The temporal relationship among socioeconomic vulnerability, dietary intake, and childhood obesity across six European countries: longitudinal results from the Feel4Diabetes-study.

This study aims to examine the temporal relationship between socioeconomic vulnerability, dietary intake, and childhood obesity in European children using longitudinal data; 1,796 parent-child dyads from the control group of the Feel4Diabetes study in six European countries were assessed at baseline (2016) and two follow-ups (2017, 2018). Socioeconomic vulnerability was measured using a cumulative index of parental education, employment, and income security. Children's dietary intake was reported by parents via a food frequency questionnaire, and BMI z-scores were objectively measured. Cross-lagged panel models tested temporal relationships between socioeconomic vulnerability and dietary intake, while moderation analyses assessed if diet moderated the socioeconomic vulnerability-BMI relationship. Higher socioeconomic vulnerability predicted poorer dietary patterns over time, with lower intake of meat (β =  - 0.100) and fruits, vegetables, legumes (β =  - 0.119), and higher consumption of salty snacks (β = 0.129) and sweets/sweetened beverages (β = 0.084, all p < 0.001). Reverse diet-to-socioeconomic vulnerability associations were mostly non-significant. Meat intake also moderated the baseline socioeconomic vulnerability-BMI association (interaction p < 0.05).

conclusionSocioeconomic vulnerability influences children's dietary habits and contributes to obesity risk over time. These findings underscore the need for public health interventions targeting vulnerable populations to improve diet quality and reduce health disparities.

trial registrationThe Feel4Diabetes-study is registered with the clinical trials registry (NCT02393872), http://clinicaltrials.gov . WHAT IS KNOWN: • Childhood obesity remains a major public health concern, with socioeconomic inequalities influencing both dietary habits and obesity risk. • Previous research has shown associations between socioeconomic status and diet or obesity, but limited evidence exists on their temporal and longitudinal interrelationships in children. WHAT IS NEW: • This study provides longitudinal evidence that socioeconomic vulnerability precedes and predicts unfavourable dietary patterns in children over time. • It demonstrates that these diet-related inequalities contribute to the development of childhood obesity, highlighting a temporal pathway linking socioeconomic vulnerability, diet, and obesity risk.