It is apparent to most that obesity has become a worldwide epidemic given that the rate of adult, and even childhood, obesity is on the rise. What is less well-known is that the rate of obesity amongst preschool children is also on the rise, with an estimated 22 million children under the age of five being overweight or obese. These alarming statistics have fueled the study and development of early intervention programs to educate and implement dietary and lifestyle changes in children. The Trim Tots preschool program has had positive results in two recent clinical trials in the UK.
According to the World Health Organization, 10% of the world’s children are overweight or obese. These children are more likely to become overweight or obese adults, increasing their risk of developing diabetes and cardiovascular disease at a younger age. While this is a worldwide health concern, obesity and its resulting health problems are largely preventable. Early lifestyle habits and nutritional intake have a great effect on development of obesity and its consequent diseases. Early intervention is therefore extremely important for improving long term health outcomes, and reducing the risk of obesity.
Trim Tots is a preschool program created at the Institute of Child Health, UniversityCollege, London, UK, by a group of healthcare professionals consisting of dieticians, pediatricians, exercise instructors, and clinical psychologists. The Trim Tots program consists of interactive teaching sessions and practical workshops that provide information on diet, physical activity, and behavioral change. Most importantly, and making it somewhat different from other programs, is the high level of parental involvement. This level of parental involvement ensures the success of the program by fostering a family-adopted healthy lifestyle. Both children and parents participate in art, music, and games where they are educated about nutrition and physical activity.
The Trim Tots program was recently the subject of two randomized, controlled clinical trials conducted in the UK. The trials randomized children (ages 1-5 years) to either an intervention or a control group. The children in the intervention group participated in the Trim Tots program for two hours, twice a week, over a period of 6 months at Sure Start Children’s Centers in Hertfordshire, UK. The control group consisted of children who were put on a waiting list for the program.
The first trial only included children who had a BMI in the 91st percentile or above, according to the WHO growth reference chart. After 6 months’ participation in the TrimTots program, there was a significant reduction in BMI, waist circumference, and blood pressure in the children who were enrolled in the program as compared to the children who were on the waiting list. This effect on BMI was maintained at a 2-year follow up assessment. The second trial did not exclude children on the basis of weight. In this trial there were no significant differences in BMI or waist circumference between children in the treatment group and the control group. There was, however, a reduction in blood pressure observed in the intervention group in this trial.
The Trim Tots program has been developed as a creative and fun way of introducing healthy lifestyle principles to preschoolers and their caregivers. Trim Tots was successful at reducing the risk of obesity in overweight and high-risk children, suggesting that it could be a useful tool in the fight against childhood obesity.
World Health Organization (2004) Global Strategy on Diet, Physical Activity and Health. Geneva: WHO; Available at: http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf Last Accessed: Jan 20, 2014.
Lanigan, J., Barber, S., Ainghal, A. “Management of Obesity Prevention of Obesity in Preschool Children.” Proceedings of the Nutrition Society (69): 204-210, 2010.
Lanigan, J., Collins, S., Birbara, T., Kokoreli, M., Singhal, A., “The TrimTots Programme for Prevention and Treatment of Obesity in Preschool Children: Evidence from Two Randomised Controlled Trials.” The Lancet, 382:S58, November 2013.
Clinicaltrials.gov “TrimTots Pre-school Obesity Prevention Programme” Available from: http://clinicaltrials.gov/ct2/show/NCT00675662?term=trimtots&rank=1 Last Accessed: Jan 20, 2014.
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Written by Deborah Tallarigo, PhD.