title: Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany.
abstract: OBJECTIVE
  To assess the association between socioeconomic status (SES) and childhood obesity, and which factor in particular stands out in relation to obesity.
  
  
  METHODS
  When 2020 children attended their obligatory health exam prior to school entry in the City of Aachen, Germany, 1979 parents (97.9%) filled out a questionnaire on their child's weight development and on indicators of their family's SES in a cross-sectional survey. In addition, standardized measures of weight and height were taken. More detailed information on several different SES variables, such as parental education, occupation, income, family constellation, single parenthood, and the location and size of the family residence was obtained by personal interviews in a subsample of all native German speaking children with a BMI > or = 85th percentile, defined as cases (n = 146), and with a BMI between the 40th and 60th percentile, defined as controls (n = 221).
  
  
  RESULTS
  The indicators of parental education were most strongly associated with children's obesity. There was a strong dose-response relationship between a composed index of social class and obesity. Children of the lowest social status had a more than three-fold risk to be obese than children of the highest social status in the screening population (OR: 3.29, CI: 1.92-5.63).
  
  
  CONCLUSIONS
  The findings established a strong relationship between parental years of education and childhood obesity. Prevention and treatment programs should endeavor to better target undereducated parents and their young children at high risk.
authors.affiliation: Department of Child and Adolescent Psychiatry, University Hospital Aachen, Neuenhofer Weg 21, Aachen, Germany. alamerz@ukaachen.de
authors.forename: A
authors.initials: A
authors.lastname: Lamerz
authors.forename: J
authors.initials: J
authors.lastname: Kuepper-Nybelen
authors.forename: C
authors.initials: C
authors.lastname: Wehle
authors.forename: N
authors.initials: N
authors.lastname: Bruning
authors.forename: G
authors.initials: G
authors.lastname: Trost-Brinkhues
authors.forename: H
authors.initials: H
authors.lastname: Brenner
authors.forename: J
authors.initials: J
authors.lastname: Hebebrand
authors.forename: B
authors.initials: B
authors.lastname: Herpertz-Dahlmann
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D005220:Fathers; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009035:Mothers; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D010290:Parents; D015995:Prevalence; D012306:Risk; D012923:Social Class