Abstract
ObjectiveTo investigate associations of family-related factors with children’s breakfast consumption and BMI-z-score and to examine whether children’s breakfast consumption mediates associations between family-related factors and children’s BMI-z-score.SubjectsTen- to twelve-year-old children (n = 6374; mean age = 11.6±0.7 years, 53.2% girls, mean BMI-z-score = 0.4±1.2) and one of their parents (n = 6374; mean age = 41.4±5.3 years, 82.7% female, mean BMI = 24.5±4.2 kg/m2) were recruited from schools in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain, and Switzerland). The children self-reported their breakfast frequency per week. The body weight and height of the children were objectively measured. The parents responded to items on family factors related to breakfast (automaticity, availability, encouragement, paying attention, permissiveness, negotiating, communicating health beliefs, parental self-efficacy to address children’s nagging, praising, and family breakfast frequency). Mediation analyses were performed using multi-level regression analyses (child-school-country).ResultsThree of the eleven family-related variables were significantly associated with children’s BMI-z-score. The family breakfast frequency was negatively associated with the BMI-z-score; permissiveness concerning skipping breakfast and negotiating about breakfast were positively associated with the BMI-z-score. Children’s breakfast consumption was found to be a mediator of the two associations. All family-related variables except for negotiating, praising and communicating health beliefs, were significantly associated with children’s breakfast consumption.ConclusionsFuture breakfast promotion and obesity prevention interventions should focus on family-related factors including the physical home environment and parenting practices. Nevertheless, more longitudinal research and intervention studies to support these findings between family-related factors and both children’s breakfast consumption and BMI-z-score are needed.
Highlights
The family breakfast frequency was negatively associated with the Body Mass Index (BMI)-z-score; permissiveness concerning skipping breakfast and negotiating about breakfast were positively associated with the BMI-z-score
More longitudinal research and intervention studies to support these findings between family-related factors and both children’s breakfast consumption and BMI-z-score are needed
[2] Breakfast consumption in children and adolescents was found to be inversely related to the Body Mass Index (BMI) and overweight in both cross-sectional [3,4,5,6,7] and longitudinal studies. [8,9] Eating breakfast has been suggested to potentially prevent snacking and the consumption of energy-rich foods. [3,6,7,10] regular breakfast consumption has been associated with overall dietary quality and nutritional profiles in school-aged children [3,7,8] and with improved cognitive performance
Summary
Overweight and obesity in youths have increased during the past decades and are associated with different physical and psychosocial health problems. [1] Overweight is caused by a longterm positive energy balance occurring when the energy intake outweighs the energy expenditure. [2] Breakfast consumption in children and adolescents was found to be inversely related to the Body Mass Index (BMI) and overweight in both cross-sectional [3,4,5,6,7] and longitudinal studies. [8,9] Eating breakfast has been suggested to potentially prevent snacking and the consumption of energy-rich foods. [3,6,7,10] regular breakfast consumption has been associated with overall dietary quality and nutritional profiles in school-aged children [3,7,8] and with improved cognitive performance. [6] whether breakfast as such is of great importance or whether skipping breakfast is an indicator of an overall irregular meal and eating pattern is unclear. Despite the potential importance of breakfast consumption, the prevalence rates of breakfast skipping among children and adolescents has increased in the past few decades. [17,18] To date, only a few studies have examined some associations between physical (e.g., availability, and accessibility), sociocultural (e.g., support) and political (e.g., rules) family factors and breakfast consumption. [17,18] to our knowledge, no studies are available that have examined a wide range of family-related factors at the same time or their relation with children’s breakfast intake. In the recent ‘‘EuropeaN Energy balance Research to prevent excessive weight Gain among Youth’’ (ENERGY)-project, [19] a wide range of physical and sociocultural family factors related to children’s breakfast consumption were measured. No studies have examined the relation between family-related variables and children’s BMI-z-score or investigated the mediating effect of children’s breakfast intake on these relations
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