title: Childcare and overweight or obesity over 10 years of follow-up.
abstract: OBJECTIVE
  To investigate the predictive association between preschool childcare arrangements and overweight/obesity in childhood.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: MRC Center of Epidemiology for Child Health, Center for Pediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, United Kingdom. m.geoffroy@ich.ucl.ac.uk
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Geoffroy
authors.forename: Chris
authors.initials: C
authors.lastname: Power
authors.forename: Evelyne
authors.initials: E
authors.lastname: Touchette
authors.forename: Lise
authors.initials: L
authors.lastname: Dubois
authors.forename: Michel
authors.initials: M
authors.lastname: Boivin
authors.forename: Jean R
authors.initials: JR
authors.lastname: Séguin
authors.forename: Richard E
authors.initials: RE
authors.lastname: Tremblay
authors.forename: Sylvana M
authors.initials: SM
authors.lastname: Côté
mesh_terms: D015992:Body Mass Index; D002648:Child; D002654:Child Care; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000175:diagnosis*; D016017:Odds Ratio; D050177:Overweight / Q000175:diagnosis*; D010290:Parents; D011792:Quebec; D012306:Risk; D012923:Social Class; D012959:Socioeconomic Factors