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Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212178. [PMID: 34831933 PMCID: PMC8622483 DOI: 10.3390/ijerph182212178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023]
Abstract
Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity.
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Rapson J, Conlon C, Ali A. Nutrition Knowledge and Perspectives of Physical Activity for Pre-Schoolers amongst Early Childhood Education and Care Teachers. Nutrients 2020; 12:nu12071984. [PMID: 32635381 PMCID: PMC7400386 DOI: 10.3390/nu12071984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
Caregivers’ nutrition and physical activity knowledge is recognised as being important for children’s health and body size. Identifying knowledge gaps amongst caregivers may inform professional development and obesity-prevention strategies in childcare settings. This cross-sectional validated online questionnaire aimed to measure current early childhood education and care (ECEC) teachers’ nutrition knowledge for pre-schoolers (2–5-year-olds) and related perspectives. Teachers’ (n = 386) knowledge of nutrition was lacking: The overall score was 22.56 ± 2.83 (mean ± SD), or 61% correct. Increased years of experience significantly predicted an increase in knowing that national nutrition and physical activity guidelines exist (B = 0.02 [95% CI, 0.00–0.03], r2 = 0.13, p = 0.033). Teachers’ increased agreement in feeling they were confident talking about nutrition to parents significantly predicted an increase in overall nutrition knowledge scores (B = 0.34 [95% CI, 0.06–0.63], r2 = 0.15, p = 0.019). The belief that ECEC teachers play a vital role in promoting pre-schoolers’ healthy eating and physical activity was widespread. Common knowledge barriers included a lack of staff training, confidence, and resources. ECEC teachers may lack nutrition knowledge for pre-schoolers, particularly in regard to basic nutrition recommendations (servings, food/beverage choices, and portion sizes).
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Affiliation(s)
| | | | - Ajmol Ali
- Correspondence: ; Tel.: +64-9-213-6414
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Allel K, Narea M, Undurraga EA. Centre-based care is a significant predictor of lower body mass index in early childhood: Longitudinal evidence from Chile. J Glob Health 2020; 10:010419. [PMID: 32373335 PMCID: PMC7182360 DOI: 10.7189/jogh.10.010419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prevalence of childhood overweight has increased by approximately 50% in the past three decades, becoming a major public health concern worldwide. In Chile, an upper middle-income country, about 38% of children between two and four years of age are overweight, almost double the average in Latin America and the Caribbean. Various environmental and individual factors, and their interactions, affect childhood weight. Emerging evidence suggests childcare may also matter. Because the public provision of centre-based care is growing, childcare may be a useful policy tool to help prevent childhood overweight. METHODS Using a nationally representative longitudinal survey of ~ 15 000 children in Chile (2010 and 2012), we estimated whether the type of child care (centre-based or maternal) a child attended at age 24 to 36 months was a significant predictor of the child's sex-and-age-specific body-mass-index (BMI) at age 36-48 months. We restricted our sample to children in full-time maternal care at baseline (12-24 months of age; n = 1273), but tested the robustness of results with the full sample. We compared children in centre-based care and in maternal care using difference-in-difference estimators and propensity score matching, and adjusted our estimates using child, family, and neighborhood characteristics. RESULTS Children attending centre-based care had 0.27 SD lower BMI than children in maternal care at follow-up (P < 0.05). We found suggestive evidence this association may be modulated by the child's socioeconomic status and by how frequently the child watched television: we found smaller BMI changes for children at the bottom 80% of socioeconomic status (P < 0.05) and also for children who frequently watched television (P < 0.10). Our results were robust to various model specifications. CONCLUSIONS Our findings suggest centre-based care programs, with adequate regulation and enforcement, may be a useful support to help curb the early childhood overweight epidemic, in addition to known effects in labor supply and child development.
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Affiliation(s)
- Kasim Allel
- Institute for Global Health, University College London, UK
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
- Society and Health Research Centre, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Marigen Narea
- Centre for Advanced Studies on Educational Justice (CJE), Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- School of Psychology, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Eduardo A Undurraga
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
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Eagleton SG, Hohman EE, Verdiglione N, Birch LL, Paul IM, Savage JS. INSIGHT Study Maternal Return to Work and Infant Weight Outcomes. Acad Pediatr 2019; 19:67-73. [PMID: 30145361 PMCID: PMC6321792 DOI: 10.1016/j.acap.2018.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 08/08/2018] [Accepted: 08/18/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Maternal return to work within 12 weeks of delivery is associated with poor child health and development. However, little is known about the impact of return to work on the risk of child obesity. We examined whether timing of maternal return to work is associated with rapid infant weight gain from 0 to 6 months and weight-for-length at 1 year. METHODS Secondary data analysis of 279 mother-newborn dyads from the Intervention Nurses Start Infants Growing on Healthy Trajectories Study, a randomized controlled trial evaluating a responsive parenting (RP) intervention. Rapid infant weight gain from 0 to 6 months was assessed using conditional weight gain (CWG) scores. Infant weight-for-length was calculated using World Health Organization reference values. Analysis of variance (ANOVA) examined whether infant weight outcomes differed by timing of maternal return to work (≤12 weeks vs >12 weeks after delivery). Moderation by study group (RP intervention vs safety control) and mediation by breastmilk feeding were examined in ANOVA models. RESULTS Among 261 mothers, approximately one half (n = 130) returned to work within 12 weeks. Compared with infants of mothers who returned to work after 12 weeks, infants of mothers who returned to work within 12 weeks had greater CWG scores from 0 to 6 months (P = .006) and were heavier at 1 year (P = .05). These associations were not moderated by study group or mediated by breastmilk feeding. CONCLUSIONS Maternal return to work within 12 weeks was associated with rapid infant weight gain in the first 6 months and greater weight-for-length at 1 year, although the mechanisms to explain our findings are unclear.
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Affiliation(s)
- Sally G. Eagleton
- Center for Childhood Obesity Research, Penn State College of Health and Human Development, University Park, PA,Department of Nutritional Sciences, Penn State College of Health and Human Development, University Park, PA
| | - Emily E. Hohman
- Center for Childhood Obesity Research, Penn State College of Health and Human Development, University Park, PA
| | - Nicole Verdiglione
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Ian M. Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, Penn State College of Health and Human Development, University Park, PA,Department of Nutritional Sciences, Penn State College of Health and Human Development, University Park, PA
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Hesketh KR, Benjamin-Neelon SE, van Sluijs EMF. How does the UK childcare energy-balance environment influence anthropometry of children aged 3-4 years? A cross-sectional exploration. BMJ Open 2018; 8:e021520. [PMID: 30002012 PMCID: PMC6082453 DOI: 10.1136/bmjopen-2018-021520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To assess the association between time spent in care, the childcare energy-balance environment, and preschool-aged children's body mass index z-score (z-BMI), waist-to-height ratio (WHR) and sum of skinfold thickness (SST). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Children aged 3-4 years were recruited from 30 childcare centres in Cambridgeshire (UK) in 2013. MAIN OUTCOME MEASURES Objectively measured height and weight was used to calculate z-BMI; waist circumference and height were used to generate WHR; subscapular and tricep skinfolds were used to calculate SST. Associations between childcare attendance, the nutrition, physical activity, and overall childcare environment, and three anthropometric outcomes were explored using two-level hierarchical regression models, adjusting for demographic and family based confounders. RESULTS Valid data were available for 196 children (49% female). Time spent in care, the nutrition, physical activity and overall childcare environment were not associated with children's z-BMI, WHR and SST. CONCLUSIONS Childcare environment and level of attendance were not associated with UK preschool-aged children's anthropometry. The childcare environment has been central to intervention efforts to prevent/reduce early childhood obesity, yet other factors, including child-level, family level, wider environmental and policy-level factors warrant substantial attention when considering obesity prevention strategies for young children.
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Affiliation(s)
- Kathryn R Hesketh
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sara E Benjamin-Neelon
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Condon EM. Chronic Stress in Children and Adolescents: A Review of Biomarkers for Use in Pediatric Research. Biol Res Nurs 2018; 20:473-496. [PMID: 29865855 DOI: 10.1177/1099800418779214] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PROBLEM Incorporating biomarkers of chronic stress into pediatric research studies may help to explicate the links between exposure to adversity and lifelong health, but there are currently very few parameters to guide nurse researchers in choosing appropriate biomarkers of chronic stress for use in research with children and adolescents. METHODS Biomarkers of chronic stress are described, including primary mediators (glucocorticoids, catecholamines, and cytokines) and secondary outcomes (neurologic, immune, metabolic, cardiovascular, respiratory, and anthropometric) of the chronic stress response. RESULTS Evidence of the use of each biomarker in pediatric research studies is reviewed. Recommendations for pediatric researchers, including selection of appropriate biomarkers, measurement considerations, potential moderators, and future directions for research, are presented. DISCUSSION A wide range of biomarkers is available for use in research studies with children. While primary mediators of chronic stress have been frequently measured in studies of children, measurement of secondary outcomes, particularly immune and metabolic biomarkers, has been limited. With thoughtful and theoretically based approaches to selection and measurement, these biomarkers present an important opportunity to further explore the physiologic pathways linking exposure to chronic stress with later health and disease. CONCLUSION The incorporation of chronic stress biomarkers into pediatric research studies may provide valuable insight into the mechanisms through which stressful environments "get under the skin" and ultimately inform efforts to promote health and reduce inequities among children exposed to adversity.
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Affiliation(s)
- Eileen M Condon
- 1 Yale School of Nursing, West Campus Drive, Orange, CT, USA
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Benjamin Neelon SE, Morgen CS, Kamper-Jørgensen M, Oken E, Gillman MW, Gallis JA, Sørensen TIA. Childcare before age 6 and body mass index at age 7 years in a cohort of Danish children. Pediatr Obes 2018; 13:307-311. [PMID: 28299907 PMCID: PMC5599321 DOI: 10.1111/ijpo.12206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies show inconsistent associations between childcare and obesity. AIMS Our prior work demonstrated that childcare in infancy was associated with higher weight in a cohort of Danish children. Here, we extend this work and examine childcare through 6 years and body mass index (BMI) at age 7 years. MATERIALS AND METHODS We examined 24 714 children in the Danish National Birth Cohort who were also in the Childcare Database. We conducted multivariable linear regressions examining children prior to age 6, overall and by type (daycare, crèche, age-integrated and kindergarten), and BMI z-score at 7 years, stratifying on maternal socio-occupational status. RESULTS A total of 19 760 (80.0%) children attended childcare before age 6. Childcare prior to age 6 was associated with BMI z-score at 7 years (0.004 units per each additional 6 months of care; 95% CI: 0.001, 0.008; p = 0.01). Childcare in a kindergarten was the only type of care associated with BMI (0.009 units; 95% CI: 0.003, 0.02; p = 0.01). For children of higher socio-occupational status mothers, childcare was associated with a 0.008 unit increase in BMI (95% CI: 0.004, 0.01; p > 0.001). CONCLUSIONS Childcare was weakly associated with later BMI. This relationship was more pronounced in children from higher socio-occupational status mothers and children in kindergarten care.
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Affiliation(s)
- Sara E Benjamin Neelon
- Department of Health, Behavior and Society, Johns Hopkins University, 624 N Broadway, Baltimore, Maryland, 21205, USA
| | - Camilla Schmidt Morgen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Nordre fasanvej 57, Hovedvejen 5, Copenhagen, Denmark
| | - Mads Kamper-Jørgensen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, CSS, Øster Farimagsgade 5, Postbox 2099, DK-1014 Copenhagen, Denmark
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, Massachusetts, 02215, USA
| | - Matthew W Gillman
- Environmental influences on Child Health Outcomes (ECHO) Program, National Institutes of Health, 6011 Executive Blvd, Rockville, MD, 20852, USA
| | - John A Gallis
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Suite 1102 Hock Plaza, Box 2721, Durham, North Carolina, 27710, USA
| | - Thorkild IA Sørensen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Nordre fasanvej 57, Hovedvejen 5, Copenhagen, Denmark,Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,MRC Integrative Epidemiology Unit, Bristol University, Oakfield Grove Bristol, Bristol, UK BS8 2BN
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Innella N, McNaughton D, Schoeny M, Tangney C, Breitenstein S, Reed M, Wilbur J. Child Temperament, Maternal Feeding Practices, and Parenting Styles and Their Influence on Obesogenic Behaviors in Hispanic Preschool Children. J Sch Nurs 2018; 35:287-298. [PMID: 29699450 DOI: 10.1177/1059840518771485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Although obesogenic behaviors (physical activity and/or sedentary behavior and dietary intake) are known predictors of childhood weight status, little is known about mother and child behaviors contributing to obesogenic behaviors and obesity in Hispanic preschool children, whose obesity rate is higher than in non-Hispanic Whites and non-Hispanic Blacks. The purpose of this cross-sectional, descriptive study was to examine relationships among child temperament, maternal behaviors (feeding practices and parenting style), child obesogenic behaviors, and child weight status in 100 Hispanic preschool children. Results showed that higher scores on the negative affectivity dimension of child temperament were associated with higher scores on the dimension of permissive parenting, and permissive parenting was associated with less time spent in sedentary behaviors (B = -3.53, confidence interval [-7.52, -0.90]). Findings can guide school nurses in developing interventions that consider child temperament and parenting style to promote nonobesogenic behavior in Hispanic preschoolers.
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Affiliation(s)
| | | | | | | | | | - Monique Reed
- 1 Rush University Medical Center, Chicago, IL, USA
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9
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Nagata JM, Gomberg S, Hagan MJ, Heyman MB, Wojcicki JM. Food insecurity is associated with maternal depression and child pervasive developmental symptoms in low-income Latino households. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018; 14:526-539. [PMID: 31673300 DOI: 10.1080/19320248.2018.1434101] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The objective of this study was to investigate associations between household food insecurity, maternal clinical depression, and child behavior problems in low-income Latino households. Data were collected from a cohort of 168 children and their Latina mothers recruited prenatally at two San Francisco hospitals from 2006 to 2007. Food insecurity at year four was associated with increased odds of maternal clinical depression at years four to five (adjusted OR 1.22, 95% confidence interval 1.03 to 1.43). Food insecurity at year four was associated with child pervasive developmental problems at year five (B=0.21, p=0.041) in adjusted models. The association between food insecurity at year four and oppositional defiant problems at year five was partially mediated (28.7% mediation, p=0.046) by maternal clinical depression in years four and five. Our results suggest that household food insecurity is associated with greater maternal depression, and both food insecurity and maternal depression uniquely predict certain types of child behavior problems. Assessing for and addressing household food insecurity may be beneficial additions to psychosocial interventions targeting maternal and child mental health.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158 USA
| | - Simon Gomberg
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158 USA.,Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Melissa J Hagan
- Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave., Bldg. 20, Suite 2100, San Francisco, CA 94110 USA
| | - Melvin B Heyman
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158 USA
| | - Janet M Wojcicki
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158 USA
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Black L, Matvienko-Sikar K, Kearney PM. The association between childcare arrangements and risk of overweight and obesity in childhood: a systematic review. Obes Rev 2017; 18:1170-1190. [PMID: 28677302 DOI: 10.1111/obr.12575] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/21/2017] [Accepted: 05/14/2017] [Indexed: 12/13/2022]
Abstract
Over 80% of preschool-aged children experience non-parental childcare. Childcare type has the potential to influence weight outcomes, but its impact on childhood overweight/obesity is not well established. This review aims to (i) systematically evaluate the effects of childcare type on childhood overweight/obesity risk and (ii) investigate the impact of childcare intensity and age at commencement. Five electronic databases were searched for observational studies quantifying an association between childcare type ≤5 years and weight outcomes <18 years. Twenty-four studies were included (n = 127,529 children). Thirteen studies reported increased risk of overweight/obesity in children attending informal care (n = 9) or centre care (n = 4) vs. parental care. Seven studies reported decreased risk of overweight/obesity for children in centre vs. 'non-centre' care (parental and informal). Four studies reported no association between informal or centre care and overweight/obesity. Early (<3 years) informal care, especially by a relative, was associated with increased risk of overweight/obesity. Higher intensity childcare, especially when commenced early (<1 year), increased overweight/obesity risk. Later (≥3 years) centre care was associated with decreased risk of overweight/obesity. Early informal care, earlier commencement age and higher intensity represent a risk for childhood obesity. Exploration of the obesogenic aspects of these contexts is essential to inform preventative measures.
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Affiliation(s)
- L Black
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
| | - K Matvienko-Sikar
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
| | - P M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork City, Ireland
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Scully H, Alberdi G, Segurado R, McNamara A, Lindsay K, Horan M, Hennessy E, Gibney E, McAuliffe F. Child Care Exposure Influences Childhood Adiposity at 2 Years: Analysis from the ROLO Study. Child Obes 2017; 13:93-101. [PMID: 27854513 DOI: 10.1089/chi.2016.0127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The first 2 years of life are instrumental for childhood physical development. Factors contributing to childhood obesity are difficult to determine; child care exposure is one to consider, by influencing food preference and physical activity development. OBJECTIVE To investigate the association of child care exposure with adiposity at 2 years. METHODS Data were collected as part of the secondary analysis of the prospective ROLO study (randomized control trial of low glycemic index diet) in Dublin, Ireland. Mothers were recruited antenatally and followed up at 2 years postpartum. Maternal and childhood anthropometric data and lifestyle questionnaires, reporting on child care attendance (defined as nonparental care), exposure (weeks), and infant-feeding practices, were collected. RESULTS Anthropometric measures and lifestyle data were collected for 273 mothers and children aged 2 years, 52.7% of whom attended child care. Child care was predominately provided by a nonrelative (83.7%), either in a crèche (57%) or by a childminder (26.7%). More than half (56.2%) of the children attended child care part-time (≤30 hours/week). Central adiposity measures (abdominal circumference, waist:height ratio) and total adiposity (sum of all skin folds) were significantly elevated in children with increasing time in child care. Children provided with "meals and snacks" had elevated adiposity measures versus those given "snacks or no food." No difference in the infant-feeding practices was identified between the child care groups. CONCLUSIONS Children attending child care have higher total and central adiposity, proportional to exposure. More research is required to investigate this link to appropriately design health promotion and obesity prevention programs targeting children at 2 years.
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Affiliation(s)
- Helena Scully
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Goiuri Alberdi
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Ricardo Segurado
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Aoife McNamara
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Karen Lindsay
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Mary Horan
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
| | - Eilis Hennessy
- 2 School of Psychology, University College Dublin , Dublin, Ireland
| | - Eileen Gibney
- 3 School of Agriculture & Food Science, University College Dublin , Dublin, Ireland
| | - Fionnuala McAuliffe
- 1 UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin , National Maternity Hospital, Dublin, Ireland
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Benjamin Neelon SE, Østbye T, Bennett GG, Kravitz RM, Clancy SM, Stroo M, Iversen E, Hoyo C. Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA. BMJ Open 2017; 7:e013939. [PMID: 28179416 PMCID: PMC5306520 DOI: 10.1136/bmjopen-2016-013939] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Childcare has been associated with obesity in children in cross-sectional and longitudinal studies, although some observed no association. Few studies have focused on care during infancy, a period when children may be especially vulnerable. PARTICIPANTS The Nurture Study is an observational birth cohort designed to assess longitudinal associations of childcare and the presence of multiple caregivers on infant adiposity and weight trajectories throughout the first year of life. We examine as potential mediators feeding, physical activity, sleep and stress. We completed recruitment in 2015. Of the 860 women who enrolled during pregnancy, 799 delivered a single live infant who met our inclusion criteria. Of those, 666 mothers (77.4%) agreed to participate in the study for themselves and their infants. FINDINGS TO DATE Among the 666 women in the study, 472 (71%) identified as black, 127 (19%) as white, 7 (1%) as Asian or Asian American, 6 (1%) as Native American and 49 (7%) as other race or more than one race; 43 (7%) identified as Hispanic/Latina. Just under half (48%) had a high school diploma or less, 61% had household incomes <$20 000/year and 59% were married or living with a partner. The mean (SD) infant gestational age was 41.28 weeks (2.29) and birth weight for gestational age z-score was -0.31 (0.93). Just under half (49%) of infants were females, 69% received some human milk and 40% were exclusively breast fed at hospital discharge. Data collection began in 2013, is currently underway, and is scheduled to conclude in late 2016. FUTURE PLANS Results will help assess the magnitude of associations between childcare in infancy and subsequent obesity. Findings will also inform intervention and policy efforts to improve childcare environments and help prevent obesity in settings where many infants spend time. TRIAL REGISTRATION NUMBER Clinicaltrials.gov, NCT01788644.
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Affiliation(s)
- Sara E Benjamin Neelon
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, Maryland, USA
| | - Truls Østbye
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Gary G Bennett
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Richard M Kravitz
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Shayna M Clancy
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Marissa Stroo
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Edwin Iversen
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
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Shah PM, Sudharsanan N, Cunningham SA. Before-school and after-school childcare and children's risk of obesity. Pediatr Obes 2017; 12:58-66. [PMID: 26860620 PMCID: PMC4980278 DOI: 10.1111/ijpo.12107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 11/27/2015] [Accepted: 12/16/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND In the USA, half of children are regularly cared for before or after school by someone other than a parent. OBJECTIVE Describe the relationship between childcare arrangements and obesity among school-aged children. METHODS Data are from the fifth-grade wave of the Early Childhood Longitudinal Study - Kindergarten Cohort 1998-1999, a nationally representative study of US children who were in kindergarten in 1998-1999 or first grade in 1999, collected in spring 2004 (analytic sample = 9617). We estimated survey-adjusted logistic regression models to examine the association between childcare arrangements before and after school and obesity. RESULTS The prevalence of obesity was highest among fifth graders who received care from multiple sources and lowest among children who received care from adults not related to them in either the child's or the caregiver's home [29.9%, 95% confidence interval {CI}: 18.7%, 44.3%; and 17.3%, 95% CI: 12.1%, 24.0%]. Childcare arrangement was not an independent risk factor for obesity for most children. However, Hispanic children who were cared for by a person who was not a relative had significantly higher odds of obesity compared with non-Hispanics in similar care arrangements (odds ratio: 5.11, 95% CI: 2.00, 13.06). CONCLUSION Type of childcare before or after school was not an independent risk factor for obesity in most fifth graders, but implications of childcare for Hispanic children should be explored further.
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Affiliation(s)
| | - Nikkil Sudharsanan
- Population Studies Center, University of Pennsylvania, 239 McNeil Building, 3718 Locust Walk; Philadelphia, PA 19104, Telephone: (661) 965-3471
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Alberdi G, McNamara AE, Lindsay KL, Scully HA, Horan MH, Gibney ER, McAuliffe FM. The association between childcare and risk of childhood overweight and obesity in children aged 5 years and under: a systematic review. Eur J Pediatr 2016; 175:1277-94. [PMID: 27631590 DOI: 10.1007/s00431-016-2768-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 08/15/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED The aim of this paper was to systematically review the published evidence on the relationship between the type of childcare and risk of childhood overweight or obesity. The databases PubMed, MEDLINE, Cochrane Library and EMBASE were searched using combinations of the various search terms to identify eligible observational studies published between 2000 and May 2016 in English. Fifteen publications from 7 countries matched the inclusion criteria. The most commonly reported childcare arrangements were centre-based (e.g. crèche) and informal care (e.g. relatives, neighbours, friends). Informal care was most frequently associated with an increased risk of childhood overweight and obesity. Associations were also found for other lifestyle variables such as low maternal education, high birth-weight, maternal employment, ethnicity, maternal overweight/obesity and father's Body Mass Index (BMI). CONCLUSION The relationship between childcare and childhood overweight/obesity is multi-faceted with many aspects linked to childhood adiposity, in particular the age of initiation to care, type of care (i.e. informal care) and shorter breastfeeding duration were related with infant adiposity. WHAT IS KNOWN • Lifestyle factors during early years affect health outcomes in adulthood, particularly in children with low birth weight. • Pre-school stage influences children's body composition and growth. What is new: • This is the first systematic review of observational studies examining the association between childcare and childhood overweight and obesity in preschool children. • 'Informal' care is linked to early introduction to solid foods, less physical activity and obesity.
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Affiliation(s)
- Goiuri Alberdi
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Aoife E McNamara
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Karen L Lindsay
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Helena A Scully
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Mary H Horan
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Fionnuala M McAuliffe
- UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
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15
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Costa S, Adams J, Phillips V, Benjamin Neelon SE. The relationship between childcare and adiposity, body mass and obesity-related risk factors: protocol for a systematic review of longitudinal studies. Syst Rev 2016; 5:141. [PMID: 27535547 PMCID: PMC4989341 DOI: 10.1186/s13643-016-0312-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rising prevalence of obesity, particularly in childhood, is a global public health emergency. There is some evidence that exposure to non-parental childcare before age 6 years is associated with subsequent development of obesity and obesity-related behaviours such as physical activity, sedentary behaviour, sleep, diet and stress, although these findings are inconsistent. It is possible that the relationship between early childcare and later obesity and obesity-related behaviours depends on characteristics of childcare exposure such as type (i.e. informal versus formal care), duration (i.e. number of years spent in childcare), intensity (e.g. number of hours per week) and timing (i.e. age of onset of childcare) of care received. The relationship may also be moderated by socio-demographic characteristics of children and their families. We will conduct a systematic review exploring longitudinal associations between childcare (type, duration, intensity and timing) and measures of adiposity and body mass, physical activity, sedentary behaviour, sleep, diet and stress. We will also assess whether these relationships vary by socio-demographic factors. METHODS We will include studies that explore longitudinal associations between childcare attendance in children aged <6 years not in primary school at first assessment and body weight, adiposity, physical activity, diet, sleep and stress. We will limit studies to those involving middle- and high-income countries. Two independent reviewers will screen search results in two stages: (1) title and abstract and (2) and full text. One reviewer will extract relevant data and a second will verify this information. We will assess risk of bias of included studies using an adaption of the United States Department of Agriculture National Evidence Library Bias Assessment Tool. We will tabulate and summarise results narratively. We may conduct meta-analysis if at least five studies report comparable data. DISCUSSION To our knowledge, this will be the first systematic review to summarise the existing evidence on longitudinal associations between childcare and adiposity, body mass and obesity-related risk factors. The results will be of relevance to other researchers, childcare practitioners and policy makers. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015027233.
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Affiliation(s)
- Silvia Costa
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Veronica Phillips
- Medical Library, School of Clinical Medicine, University of Cambridge, Box 111, Cambridge Biomedical Campus, Cambridge, CB2 0SP UK
| | - Sara E Benjamin Neelon
- UKCRC Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD 21205 USA
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16
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Wojcicki JM, Heyman MB, Elwan D, Lin J, Blackburn E, Epel E. Early exclusive breastfeeding is associated with longer telomeres in Latino preschool children. Am J Clin Nutr 2016; 104:397-405. [PMID: 27440083 PMCID: PMC4962153 DOI: 10.3945/ajcn.115.115428] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/09/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Telomere length (TL) is a marker of cellular aging, with the majority of lifetime attrition occurring during the first 4 y. Little is known about risk factors for telomere shortening in childhood. OBJECTIVE We evaluated the relation between early life feeding variables and preschool TL. DESIGN We assessed the relation between dietary, feeding, and weight-associated risk factors measured from birth and TL from blood samples taken at 4 y of age (n = 108) and 5 y of age (n = 92) in a cohort of urban, Latino children (n = 121 individual children). Feeding variables were evaluated in children with repeat measurements (n = 77). RESULTS Mean TL (in bp) was associated with exclusive breastfeeding at 4-6 wk of age (adjusted coefficient: 353.85; 95% CI: 72.81, 634.89; P = 0.01), maternal TL (adjusted coefficient: 0.32; 95% CI: 0.11, 0.54; P < 0.01), and older paternal age (adjusted coefficient: 33.27; 95% CI: 4.10, 62.44; P = 0.03). The introduction of other foods or drinks in addition to breast-milk or replacement-milk substitutes before 4-6 wk of age was associated with mean TL at 4 and 5 y of age (adjusted coefficient: -457.01; 95% CI: -720.50, -193.51; P < 0.01). Infant obesity at 6 mo of age and soda consumption at 4 y of age mediated the relation in part between exclusive breastfeeding at 4-6 wk of age and mean TL at 4 and 5 y of age. High soda consumption at 3 y of age was associated with an accelerated attrition from 4 to 5 y of age (adjusted coefficient: -515.14; 95% CI: -986.06, -41.22; P = 0.03). CONCLUSION Exclusive breastfeeding at 4-6 wk of age may have long-term effects on child health as evidenced by longer TL at 4 and 5 y of age.
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Affiliation(s)
| | | | | | - Jue Lin
- Biochemistry and Biophysics, and
| | | | - Elissa Epel
- Psychiatry, University of California, San Francisco, San Francisco, CA
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Sisson SB, Li J, Stoner JA, Lora KR, Campbell JE, Arnold SH, DeGrace B, Horm D, Stephens L. Obesogenic environments in tribally-affiliated childcare centers and corresponding obesity rates in preschool children. Prev Med Rep 2016; 3:151-8. [PMID: 27419008 PMCID: PMC4929137 DOI: 10.1016/j.pmedr.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Determine the relationship between obesogenic characteristics of childcare and child adiposity in tribally-affiliated centers in Oklahoma. METHODS The two-day Environment and Policy Assessment and Observation (EPAO) included a total environment (TE), nutrition (N), and physical activity (PA) score and took place in 11 centers across Oklahoma. Eighty-two preschool children (3-5 years) participated. Child height and weight were measured and overweight status (≥ 85th percentile for age and sex) was determined. Regression models, fit using Generalized Estimating Equations methodology to account for clustering by center were used and adjusted for center characteristics. RESULTS Participants were 3.8 (0.8) years old, 55% male, 67% American Indian (AI) and 38% overweight. A healthier TE and PA was associated with a reduced odds of overweight, which remained significant after adjusting for some center characteristics, but not all. A healthier TE, N, and PA was associated with lower BMI percentile, which remained significant after some center-level adjustments, but not all. Lower sedentary opportunity and sedentary time were no longer associated with reduced odds of overweight following adjustment. Lower opportunity for high sugar and high fat foods and minutes of active play were associated with reduced odds of overweight in some adjusted models. CONCLUSIONS Collectively unadjusted and adjusted models demonstrate that some aspects of a healthier childcare center environment are associated with reduced odds of overweight and lower BMI percentile in preschool children attending tribally-affiliated childcare in Oklahoma. Future research should examine the association of childcare and health behaviors and further explore the role of potential confounders.
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Affiliation(s)
- Susan B. Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ji Li
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Julie A. Stoner
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Shared Clinical and Translational Resources, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Karina R. Lora
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Janis E. Campbell
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Sandra H. Arnold
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Beth DeGrace
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Diane Horm
- Early Chyildhood Education Institute, University of Oklahoma, Tulsa, OK, United States
| | - Lancer Stephens
- Oklahoma Shared Clinical and Translational Resources, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- American Indian Diabetes Prevention Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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18
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Lehto R, Mäki P, Ray C, Laatikainen T, Roos E. Childcare use and overweight in Finland: cross-sectional and retrospective associations among 3- and 5-year-old children. Pediatr Obes 2016; 11:136-43. [PMID: 25955215 DOI: 10.1111/ijpo.12036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 03/24/2015] [Accepted: 03/26/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Different types of non-parental childcare have been found to associate with childhood overweight in several, but not all studies. Studies on the matter are mainly North American. OBJECTIVES The objective of our study was to examine associations between childcare use and overweight in Finland. METHODS The cross-sectional and partly retrospective data consists of 1683 3- and 5-year-old children participating in the Child Health Monitoring Development project (LATE-project) conducted in 2007-2009 in Finland. Children were measured at health check-ups and information on child's age when entering childcare, the number of childcare places the child has had, current type of childcare (parental, informal, [group] family childcare, childcare centre) and the current amount of childcare (hours) were gathered. Parents' body mass indices, family educational level, family structure, maternal smoking during pregnancy and child's birth weight were treated as covariates. RESULTS Beginning childcare before age 1 (adjusted model: odds ratio [OR] 2.53, 95% confidence interval [CI] 1.41-4.52) and, for girls only, number of childcare places (adjusted model: OR 1.33, 95% CI 1.11-1.60), were associated with an increased risk of overweight. The current type of childcare or the time currently spent in childcare was not associated with overweight. CONCLUSION Beginning childcare before age 1, which is quite rare in Finland, and having attended several childcare places were associated with overweight even when adjusting for family socioeconomic status and other family background variables. The significance of these findings needs to be further studied.
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Affiliation(s)
- R Lehto
- Folkhälsan Research Center, Helsinki, Finland
| | - P Mäki
- National Institute for Health and Welfare, Health Department, Helsinki, Finland
| | - C Ray
- Folkhälsan Research Center, Helsinki, Finland
| | - T Laatikainen
- National Institute for Health and Welfare, Health Department, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,North Karelia Hospital District, Joensuu, Finland
| | - E Roos
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health, University of Helsinki, Finland
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Innella N, Breitenstein S, Hamilton R, Reed M, McNaughton DB. Determinants of Obesity in the Hispanic Preschool Population: An Integrative Review. Public Health Nurs 2015; 33:189-99. [DOI: 10.1111/phn.12215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Innella
- College of Nursing; Rush University; Chicago Illinois
| | | | | | - Monique Reed
- College of Nursing; Rush University; Chicago Illinois
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20
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Nagata JM, Hagan MJ, Heyman MB, Wojcicki JM. No Association between Obesity and Behavior in Low-income, Preschool Latino Children. J Health Care Poor Underserved 2015; 26:410-20. [PMID: 25913339 PMCID: PMC4469650 DOI: 10.1353/hpu.2015.0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The relationship between behavioral problems and obesity in early childhood in Latinos is largely unknown. METHODS Cross-sectional anthropometric and behavioral data of children at three years of age were gathered from a cohort of 174 children of Latina mothers at two San Francisco hospitals. Child behaviors were assessed using the preschool Child Behavior Checklist (CBCL/1½-5). Logistic regression was used to analyze the association between behavior and obesity. RESULTS At three years, 27.7% were obese. There were no associations between affective (OR = 1.89; 95% confidence interval [CI] 0.42-8.59), anxiety (OR = 1.86; 95% CI 0.53-6.47), pervasive developmental (OR = 0.42; 95% CI 0.13-1.36), attention deficit hyperactivity (OR = 0.58; 95% CI 0.12-2.76), or oppositional defiant (OR = 6.49; 95% CI 0.65-64.49) problems and obesity. CONCLUSIONS Though psychological problems and obesity are associated among older children and adolescents, there was no association in Latino three-year olds in a low-income sample.
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Verstraete SG, Heyman MB, Wojcicki JM. Breastfeeding offers protection against obesity in children of recently immigrated Latina women. J Community Health 2014; 39:480-6. [PMID: 24249439 DOI: 10.1007/s10900-013-9781-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Breastfeeding has been found to have a protective effect on subsequent development of obesity in childhood, particularly in white, non-Hispanic populations. The protective effect of nursing for more than 12 months in children of Latina women is less clear, which may be due to differences in levels of acculturation in previously studied populations. We evaluated the association between breastfeeding for 12 months or more and risk for obesity in a cohort of children of recently immigrated relatively unacculturated Latina mothers. Maternal characteristics at birth, including length of stay in the United States, breastfeeding habits at 4-6 weeks of age, 6 months, and 1 year, and anthropometric measurements were obtained for a cohort of 196 children participating in a prospective study. At 1 year of age 39.0% of infants were being breastfed. Being breastfed at 1 year of age was associated with a decreased risk of obesity in both univariate (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.21-0.83) and multivariate models (OR 0.39, 95% CI 0.02-0.93) adjusting for maternal BMI, marital status, education level, country of origin, age, years of living in the United States, and child's birth weight at 3 years of age, regardless of mother's acculturation status using length of stay in the United States as a proxy for acculturation. The association with breastfeeding persisted at 4 years of age as a protective factor for obesity (OR 0.29, 95% CI 0.11-0.80). Breastfeeding for longer than 12 months provides a significant protective effect on the development of obesity in early childhood in a cohort of children of high-risk recently immigrated Latina women in San Francisco who were relatively unacculturated to the United States.
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Early child care and obesity at 12 months of age in the Danish National Birth Cohort. Int J Obes (Lond) 2014; 39:33-8. [PMID: 25233894 PMCID: PMC4286493 DOI: 10.1038/ijo.2014.173] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 07/13/2014] [Accepted: 07/29/2014] [Indexed: 01/24/2023]
Abstract
Background/Objectives Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries. Subjects/Methods We studied 27821 children born to mothers participating in the Danish National Birth Cohort (DNBC), a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body mass index (BMI) z-score and overweight/obesity (BMI ≥85th percentile based on the World Health Organization classification) at 12 months. We conducted multivariable linear and logistic regression analyses examining child care use and weight outcomes. Results A total of 17721 (63.7%) children attended child care during their first year of life. After adjustment for potential confounders, a 30-day increment of child care was associated with a modestly higher BMI z-score at 12 months (0.03 units; 95% CI: 0.01, 0.05; p=0.003). Similarly, child care use was associated with increased odds of being overweight/obese at 12 months of age (OR 1.05; 95% CI: 1.01, 1.10; p=0.047). Conclusions Child care in the first year of life was associated with slightly higher weight at 12 months, suggesting that child care settings may be important targets for obesity prevention in infancy.
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