ECE increases the odds of children being overweight

meal timesBy Dr Alexander


When parents are busy with work or other things and rely on others to provide care and education for their child a major Canadian Study has revealed that children are more likely to be overweight or obese than if parents provided the care themselves. 

This article outlines the study and raises policy and practice implications that are potentially relevant to us here in NZ and Australia.  It also refers to other research showing some different and interesting findings.

In the Journal of Pediatrics, Geoffroy et al (2012) provide the results of their investigation into whether being overweight and obese in childhood can be predicted by what arrangements parents make for their child’s care.

Sample and Methodology

A sample of 1,649 children born in 1997-1998 in Quebec, Canada was studied. Mothers were questioned via a questionnaire about their child’s care arrangements at 1½ years, 2½ years, 3½ years, and 4 years. Thirty percent of children spent most of their time at an early childhood centre, 35% in family daycare (home-based ECE in another family’s home), 11% with an extended family member/relative, 5% with a nanny, and 19% stayed with their parents. Over a six year period (at ages 4, 6, 7, 8 and 10) the researchers measured the children's weight and height and calculated their Body Mass Index. Children with excessive weight or obesity were identified using international standards (IOTF).

Generalised estimating equations were used to model the effect of main childcare arrangement (early childhood centre/family-based/relative/nanny) (vs parental care) on overweight/obesity adjusting for several potential confounding factors, including breastfeeding, maternal employment, and family socio-economic status.


Children who attended an early childhood centre or were cared for by a relative (although with greater uncertainty than the centre data) had higher odds (50% more likely) of being overweight or obese up to 10 years of age compared to those cared for at home by their parents.

Analyses of number of hours of care additionally suggested that each increment of 5 hours spent in either an early childhood centre or with relatives increased the odds of being overweight or obese by 9%.


In an earlier study, UK researchers Pearce et al (2010) looked at associations between weight gain and childcare for a cohort of 12,354 children at age 3 years.  Children who were cared for in informal childcare (5% of the carers were grandparents) between the age of 9 months and 3 years were more likely to be overweight than those cared for only by a parent. The increased risk of unhealthy weight gain for children experiencing informal childcare (compared with parental care) was limited to children from more socio-economically advantaged groups. No association was found between formal (licensed) childcare centre care and children’s weight. The study authors conclude that children from more advantaged families who use informal childcare (namely relative care) are at increased risk of being overweight at age 3 years.

In the Canadian Study Geoffroy et al (2012) did not look into what mechanisms might be responsible for the increased proportion of overweight children associated with attending an early childhood centre or being care for by relatives.

There is potential for early childhood centres as part of the educational programme to promote healthy eating and physical activity.  Therefore, we can only begin to hypothesise what mechanisms might lead to greater weight gain among children attending a centre or being cared for by relatives:

  • Relatives (it is most often grandparents who are the informal carers) may treat children to more lollies, unhealthy snacks , takeaways, and party-type food treats.
  • Early childhood centres that do not provide children with healthy snacks and home-cooked lunches or dinners may be putting children at greater risk of weight gain. 
  • Early childhood centres with less indoor and outdoor space per person (child and adult) may unwittingly place restrictions on children’s physical movement.
  • Early childhood centres that do not regularly take children to parks or other larger playground and natural tree/garden areas, and centres that do not have a range of gross-motor play equipment sufficient for the number of children enrolled may unknowingly place restrictions on children’s level of physical activity.
  • If it is left up to parents to send food to the centre along with their child.  Lunch boxes may contain unhealthy and prepared food. 
  • If parents are working and are time-poor they may not have time at home to put into preparing home-cooked healthy meals for children and may rely more on prepared foods and takeaways.   They may also have less time to take children places and engage in physical activities such as swimming.



Marie-Claude Geoffroy, M-C., Power, C., Touchette, E.,  Dubois, L.,  Boivin, M.,  Séguin, J. R., Tremblay, R. M., &  Côté, S. M. (2012). Childcare and overweight or obesity over 10 Years of follow-up. The Journal of Pediatrics.  Article in Press DOI: 10.1016/j.jpeds.2012.09.026

Pearce, A., Li. L., Abbas, J., Ferguson, B., Graham, H., Law, C., & Millennium Cohort Study Child Health (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. 


Further Recommended Reading

Oliver, M., Schofield, G. M., Kolt, G. S. & McLachlan, C. (2007). Physical activity in early childhood: Current state of knowledge. NZ Research in Early Childhood Education Journal, 10, 47 - 68. (this is available for members in the research library section on our website)


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