Centre-based childcare in early childhood and growth in later childhood: a prospective cohort study

• Published in: International Journal of Obesity 2023-08, Vol.47 (8), p.724-731
• Main Authors: Kucab, Michaela D., Keown-Stoneman, Charles D. G., Birken, Catherine S., Perlman, Michal, Maguire, Jonathon L.
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/700/1720; Age; Body Mass Index; Body size; Body weight; Child; Child Care; Child, Preschool; Childhood; Children; Clinical trials; Cohort analysis; Epidemiology; Health Promotion and Disease Prevention; Humans; Income; Infant; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Modelling; Obesity; Overweight; Pediatric Obesity - epidemiology; Pediatric Obesity - etiology; Pediatric Obesity - prevention & control; Physical activity; Prospective Studies; Public Health
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/s41366-023-01316-2

Background Attending government-regulated centre-based childcare may influence important health behaviours including dietary quality, physical activity and routines related to child growth. However, the relationship between centre-based childcare and childhood obesity remains unclear. Objectives The primary objective was to evaluate the association between centre-based childcare attendance in early childhood and body mass index z-score (zBMI) in later childhood. Secondary objectives included exploring whether family income, child sex, or non-centre-based setting modified these relationships. Methods A prospective cohort study of children aged 1 to 10 years who participated in the TARGet Kids! cohort was conducted. Linear mixed-effect modelling was used to evaluate the relationship between centre-based childcare attendance (in hours/week) compared to non-centre-based childcare between 1–4 years of age and zBMI between 4 and 10 years of age. Generalised estimating equation modelling was used to explore weight status categories. Models were adjusted for confounders and effect modification was explored. Results A total of 3503 children were included. Children who attended centre-based childcare full-time (40 h/week) had 0.11 (95% CI: −0.19, −0.03; p  = 0.01) lower zBMI at 4 and 7 years of age and lower odds of overweight and obesity at 4 years (OR 0.78; 95% CI: 0.62, 0.97; p  = 0.03), but no evidence of an association was found at 10 years of age. Children from families with income