Center-Based Child Care Can Improve Health and Developmental Outcomes in Children

A new study from Canada found that children who attended child care between the ages of 1 and 4 had a lower body mass index (BMI) and were less likely to be overweight or obese in later childhood than children who had no parental care. child care in the home or provided by relatives or nannies. These associations were strongest for children from low-income families.

Although more research is needed, our findings suggest that center-based child care may help offset socioeconomic-related health disadvantages for children from low-income families.”

Michaela Kucab, a graduate student at St. Michael’s Hospital, a site of Unity Health Toronto, and the University of Toronto, both in Canada

Kucab will present the findings online at NUTRITION 2022 LIVE ONLINE, the American Society for Nutrition’s flagship annual meeting taking place June 14-16.

“We hope this work will bring much-needed attention to prioritizing centered child care while encouraging future research on the impact of centered child care on growth and other important health and development outcomes.” in children,” said the study’s lead author, Jonathon Maguire, MD, of St. Michael’s Hospital.

Previous studies evaluating the relationship between daycare attendance and obesity have focused primarily on comparing parental care with non-parental childcare settings.

“Given the rise of dual-income families and the fact that many families are faced with making childcare decisions, our work aimed to assess parentless childcare settings,” Kucab said. “We hope our findings can help parents and policymakers advocate for and prioritize the best child care settings for children.”

The researchers analyzed data collected from a large multicultural sample of healthy Canadian children using The Applied Research Group for Kids (TARGet Kids!) primary care research network based in Toronto. They compared the BMI of children aged 4 to 10 years of those who had attended a child care center between 1 and 4 years of age versus those who attended other non-parental child care settings.

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“One advantage of using data from TARGetKids! is that it started in 2008 and continues, whereas many previous studies have used data collected decades ago,” Kucab said. “This may have allowed us to capture the effects of the many improvements implemented by modern child care programs.”

The detailed questionnaire data collected in TARGetKids! made it possible for researchers to take into account numerous variables and explore important factors such as socioeconomic status and the number of hours per week each child spent in a child care setting.

The researchers found that children who attended a care facility full-time had a 0.11 lower BMI at ages 4 and 7 and were less likely to be overweight or obese at age 4 compared with children who did not. They attended a care center. Children from low-income families who attended a full-time care facility had a 0.32 lower BMI and were less likely to be overweight or obese at 10 years of age compared with those who did not attend a facility of attention.

“Our findings make sense because health behaviors develop in early childhood and can be influenced by the environments children encounter,” Kucab said. “There may be underlying factors and care practices that differ between child care arrangements that help explain the effects on child growth.”

For example, child care centers in both Canada and the US must follow nutrition guidelines and adhere to other health behavior guidelines related to physical activity and rest. They also have licensed early childhood educators who oversee child care practices and make sure programs provide appropriate routines for growing children. Although these factors may contribute to the findings, the researchers note that the study was observational and not designed to assess cause-and-effect relationships, adding that clinical trials would be needed to confirm causality.

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The researchers are now expanding their work by studying the relationship between center-based child care in young children and subsequent nutritional risk, dietary intake, and eating behaviors. They are also working to implement a clinical trial, called the Nutritional Recommendation Intervention Trials in Children’s Health Care (NuRISH), that will leverage the methods used by TARGet Kids! to assess whether connecting families with child care centers through the primary health care system can improve the physical, mental, nutritional, and developmental health of children from low-income families. The researchers say the trial findings could be used to inform policy decisions about the use of center-based child care as an intervention to improve health and productivity throughout life.