PhD Candidate University of Toronto Pickering, Ontario, Canada
Background: Early childhood is an important period for establishing eating behaviours and dietary preferences. Government regulated centre-based childcare has been identified as a highly promising early environment as nutrition policies, routines, skilled caregiver-child interactions, and providing meals and snacks that adhere to Health Canada’s nutrition guidelines may serve as mechanisms for supporting healthy dietary behaviours. Despite the movement towards a national childcare system in Canada, there is little known about the impact of centre-based childcare on child dietary behaviours. Objective: The primary objective will be to evaluate if attendance to centre-based childcare in early childhood (≥ 1 to < 4 y) is associated with nutritional risk in later childhood (≥ 4 to ≤ 5 y). Secondary objectives will be to evaluate the associations between centre-based childcare and high nutritional risk, dietary intake and eating behaviours. Finally, to explore if family income, child biological sex, and childcare intensity modify the associations. Design/Methods: A prospective cohort study of children aged 1 to 5 years will be conducted through the TARGet Kids! primary care research network in Toronto, Canada. Children who attended centre-based childcare will be compared to children who attended non-centre-based childcare. Nutritional risk, dietary intake and eating behaviours will be measured using a validated questionnaire (Nutrition Screening Tool for Every Preschooler). Generalized Estimating Equations models will be used to evaluate the associations adjusting for clinically relevant confounders and effect modification will be explored. Data analysis will be completed by December 2023. Ethics approval was obtained from the Hospital for Sick Children and Unity Health Toronto. These findings may be important to families, healthcare professionals and policy makers who are interested in the potential of centre-based childcare to act as an early intervention to support healthy dietary behaviours in children.
