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J Pediatr. 2013 Apr;162(4):753-758.e1. doi: 10.1016/j.jpeds.2012.09.026. Epub 2012 Nov 6.

Childcare and overweight or obesity over 10 years of follow-up.

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  • 1MRC Center of Epidemiology for Child Health, Center for Pediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, United Kingdom.



To investigate the predictive association between preschool childcare arrangements and overweight/obesity in childhood.


Children were enrolled in a prospective birth cohort in Quebec, Canada (n = 1649). Information about childcare obtained via questionnaires to the mothers at ages 1.5, 2.5, 3.5, and 4 years was used to compute a main childcare arrangement exposure variable (center-based/family-based/care by a relative/nanny). Body mass index was derived from measured weights and heights at ages 4, 6, 7, 8, and 10 years and children were classified as overweight/obese versus normal weight. Generalized estimating equations were used to model the effect of main childcare arrangement (center-based/family-based/relative/nanny) (vs parental care) on overweight/obesity adjusting for several potential confounding factors.


Compared with parental care, children who attended a center-based childcare (OR: 1.65, 95% CI: 1.13-2.41) or were cared for by a relative (OR: 1.50; 95% CI: 0.95-2.38, although with greater uncertainty) had higher odds of being overweight/obese in childhood (4-10 years). Analyses of number of hours additionally suggested that each increment of 5 hours spent in either center-based or relative childcare increased the odds of overweight/obesity in the first decade of life by 9%. Associations were not explained by a wide range of confounding factors, including socioeconomic position, breastfeeding, maternal employment, and maternal body mass index.


Overweight/obesity was more frequently observed in children who received non-parental care in center-based settings or care by a relative other than the parent. "Obesogeonic" features of these childcare arrangements should be investigated in future studies.

Copyright © 2013 Mosby, Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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