Before-school and after-school childcare and children's risk of obesity.

BACKGROUND: In the USA, half of children are regularly cared for before or after school by someone other than a parent.

OBJECTIVE: Describe the relationship between childcare arrangements and obesity among school-aged children.

METHODS: Data are from the fifth-grade wave of the Early Childhood Longitudinal Study - Kindergarten Cohort 1998-1999, a nationally representative study of US children who were in kindergarten in 1998-1999 or first grade in 1999, collected in spring 2004 (analytic sample = 9617). We estimated survey-adjusted logistic regression models to examine the association between childcare arrangements before and after school and obesity.

RESULTS: The prevalence of obesity was highest among fifth graders who received care from multiple sources and lowest among children who received care from adults not related to them in either the child's or the caregiver's home [29.9%, 95% confidence interval {CI}: 18.7%, 44.3%; and 17.3%, 95% CI: 12.1%, 24.0%]. Childcare arrangement was not an independent risk factor for obesity for most children. However, Hispanic children who were cared for by a person who was not a relative had significantly higher odds of obesity compared with non-Hispanics in similar care arrangements (odds ratio: 5.11, 95% CI: 2.00, 13.06).

CONCLUSION: Type of childcare before or after school was not an independent risk factor for obesity in most fifth graders, but implications of childcare for Hispanic children should be explored further.