Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach

Background: The aim of this study was to assess the less studied interrelationships and pathways between parental BMI, socioeconomic factors, family structure and childhood overweight. Methods: The cross-sectional LATE-study was carried out in Finland in 2007-2009. The data for the analyses was classified into four categories: younger boys and girls (ca 3-8 years) (n = 2573) and older boys and girls (ca 11-16 years) (n = 1836). Associations between parental BMI, education, labor market status, self-perceived income sufficiency, family structure and childhood overweight were first examined by logistic regression analyses. As parental BMI and education had the most consistent associations with childhood overweight, the direct and indirect (mediated by parental BMI) associations of maternal and paternal education with childhood overweight were further assessed using a path model. Results: Parental BMI and education were the strongest determinants of childhood overweight. Children of overweight parents had an increased risk of being overweight. In younger boys, maternal and paternal education had both direct (b-coefficient paternal -0.21, 95% CI -0.34 to -0.09; maternal -0.17, 95% CI -0.28 to -0.07) and indirect (b-coefficient paternal -0.04, 95% CI -0.07 to -0.02; maternal -0.04, 95% CI -0.06 to -0.02) inverse associations with overweight. Among the older boys, paternal education had both direct (b-coefficient -0.12, 95% CI -0.24 to -0.01) and indirect (b-coefficient -0.03, 95% CI -0.06 to -0.01) inverse associations with overweight, but maternal education had only an indirect association (b-coefficient -0.04, 95% CI -0.07 to -0.02). Among older girls, only an indirect association of maternal education with childhood overweight was found (b-coefficient -0.03, 95% CI -0.06 to -0.01). In younger girls, parental education was not associated with childhood overweight. Conclusion: The observed pathways between parental BMI and education and childhood overweight emphasize a need for evidence-based health promotion interventions tailored for families identified with parental overweight and low level of education.