EndObesity

Childhood obesity is a major public health problem leading to short-term and long-term adverse health outcomes, reduced quality of life and high societal costs. Obesity and related comorbidities seem to originate in the earliest phase of life. Adverse maternal and offspring lifestyle factors in the preconception period, pregnancy and early childhood are major risk factors for childhood obesity and its comorbidities.

These adverse maternal and offspring lifestyle factors are highly prevalent, cluster within families and are modifiable risk factors for childhood obesity. Urgent development of evidence-based childhood obesity prevention strategies targeting these family-based lifestyle factors in these three crucial transition periods is needed. These prevention strategies need to be developed in strong collaboration with consumers and stakeholders to enable effective large-scale implementation.

EndObesity will develop, implement and evaluate innovative, multi-disciplinary strategies for prevention of childhood obesity by targeting family-based lifestyle factors in the preconception period, pregnancy and early childhood, covering the first 1000 days of life. EndObesity includes transnational European experts from academia, municipal/governmental health care services, educational stakeholders, industry partners and parent-childhood organizations, and combines outstanding expertise in multiple areas of childhood obesity science and implementation.

• First, in WP1 and WP 2 we identified, from preconception to early-childhood, facilitators and barriers for family-based behaviours patterns associated with childhood obesity and developed dynamic population-based prediction models for early identification of children at high risk of obesity and its comorbidities.
• Second, in WP3 and WP4 we will develop evidence-based innovative intervention strategies for childhood obesity prevention by optimizing family lifestyle and nutrition in the preconception period, pregnancy and early-childhood using population-level strategies and more personalized intervention strategies for higher risk groups.
• Finally, in WP5 we will implement and evaluate childhood obesity prevention strategies through novel and existing partnerships with health care, governmental, educational and industry stakeholders and parent-childhood organizations addressing identified facilitators and barriers and using evaluation studies.
• Ultimately, EndObesity will optimize family-based health behaviours in three crucial transition periods to prevent childhood obesity. This innovative, novel approach is not only beneficial for the child, but for the entire family and will break the transgenerational vicious cycle of obesity.

EndObesity Highlights achieved in the first 18 months of the project:

• We characterized family health behaviours patterns in the preconception period and during pregnancy related to the development of childhood overweight. We showed that a family-based health pattern defined by high parental BMI, smoking and sedentary lifestyle, before and during pregnancy, was associated with a higher childhood BMI in children aged 5 to 12 years.
• In a large meta-analysis with data from the EndObesity partners, we developed a prediction model for childhood obesity using readily available maternal and paternal preconception characteristics, including age, ethnicity, parity, body mass index and smoking. This model had a moderate to good predictive performance for childhood obesity. We will further improve this prediction model by including additional maternal, paternal and infant factors, obtained during pregnancy and early-childhood.
• Multiple intervention studies targeting different  family lifestyle factors from preconception to early-childhood are ongoing within the EndObesity Consortium. For the ECAIL trial, a second investigating center was opened at the maternity hospital of Valenciennes in June 2021. A qualitative study was initiated in 2022 to foster the process evaluation of the intervention (2 observations and 9 semi-structured interviews already implemented with families included in the trial). Furthermore, the set-up for the Generation R Next Intervention Study, a preconception lifestyle intervention study, has been completed and we aim to start study recruitment at the end of 2022.
• We presented our results at international scientific conferences (e.g DOHaD World Conference 2022) and national and regional large interdisciplinary conferences/meetings focused on preconception, pregnancy and childhood care (e.g BECO “Bébé, petite enfance en contexte, Annual DPSG "Diabetic Pregnancy Study Group" meeting  ). We also disseminated our research findings to future parents via a novel EndObesity Instagram page (https://www.instagram.com/end.obesity1/) and in close collaboration with the collaborating parent-childhood organizations (https://www.efcni.org/endobesity/)