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Lifestyle counselling targeting infant's mother during the child's first year and offspring weight development until 4 years of age: a follow-up study of a cluster RCT
  1. Taina Mustila1,
  2. Jani Raitanen2,3,
  3. Päivi Keskinen4,5,
  4. Antti Saari6,7,
  5. Riitta Luoto2,8
  1. 1Department of Pediatrics, Central Hospital of Seinäjoki, Seinäjoki, Finland
  2. 2UKK Institute for Health Promotion, Tampere, Finland
  3. 3Tampere School of Health Sciences, University of Tampere, Tampere, Finland
  4. 4Pediatric Research Centre, University of Tampere, Tampere, Finland
  5. 5Department of Pediatrics, Tampere University Hospital, Tampere, Finland
  6. 6Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
  7. 7Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
  8. 8National institute for Health and Welfare, Department of children, young people and families, Helsinki, Finland
  1. Correspondence to Dr Taina Mustila; taina.mustila{at}


Objective To investigate the effect of intensified lifestyle counselling targeting infants' mothers on offspring weight development during the first 4 years of life.

Design and setting Follow-up of a cluster-randomised controlled trial in primary care child health clinics during 2004–2006 in Finland. Participants received a follow-up survey during 2010 concerning weight and height measurements of their offspring. Number of clusters was six and the response rate to the follow-up 71.9% (N=64/89).

Participants The participants (N=89) were mothers of infants aged 2–10 months.

Intervention The intervention included individual counselling on diet and physical activity when the infant was 2–10 months of age and an option to attend supervised group exercise sessions.

Primary and secondary outcome measures The authors analysed the secondary outcome of the intervention study: the weight development of the offspring. The primary outcome was the proportion of women returning to their prepregnancy weight by 10 months post partum, reported earlier.

Results Multilevel mixed effect non-linear regression models included group, age of the child and interaction between group and age of the child. The increase of BMI z-score between 24 and 48 months was slower among the intervention group offspring (−0.034 to −0.002, p=0.028) as compared with control group. Z-scores for weight-for-length/height did not differ between groups when the period 0–48 months was analysed (p=0.23) but for the period of 24–48 months, between-group differences were significant (p=0.012).

Conclusions Lifestyle counselling targeting mothers during the child's first year may be effective in slowing offspring weight gain until 4 years of age. However, larger studies are needed to confirm the findings which may have the potential in combatting the obesity epidemic.

Trial registration number Current Controlled Trials ISRCTN21512277.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • To cite: Mustila T, Raitanen J, Keskinen P, et al. Lifestyle counselling targeting infant's mother during the child's first year and offspring weight development until 4 years of age: a follow-up study of a cluster RCT. BMJ Open 2012;2:e000624. doi:10.1136/bmjopen-2011-000624

  • Funding This project was funded by the Competitive Research Funding of the Tampere University Hospital (Dr Riitta Luoto, grant 9G042, Dr Päivi Keskinen), Medical Research Fund of Vaasa Hospital District (Dr Taina Mustila), this project was funded by the UKK Institute for Health Promotion (Tampere, Finland), the Ministry of Health and Welfare, the Academy of Finland and the Foundation of Pediatric Research (Finland).

  • Competing interests None.

  • Ethics approval The study was approved by the Ethics Committee of the Pirkanmaa Hospital District.

  • Contributors RL is the guarantor of the study. TM, PK and RL planned the follow-up questionnaire to the mothers. TM coded the data together with a research assistant. AS produced the BMI-for-age statistics and participated in the interpretation of the BMI-for-age results. JR performed the statistical analyses. All contributors participated in drafting the manuscript and approved the final manuscript. All authors had full access to all data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Technical appendix, statistical codes and data set available from the authors at email riitta.luoto{at} Consent for data sharing was obtained from the participants.

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