Associations of childcare arrangements with adiposity measures in a multi-ethnic Asian cohort: The GUSTO study

Beverly Wen Xin Wong, Jia Ying Toh, Ray Sugianto, Airu Chia, Mya Thway Tint, Wen Lun Yuan, Natarajan Padmapriya, Carla Lança, Seang Mei Saw, Yung Seng Lee, Lynette Pei-Chi Shek, Kok Hian Tan, Fabian Yap, Keith M. Godfrey, Yap Seng Chong, Falk Müller-Riemenschneider, Johan G. Eriksson, Shiao Yng Chan, Mary Foong Fong Chong

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Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: Full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity.

Original languageEnglish
Article number12178
JournalInternational Journal of Environmental Research and Public Health
Issue number22
Publication statusPublished - 1 Nov 2021


  • Adiposity
  • Asian
  • Caregiver type
  • Childcare
  • Preschool


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