title: Does an intervention that improves infant sleep also improve overweight at age 6? Follow-up of a randomised trial.
abstract: OBJECTIVE
  Short sleep duration may contribute to childhood obesity. Amenable to intervention, sleep thus provides a potential path for prevention. The authors aimed to determine the impact of a behavioural intervention that successfully reduced parent-reported infant sleep problems on adiposity at age 6.
  
  
  METHODS
  5-year follow-up of a previously reported population-based cluster randomised trial. Participant allocation was concealed to researchers and data collection blinded.
  
  
  METHODS
  Recruitment from well-child centres in Melbourne, Australia.
  
  
  METHODS
  328 children (174 intervention) with parent-reported sleep problems at age 7-8 months drawn from 49 centres (clusters).
  
  
  METHODS
  Behavioural sleep strategies delivered over one to three structured individual nurse consultations from 8 to 10 months, versus usual care. MAIN OUTCOMES AT AGE 6 YEARS: Body mass index (BMI) z-score, percentage overweight/obese and waist circumference.
  
  
  METHODS
  Intention-to-treat regression analyses adjusted for potential confounders.
  
  
  RESULTS
  Anthropometric data were available for 193 children (59% retention) at age 6. There was no evidence of a difference between intervention (N=101) and control (N=92) children for BMI z-score (adjusted mean difference 0.2, 95% CI -0.1 to 0.4), overweight/obese status (20% vs 17%; adjusted OR 1.4, 95% CI 0.7 to 2.8) and waist circumference (adjusted mean difference -0.3, 95% CI -1.6 to 1.1). In posthoc analyses, neither infant nor childhood sleep duration were associated with anthropometric outcomes.
  
  
  CONCLUSIONS
  A brief infant sleep intervention did not reduce overweight/obesity at 6 years. Population-based primary care sleep services seem unlikely to reduce the early childhood obesity epidemic.
authors.affiliation: Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia. melissa.wake@rch.org.au
authors.forename: Melissa
authors.initials: M
authors.lastname: Wake
authors.forename: Anna
authors.initials: A
authors.lastname: Price
authors.forename: Susan
authors.initials: S
authors.lastname: Clifford
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
mesh_terms: D000886:Anthropometry / Q000379:methods; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors; D014739:Victoria / Q000453:epidemiology; D055105:Waist Circumference