Mediators of the association between parental education and breakfast consumption among adolescents : the ESSENS study

Background: Regular breakfast consumption has several health benefits. However, breakfast skipping is common among adolescents, in particular among those with a low socioeconomic background. The aims of the study were to explore individual and home environmental correlates of breakfast consumption, and to assess their potential mediating role in the association between parental education and breakfast consumption. Methods: A cross-sectional study including 706 adolescents with a mean age of 13.6 (SD = 0.3) was conducted between October and December 2016. Data were collected at school through an online questionnaire. Regression analyses were used to explore whether parental modelling, parental co-participation in breakfast consumption, parental rules, the availability of breakfast foods at home and screen time were associated with breakfast consumption. Mediation analyses were conducted to assess whether these factors mediated the association between parental education and breakfast consumption. Results: Breakfast consumption was significantly positively associated with parental education (OR = 1.97 (95% CI 1. 43-2.72)). A higher parental modelling (OR = 2.17 (95% CI 1.70-2.79)), a higher parental co-participation in breakfast consumption (OR = 1.37 (95% CI 1.26, 1.49)), higher parental rules (OR = 1.36 (95% CI 1.21, 1.53)) and a higher availability of breakfast foods at home (OR = 2.21 (95% CI 1.65, 2.97)) were associated with higher odds of being a daily breakfast consumer. Higher levels of screen time (hrs/day) were associated with lower odds of being a daily breakfast consumer (OR = 0.85 (95% CI 0.79, 0.91). Parental modelling (B = 0.254 (95% CI 0.149, 0.358)) and the availability of breakfast foods at home (B = 0.124 (95% CI 0.033, 0.214)) were significantly positively related to parental education, whereas screen time (hrs/day) (B = -1.134 (95% CI -1.511, -0.758)) was significantly inversely related to parental education. Parental modelling, the availability of breakfast foods at home and screen time were found to mediate parental educational differences in breakfast consumption. Conclusions: Increasing the availability of breakfast food, improving parental modelling of breakfast consumption and targeting screen time might be promising strategies to reduce parental educational differences in breakfast consumption.