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 ( = -0.51, = 0.004) and a lower risk of being overweight (ORj = 0.30, = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: = -0.66, < 0.001; risk of overweight: OR = 0.22, = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: = 0.49, < 0.001; risk of overweight: OR = 3.29, < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: = 0.43, < 0.001; risk of overweight: OR = 2.72, = 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.