|
 But there are several potential reasons for the lack of effect, the
researchers say, and they think more study is needed and clearly
worth doing.
Almost a quarter of preschool-age children in the United States are
overweight or obese, yet few obesity-prevention programs for this
age group have been tested, Dr. Julie Lumeng of the Center for Human
Growth and Development at University of Michigan in Ann Arbor and
colleagues write in the journal Pediatrics.
They tested two interventions, alone and in combination, embedding
the experiment within the federally-funded Head Start program for
low-income children. During each of four academic years, classrooms
were randomly allocated to one of three groups: Head Start alone
(HS), Head Start plus the Preschool Obesity Prevention Series (HS+POPS),
or Head Start plus POPS and the Incredible Years Series (HS+POPS+IYS).
POPS provides obesity prevention messages to preschoolers and their
parents while IYS emphasizes positive behavioral management
techniques and self-regulation.
Altogether the study involved 697 children around 4 years old, about
half of them white, 30 percent black and 12 percent Hispanic. Some
16 percent to 17 percent of kids in the intervention groups were
obese at the start while about 12 percent in the Head Start alone
group were obese.
According to the researchers, HS+POPS+IYS improved the kids'
teacher-reported self-regulation compared with HS+POPS and HS alone.
But the programs failed to have significant effects on the
prevalence of obesity, which was about 14 percent in both the
HS+POPS+IYS and HS+POPS groups after the interventions. Obesity
prevalence rose to about 13 percent among kids in the HS alone
group.
The interventions also had no effect on other outcomes aside from
sugar-sweetened beverage intake.
Lumeng told Reuters Health she really thought the intervention would
be helpful. "Unfortunately, it was not.”
The study team writes that the intervention might not have been
intense or long enough, or the assessment might not been long enough
to reveal any effects on weight.
“It may be that the effects of promoting self-regulation to prevent
obesity do not emerge until children are older,” Lumeng said by
email. “For example, it may be that self-regulation of emotion and
behavior may not impact food intake until children start to
consciously attend more to their dietary intake, perhaps at ages 9
to 10 years or even a little older. When children are in the
preschool age range, most of their food choices and dietary intake
may still be primarily governed by parents and other adults,” she
said.
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More work is needed with more powerful and targeted behavioral
approaches to self-regulation to adequately test whether improving
children's self-regulation can prevent obesity, the researchers
conclude.
“Stress has been linked to overeating and obesity in multiple
studies," Lumeng noted. "Providing children tools to better regulate
emotion and behavior in the context of stress may still be an
important strategy. Future work may wish to more closely tailor
these types of interventions specifically to emotional overeating or
eating in response to stress.”
In a related editorial, two pediatricians write, “We live in an
obesity-promoting environment, with ubiquitous highly palatable,
energy-dense foods and easy access to reinforcing sedentary
activities. To navigate through the environment unscathed by these
dual threats, children need adult supervision and guidance and an
ability to control temptation.”
Dr. Leonard Epstein and Dr. Stephanie Anzman-Frasca of the
University of Buffalo in New York call the study "valuable," and
write that while it didn't show improving self-regulation impacted
on kids' weight, it's premature to call the case closed.
“This research offers the potential for collateral benefits, given
that self-regulation is linked with multiple aspects of well-being
over time,” they write.
SOURCE: http://bit.ly/2nZ4yGS and http://bit.ly/2o3gkRl Pediatrics,
online April 11, 2017.
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