Tuesday, November 20, 2012

Do Child Care Centres Promote Obesity?

One of the often ignored factors in the childhood obesity epidemic is the fact that working parents have less time to devote themselves to the nutritional and emotional needs of their children than in families with at least one stay-at-home parent.

This has, in some circles led to discussions whether such parental home care can be replaced by putting the kids in childcare centres.

A study by Marie-Claude Geoffroy and colleagues from the University College London, UK, published in the Journal of Pediatrics now reports that preschool daycare may substantially increase the risk for overweight and obesity in kids.

The study looks at 1600 kids enrolled in a prospective birth cohort in Quebec, Canada with information on child care arrangements (center-based/family-based/care by a relative/nanny) and other relevant variables at ages 1.5, 2.5, 3.5, and 4 years in relationship to measured weights and heights at ages 4, 6, 7, 8, and 10 years of age.

Despite adjusting for several potential confounding factors (including socioeconomic position, breastfeeding, maternal employment, and maternal body mass index), children who attended a center-based childcare were about 65% more likely to be overweight or obese in childhood (4-10 years) than kids in parental care.

Similarly, kids cared for by a relative were about 50% more likely to be overweight or obese.

Further analyses suggested that for each increment of 5 hours spent in either center-based or relative childcare, the odds of overweight/obesity in the first decade of life increased by 9%.

As the authors point out, it may be time to carefully scrutinize the “obesogeonic” features of childcare arrangements in comparison to parental care.

As noted previously on these pages, when parents have more important issues to deal than being home to raise their kids, their offspring may well be at increased risk of obesity – a fact that is often lost (or rather ignored) in public health discussion on the the root causes of the childhood obesity epidemic.

I wonder how my readers feel about the impact of non-parental childcare on childhood weight management.

AMS
Edmonton, Alberta

ResearchBlogging.orgGeoffroy MC, Power C, Touchette E, Dubois L, Boivin M, Séguin JR, Tremblay RE, & Côté SM (2012). Childcare and Overweight or Obesity over 10 Years of Follow-Up. The Journal of pediatrics PMID: 23140878

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5 Responses to “Do Child Care Centres Promote Obesity?”

  1. E. says:

    I dunno about the study, but I’d suggest you be a little more careful in some of your phrasing – this sort of thing, which implies working parents aren’t raising their children, tends to really irritate working parents*: “As noted previously on these pages, when parents have more important issues to deal than being home to raise their kids”

    I may have had my children in childcare when they were daycare age, but I was still raising them, thank you very much.

    *well, to be realistic, moms. Since generally the undercurrent of these things is that really mom should be at home.

  2. Janet in Toronto says:

    I would be interested to know where the (presumably) excess calories are coming from in non-family based childcare. Are they coming from home or from the alternative arrangements? I will try to find the full-text article for more information.

  3. Anna Louise says:

    Wow, judgmental much? This is an interesting first study, but to leap to the conclusion that parents should not work (read moms?) and, even worse, that parents who do work do not care sufficiently about their children, is hurtful, non-scientific and ignores the important economic and personal responsibility reasons work is necessary for most people around the world. And most day care providers support families too, Dr. Sharma!

    As a scientist I normally abhor anecdote, but I must say that after working almost 35 years, with hundreds of colleagues, almost all two income families, I have not met any children who are obese unless their parents are obese. Let’s do a little more work on this issue before casting aspersions on two income families.

    Not your best effort Dr. Sharma.

  4. DeeLeigh says:

    E makes a good point. Additionally, children inherit the genes that govern size from both parents, not just from the mother. I find it really strange that they controlled for the mother’s size, but not the father’s. What does that tell you about their assumptions?

    They’re not really compensating for inherited build, they still think it’s all about calories in- calories out, and that they think the mother is solely in charge of feeding the family? I mean, what decade are they living in?

  5. Alexie says:

    It would be interesting to unpack why kids are gaining weight when cared for by people other than their parents, particularly since children being raised at home in the nuclear family is a relatively recent development. For a lot of Western civilisation, children were cared for by nannies or nurses, or farmed out, in the case of the children of poor working women.

    So my first reaction is that it isn’t the fact that children are away from their parents, but something unique about the modern child raising of other people’s children that is at work. Is it that non-family members feel less confident about disciplining or saying no to other people’s children? Is it easier to give them food or treats to get them to be compliant, rather than doing the wearying work of saying ‘no’?

    There must be something cultural at work that needs to be addressed, because we know from history that children have done very well when being cared for by parent substitutes.

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