Nutr Rev. 2026 Mar 11:nuag004. doi: 10.1093/nutrit/nuag004. Online ahead of print.
ABSTRACT
CONTEXT: Childhood obesity is a major global health concern, with various strategies aimed at prevention. Early childhood represents a critical window for intervention; however, the effectiveness of strategies during this period remains unclear.
OBJECTIVE: To evaluate the effectiveness of interventions implemented during the first 3 years of life in preventing childhood overweight and obesity, through a systematic review of reviews.
DATA SOURCES: A systematic review of systematic reviews and meta-analyses was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviews targeting children up to 3 years of age in Organization for Economic Co-operation and Development countries were included.
DATA EXTRACTION: The primary outcomes were the incidence of overweight and obesity, assessed at least 1 year postintervention. Secondary outcomes included body mass index z-score, weight-gain velocity, and body composition. The quality of the reviews was assessed using the AMSTAR-2 tool.
DATA ANALYSIS: Thirty-nine systematic reviews were included in the qualitative synthesis, from which only 45 randomized controlled trials were identified as meeting the inclusion criteria. Evidence suggests that multicomponent interventions incorporating physical activity or responsive feeding show modest positive effects, although the quality of evidence is generally low. Reducing protein intake from infant formula during the first 2 years of life showed moderate evidence in reducing obesity risk up to 6 years of age. Breastfeeding, sleep, and weaning interventions had limited or inconclusive effects.
CONCLUSION: While reducing protein intake from infant formula during the first 2 years of life showed moderate evidence of benefit, there is limited and low-quality evidence supporting early-life interventions to prevent childhood obesity. Multicomponent interventions, particularly those incorporating physical activity or promoting responsive feeding, appear modestly beneficial. Further high-quality research, particularly randomized clinical trials with longer follow-up, is needed to confirm these findings and optimize obesity-prevention strategies.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022338940.
PMID:41812134 | DOI:10.1093/nutrit/nuag004
