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OverweightNCT01583335

The Healthy Start Project: Primary Prevention of Overweight in Preschool Children Susceptible to Future Overweight

A study testing Lifestyle habits, including sleep and stress in people with Overweight and Obesity, run by Bispebjerg Hospital at 1 site in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Obesity prevention should remain a priority, although there is some evidence of a possible leveling off in some age groups across European countries and in USA, Japan and Australia. Read more about this study

Who is it for?
Ages 2 to 6 yearsHealthy volunteers can take part
Conditions the study is for
Overweight, Obesity
What is being tested?
Lifestyle habits, including sleep and stress
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,202 participants
Where
1 siteDenmark
Study dates
May 2009to Jun 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 6 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Born between 2004-2007
  • Born in 11 selected municipalities in the greater Copenhagen area
  • Classified as susceptible to overweight and obesity (At least one of the following risk factors present: A high birth weight (> 4000 grams), maternal pre-pregnancy obesity (BMI > 28 kg/m^2), or maternal low education (<= 10 years)
  • Normal weight at baseline examination

Who cannot join

  • Moved to another municipality after birth,
  • Had requested protection from participation in statistical or scientific surveys based on data delivered from the Danish Central Person Registry
  • No permanent address
  • Lived in a children's home
  • Had died
  • Had emigrated
Show all 9Show fewer
  • Registered in the Danish Central Person Registry as being disappeared or had unknown life status
  • Not speaking Danish
  • Overweight (including obesity) at baseline examination

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Parker Institute, Research Unit for Dietary Studies

    Frederiksberg, 2000

Other trials in Denmark

About this study

Official title: Prevention of Weight Gain Among Normal Weight, Obesity Susceptible, Pre-school Children - a Randomized Controlled Interventions Study.

Obesity prevention should remain a priority, although there is some evidence of a possible leveling off in some age groups across European countries and in USA, Japan and Australia. Besides adult health problems such as type-2 diabetes and cardiovascular diseases, obesity in childhood is associated with psychological and social problems, low self-esteem, stigmatization and being teased and bullied by friends. Danish research suggests that the causes behind the increase in obesity occurrence are present already in early childhood, and that prevention of obesity therefore has to start early. Research has suggested that at least three sub-groups can be considered susceptible to develop obesity: Children with obesity among their 1st degree relatives; children with a high birth weight or children coming from socially disadvantaged families (low socioeconomic status). Earlier intervention programs has showed little effect in preventing excessive weight gain and knowledge on how to develop effective intervention programs that reduce overweight and obesity remains limited. It has been suggested that future prevention programs may be more successful if specifically targeting groups that are at high risk, as mention above, of excessive weight gain.

Based on these suggestions, the "Sund Start" project was initiated. The purpose of the study was to determine whether aiming prevention towards 2-6 years old Danish children who were yet normal weight, but were considered susceptible to develop overweight or obese could prevent later on risk of becoming overweight or obese. Furthermore, to investigate if it was possible to improve diet habits, increase physical activity, reduce stress and improve sleeping habits among children at high risk for later on overweight and obesity.

The "Sund Start" project will contribute with knowledge about whether targeting normal weight, predisposed children is effective in preventing overweight and obesity, and if reduced stress and improved sleep, should be considered important new obesity prevention tools. Moreover, the project will contribute with knowledge about how to change lifestyle and its effects on development of overweight and obesity in high risk Danish preschool children.

Read the detailed description

In 2009, data on all births between 2004 and 2007 in 11 selected municipalities from the greater Copenhagen area was obtained from the Danish national birth register at the National Board of Health. This register contains information on all births, whether at hospital or home, on factors such as birth weight and length, height and pre-pregnant weight of the mother, parity, and Central Personal Registry number (CPR-number). Data on socioeconomic status was obtained from the administrative birth forms. This was done manually using the CPR-numbers obtained from the birth register.

After selection of the children eligible for participation, the children were allocated to three groups, (intervention group, control group, shadow group) using computer based randomization. All siblings were allocated to the same group. After the random allocation, children from the intervention group and the control group were sent a letter with an invitation to participate in the project. Children from the shadow group were also identified, and their general practitioners were contacted and asked for information on each child's height and weight.

Conditions
Overweight, Obesity
Being tested
Lifestyle habits, including sleep and stress
Keywords
Overweight, Obesity, Susceptibility, Prevention, Diet, Physical activity, Sleep, Family stress
Medical subject headings
Overweight, Obesity, Disease Susceptibility, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lifestyle habits, including sleep and stressBehavioural

    The intervention group was offered up to 10 individual consultations focusing on improving diet, physical activity and sleep habits and reducing stress. Moreover, the intervention group was offered participation in monthly cooking classes and playing arrangements

Study groups in NCT01583335
Study groupRoleWhat they receive
Improved lifestyleExperimentalNot described
Receives: Behavioral: Lifestyle habits, including sleep and stress
Control groupNo interventionThe control group was seen at baseline and follow-up, but not in between.
Shadow groupNo interventionThe shadow group was followed in registers exclusively

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Anthropometric measurements

    Changes between baseline and 1.3 years follow.up per intervention year in:

    Height in cm Weight in kg BMI in kg/m^2 BMI z-score in SD Waist circumference in cm Hip circumference in cm Sum of four skinfolds (biceps, triceps, subscapular and suprailiac) in cm Body composition measured by bio-electrical impedance

    Measured: 1.3 years

  2. Anthropometric measurements

    Changes between baseline and 5 years follow.up per intervention year in:

    Height in cm Weight in kg BMI in kg/m^2 BMI z-score in SD

    Measured: 5 years

  3. Anthropometric measurements

    Changes between baseline and 10 years follow.up per intervention year in:

    Height in cm Weight in kg BMI in kg/m^2 BMI z-score in SD

    Measured: 10 years

Secondary outcomes (25)
  1. Dietary intake

    Four day dietary record completed Wednesday-Saturday

    Measured: 1.3 years

  2. Priority of serving fruit and vegetables

    How high do you prioritize that fruit and vegetables are served at the meals? (Scale from 1 to 4, 1 being low and 4 being high. Higher values considered better outcome)

    Measured: 1.3 years

  3. Physical activity

    Children's Physical Activity Questionnaire (C-PAQ. 7-day recording of sports, games and leisure time activities outside daycare. The response options were indicated by doing a particular activity ("yes" or "no") and by an indication of total time used on the activity during the week (minutes per week). All minutes per week were summed to obtain an indication of overall physical activity level. Higher values considered better outcome)

    Measured: 1.3 years

  4. Sleep duration

    7 day sleep record from completed questionnaire (average number of minutes sleep summed from 7 day record on sleep- and wake time points)

    Measured: 1.3 years

  5. Child stress level

    Measured concentration of cortisol in hair samples

    Measured: 1.3 years

  6. Parental stress level

    Measured concentration of cortisol in hair samples

    Measured: 1.3 year

  7. Sleep quality

    Child's sleep is considered (calm all night, a little disturbed, disturbed with occasional awakenings, very disturbed with several awakenings. Calm all night considered best outcome).

    Measured: 1.3 year

  8. Child stress level

    Strengths and Difficulties Questionnaire (SDQ). Scored 0-2 and summed to Total Difficulties score (0-40, lower score indicate better outcome), and Prosocial Behavior score (0-10, lower score indicate worst outcome)

    Measured: 1.3 year

  9. Parental stress level

    Modified version of the Swedish Parental Stress Index (PSI). Each question was scored between 0 and 2 (0 considered best score and 2 the worst), according to its estimated indication of an overall stress level. Analysis of intercorrelations among the 10 questions and a principal component analysis suggested that 9 of the 10 questions could be added together to get a score for the overall family stress level (0-18)

    Measured: 1.3 years

  10. Daily physical activity: Enjoys being active

    If the child enjoyed being physically active (Never, often, some times, usually, always. Always considered best outcome)

    Measured: 1.3 years

  11. Meal habits: Eating breakfast together

    How many times per week does the family eat breakfast together (None, 1 day, 2-3 days, 4-5 days, 6-7 days. 6-7 days considered best outcome).

    Measured: 1.3 years

  12. Meal habits: Eating dinner together

    How many times per week does the family eat dinner together (None, 1 day, 2-3 days, 4-5 days, 6-7 days. 6-7 days considered best outcome).

    Measured: 1.3 years

  13. Meal habits: Mealtime situation

    How would you describe the meals with the child (Very conflictive, little conflictive, very cozy, little cozy, don't know. Very cozy considered best outcome).

    Measured: 1.3 years

  14. Meal habits: Pickiness

    How would you describe your child's way of eating (Picky, open to new tastes, eats everything. Eats everything considered best outcome).

    Measured: 1.3 years

  15. Meal habits: Appetite

    How would you describe your child's appetite (Too big appetite, good appetite, normal appetite, too small appetite, don't know. Normal appetite considered best outcome).

    Measured: 1.3 years

  16. Sleep quality: Difficulties falling asleep

    Difficulties falling asleep (yes/no. No considered best outcome)

    Measured: 1.3 years

  17. Sleep quality: Difficulties waking up

    Difficulties waking up (yes/no. No considered best outcome)

    Measured: 1.3 years

  18. Sleep quality: Sleep onset latency

    Sleep onset latency (numerical. Lower values considered better outcome)

    Measured: 1.3 years

  19. Sleep quality: Bedtime routines

    Routine activities before bedtime (No, < 1/week, 1-2 times/week, 3-4 times/week, 5-6 times/week, every day. Every day considered best outcome)

    Measured: 1.3 years

  20. Sleep quality: Joining parents' bed

    Child joining parents' bed (yes/no. If yes, how often (< 1/month, 1-3 times/month,1-3 times/week, 4-6 times/week, every night)

    Measured: 1.3 years

  21. Sleep quality: Falling asleep

    Child afraid to fall asleep (Never, rarely, some times, often, very often. Never considered best outcome)

    Measured: 1.3 years

  22. Sleep quality: Dreams

    Child has frightening/upsetting dreams (Never, rarely, some times, often, very often. Never considered best outcome)

    Measured: 1.3 years

  23. Daily physical activity: Means of transportation

    Means of transportation to and from day-care, and frequency (Walk, strolling, bike on its own, biked by parent, and bus, train or car, number of times per week (1,2,3,4 or 5. Walking or biking on its own considered best outcome).

    Measured: 1.3 years

  24. Daily physical activity: Activity compared to other children

    How active is the child compared to other children at similar age? (as active, somewhat active, very active, don't know. Very active considered best outcome)

    Measured: 1.3 years

  25. Daily physical activity: Activity with parents

    Frequency of which one or both parents were physically active with the child (once per week, 2-4 times per week, 5-7 times per week, multiple times per day. Multiple times per day considered best outcome)

    Measured: 1.3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Apr 2012 (estimated)
  2. Study startMay 2009
  3. Primary completionAug 2012
  4. Study completionJun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
1,202 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01583335
Sponsor's protocol ID
Tryg-7984-07
Status last verified
May 2020
First submitted
31 Mar 2012
Last updated
15 May 2020
Results posted
No
Data monitoring committee
No

Publications

  • Rohde JF, Larsen SC, Handel MN, Olsen NJ, Stougaard M, Heitmann BL. Associations between Parental Stress and Subsequent Changes in Dietary Intake and Quality among Preschool Children Susceptible to Obesity. Int J Environ Res Public Health. 2021 Mar 30;18(7):3590. doi: 10.3390/ijerph18073590.

    PubMed 33808371
  • Zheng M, Rangan A, Olsen NJ, Heitmann BL. Longitudinal association of nighttime sleep duration with emotional and behavioral problems in early childhood: results from the Danish Healthy Start Study. Sleep. 2021 Jan 21;44(1):zsaa138. doi: 10.1093/sleep/zsaa138.

    PubMed 32691048
  • Olsen NJ, Rohde JF, Handel MN, Stougaard M, Mortensen EL, Heitmann BL. Joining Parents' Bed at Night and Overweight among 2- to 6-Year-Old Children - Results from the 'Healthy Start' Randomized Intervention. Obes Facts. 2018;11(5):372-380. doi: 10.1159/000492003. Epub 2018 Oct 12.

    PubMed 30308484
  • Handel MN, Larsen SC, Rohde JF, Stougaard M, Olsen NJ, Heitmann BL. Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity. PLoS One. 2017 Oct 9;12(10):e0185266. doi: 10.1371/journal.pone.0185266. eCollection 2017.

    PubMed 28991907
  • Olsen NJ, Buch-Andersen T, Handel MN, Ostergaard LM, Pedersen J, Seeger C, Stougaard M, Traerup M, Livemore K, Mortensen EL, Holst C, Heitmann BL. The Healthy Start project: a randomized, controlled intervention to prevent overweight among normal weight, preschool children at high risk of future overweight. BMC Public Health. 2012 Aug 1;12:590. doi: 10.1186/1471-2458-12-590.

    PubMed 22852799

Questions about this trial

What is this clinical trial studying?

A study testing Lifestyle habits, including sleep and stress in people with Overweight and Obesity, run by Bispebjerg Hospital at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 May 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Anthropometric measurements (time frame: 1.3 years). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01583335, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 May 2020.

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