The Influence of Childcare on Preschool Dietary Patterns and Body Size — ASN Events

The Influence of Childcare on Preschool Dietary Patterns and Body Size (#231)

Sarah Gerritsen 1
  1. Centre for Longitudinal Research, University of Auckland, Auckland, New Zealand

New Zealand has one of the highest rates of childhood obesity in the OECD1 and even our infants and pre-schoolers are affected by this public health crisis; the most recent NZ Health Survey found one in eleven (9.2%) 2–4 year olds are obese and a further 20.6% are overweight2. Obesity at such a young age often sets children on a life-course risk trajectory of mental and physical health problem3, including cardiovascular disease, type 2 diabetes and some cancers4,5. With this high prevalence of obesity among pre-schoolers–and growing evidence that dietary habits, preferences and eating behaviours are set early in childhood6 –obesity prevention in the first few years of life is critical7

A key environment for obesity prevention may be early childhood education (ECE). Statistics NZ reports that half of all under 5s attend ECE, rising to over 80% of 4 year olds8 . Childcare may influence a child’s weight by changing dietary patterns, and eating or physical activity behaviour. However, the few overseas studies in this area have produced conflicting results; some showed a link between childcare attendance and an increased risk of obesity9,10,15 some found an association only when care was provided by a relative/friend11,12,13,14and some found childcare was protective against obesity.16,17  

This PhD research uses data collected in the Growing Up in New Zealand longitudinal study18 of approximately 6800 children from before birth until 4.5 years old, to explore the role of childcare in shaping dietary patterns and body weight in pre-schoolers. Additional data will also be collected from the cohort children’s childcare providers to examine the ‘obesogenic’ nature of policies and practices in ECE settings. Informed by a public health perspective, analyses will focus on modifiable factors which can be influenced by policy in order to reduce the burden of obesity-related health issues on future generations.

  1. National Obesity Observatory. (2013). Childhood Obesity International Comparisons. Retrieved 7 March, 2013, from
  2. Ministry of Health. (2012). The Health of New Zealand Children 2011/12: Key findings of the NZ Health Survey Retrieved from
  3. Ferraro, K. F., Thorpe Jr, R. J., & Wilkinson, J. A. (2003). The life course of severe obesity: Does childhood overweight matter? Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 58(2), S110-S119.
  4. Gunnell, D. J., Frankel, S. J., Nanchahal, K., Peters, T. J., & Smith, G. D. (1998). Childhood obesity and adult cardiovascular mortality: A 57-y follow-up study based on the Boyd Orr cohort. American Journal of Clinical Nutrition, 67(6), 1111-1118.
  5. National Task Force on the Prevention and Treatment of Obesity. (2000). Overweight, Obesity, and Health Risk. JAMA (Formally Archives of Internal Medicine), 160(7), 898-904.
  6. Fildes, A., & Cooke, L. (2012). The munch bunch: healthy habits start at weaning. The Journal of Family Health Care, 22(1), 30-32.
  7. Gluckman, P. D., Hanson, M., Zimmet, P., & Forrester, T. (2011). Losing the war against obesity: The need for a developmental perspective. Science Translational Medicine, 3(93).
  8. Statistics New Zealand. (2010). New Zealand Childcare Survey 2009. Retrieved from
  9. Geoffroy, M. C., Power, C., Touchette, E., Dubois, L., Boivin, M., Séguin, J. R., et al. (2012). Childcare and Overweight or Obesity over 10 Years of Follow-Up. Journal of Pediatrics.
  10. Kim, J., & Peterson, K. E. (2008). Association of Infant Child Care With Infant Feeding Practices and Weight Gain Among US Infants. Archives of Pediatrics and Adolescent Medicine, 162(7), 627-633. doi:10.1001/archpedi.162.7.627
  11. Pearce, A., Li, L., Abbas, J., Ferguson, B., Graham, H., & Law, C. (2010). Is childcare associated with the risk of overweight and obesity in the early years? Findings from the UK millennium cohort study. International Journal of Obesity, 34(7), 1160-1168.
  12. Maher, E. J., Li, G., Carter, L., & Johnson, D. B. (2008). Preschool Child Care Participation and Obesity at the Start of Kindergarten. Pediatrics, 122(2), 322-330.
  13. Benjamin, S. E., Rifas-Shiman, S. L., Taveras, E. M., Haines, J., Finkelstein, J., Kleinman, K., & Gillman, M. W. (2009). Early child care and adiposity at ages 1 and 3 years. Pediatrics, 124(2), 555-562.
  14. Lin, S. L., Leung, G. M., Hui, L. L., Lam, T. H., & Schooling, C. M. (2011). Is informal child care associated with childhood obesity? Evidence from Hong Kong's "children of 1997" birth cohort. International Journal of Epidemiology, 40(5), 1238-1246.
  15. Gubbels, J. S., Kremers, S. P. J., Stafleu, A., Dagnelie, P. C., De Vries, N. K., Van Buuren, S., et al. (2010). Child-care use and the association with body mass index and overweight in children from 7 months to 2 years of age. International Journal of Obesity, 34(10), 1480-1486.
  16. Lumeng, J. C., Gannon, K., Appugliese, D., Cabral, H. J., & Zuckerman, B. (2005). Preschool child care and risk of overweight in 6- to 12-year-old children. International Journal of Obesity, 29(1), 60-66.
  17. Koleilat, M., Harrison, G. G., Whaley, S., McGregor, S., Jenks, E., & Afifi, A. (2012). Preschool Enrollment is Associated with Lower Odds of Childhood Obesity Among WIC Participants in LA County. Maternal and Child Health Journal, 16(3), 706-712
  18. Morton, S. M. B., Atatoa Carr, P., Grant, C. C., Lee, A. C., Bandara, D. K., Mohal, J., et al. (2012). Growing Up in New Zealand: A longitudinal study of New Zealand children and their families. Report 2: Now we are born. Auckland: Growing Up in New Zealand.