Comprehensive Preschool Program Tied to Lower BMI Decades Later

By Lisa Rapaport

March 24, 2021

(Reuters Health) - Children who attend a comprehensive preschool program with workshops for families on topics like health literacy and nutrition may have a lower BMI as adults than peers without that early experience, a new study suggests.

Researchers examined data on 1,042 adults born in 1979 and 1980 who were part of the Chicago Longitudinal Study, including 689 people who were part of a Child-Parent Center (CPC) preschool program at ages 3 or 4 years, and 353 people who were not exposed to the program. At baseline, all the children and families lived in high-poverty areas of Chicago where more than 90% of residents were Black.

The CPC program was designed to not only give children a headstart on school, but also provide parenting classes on nutrition and health, family support, and community engagement. Children in the program and their families received some ongoing services through third grade, while children in the comparison group had no support of this kind or preschool prior to starting kindergarten.

When participants completed surveys about their health and wellbeing in their mid-30s, 44.9% were obese, with a mean BMI of 30.4. However, people who had gone through the CPC program had a significantly lower BMI (30.0) than those who didn't (31.0).

"In addition to promoting school success and economic well-being, high quality early childhood programs that provide comprehensive education, family support, and health services can promote healthy weight decades later and into midlife," said lead study author Arthur Reynolds, a professor at the Institute of Child Development and director of the Human Capital Research Collaborative at the University of Minnesota, in Minneapolis.

"This is especially the case for population groups at higher risk of experiencing obesity and less-than-healthy weight status, including children growing up in poverty and facing adversity, children and families residing in high-poverty neighborhoods, and females," Reynolds said by email.

The differences in BMI between groups were more pronounced for certain high-risk groups, including residents of high-poverty neighborhoods and people with high family risk status for obesity, the researchers report in JAMA Pediatrics.

Among residents of high-poverty neighborhoods, 41.6% of those who went through CPC had obesity, compared with 56.9% of those who hadn't gone through the program.

And among people with a high family risk status, 42.3% of those who went through CPC had obesity, compared with 51.2% of those who didn't.

One limitation of the study is that adult BMI was based on self-reported height and weight, the study team notes. It's also possible that results from CPC might not be representative of what would happen with other, less comprehensive preschool programs.

"These are interesting preliminary data on the potential of community-based intervention early in life to shift the curve on lifelong obesity risk," said Dr. David Ludwig, co-director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital.

"We'll need further study to know how effective this intervention might actually be," Dr. Ludwig, who wasn't involved in the study, said by email.

SOURCE: https://bit.ly/2Plgaay JAMA Pediatrics, online March 22, 2021.

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