Breakfast Skipping and School Lunch Utilization in Leipzig Students: Determinants and Associations with Weight Status

This thesis includes two publications originating from the Leipzig School Nutrition Study. Data from the first publication show associations of weekday eating habits with the prevalence of overweight in 4th- and 6th- to 8th-grade students in a city of about 600,000 inhabitants in Germany. Unsteady breakfast habits, skipping breakfast, or not having lunch during the school day were positively associated with the prevalence of being overweight. The associations with having breakfast persist after controlling for known risk factors like parental overweight and SES [28]. Having two breakfasts resulted in even stronger associations. The finding that children with a low SES skipped breakfast more often confirms our hypothesis as well as previous research. In the second paper, we investigated predictors of school lunch participation and reasons for non-participation, i.e., possible intervention targets in 1215 German schoolchildren. The main finding of this study is that school lunch participation is primarily associated with family factors (migration background, parental overweight, SES, families with many children). The most stated reasons for nonparticipation were school-and lunch-related factors like taste, time constraints, and pricing. For children, time constraints were as important as pricing whereas parents reported pricing was as crucial a reason as the taste for nonparticipation. In line, one-third of the parents stated their child would be more likely to participate if school lunch was free of charge. Therefore, our data stress school-and lunch-related factors as an important opportunity to foster school lunch utilization.:Contents Abbreviations ............................................................................................................ 1 Introduction ............................................................................................................... 2 Background............................................................................................................ 2 School meals ......................................................................................................... 3 Relevance of the topic ........................................................................................... 5 Leipzig School Nutrition study................................................................................ 7 Research questions ............................................................................................... 9 Publications - manuscripts ...................................................................................... 10 Summary ................................................................................................................ 12 References ............................................................................................................. 18 Spezifizierung des eigenen wissenschaftlichen Beitrags ........................................... I Selbstständigkeitserklärung ...................................................................................... V Lebenslauf ............................................................................................................... VI Personalien ........................................................................................................... VI Akademischer Werdegang:................................................................................... VI Berufliche Tätigkeit: .............................................................................................. VI Publikationen .......................................................................................................... VII Danksagung ........................................................................................................... VII

Associations of Green Spaces and Streets in the Living Environment with Outdoor Activity, Media Use, Overweight/Obesity and Emotional Wellbeing in Children and Adolescents

Aspects of the living environment can affect health and wellbeing of children and adolescents. Whereas most previous studies assessed the more distant residential urban environment, less is known on possible effects of the close environment. The present study investigated associations of the proportion of streets and green spaces in the immediate urban living environment (50, 100 and 400 m around the home) with media use, outdoor activity, overweight/obesity and emotional problems in two samples of younger (age 3–10, n = 395) and older children (age 10–19, n = 405). Independently of socioeconomic parameters, a higher proportion of streets was associated with overweight/obesity (in younger and older children), higher media use (in younger children), less outdoor activity and more emotional problems (in older children). Older children’s outdoor activity in winter increased with increasing proportions of green spaces. The observations suggest that the immediate urban living environment is a factor that can affect leisure behavior and health in children

Purchasing Behavior, Setting, Pricing, Family: Determinants of School Lunch Participation

Despite growing school lunch availability in Germany, its utilization is still low, and students resort to unhealthy alternatives. We investigated predictors of school lunch participation and reasons for nonparticipation in 1215 schoolchildren. Children reported meal habits, parents provided family-related information (like socioeconomic status), and anthropometry was conducted on-site in schools. Associations between school lunch participation and family-related predictors were estimated using logistic regression controlling for age and gender if necessary. School was added as a random effect. School lunch participation was primarily associated with family factors. While having breakfast on schooldays was positively associated with school lunch participation (ORadj = 2.20, p = 0.002), lower secondary schools (ORadj = 0.52, p < 0.001) and low SES (ORadj = 0.25, p < 0.001) were negatively associated. The main reasons for nonparticipation were school- and lunch-related factors (taste, time constraints, pricing). Parents reported pricing as crucial a reason as an unpleasant taste for nonparticipation. Nonparticipants bought sandwiches and energy drinks significantly more often on school days, whereas participants were less often affected by overweight (OR = 0.66, p = 0.043). Our data stress school- and lunch-related factors as an important opportunity to foster school lunch utilization

And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren

Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio–economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = −0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = −0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children

Breakfast Skipping and School Lunch Utilization in Leipzig Students: Determinants and Associations with Weight Status

This thesis includes two publications originating from the Leipzig School Nutrition Study. Data from the first publication show associations of weekday eating habits with the prevalence of overweight in 4th- and 6th- to 8th-grade students in a city of about 600,000 inhabitants in Germany. Unsteady breakfast habits, skipping breakfast, or not having lunch during the school day were positively associated with the prevalence of being overweight. The associations with having breakfast persist after controlling for known risk factors like parental overweight and SES [28]. Having two breakfasts resulted in even stronger associations. The finding that children with a low SES skipped breakfast more often confirms our hypothesis as well as previous research. In the second paper, we investigated predictors of school lunch participation and reasons for non-participation, i.e., possible intervention targets in 1215 German schoolchildren. The main finding of this study is that school lunch participation is primarily associated with family factors (migration background, parental overweight, SES, families with many children). The most stated reasons for nonparticipation were school-and lunch-related factors like taste, time constraints, and pricing. For children, time constraints were as important as pricing whereas parents reported pricing was as crucial a reason as the taste for nonparticipation. In line, one-third of the parents stated their child would be more likely to participate if school lunch was free of charge. Therefore, our data stress school-and lunch-related factors as an important opportunity to foster school lunch utilization.:Contents Abbreviations ............................................................................................................ 1 Introduction ............................................................................................................... 2 Background............................................................................................................ 2 School meals ......................................................................................................... 3 Relevance of the topic ........................................................................................... 5 Leipzig School Nutrition study................................................................................ 7 Research questions ............................................................................................... 9 Publications - manuscripts ...................................................................................... 10 Summary ................................................................................................................ 12 References ............................................................................................................. 18 Spezifizierung des eigenen wissenschaftlichen Beitrags ........................................... I Selbstständigkeitserklärung ...................................................................................... V Lebenslauf ............................................................................................................... VI Personalien ........................................................................................................... VI Akademischer Werdegang:................................................................................... VI Berufliche Tätigkeit: .............................................................................................. VI Publikationen .......................................................................................................... VII Danksagung ........................................................................................................... VII

Purchasing Behavior, Setting, Pricing, Family: Determinants of School Lunch Participation

Despite growing school lunch availability in Germany, its utilization is still low, and students resort to unhealthy alternatives. We investigated predictors of school lunch participation and reasons for nonparticipation in 1215 schoolchildren. Children reported meal habits, parents provided family-related information (like socioeconomic status), and anthropometry was conducted on-site in schools. Associations between school lunch participation and family-related predictors were estimated using logistic regression controlling for age and gender if necessary. School was added as a random effect. School lunch participation was primarily associated with family factors. While having breakfast on schooldays was positively associated with school lunch participation (ORadj = 2.20, p = 0.002), lower secondary schools (ORadj = 0.52, p &lt; 0.001) and low SES (ORadj = 0.25, p &lt; 0.001) were negatively associated. The main reasons for nonparticipation were school- and lunch-related factors (taste, time constraints, pricing). Parents reported pricing as crucial a reason as an unpleasant taste for nonparticipation. Nonparticipants bought sandwiches and energy drinks significantly more often on school days, whereas participants were less often affected by overweight (OR = 0.66, p = 0.043). Our data stress school- and lunch-related factors as an important opportunity to foster school lunch utilization

Breakfast Skipping and School Lunch Utilization in Leipzig Students: Determinants and Associations with Weight Status

This thesis includes two publications originating from the Leipzig School Nutrition Study. Data from the first publication show associations of weekday eating habits with the prevalence of overweight in 4th- and 6th- to 8th-grade students in a city of about 600,000 inhabitants in Germany. Unsteady breakfast habits, skipping breakfast, or not having lunch during the school day were positively associated with the prevalence of being overweight. The associations with having breakfast persist after controlling for known risk factors like parental overweight and SES [28]. Having two breakfasts resulted in even stronger associations. The finding that children with a low SES skipped breakfast more often confirms our hypothesis as well as previous research. In the second paper, we investigated predictors of school lunch participation and reasons for non-participation, i.e., possible intervention targets in 1215 German schoolchildren. The main finding of this study is that school lunch participation is primarily associated with family factors (migration background, parental overweight, SES, families with many children). The most stated reasons for nonparticipation were school-and lunch-related factors like taste, time constraints, and pricing. For children, time constraints were as important as pricing whereas parents reported pricing was as crucial a reason as the taste for nonparticipation. In line, one-third of the parents stated their child would be more likely to participate if school lunch was free of charge. Therefore, our data stress school-and lunch-related factors as an important opportunity to foster school lunch utilization.:Contents Abbreviations ............................................................................................................ 1 Introduction ............................................................................................................... 2 Background............................................................................................................ 2 School meals ......................................................................................................... 3 Relevance of the topic ........................................................................................... 5 Leipzig School Nutrition study................................................................................ 7 Research questions ............................................................................................... 9 Publications - manuscripts ...................................................................................... 10 Summary ................................................................................................................ 12 References ............................................................................................................. 18 Spezifizierung des eigenen wissenschaftlichen Beitrags ........................................... I Selbstständigkeitserklärung ...................................................................................... V Lebenslauf ............................................................................................................... VI Personalien ........................................................................................................... VI Akademischer Werdegang:................................................................................... VI Berufliche Tätigkeit: .............................................................................................. VI Publikationen .......................................................................................................... VII Danksagung ........................................................................................................... VII

Associations Between Socio-Economic Status and Child Health: Findings of a Large German Cohort Study

The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3&#8315;18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (&#946; = &#8722;0.26), fewer behavioral difficulties (&#946; = &#8722;0.18), higher quality of life (&#946; = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p &lt; 0.05) and a healthier lifestyle (healthier nutrition (&#946; = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p &lt; 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (&#946; = &#8722;0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies

Comparing methane ebullition variability across space and time in a Brazilian reservoir

The potent greenhouse gas methane (CH4) is readily emitted from tropical reservoirs, often via ebullition (bubbles). This highly stochastic emission pathway varies in space and time, however, hampering efforts to accurately assess total CH4 emissions from water bodies. We systematically studied both the spatial and temporal scales of ebullition variability in a river inflow bay of a tropical Brazilian reservoir. We conducted multiple highly resolved spatial surveys of CH4 ebullition using a hydroacoustic approach supplemented with bubble traps over a 12‐month and a 2‐week timescale to evaluate which scale of variation was more important. To quantify the spatial and temporal variability of CH4 ebullition, we used the quartile coefficients of dispersion at each point in space and time and compared their frequency distributions across the various temporal and spatial scales. We found that CH4 ebullition varied more temporally than spatially and that the intra‐annual variability was stronger than daily variability within 2 weeks. We also found that CH4 ebullition was positively related to water temperature increase and pressure decrease, but no consistent relationship with water column depth or sediment characteristics was found, further highlighting that temporal drivers of emissions were stronger than spatial drivers. Annual estimates of CH4 ebullition from our study area may vary by 75–174% if ebullition is not resolved in time and space, but at a minimum we recommend conducting spatially resolved measurements at least once during each major hydrologic season in tropical regions (i.e., in dry and rainy season when water levels are falling and rising, respectively)

Loss of childcare and classroom teaching during the Covid-19-related lockdown in spring 2020: A longitudinal study on consequences on leisure behavior and schoolwork at home.

AimIn spring 2020, the first Covid-19-related lockdown included the closing of kindergartens and schools. Home schooling, the lack of social contacts with peers and the care of the children at home posed an enormous challenge for many families.MethodsThe present study investigated the leisure behavior of 285 one- to 10-year-old German children at two time points (t1 and t2) during the Covid-19-related lockdown in spring 2020. In the subsample of primary school children (n = 102), we also explored children's attitudes towards schoolwork at home. Analyses focused on the change of behavior from t1 to t2, on differences in these changes depending on socio-economic status (SES), and on associations of behavior with SES, the number of children at home, and the frequency of receiving learning materials from school.ResultsWhile the frequency of playing outside increased significantly from t1 to t2, the frequency of handicrafts, playing board games, indoor sports, and motivation to do schoolwork decreased. The observed changes between t1 and t2 did not differ depending on SES. However, a lower SES was associated with higher media use, less outdoor activity, and (though only marginally significant) a reduced time doing schoolwork and a reduced ability to concentrate on schoolwork at t1. In households with more children, children played outside more often, but were read to less frequently and (though only marginally significant) watched movies and series less frequently. Children receiving learning materials from school on a regular basis spent significantly more time doing schoolwork at home than children receiving materials only irregularly.ConclusionsA continuing loss of childcare in day-care facilities and schools entails the danger of declining education in the form of (inter)active indoor activities and schoolwork