title: Targeting Sleep, Food, and Activity in Infants for Obesity Prevention: An RCT.
abstract: OBJECTIVE
  The few existing early-life obesity prevention initiatives have concentrated on nutrition and physical activity, with little examination of sleep.
  
  
  METHODS
  This community-based, randomized controlled trial allocated 802 pregnant women (≥16 years, <34 weeks' gestation) to: control, FAB (food, activity, and breastfeeding), sleep, or combination (both interventions) groups. All groups received standard well-child care. FAB participants received additional support (8 contacts) promoting breastfeeding, healthy eating, and physical activity (antenatal-18 months). Sleep participants received 2 sessions (antenatal, 3 weeks) targeting prevention of sleep problems, as well as a sleep treatment program if requested (6-24 months). Combination participants received both interventions (9 contacts). BMI was measured at 24 months by researchers blinded to group allocation, and secondary outcomes (diet, physical activity, sleep) were assessed by using a questionnaire or accelerometry at multiple time points.
  
  
  RESULTS
  At 2 years, 686 women remained in the study (86%). No significant intervention effect was observed for BMI at 24 months (P= .086), but there was an overall group effect for the prevalence of obesity (P= .027). Exploratory analyses found a protective effect for obesity among those receiving the "sleep intervention" (sleep and combination compared with FAB and control: odds ratio, 0.54 [95% confidence interval, 0.35-0.82]). No effect was observed for the "FAB intervention" (FAB and combination compared with sleep and control: odds ratio, 1.20 [95% confidence interval, 0.80-1.81]).
  
  
  CONCLUSIONS
  A well-developed food and activity intervention did not seem to affect children's weight status. However, further research on more intensive or longer running sleep interventions is warranted.
authors.affiliation: Departments of the Dean, Dunedin School of Medicine, rachael.taylor@otago.ac.nz.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Taylor
authors.affiliation: Preventive and Social Medicine.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Gray
authors.affiliation: Women's and Children's Health.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Galland
authors.affiliation: Human Nutrition, and.
authors.forename: Anne-Louise M
authors.initials: AM
authors.lastname: Heath
authors.affiliation: Women's and Children's Health.
authors.forename: Julie
authors.initials: J
authors.lastname: Lawrence
authors.affiliation: Women's and Children's Health.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Sayers
authors.affiliation: Women's and Children's Health.
authors.forename: Sonya
authors.initials: S
authors.lastname: Cameron
authors.affiliation: Women's and Children's Health.
authors.forename: Maha
authors.initials: M
authors.lastname: Hanna
authors.affiliation: Women's and Children's Health.
authors.forename: Kelly
authors.initials: K
authors.lastname: Dale
authors.affiliation: Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: Coppell
authors.affiliation: Medicine, University of Otago, Dunedin, New Zealand rachael.taylor@otago.ac.nz.
authors.forename: Rachael W
authors.initials: RW
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009520:New Zealand; D063766:Pediatric Obesity / Q000517:prevention & control*; D011247:Pregnancy; D012890:Sleep; D000070263:Sleep Hygiene