Is there an association between childcare and obesity?

08 September 2017
kids at a childcare centre

A review of studies looking at the links between childcare and obesity has concluded that childcare before the age of 3 leads to poorer weight outcomes.

However, children over the age of three who attend centre care may have lower risk of becoming overweight or obese.

The authors conclude that first three years of life are crucially important in whether a child becomes overweight and childcare facilities are a prime setting obesity prevention interventions.

The review, published in the journal Pediatric Obesity, looked at 24 studies which had examined the link between childcare and obesity.

The authors say that more than 80% of pre-school aged children in OECD countries are in some form of childcare.

They say variations in the childcare environment and practices may directly influence children's weight status through key risk factors such as:

  • physical activity
  • dietary quality
  • sleep duration.

The review found poorer weight outcomes for children in all types of childcare up to the age of three.

Care by a relative, particularly a grandparent, is associated with an increased risk of a child becoming overweight or obese possibly because grandparents:

  • Are unlikely to have childcare qualifications
  • May be more permissive of high calorie foods
  • May be less aware of modern nutritional advice.

Care by a relative is also associated with the early introduction of solid foods and reduced breastfeeding duration.

Infants receiving informal care, particularly by a grandparent, demonstrated significantly increased BMI before the age of three.

Childcare in a centre was associated with an increased risk of obesity up to the age of 10.  This risk was magnified if children were cared for in a large centre as opposed to a smaller centre.

However, there seemed to be protective effects of centre care between the ages of three and five.  This association was stronger for children from lower socio-economic backgrounds

The authors say a handful of studies have also identified a “dose response” link between childcare and obesity, with the more hours spent in childcare increasing the child’s risk of obesity.  However, they say more work needs to be done in this area.

They conclude that informal care before the age of five is associated with an increased risk of a child being overweight or obese, particularly those who are cared for by a relative and who come from a higher socio-economic group.

Conversely, centre-based care conferred some protective effects on children from lower socio-economic backgrounds.

The authors say, most interventions to address obesity are conducted in childcare settings for children over the age of three, but this research shows that these need to be extended for children younger than three.

They say more research is needed to explore how the timing and extent of care influences childhood weight outcomes.