Parent-focused interventions do not work to prevent childhood obesity

An international study involving over 9,000 children reveals that measures aimed at parents do not work to prevent childhood obesity. “We need to think differently,” says researcher Nina Cecilie Øverby.

For the first time, there are now more overweight than underweight individuals aged 5-19. Obesity in children and adolescents is being called a global health crisis. 

To prevent this early on, we thought it was crucial to focus on parents during the child's first year of life." 

Nina Cecilie Øverby, researcher, University of Agder (UiA)

She is feeling a little discouraged right now. A large international study, which UiA also participated in, shows that measures aimed at parents have no effect on children's weight at the age of two.

"The difference was 0.01 units on the BMI scale, and that is far below what is considered a significant difference," says Øverby.

Data from 9,000 children

Øverby leads the Centre for Lifecourse Nutrition at UiA, where they have been researching children's eating habits for several years, as well as how to facilitate a healthy diet during their first year of life.

Three of the studies conducted at UiA have now become part of a large project led by the University of Sydney. Researchers there have compiled data from seventeen international studies and re-analysed them. In total, there is data on 9,000 children from ten countries.

"This is the gold standard. The fact that they have collected and analysed data from so many studies allows them to speak about the effect with greater authority than any individual study could," says Christine Helle.

She also works at the centre led by Øverby and was behind one of the studies used by the researchers from Australia.

"We were prepared for these results, but of course it's disappointing. The researchers also found no connection between parent-focused interventions and diet or physical activity. The only difference they were able to measure was that the children who participated had ten minutes less screen time," she says.

Want to change the system

The studies from UiA looked at various measures such as training videos for parents about what's important for children to develop good eating habits. The goal was to get families to change their diets, which they succeeded in doing. But this had no effect on the children's weight.

"The time with young children is especially hectic for parents. When you demand something extra of them, you rely on them having the resources to follow through. For everyone to succeed, we need measures that are less dependent on parents' time," says Øverby.

The researchers think the study shows that it's more important to change the system around parents than just give knowledge and information to individual families. This means that we need to have programmes that focus on diet in kindergartens and schools and include training about nutrition as part of the offerings at child health centres.

This also involves measures like stricter rules on advertising unhealthy food to children, and making it cheaper to buy healthy food in stores.

"In recent years, our research has shown that we need to move away from the individual focus we've had in our studies. We should still keep that, but stronger efforts are needed to combat obesity in young people," says Øverby.

The researchers are clear that this does not mean that diet is unimportant.

"Good food is essential for children's growth and development. But we need to find more effective ways to promote healthy habits, like working with health centres, which reach almost all children and parents in Norway," says Øverby.

About the research:

• Around 37 million children under the age of five are overweight or obese.
• A high body mass index (BMI) in infancy increases the risk of being overweight later in life.
• Children's biology is most susceptible at an early age, before overweight or obesity develops. Interventions aimed at parents concerning children's diet, physical activity and sleep have therefore been considered important.
• TOPCHILD is a research collaboration led by the University of Sydney. The researchers have conducted the largest systematic review to date to assess the effect of parent-focused interventions to reduce childhood obesity.
• The TOPCHILD collaboration included experts in child health, nutrition, psychology, statistics and public health from Australia, Norway, Italy, the Netherlands, New Zealand, Sweden, the UK and the US.
• Three studies from the University of Agder were included in the review.