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Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany



To assess the association between socioeconomic status (SES) and childhood obesity, and which factor in particular stands out in relation to obesity.


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≥85th percentile, defined as cases (n=146), and with a BMI between the 40th and 60th percentile, defined as controls (n=221).


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).


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.

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We would like to thank the entire staff of the Aachen Public Health Service and the medical students Sandra Schäfer, Christine Schell and Martina Selzner for their support and cooperation. This study was funded by the German Society for the Advancement of Scientific Research (DFG Grants HE 1809/5-1 and BR 1704/4-1) and by the START-Program of the Medical Faculty, RWTH Aachen, Germany.

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Lamerz, A., Kuepper-Nybelen, J., Wehle, C. et al. Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany. Int J Obes 29, 373–380 (2005).

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  • children
  • socioeconomic status
  • cross-sectional survey
  • case–control study
  • overweight

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