Hunter, Kylie E;
Nguyen, David;
Libesman, Sol;
Williams, Jonathan G;
Aberoumand, Mason;
Aagerup, Jannik;
Johnson, Brittany J;
... TOPCHILD Collaboration; + view all
(2025)
Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis.
The Lancet
, 406
(10509)
pp. 1235-1254.
10.1016/S0140-6736(25)01144-4.
![[thumbnail of Godolphin_TOPCHILD_IPDMA_TheLancetAcceptedVersion2025.pdf]](https://discovery.ucl.ac.uk/style/images/fileicons/text.png) |
Text
Godolphin_TOPCHILD_IPDMA_TheLancetAcceptedVersion2025.pdf Access restricted to UCL open access staff until 11 March 2026. Download (1MB) |
Abstract
BACKGROUND: Childhood obesity is a global public health issue, which has prompted governments to invest in prevention programmes. We aimed to investigate the effectiveness of parent-focused early childhood obesity prevention interventions globally. METHODS: We did a systematic review and individual participant data meta-analysis. We searched databases and trial registries (MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform) from inception until Sept 30, 2024, for randomised controlled trials commencing before 12 months of age examining parent-focused behavioural interventions to prevent obesity in children, compared with usual care, no intervention, or attention control. Individual participant data were checked, harmonised, and assessed for integrity and risk of bias. We excluded trials that were quasi-randomised, investigated pregnancy-only interventions, or did not collect any child weight-related outcomes. The primary outcome was BMI Z score at age 24 months (±6 months). We did an intention-to-treat, two-stage, random effects meta-analysis to examine effects overall and for prespecified subgroups. We assessed certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation. This study is registered with PROSPERO, CRD42020177408. FINDINGS: Of 19 990 identified records, 47 (0·24%) trials were completed and eligible. Of these, 18 (38%) assessed our primary outcome, BMI Z score. We obtained individual participant data for 17 (94%; n=9128) of these 18 trials (n=9383), representing 97% of eligible participants. Of these 9128 participants, 4549 (50%) were boys, 4415 (48%) were girls, and 164 (2%) had unknown sex. We found no evidence of an effect of interventions on BMI Z score at age 24 months (±6 months; mean difference -0·01 [95% CI -0·08 to 0·05]; high certainty evidence, τ2=0·01; n=6505; 2623 missing). Findings were robust to prespecified sensitivity analyses (eg, different analysis methods and missing data), and we found no evidence of differential intervention effects for prespecified subgroups including priority populations and trial-level factors. INTERPRETATION: These findings indicate that examined parent-focused behavioural interventions are insufficient to prevent obesity at age 24 months (±6 months). This evidence highlights a need to re-think childhood obesity prevention approaches. FUNDING: Australian National Health and Medical Research Council.
| Type: | Article |
|---|---|
| Title: | Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis |
| Location: | England |
| DOI: | 10.1016/S0140-6736(25)01144-4 |
| Publisher version: | https://doi.org/10.1016/s0140-6736(25)01144-4 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Humans, Pediatric Obesity, Parents, Child, Preschool, Female, Behavior Therapy, Male, Randomized Controlled Trials as Topic, Infant, Body Mass Index |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10215120 |
Archive Staff Only
 |
View Item |
