Healthy Beginnings Trial: The journey from the beginning

e2 Abstracts

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Early-life approaches to obesityprevention

Jodie Dodd

University of Adelaide, NorthAdelaide, SA, Australia

Overweight and obesity represents a significanthealth issue, with 50% of women entering preg-nancy with a body mass index > 25 kg/m2. Obesity isassociated with a well-documented increase in riskof complications during pregnancy and childbirth,for both women and their infants. Increasingly,events that occur during pregnancy are recog-nised to have a critical impact on an individual’ssubsequent health and risk of disease, includingobesity. This presentation will focus on in-uterofactors associated with risk of subsequent obesity,and consider the available evidence for preventivestrategies targeting this early-life period.

http://dx.doi.org/10.1016/j.orcp.2013.12.501

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Healthy Beginnings Trial: Thejourney from the beginning

Li Ming Wen ∗, Louise A. Baur, JudyM. Simpson, Chris Rissel, KarenWardle, Victoria M. Flood

School of Public Health, SydneyMedical School, University of SydneyHealth Promotion Service, SouthWestern Sydney & Sydney LocalHealth Districts, Sydney, Australia

Australia’s obesity epidemic continues to be oneof the major health burdens in society, which hashad a direct flow-on effect to our younger gener-ation. About one in five children aged 2—3 yearsnow are either overweight or obese — highlight-ing the need for early intervention. To evaluate theeffectiveness of an early obesity intervention, theHealthy Beginnings Trial has been conducted with667 first-time mothers in South West Sydney overthe past 5 years. It was a randomised controlledtrial which has attracted two lots of NHMRC fundingtotalling $1.2 million.

The intervention group received 8 home visitsfrom a specially trained community nurse whodelivered the staged intervention, which comprisedone home visit at gestational age 30—36 weeks,and 7 visits at 1, 3, 5, 9, 12, 15 and 24 monthsafter birth. The timing of the visits correspondsto early childhood development milestones. The

main outcomes included children’s body mass index(BMI), infant feeding practices, and television view-ing time when children were 2 years of age.

The results show that the Healthy Beginningsintervention led, at age 2 years, to significantreduction in BMI and television viewing time, andalso improvements in vegetable consumption.The mothers involved also showed a significantimprovement in their rates of breastfeeding,while also reducing the proportion of motherswho introduced solids before six months. Theintervention also had a significant effect on par-ticipating mothers’ own healthy lifestyles. Theseresults from the trial were published in BMJ 2012(http://www.bmj.com/content/344/bmj.e3732).The sustainability assessment and economic evalu-ation of the Healthy Beginnings Trial are currentlyunderway and will be completed by mid 2014.More intonation about Healthy Beginnings Trial canbe found at http://healthybeginnings.net.au/.

http://dx.doi.org/10.1016/j.orcp.2013.12.502

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Early life nutrition anddevelopmental programming ofobesity — Evidence from animalmodels and potential strategies forintervention

Mark H. Vickers

Liggins Institute and Gravida,University of Auckland, Auckland,New Zealand

Obesity is a world-wide epidemic associated withsignificant morbidity and mortality which costs bil-lions of dollars per year and is a major cause ofnon-communicable chronic diseases and prematuredeaths. Of increasing concern is the rise in theprevalence of childhood obesity — with concomi-tant increases in childhood type 2 diabetes andfatty liver disease. Although metabolic disordersarise from a complex interaction of many factors,including genetic, physiologic, behavioural andenvironmental influences, the rates at which thesediseases have increased suggest that environmen-tal and behavioural influences, rather than geneticcauses, are fuelling the epidemic. The develop-mental origins of health and disease (DOHaD)hypothesis has highlighted the link between theearly life nutritional environment and the laterdevelopment of adult obesity and related metabolicdisorders. Although the mechanisms are not yetfully understood, this developmental programmingwas generally considered an irreversible change in