Child Care Exposure Influences Childhood Adiposity at 2 Years: Analysis from the ROLO Study.

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.