Study suggests integrated, communitywide initiatives can impact children from low–income families with greatest obesity risk.
Preschoolers from low–income families living in cities that took part in a two–year communitywide intervention to foster healthy eating and lifestyle habits consumed fewer sugary drinks, got more sleep, and showed improvement in weight, according to a study led by a researcher at Columbia University Medical Center (CUMC).

The study – one of a trio of studies published in the journal Obesity – was designed to test a childhood obesity–prevention program known as the Massachusetts Childhood Obesity Research Demonstration (MA–CORD) initiative among families in low–income communities, where high obesity rates persist.

“Evidence strongly suggests that instilling healthy habits in young children is a necessary cornerstone in efforts to prevent obesity and its sequelae,” said study leader Jennifer Woo Baidal, MD, assistant professor of pediatrics and director of pediatric weight management at CUMC and a pediatric gastroenterologist in the Comprehensive Adolescent Bariatric Surgery Program at NewYork–Presbyterian/Columbia University Medical Center. “Though some progress has been made in reducing childhood obesity, not all families are aware that certain strategies – like eliminating sugary drinks, limiting screen time, and getting enough physical activity and sleep – help young children achieve and maintain a healthy weight. Solutions that can be scaled–up are urgently needed to prevent obesity in young children at highest risk.”

To increase adoption of these strategies, the researchers in this study implemented the MA–CORD initiative at two communitywide offices of the Special Supplementation for Women, Infants and Children (WIC) program in Massachusetts, which provides healthy foods, nutrition assessment and education, breastfeeding support, and referrals to health care and other services for low–income families with very young children. WIC providers were trained to deliver consistent messages during office visits about how much sugar–sweetened beverage, juice, junk food, screen time, and exercise young children should get. Families at a third community WIC site did not get the intervention.

At the end of the study, children from the intervention sites reduced their intake of sugary beverages and juice and got more sleep compared with children who did not receive the intervention. Children from the intervention sites also engaged in more physical activity and less screen time than their counterparts in the comparison group, though these differences were not statistically significant.

In one intervention site, non–Asian children also had small decreases in adjusted BMI scores compared with children in the comparison group.

“Overall, the intervention had a positive impact on reducing obesity risk factors among the children in our study, but the smaller impact on reducing BMI may be due to factors that can’t be easily controlled, such as access to high–quality, nutritious foods in the community and the challenge of measuring rapid changes in growth during early childhood,” said Rachel Colchamiro, director of nutrition services for the Nutrition Division at the Massachusetts Department of Public Health and a co–author of the paper. “Because obesity disproportionately affects lower–income families, ncorporating WIC providers and community systems into multisector obesity prevention efforts could yield high results at a national level.”

The study is titled, “Childhood Obesity Prevention in the Women, Infants, and Children Program: Outcomes of the MA–CORD Study.”