Association of childcare arrangement with overweight and obesity in preschool-aged children: a narrative review of literature

Abstract

The time children spend in childcare overlaps with daily meals and opportunities to be active. Thus these environments have the opportunity to promote-or hinder-healthy weight gain among children who attend them. The purpose of this narrative review was to compile findings from studies examining childcare type and weight outcomes among preschool-age children. A literature search was conducted using PubMed, PsychInfo and ERIC. Inclusion criteria were infant- to 5-year-old children exposed to any type of childcare with a cross-sectional or longitudinal weight outcome. Among 385 studies screened, 18 were included. For comparison across studies, type of childcare was categorized as: childcare center, Head Start, nanny/babysitter, non-relative care/family childcare home and relative care. Four studies found no association with childcare type and obesity, and 10 studies reported mixed results by type of care or subpopulation analyses. Two studies found an overall positive association, and two reported an inverse association. There were differences in direction of associations and findings by type of care arrangement. For Head Start, three of eight studies demonstrated a negative relationship with obesity; none demonstrated a positive association. No other childcare type demonstrated this inverse association. Informal types of care (relative and non-relative care in a home) were positively associated with child obesity in 3 of 10 studies. This association was less commonly reported among formal childcare centers (2 of 15 studies). The majority of studies, however, reported mixed findings or no association by childcare type. Results suggested no consistent evidence for a relationship between childcare and obesity risk, except Head Start. This review exposed the need for a consistent definition of childcare type and the exploration of unmeasured confounders, such as the nutrition and physical activity environment of childcare settings, to understand how they contribute to or protect against the development of overweight/obesity among children.

Childcare and childhood obesity – what's the risk?

“…provided by nurseries, playgroups, nannies/au pairs, preschools and childminders), particularly when the care was provided by grandparents (three studies in the review reported an association). Similar inconsistent findings were reported in a recent narrative review of 18 studies examining the same topic, although in this review the authors found that the majority of studies reported no association between childcare type and risk of childhood overweight and obesity (Swyden et al 2016).…”

“…Similar inconsistent findings were reported in a recent narrative review of 18 studies examining the same topic, although in this review the authors found that the majority of studies reported no association between childcare type and risk of childhood overweight and obesity (Swyden et al . ).…”

Exploring Grandparents' Roles in Young Children's Lifestyle Behaviors and the Prevention of Childhood Obesity: An Australian Perspective

“…In particular, grandparents are an important source of child care worldwide, providing care to approximately one-quarter of children in the US 19 , UK 20 , and Australia 21 , with the prevalence highest among children under 5 years. Although child care type may not be associated with child weight status per se 22 , the nutrition and physical activity environments within these settings can impact on children's health outcomes. Grandparents could therefore play a potential role in the prevention of obesity-related diet and activity behaviours in young children.…”

Centre-based care is a significant predictor of lower body mass index in early childhood: Longitudinal evidence from Chile

“…Broadly, those authors suggest CBC may protect against overweight by promoting a healthier diet and providing health care [62]. Yet other studies have found no association between CBC and childhood overweight [67][68][69][70][71][72][73][74]. Attending CBC could be associated with lower risk of child overweight or obesity through several pathways, including planned nutritional programs and learning environments, healthy eating, regular opportunities for physical activity, regular bedtime and rise time, and reduced screen time (eg, computers, mobile phones, television) [62,63,75,76].…”