Unfavourable food consumption is exacerbated by low socioeconomic status among children aged 1-5 years in Germany.

Abstract

Diet in the first years of life is a key determinant of lifelong disease risk and is highly affected by socio-economic status (SES). However, the specific relation between SES and food consumption in toddlers and preschoolers is poorly understood. This study assesses SES-related differences in food consumption in 1- to 5-year-olds in Germany using weighed food records (3 + 1 d) of a subsample of 887 children from the cross-sectional Children's Nutrition Survey to Record Food Consumption (KiESEL) undertaken between 2014 and 2017. Children were categorised as having a low, medium or high SES depending on parental income, education and occupation. A two-step generalised linear model corrected for age and sex was applied to assess differences in food consumption, using bootstrapping to address unequal group sizes. Differences between SES groups were found for unfavourable foods (and the subgroups sugar-sweetened beverages and confectionary/desserts), fruit, bread/cereals and fats/oils (P_Boot < 0·05). Mean daily consumption in the low-SES group as compared with the high-SES group was 84 g lower for total fruit, 22 g lower for bread/cereals and 3 g lower for fats/oils, while being 123 g higher for sugar-sweetened beverages and 158 g higher for unfavourable foods in total (based on bootstrap 95 % CI). In conclusion, this study suggests a social gradient in the diet of German toddlers and preschoolers, with lower SES linked to lower diet quality. To prevent adverse health trajectories, public health measures to improve early life nutrition should address all children, prioritising those of lower SES.