Associations among family sociodemographic factors, breakfast habits, and weight status in preschool children and the mediating role of breakfast habits: the ToyBox-study.

PURPOSE: To investigate the associations between children’s breakfast habits and sociodemographic factors with overweight in preschool children. METHODS: The analysis used data from 6451 European preschoolers and their parents participating in the ToyBox-study. Children’s weight and height were measured, and family sociodemographic data were collected using standardised questionnaires. International Obesity Task Force cut-off points were used to categorise children’s weight status. The associations between children’s breakfast habits, weight status and family sociodemographic characteristics were analysed using multiple logistic regression. In addition, mediation analysis was performed to test the hypothesis that children’s breakfast habits mediate the association of selected sociodemographic factors and weight status. RESULTS: Girls were more likely than boys to skip breakfast daily (16.7% vs 12.4%; p < 0.01) and were at a higher risk of being overweight (17.1% vs 12.4%; p < 0.01). Children whose mothers’ years of education were more than 14 years were more likely to consume breakfast daily (OR 1.46 (95% CI 1.20; 1.78)) and less likely to be overweight (0.73 (95% CI 0.60; 0.88)) compared to children of mothers with lower levels of education. Girls (1.48 (95% CI 1.26; 1.73)) and children whose mother (1.71 (95% CI 1.44; 2.02)) or father (1.78 (95% CI 1.49; 2.14)) was overweight were more likely to be overweight. After adjusting for confounding factors, no mediation of preschool children’s breakfast habits was found in the association between family sociodemographic factors and children’s weight status. CONCLUSION: The lower likelihood of being overweight among children aged 3.5–5.5 was associated with medium and high mothers’ education and non-overweight parents. CLINICAL TRIAL AND STUDY REGISTRATION: The ToyBox-study is registered with the clinical trials registry: clinicaltrials.gov, ID: NCT02116296; 2014-04-15.