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. 2023 Jun 22:11:1079871.
doi: 10.3389/fpubh.2023.1079871. eCollection 2023.

Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference?

Alena Mayer #  1 , Raphael M Herr #  1   2 , Thomas Klein  3 , Eva Wiedemann  1 , Katharina Diehl  2 , Stephanie Hoffmann  4 , Miriam Blume  5 , Dennis Jepsen  6 , Leonie Sundmacher  7 , Marike Andreas  1 , Sven Schneider  1
Affiliations

Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference?

Alena Mayer et al. Front Public Health. .

Abstract

Background: Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI.

Methods: We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents.

Results: Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus.

Conclusion: We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity.

Keywords: BMI; children; early childhood education and care center; health equalities; meso-level; pre-school; sport.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Predictive margins of ECEC center sports focus (yes vs. no) and socio-economic position (family SEP) on BMI for boys.
Figure 2
Figure 2
Predictive margins of ECEC center sports focus (yes vs. no) and socio-economic position (family SEP) on BMI for girls.
See this image and copyright information in PMC

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