Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Cardiovascular benefits of early childhood obesity prevention: a pragmatic evaluation of a randomised controlled trial in pre-school aged children (128273)

Reeja Nasir 1 , Li Ming Wen 2 3 , Huilan Xu 3 , Erin Kerr 3 , Julian Ayer 4 , Frances Garden 5 , David Celermajer 2 3 , Michael Skilton 1 , Adrienne Gordon 1 2 3
  1. Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
  2. Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
  3. Sydney Local Health District, Camperdown, NSW, Australia
  4. Sydney Children's Hospitals Network, Sydney, 2000, Australia
  5. University of New South Wales, Kensington, NSW, Australia

Background: Atherosclerotic cardiovascular disease begins early in life and can be measured non-invasively at a pre-clinical stage using ultrasound-derived intima-media thickness (IMT) [1]. Early childhood efforts to prevent obesity may provide cardiovascular benefits, even without substantial changes in adiposity. The Communicating Healthy Beginnings Advice by Telephone (CHAT) trial was a nurse-led, telephone-based intervention conducted in Sydney, Australia, that aimed to support parental behaviours to reduce childhood obesity [2]. This study evaluated the effect of the CHAT intervention on vascular health in preschool-aged children.

Methods: Eligible children from the CHAT trial were invited for an in-person health assessment between the ages of 5 and 6 years. Abdominal aortic IMT (aIMT), the primary outcome, was measured using high-resolution ultrasound. evaluated whether the intervention affected aIMT directly or indirectly via BMI changes from infancy. To explore dose-response effects, participants were grouped by exposure across the trial’s two phases (birth–2 years and 2–4 years): no intervention, one phase, or both phases.

Results: The study included 92 mother-child dyads. At follow-up (mean age 5.8 ± 0.2 years), children had mean weight and height z-scores of 0.13 (±1.17) and 0.46 (±1.08), and a BMI z-score of -0.10 (±1.22), indicating a cohort taller and leaner than population norms. Males and females were evenly distributed. No significant difference in aIMT or BMI was observed between intervention and control groups. A dose-response trend suggested that children who received no intervention across both phases had higher aIMT compared to those with partial or full exposure (p = 0.04). However, the sample size was too small to draw firm conclusions.

Conclusions: Early-life obesity prevention trials may influence vascular health; however, they must be adequately powered. In addition, substantial resources are required to support in-person assessments and imaging. These considerations should be factored into the design and planning of future trials.

  1. Skilton MR, Celermajer DS, Cosmi E, Crispi F, Gidding SS, Raitakari OT, Urbina EM. Natural History of Atherosclerosis and Abdominal Aortic Intima-Media Thickness: Rationale, Evidence, and Best Practice for Detection of Atherosclerosis in the Young. J Clin Med. 2019 Aug 12;8(8):1201. doi: 10.3390/jcm8081201. PMID: 31408952; PMCID: PMC6723244.
  2. Wen, Li Ming and Xu, Huilan and Chen, Zoe and Hayes, Alison and Phongsavan, Philayrath and Taki, Sarah and Kerr, Erin and Jawad, Danielle and Simone, Lisa and Rissel, Chris and Baur, Louise A., Effectiveness of a Telephone-Based Randomised Controlled Trial Targeting Obesity Risk of Preschool-Aged Children: An Extension Study During the COVID-19 Pandemic. Available at SSRN: https://ssrn.com/abstract=4875995 or http://dx.doi.org/10.2139/ssrn.4875995