Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis

Hunter, KE; Nguyen, D; Libesman, S; Williams, JG; Aberoumand, M; Aagerup, J; Johnson, BJ; Golley, RK; Barba, A; Sotiropoulos, JX; Shrestha, N; Palacios, T; Pryde, SJ; Wolfenden, L; Taylor, RW; Godolphin, PJ; Matvienko-Sikar, K; Sanders, LM; Robledo, KP; Brown, V; Wood, CT; Taki, S; Yin, HS; Hayes, AJ; O'Connor, DA; Smith, W; Espinoza, DE; Askie, L; Chadwick, PM; Rissel, C; Webster, AC; Hesketh, KD; Bryant, M; Thomson, JL; Lakshman, R; Fiks, AG; Helle, C; Odar Stough, C; Ong, KK; Perrin, EM; Karssen, L; Larsen, JK; Linares, AM; Messito, MJ; Wen, LM; Oken, E; Øverby, NC; Palacios, C; Paul, IM; Rasmussen, FE; Reifsnider, EA; Rothman, RL; Byrne, RA; Rybak, TM; Salvy, SJ; Wasser, HM; Thompson, AL; Ghaderi, A; Taylor, BJ; Maffeis, C; Xu, H; Savage, JS; Joshipura, KJ; de la Haye, K; Røed, M; Copsey, B; Golova, N; Gross, RS; Anzman-Frasca, S; Banna, J; Baur, LA; Seidler, AL; TOPCHILD Collaboration

doi:10.1016/s0140-6736(25)01144-4

Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis

LancetPublished 10 Sep 2025Systematic review and individual participant data meta-analysis of randomised controlled trials

Pooled result · BMI Z scoreResultMean difference −0.01 95% CI −0.08 to 0.05

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Authors' conclusion

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.

Study context

Population: Children in RCTs commencing before 12 months of age; 50% boys, 48% girls, 2% unknown sex
Participants: 9,128 children17 RCTs

Comparison: Parent-focused behavioural obesity prevention interventions vs usual care, no intervention or attention control
Outcome: BMI Z score
Follow-up: Age 24 months (±6 months)

Methodological detailsintention-to-treat, two-stage, random effects, GRADE certainty assessment, Searched MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo, ClinicalTrials.gov and WHO ICTRP to Sept 30, 2024, IPD obtained for 17 of 18 eligible trials, 97% of eligible participants

Intention-to-treat
Two-stage
Random effects
GRADE certainty assessment
Searched MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo, ClinicalTrials.gov and WHO ICTRP to Sept 30, 2024
IPD obtained for 17 of 18 eligible trials, 97% of eligible participants

Pooled result

As reported in the abstract

Mean difference

−0.01

95% CI −0.08 to 0.05

Interventionvs Control

mean difference −0.01 (95% CI −0.08 to 0.05)

Further pooled results

Findings robust to prespecified sensitivity analyses; no evidence of differential intervention effects for prespecified subgroups including priority populations and trial-level factors

Reference

Authors: Hunter KE, Nguyen D, Libesman S, Williams JG, Aberoumand M, Aagerup J, et al.
All 73 authors
Hunter KE, Nguyen D, Libesman S, Williams JG, Aberoumand M, Aagerup J, Johnson BJ, Golley RK, Barba A, Sotiropoulos JX, Shrestha N, Palacios T, Pryde SJ, Wolfenden L, Taylor RW, Godolphin PJ, Matvienko-Sikar K, Sanders LM, Robledo KP, Brown V, Wood CT, Taki S, Yin HS, Hayes AJ, O'Connor DA, Smith W, Espinoza DE, Askie L, Chadwick PM, Rissel C, Webster AC, Hesketh KD, Bryant M, Thomson JL, Lakshman R, Fiks AG, Helle C, Odar Stough C, Ong KK, Perrin EM, Karssen L, Larsen JK, Linares AM, Messito MJ, Wen LM, Oken E, Øverby NC, Palacios C, Paul IM, Rasmussen FE, Reifsnider EA, Rothman RL, Byrne RA, Rybak TM, Salvy SJ, Wasser HM, Thompson AL, Ghaderi A, Taylor BJ, Maffeis C, Xu H, Savage JS, Joshipura KJ, de la Haye K, Røed M, Copsey B, Golova N, Gross RS, Anzman-Frasca S, Banna J, Baur LA, Seidler AL, TOPCHILD Collaboration
Journal: The Lancet
Published: 10 Sep 2025
DOI: 10.1016/s0140-6736(25)01144-4
PubMed: 40945528
Registration: CRD42020177408

Topic: Obesity

Group definitions

Intervention: parent-focused behavioural interventions to prevent obesity, commencing before 12 months of age

Key notes

No evidence of an effect of interventions on BMI Z score
High certainty evidence; τ2=0.01; n=6505; 2623 missing

More notes

Intention-to-treat

Original publication

Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis. Lancet. Published 10 September 2025. doi:10.1016/s0140-6736(25)01144-4

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