title: An Early Feeding Practices Intervention for Obesity Prevention.
abstract: OBJECTIVE
  Report long-term outcomes of the NOURISH randomized controlled trial (RCT), which evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on "protective" complementary feeding practices that were hypothesized to reduce childhood obesity risk.
  
  
  METHODS
  The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed 5 times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear mixed models evaluated intervention (group) effect across time.
  
  
  RESULTS
  Retention at age 5 years was 61%. Across ages 2 to 5 years, intervention mothers reported less frequent use of nonresponsive feeding practices on 6 of 9 scales. At 5 years, they also reported more appropriate responses to food refusal on 7 of 12 items (Ps ≤ .05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P = .06) or the prevalence of overweight/obesity (control 13.3% vs intervention 11.4%, P = .66).
  
  
  CONCLUSIONS
  Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to 5 years of age and were paralleled by a nonsignificant trend for lower child BMI Z-scores at all postintervention assessment points.
authors.affiliation: Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Department Nutrition and Dietetics, Flinders University, Adelaide, Australia; and l2.daniels@qut.edu.au.
authors.forename: Lynne Allison
authors.initials: LA
authors.lastname: Daniels
authors.affiliation: Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences.
authors.forename: Kimberley Margaret
authors.initials: KM
authors.lastname: Mallan
authors.affiliation: La Trobe University, Melbourne, Australia Centre for Learning Innovation, and.
authors.forename: Jan Maree
authors.initials: JM
authors.lastname: Nicholson
authors.affiliation: Institute of Health and Biomedical Innovation, School Psychology and Counselling, Queensland University of Technology, Brisbane, Australia;
authors.forename: Karen
authors.initials: K
authors.lastname: Thorpe
authors.affiliation: Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences.
authors.forename: Smita
authors.initials: S
authors.lastname: Nambiar
authors.affiliation: Department Nutrition and Dietetics, Flinders University, Adelaide, Australia; and.
authors.forename: Chelsea Emma
authors.initials: CE
authors.lastname: Mauch
authors.affiliation: School of Exercise and Nutrition Sciences, Department Nutrition and Dietetics, Flinders University, Adelaide, Australia; and.
authors.forename: Anthea
authors.initials: A
authors.lastname: Magarey
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology*; D009765:Obesity / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013997:Time Factors