“The Lasting Effects of Early Sleep and Lifestyle Tweaks on Childhood BMI: Insights from the POI Randomized Trial”

Purpose:

The aim was to ascertain whether the BMI disparities noted at 5 years of age, resulting from early interventions during infancy, persisted at 11 years.

Procedures:

Individuals (n = 734) from the initial randomized controlled study (n = 802) underwent assessments of body mass index (BMI), body composition (DXA), sleep patterns and physical activity (24-hour accelerometry, surveys), dietary intake (repeated 24-hour recalls), screen exposure (daily logs), wellbeing (CHU-9D, WHO-5), and family dynamics (McMaster FAD) around their 11th birthday. After multiple imputations, regression analyses were performed to evaluate the impacts of two interventions (‘Sleep’ versus ‘Food, Activity and Breastfeeding’ [FAB]) utilizing a 2 × 2 factorial design.

Findings:

Five hundred twelve participants (48% female, average [SD] age 11.1 [0.1] years) attended the assessment at 11 years (63% of the original group). No substantial differences in BMI z-score (mean difference; 95% CI: -0.16; -0.41, 0.08) or the likelihood of being overweight (including obesity) (odds ratio; 95% CI: 0.85; 0.56, 1.29) were seen between those who underwent the sleep intervention and those who did not. Conversely, children who participated in the FAB intervention exhibited elevated BMI z-scores (0.24; 0.01, 0.47) and a heightened risk of obesity (1.56; 1.03, 2.36) compared to those who were not part of FAB. No remarkable differences were found in any lifestyle factors or wellbeing indicators among all groups.

Summary:

Persistent reductions in BMI and obesity risk from an initial sleep intervention were not evident 9 years later, whereas a conventional lifestyle intervention led to increased obesity rates, which could not be explained by variations in assessed lifestyle behaviors.

Clinical trial registry:

ClinicalTrials.gov identifier NCT00892983,