Responsive parenting intervention results in lower bmis through age 3 penn state university

The researchers — who published their findings today (Aug. 7) in the Journal of the American Medical Association (JAMA) — said that because overweight children are more likely to become overweight adults, it’s critical to find ways to prevent obesity before it and its associated problems, including heart disease, high blood pressure and type 2 diabetes, begin to develop.

“There’s evidence that a lot of our behaviors, including ones related to eating and sleeping, are ‘programmed’ at a very young age,” Paul said. “Some of our research is based on the idea that food should be used for hunger, not for other purposes such as to soothe or to reward a child. Babies that are soothed with food early on may be more likely to use food to soothe their distress later on in life.


These behaviors are imprinted early. So our research intervention was designed to intervene early when these behaviors are being established and before overweight or obesity develops.”

Leann L. Birch, professor of foods and nutrition and director of the Obesity Initiative at University of Georgia who co-led the project with Paul, said that adequate nutrition is essential to infants’ healthy growth and development, and because parents are often concerned about making sure the child is getting enough to eat, feeding may be the first response to infant crying.

Mothers in the intervention received four nurses’ home visits during their baby’s first year. Strategies included ways to soothe non-hungry yet fussy infants without feeding them; avoiding using food as a reward, and not forcing the children to eat when they show signs of fullness; how to improve early-life sleep through good bedtime routines and responses to night wakings; and how to create healthy diets by repeatedly exposing infants to vegetables and fruits even when the infant initially rejects them.

“We were able to demonstrate the most sustained effects of an early-life obesity prevention intervention to date,” Paul said. “Our results show that our intervention — which showed benefits very early, shortly after the intervention began — persisted as the children aged through age three years, and that the longitudinal change over time shows we made a difference on their growth trajectories over the three years.”

“Taking care of young children isn’t one size fits all, and from my perspective as a pediatrician, there may be different parts of the program that work for different people,” Paul said. “There may have been some children in the program who may have otherwise been bad sleepers, or some parents who would have used the old school ‘clean your plate’ philosophy before we taught them not to do that. I think different parts will be important for different families.”

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the Children’s Miracle Network at Penn State Children’s Hospital, the U.S. Department of Agriculture, the Penn State Clinical and Translational Research Institute, and National Institutes of Health National Center for Advancing Translational Sciences.

Jennifer S. Savage, assistant professor, Penn State; Michele E. Marini, data analyst/statistician, Penn State; Jessica S. Beiler, Penn State; Lindsey B. Hess, Penn State; Eric Loken, research associate professor, University of Connecticut; and Stephanie Anzman-Frasca, assistant professor, University at Buffalo, also participated in this research.