European Journal of Pediatrics

, Volume 175, Issue 10, pp 1277–1294 | Cite as

The association between childcare and risk of childhood overweight and obesity in children aged 5 years and under: a systematic review

  • Goiuri Alberdi
  • Aoife E. McNamara
  • Karen L. Lindsay
  • Helena A. Scully
  • Mary H. Horan
  • Eileen R. Gibney
  • Fionnuala M. McAuliffe


The aim of this paper was to systematically review the published evidence on the relationship between the type of childcare and risk of childhood overweight or obesity. The databases PubMed, MEDLINE, Cochrane Library and EMBASE were searched using combinations of the various search terms to identify eligible observational studies published between 2000 and May 2016 in English. Fifteen publications from 7 countries matched the inclusion criteria. The most commonly reported childcare arrangements were centre-based (e.g. crèche) and informal care (e.g. relatives, neighbours, friends). Informal care was most frequently associated with an increased risk of childhood overweight and obesity. Associations were also found for other lifestyle variables such as low maternal education, high birth-weight, maternal employment, ethnicity, maternal overweight/obesity and father’s Body Mass Index (BMI).

Conclusion: The relationship between childcare and childhood overweight/obesity is multi-faceted with many aspects linked to childhood adiposity, in particular the age of initiation to care, type of care (i.e. informal care) and shorter breastfeeding duration were related with infant adiposity.

What is known:

• Lifestyle factors during early years affect health outcomes in adulthood, particularly in children with low birth weight.

• Pre-school stage influences children’s body composition and growth.

What is new:

• This is the first systematic review of observational studies examining the association between childcare and childhood overweight and obesity in preschool children.

• ‘Informal’ care is linked to early introduction to solid foods, less physical activity and obesity.


Childcare Childhood overweight Childhood obesity Adiposity Review 



Body Mass Index


Organisation for Economic Co-operation and Development


Socioeconomic Status



This study was supported by the Health Research Board Ireland, the Health Research Centre for diet, and Health research and the European Union’s Seventh Framework Programme (FP7/2007-2013), project Early Nutrition under grant agreement no. 289346.

Author contributions

AEM conducted the literature search, completed data collection and interpretation and wrote the manuscript. GA and KLL assisted with the literature search, data interpretation and writing of the manuscript. HAS and MHH assisted with writing of the paper. ERG and FMM conceived the idea for this project and approved the final draft.

Compliance with ethical standards

Conflicts of interest

Goiuri Alberdi declares that she has no conflict of interest. Aoife E. McNamara declares that she has no conflict of interest. Karen L. Lindsay declares that she has no conflict of interest. Helena Scully declares that she has no conflict of interest. Mary H. Horan declares that she has no conflict of interest. Eileen R. Gibney declares that she has no conflict of interest. Fionnuala M. McAuliffe declares that she has no conflict of interest. Goiuri Alberdi, Karen L. Lindsay and Mary H. Horan were funded by European Union’s Seventh Framework Programme (FP7/2007–2013).

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.UCD Obstetrics and Gynaecology, School of MedicineUniversity College Dublin, National Maternity HospitalDublin 2Ireland
  2. 2.UCD Institute of Food and HealthUniversity College DublinDublin 4Ireland

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