Children with overweight, obesity may lack readiness for kindergarten
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Among a group of Canadian children in year 2 of kindergarten, those with overweight or obesity were twice as likely to be unready for school as their peers with normal weight, according to study data.
In the Toronto-based study, Jessica A. Omand, PhD, MSc, a dietitian researcher and postdoctoral fellow at the Hospital for Sick Children Research Institute in Toronto, and colleagues sought to identify any association between BMI and body weight status and school readiness for young children. The researchers included children enrolled in the prospective study TARGet Kids!, a primary care practice-based research network that partners with community health care providers, families and children to foster knowledge to raise healthy children for lifelong health.
Researchers determined children’s height and weight before the start of kindergarten and assessed school readiness with the Early Development Instrument, a validated teacher-completed instrument that evaluates children’s skills and behaviors in five developmental domains in kindergarten. Children entered year 1 of kindergarten (K1) the year they turned age 4 years and year 2 of kindergarten (K2) the year they turned age 5 years.
In all, 1,015 healthy urban children (1,217 observations; 52% boys) were included in the study with 591 observations of children in K1 and 626 from children in K2. Among the entire group, 13% were born late preterm, 93% had mothers with education beyond high school, 47% had self-reported annual family income of less than $150,000, and 70% were of European ethnicity. BMI z score was calculated at a mean age of 4.2 years for K1 and 4.5 years for K2 participants, and school readiness was assessed at a mean age of 5.2 years for those in K1 and 5.8 years for those in K2.
Researchers made 1,041 observations of children with normal weight or underweight, 138 observations of children with overweight and 38 observations of children with obesity.
Among the cohort, 16% of those with normal weight, 22% with overweight and 26% with obesity were assessed to be vulnerable in school readiness, for a total of 202 children, 86 in K1 and 116 in K2.
BMI z score was not associated with school readiness. However, a post hoc analysis indicated that K2 children — but not K1 children — classified with overweight or obesity in kindergarten had twice the odds of vulnerability in school readiness as those with normal weight (adjusted OR = 2.07; 95% CI, 1.09-3.9; P = .03).
“It may take time for overweight or obesity to have a negative impact on school readiness, and the impact of weight bias in the classroom may increase as a child gets older, hence the relationship in K2 and not in K1,” the researchers wrote. “A larger sample of children would be beneficial to differentiate associations in different body weight status groups.”
In other post hoc analysis data, children classified with overweight or obesity in kindergarten had a lower social competence score compared with their normal-weight counterparts.
“The ability to meet age-appropriate developmental expectations at school entry is important for setting children up for future success in school and life. Early interventions to promote healthy growth before school entry may help promote development and school readiness,” the researchers wrote.
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