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e2 Abstracts 2 Early-life approaches to obesity prevention Jodie Dodd University of Adelaide, North Adelaide, SA, Australia Overweight and obesity represents a significant health issue, with 50% of women entering preg- nancy with a body mass index > 25 kg/m 2 . Obesity is associated with a well-documented increase in risk of 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’s subsequent health and risk of disease, including obesity. This presentation will focus on in-utero factors associated with risk of subsequent obesity, and consider the available evidence for preventive strategies targeting this early-life period. http://dx.doi.org/10.1016/j.orcp.2013.12.501 3 Healthy Beginnings Trial: The journey from the beginning Li Ming Wen , Louise A. Baur, Judy M. Simpson, Chris Rissel, Karen Wardle, Victoria M. Flood School of Public Health, Sydney Medical School, University of Sydney Health Promotion Service, South Western Sydney & Sydney Local Health Districts, Sydney, Australia Australia’s obesity epidemic continues to be one of the major health burdens in society, which has had a direct flow-on effect to our younger gener- ation. About one in five children aged 2—3 years now are either overweight or obese — highlight- ing the need for early intervention. To evaluate the effectiveness of an early obesity intervention, the Healthy Beginnings Trial has been conducted with 667 first-time mothers in South West Sydney over the past 5 years. It was a randomised controlled trial which has attracted two lots of NHMRC funding totalling $1.2 million. The intervention group received 8 home visits from a specially trained community nurse who delivered the staged intervention, which comprised one home visit at gestational age 30—36 weeks, and 7 visits at 1, 3, 5, 9, 12, 15 and 24 months after birth. The timing of the visits corresponds to 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 Beginnings intervention led, at age 2 years, to significant reduction in BMI and television viewing time, and also improvements in vegetable consumption. The mothers involved also showed a significant improvement in their rates of breastfeeding, while also reducing the proportion of mothers who introduced solids before six months. The intervention also had a significant effect on par- ticipating mothers’ own healthy lifestyles. These results 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 currently underway and will be completed by mid 2014. More intonation about Healthy Beginnings Trial can be found at http://healthybeginnings.net.au/. http://dx.doi.org/10.1016/j.orcp.2013.12.502 4 Early life nutrition and developmental programming of obesity — Evidence from animal models and potential strategies for intervention Mark H. Vickers Liggins Institute and Gravida, University of Auckland, Auckland, New Zealand Obesity is a world-wide epidemic associated with significant morbidity and mortality which costs bil- lions of dollars per year and is a major cause of non-communicable chronic diseases and premature deaths. Of increasing concern is the rise in the prevalence of childhood obesity — with concomi- tant increases in childhood type 2 diabetes and fatty liver disease. Although metabolic disorders arise from a complex interaction of many factors, including genetic, physiologic, behavioural and environmental influences, the rates at which these diseases have increased suggest that environmen- tal and behavioural influences, rather than genetic causes, are fuelling the epidemic. The develop- mental origins of health and disease (DOHaD) hypothesis has highlighted the link between the early life nutritional environment and the later development of adult obesity and related metabolic disorders. Although the mechanisms are not yet fully understood, this developmental programming was generally considered an irreversible change in

Healthy Beginnings Trial: The journey from the beginning

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e2 Abstracts

2

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

3

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

4

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