Context
The “first 1,000 days”—conception through age 24 months—are critical for the development
and prevention of childhood obesity. This study systematically reviews existing and
ongoing interventions during this period, identifies gaps in current research, and
discusses conceptual frameworks and opportunities for future interventions.
Evidence acquisition
PubMed, Embase, Web of Science, and ClinicalTrials.gov were searched to identify completed and ongoing interventions implemented during
pregnancy through age 24 months that aimed to prevent overweight/obesity between ages
6 months and 18 years. English-language, controlled interventions published between
January 1, 1980 and December 12, 2014, were analyzed between December 13, 2014 and
March 15, 2015.
Evidence synthesis
Of 34 completed studies from 26 unique identified interventions, nine were effective.
Effective interventions focused on individual- or family-level behavior changes through
home visits, individual counseling or group sessions in clinical settings, a combination
of home and group visits in a community setting, and using hydrolyzed protein formula.
Protein-enriched formula increased childhood obesity risk. Forty-seven ongoing interventions
were identified. Across completed and ongoing interventions, the majority target individual-
or family-level changes, many are conducted in clinical settings, and few target early-life
systems and policies that may impact childhood obesity.
Conclusions
Obesity interventions may have the greatest preventive effect if begun early in life.
Yet, few effective interventions in the first 1,000 days exist, and many target individual-level
behaviors of parents and infants. Interventions that operate at systems levels and
are grounded in salient conceptual frameworks hold promise for improving future models
of early-life obesity prevention.
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Published online: February 21, 2016
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© 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
