We used longitudinal data from 1054 children 1–5 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children and followed (WIC) from 2008 to 2010 for a mean duration of 23 months. The data came from a random sample of WIC families living in Los Angeles County in 2008. We used the parametric g‐formula to estimate the impact of various hypothetical behavioural interventions. Results: Adjusted mean weight‐for‐height Z score at the end of follow‐up was 0.73 (95% CI 0.65, 0.81) under no intervention and 0.63 (95% CI 0.38, 0.87) for all interventions given jointly. Exclusive breastfeeding for 6 months or longer was the most effective intervention [population mean difference = −0.11 (95% CI −0.22, 0.01)]. Other interventions had little or no effect. Conclusions: Compared with interventions promoting healthy eating and physical activity behaviours, breastfeeding was more effective in reducing obesity risk in children aged 1–5 years. When carefully applied, causal inference methods may offer viable alternatives to randomized trials in etiologic and evaluation research.