The relationship between childcare and adiposity, body mass and obesity-related risk factors: protocol for a systematic review of longitudinal studies

Abstract

BackgroundThe rising prevalence of obesity, particularly in childhood, is a global public health emergency. There is some evidence that exposure to non-parental childcare before age 6 years is associated with subsequent development of obesity and obesity-related behaviours such as physical activity, sedentary behaviour, sleep, diet and stress, although these findings are inconsistent. It is possible that the relationship between early childcare and later obesity and obesity-related behaviours depends on characteristics of childcare exposure such as type (i.e. informal versus formal care), duration (i.e. number of years spent in childcare), intensity (e.g. number of hours per week) and timing (i.e. age of onset of childcare) of care received. The relationship may also be moderated by socio-demographic characteristics of children and their families. We will conduct a systematic review exploring longitudinal associations between childcare (type, duration, intensity and timing) and measures of adiposity and body mass, physical activity, sedentary behaviour, sleep, diet and stress. We will also assess whether these relationships vary by socio-demographic factors.MethodsWe will include studies that explore longitudinal associations between childcare attendance in children aged <6 years not in primary school at first assessment and body weight, adiposity, physical activity, diet, sleep and stress. We will limit studies to those involving middle- and high-income countries. Two independent reviewers will screen search results in two stages: (1) title and abstract and (2) and full text. One reviewer will extract relevant data and a second will verify this information. We will assess risk of bias of included studies using an adaption of the United States Department of Agriculture National Evidence Library Bias Assessment Tool. We will tabulate and summarise results narratively. We may conduct meta-analysis if at least five studies report comparable data.DiscussionTo our knowledge, this will be the first systematic review to summarise the existing evidence on longitudinal associations between childcare and adiposity, body mass and obesity-related risk factors. The results will be of relevance to other researchers, childcare practitioners and policy makers.Systematic review registrationPROSPERO CRD42015027233Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0312-7) contains supplementary material, which is available to authorized users.

Childcare before age 6 and body mass index at age 7 years in a cohort of Danish children

“…A recent study found that children spent more time being sedentary in childcare than at home . These previous studies have yielded mixed results; findings from a forthcoming systematic review will help clarify these relationships .…”

The adiposity rebound in the 21st century children: meaning for what?

“…Globally, there has been a time shift in the BMI distribution and adiposity rebound timing. In Scotland, there has been a substantial shift of BMI distribution in the general population of a birth cohort born in 2004 compared with those born in 1990 [43]. A longitudinal study in Japan showed that the mean age of having minimal BMI was 4.8 years in boys and 4.7 years in girls born between 1995 and 1996 [5].…”

Childcare in Infancy and Later Obesity: a Narrative Review of Longitudinal Studies

“…In addition, we did not perform all aspects of searching and screening in duplicate which may have led to additional errors. We are currently conducting a systematic review examining the association of childcare factors with diet, physical activity, sedentary behavior, sleep, and stress that will help overcome these limitations [ 46 ]. We also restricted the review to longitudinal data in order to reduce the possibility of reverse causality [ 47 ].…”