The Dimensionality, Consistency, and Structural Validity of an Instrument Used to Measure Obesogenic Attitudes in Parents from Southern Spain (The PRELSA Scale).

(1) Background: We aimed to analyze the dimensionality, internal consistency, and structural validity of the Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale), which is an instrument that was designed to measure obesogenic behaviors. (2) Methods: We carried out an observational study by means of an online survey. The PRELSA Scale consists of 13 dimensions and 60 items relating to the most common obesogenic behaviors and attitudes. Additionally, we obtained sociodemographic characteristics and concrete habits from the sample. We obtained the responses of 791 parents and caregivers of preschool children between 2 and 6 years of age in Andalusia (southern Spain). We analyzed dimensionality through an Exploratory Factor Analysis (EFA), consistency through Cronbach's Alpha, structural validity through a Confirmatory Factor Analysis (CFA), and measurement invariance with multigroup CFA models. (3) Results: The EFA showed a 14-dimensional structure with 48 items. The internal consistency was acceptable in all dimensions (Cronbach's Alpha range of 0.72 to 0.97). The structure was confirmed in the CFA with good fit indices (CFI and TLI > 0.9 and RMSEA < 0.05). We ensured that the scale had measurement invariance regarding education, income, and marital status. (4) Conclusions: The PRELSA Scale shows promising properties that have the potential to measure obesogenic behaviors in Spain, which could be the basis for future interventions associated with the prevention of childhood obesity in healthcare and educational settings.

Impact of an early 1000-day intervention for obesity prevention on adiposity and BMI at two years of age: A quasi-experimental study.

Background: The 1000-day period encompassing pregnancy and the first two years of postnatal life is critical for preventing childhood obesity. Existing interventions targeting this period have been characterised by great variability in duration, objectives, and evaluation indicators. We aimed to evaluate the impact of an intervention developed during the entire 1000-day period on body mass index and body fat percentage at two years of age. Methods: We designed a prospective, interventional, quasi-experimental study (ie, without randomisation or blinding of both groups) targeting mother-child pairs from the beginning of pregnancy up to two years of age belonging to the basic health area of Puerto Real (Cádiz). We developed and delivered an intervention from pregnancy to two years and assessed its effect. Results: The duration of breastfeeding and vitamin D supplementation increased significantly after the intervention. The intervention group showed lowed skinfolds values, a significantly lower body fat percentage, as well as a lower accumulation of factor at two years than the control group. Conclusions: The intervention has had an impact on body fat percentage at two years, potentially justified through its overall effect and the lower accumulation of early risk factors.

The Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale): Construction and Pilot Testing of a Tool to Measure Factors Associated with Childhood Obesity.

(1) Background: Childhood obesity poses a global health challenge. In the period from two to six years, the fundamental risk factors are associated with modifiable habits, related to parental attitudes. In this study, we will analyze the construction and pilot test of the PRELSA Scale, designed to be a comprehensive tool that covers the whole problem of childhood obesity, from which we can later develop a brief instrument. (2) Methods: First, we described the scale construction process. After that, we conducted a pilot test on parents to check the instrument's comprehensibility, acceptability, and feasibility. We detected items to be modified or eliminated through two criteria: the frequencies of the categories of each item and responses in the Not Understood/Confused category. Finally, we sought expert opinion through a questionnaire to ensure the content validity of the scale. (3) Results: The pilot test on parents detected 20 possible items for modification and other changes in the instrument. The experts' questionnaire showed good values on the scale's content, highlighting some feasibility problems. The final version of the scale went from 69 items to 60. (4) Conclusions: Developing scales that detect parental attitudes associated with the onset of childhood obesity may be the basis for future interventions to address this health challenge.

Interventions in the first 1000 days to prevent childhood obesity: a systematic review and quantitative content analysis.

BACKGROUND: Childhood obesity poses a global health challenge. In recent years, there has been an increase in interventions that begin in pregnancy, putting the concept of early programming and early risk factors into practice. The present study aims to update the findings regarding interventions in the first 1000 days of life. METHODS: A systematic review based on the PRISMA guidelines was carried out in PubMed, WoS, Scopus and CINAHL to obtain the articles to be analysed. We included those studies published between 2016 and 2021. Human interventions that started within the first 1000 days of life and acted on at least one programming factor were included. Once selected, coding and quantitative content analysis was carried out to obtain a profile of the interventions during the first 1000 days. RESULTS: From all screened articles, 51 unique interventions, which met the selection criteria, were included. The majority of interventions (81%) took place in high-income areas. Almost all (86%) were targeted at the general population. The majority (54%) started in the second trimester of pregnancy. A clear majority (61%) ended at the time of birth. 44% of the interventions included all pregnant women. Only 48% of these interventions were focused on improving the nutritional status of the offspring in the short term. Most interventions collected the baby's weight at birth (68%). CONCLUSIONS: It can be concluded that current interventions are not covering as many aspects as they should. Future research should be conducted more frequently in developing countries and target disadvantaged groups. These interventions should include all pregnant women, regardless of their nutritional status, aiming to cover as many programming factors as possible and extending through the first 1000 days of life, with body mass index or skinfolds as measures of effectiveness during this period.

Early Risk Factors for Obesity in the First 1000 Days-Relationship with Body Fat and BMI at 2 Years.

(1) Background: Obesity is defined as an excessive accumulation of body fat. Several early developmental factors have been identified which are associated with an increased risk of childhood obesity and increased adiposity in childhood. The primary objective of the present study is to analyse the effect of various early risk factors on Body Mass Index (BMI) and body fat percentage at 2 years of age. (2) Methods: A prospective cohort study design was used, with the sample consisting of 109 mother-child pairs from whom data were collected between early pregnancy and 2 years old. Adiposity was determined based on skinfold measurements using the Brooks and Siri formulae. Mean comparison tests (Student's t-test and ANOVAs) and multiple linear regression models were used to analyse the relationship between early programming factors and dependent variables. (3) Results: Maternal excess weight during early pregnancy (ß = 0.203, p = 0.026), gestational smoking (ß = 0.192, p = 0.036), and accelerated weight gain in the first 2 years (ß = - 0.269, p = 0.004) were significantly associated with high body fat percentage. Pre-pregnancy BMI and accelerated weight gain in the first 2 years were associated with high BMI z-score (ß = 0.174, p = 0.047 and ß = 0.417, p = 0.000 respectively). The cumulative effect of these variables resulted in high values compared to the baseline zero-factor group, with significant differences in BMI z-score (F = 8.640, p = 0.000) and body fat percentage (F = 5.402, p = 0.002) when three factors were present. (4) Conclusions: The presence of several early risk factors related to obesity in infancy was significantly associated with higher BMI z-score and body fat percentage at 2 years of age. The presence of more than one of these variables was also associated with higher adiposity at 2 years of age. Early prevention strategies should address as many of these factors as possible.

Effectiveness of a Multifactorial Intervention in the First 1000 Days of Life to Prevent Obesity and Overweight in Childhood: Study Protocol.

(1) Background: Obesity is a global health problem, and its prevention must be a priority goal of public health, especially considering the seriousness of the problem among children. It is known that fetal and early postnatal environments may favor the appearance of obesity in later life. In recent years, the impact of the programs to prevent obesity in childhood has been scarce. The aim of this research is to evaluate the effectiveness of an intervention based on the concept of early programming. (2) Methods: Non-randomized controlled trial design. Inclusion criteria are: two-year-old infants whose gestational period begins in the 14 months following the start of the intervention, and whose mothers have made the complete follow-up of their pregnancy in the same clinical unit of the study. The intervention will be developed over all the known factors that affect early programming, during pregnancy up to 2 years of life. Data will be collected through a data collection sheet by the paediatricians. A unibivariate and multivariate analysis of the data will be carried out. (3) Ethics and dissemination: The trial does not involve any risk to participants and their offspring. Signed informed consent is obtained from all participants. Ethical approval has been obtained. (4) Results: It is expected that this study will provide evidence on the importance of the prevention of obesity from the critical period of the first 1000 days of life, being able to establish this as a standard intervention in primary care.