Centre-Based Childcare in Early Childhood and Nutritional Risk in Later Childhood: A Prospective Cohort Study.

IF 3.8 3区医学 Q2 NUTRITION & DIETETICS

Journal of Nutrition Pub Date : 2025-09-27 DOI:10.1016/j.tjnut.2025.09.028

Michaela D Kucab, Charles D G Keown-Stoneman, Catherine S Birken, Michal Perlman, Janet Parsons, Danielle D'Annunzio, Sharon Thadani, Chris A D Allen, Jonathon L Maguire

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引用次数: 0

Abstract

Background: Centre-based childcare is a promising environment for promoting healthy lifestyle behaviours in early childhood. Little is known about the impact of centre-based childcare on child nutrition.

Objectives: The primary objective was to evaluate the association between centre-based childcare, compared to non-centre-based childcare, and nutritional risk in early childhood. Secondary objectives were to evaluate associations with dietary intake and eating behaviours, and whether the associations were modified by family income and childcare intensity.

Methods: A prospective cohort study of children aged 1 to 5 years was conducted through the TARGet Kids! primary care research network in Toronto, Canada (n = 2420). Childcare attendance was measured between 1 and 4 years of age. Nutritional risk, dietary intake and eating behaviours were measured using the Nutrition Screening Tool for Every Toddler and Preschooler (NutriSTEP®) between 4 to 5 years of age.

Results: Centre-based childcare was associated with a more favourable NutriSTEP® (-0.66 units; 95%CI: -1.11, -0.21), dietary intake (-0.31 units; 95%CI: -0.57, -0.06) and eating behaviours score (-0.14 units; 95% CI: -0.29, 0.00) compared to non-centre-based childcare. Associations were stronger for children who attended centre-based childcare full time with a more favourable NutriSTEP® (-0.89 units; 95%CI: -1.39, -0.41), dietary intake (-0.44 units; 95%CI: -0.72, -0.16) and eating behaviours score (-0.20 units; 95%CI: -0.36, -0.03). Associations were stronger for children from lower income families (< $50,000CDN) who attended centre-based childcare with a more favourable NutriSTEP® (-2.39 units, 95%CI: -3.99, -0.78), dietary intake (-1.43 units; 95%CI: -2.35, -0.50), and lower odds of high nutritional risk (OR 0.44; 95%CI: 0.20, 0.97).

Conclusions: Centre-based childcare was associated with more favourable nutritional risk scores, which were stronger for children who attended centre-based childcare full time and those who were from lower income families. Centre-based childcare may be an important early environment for supporting childhood nutrition.

Clinical trial registry number: NCT01869530 (clinicaltrials.gov).

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幼儿中心托儿和儿童后期营养风险：一项前瞻性队列研究。

背景：中心托儿是促进幼儿健康生活方式行为的良好环境。人们对中心托儿对儿童营养的影响知之甚少。目的：主要目的是评估中心托儿与非中心托儿与幼儿营养风险之间的关系。次要目的是评估饮食摄入和饮食行为之间的关联，以及这种关联是否会受到家庭收入和育儿强度的影响。方法：通过TARGet Kids!对1 ~ 5岁儿童进行前瞻性队列研究。加拿大多伦多初级保健研究网络（n = 2420）。儿童保育率是在1到4岁之间测量的。营养风险、饮食摄入和饮食行为使用4至5岁的每个幼儿和学龄前儿童营养筛查工具（NutriSTEP®）进行测量。结果：与非中心托儿相比，中心托儿与更有利的NutriSTEP®（-0.66单位；95%CI: -1.11, -0.21）、饮食摄入（-0.31单位；95%CI: -0.57, -0.06）和饮食行为评分（-0.14单位；95%CI: -0.29, 0.00）相关。全职参加中心托儿服务的儿童与更有利的NutriSTEP®（-0.89单位；95%CI: -1.39, -0.41）、饮食摄入（-0.44单位；95%CI: -0.72, -0.16）和饮食行为评分（-0.20单位；95%CI: -0.36, -0.03）的相关性更强。来自低收入家庭（< $50,000CDN）的儿童接受更有利的NutriSTEP®（-2.39单位，95%CI: -3.99, -0.78）、膳食摄入量（-1.43单位，95%CI: -2.35, -0.50）和高营养风险的几率较低（OR 0.44; 95%CI: 0.20, 0.97）的中心托儿服务的相关性更强。结论：以中心为基础的托儿服务与更有利的营养风险评分相关，对于全职参加以中心为基础的托儿服务的儿童和来自低收入家庭的儿童，营养风险评分更强。以中心为基础的儿童保育可能是支持儿童营养的重要早期环境。临床试验注册号：NCT01869530 （clinicaltrials.gov）。

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来源期刊

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.