Parent-Focused Interventions Fail to Prevent Toddler Obesity, suggests research
Researchers have found in a systematic review and meta-analysis that parent-focused behavioral interventions did not effectively prevent obesity in toddlers. While minor improvements in children’s screen time were noted, most outcomes showed no benefit, suggesting that broader policy and societal measures may be needed to address childhood obesity prevention. The study was published in The Lancet by Kylie E. and colleagues.
This research was an individual participant data (IPD) meta-analysis and systematic review registered with PROSPERO (CRD42020177408). Investigators conducted searches in several databases and trial registries, including MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo, ClinicalTrials.gov, and WHO ICTRP, through September 30, 2024. The criteria for inclusion were randomized controlled trials (RCTs) with initiation prior to 12 months of age, parent-targeted behavioural interventions for prevention of obesity.
Trials that were quasi-random, pregnancy only, or did not include child weight-related outcomes were excluded. The main outcome was BMI Z score at 24 months (±6 months). Analyses were based on intention-to-treat principles using random effects models, and certainty of evidence was graded according to the GRADE approach.
Results
Of 19,990 records screened, 47 trials (0.24%) were found eligible, and 18 trials (38%) had reported the primary outcome.
Individual participant data were available from 17 trials (94%), with 9128 children (out of 9383 eligible; 97%).
There were 4549 (50%) boys, 4415 (48%) girls, and 164 (2%) with unknown sex among these participants.
The primary analysis revealed no important effect of parent-centered interventions on BMI Z score at 24 months (mean difference –0.01, 95% CI –0.08 to 0.05; high-certainty evidence, τ²=0.01; n=6505 with 2623 missing).
Sensitivity analyses with varying statistical methods and missing data treatment ensured the stability of results.
In addition, no differential effects evidence was found in prespecified subgroups, such as priority populations or trial-level features.
These population-level findings revealed that parent-directed behaviour change interventions initiated in infancy did not have an effect on preventing obesity at 24 months of age. Therefore, depending on parent-directed solutions is not enough, and childhood obesity prevention efforts worldwide need to shift towards wider, systemic, and more integrated strategies.
Reference:
Hunter, K. E., Nguyen, D., Libesman, S., Williams, J. G., Aberoumand, M., Aagerup, J., Johnson, B. J., Golley, R. K., Barba, A., Sotiropoulos, J. X., Shrestha, N., Palacios, T., Pryde, S. J., Wolfenden, L., Taylor, R. W., Godolphin, P. J., Matvienko-Sikar, K., Sanders, L. M., Robledo, K. P., … Seidler, A. L. (2025). Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis. Lancet. https://doi.org/10.1016/s0140-6736(25)01144-4
