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Background: Health (in)equity has a high priority on research and policy agendas. Even though it is known that inequalities in overweight prevalence accumulate with age and are already existent among children below the age of six, research on this topic is scarce. In this young age group, parents play an important role in preventing overweight and associated adverse consequences. This study examines the magnitude of parental misclassification of child weight status and its correlates, focussing on the factors that determine social status and equity., Methods: Preschool children's weight and height was measured objectively. Parents gave information on their socioeconomic background. Family education was dichotomised into tertiary and non-tertiary educational level, according to CASMIN. Binary logistic regression, adjusted for parental BMI, was applied to detect odds of childhood overweight., Results: Data on family educational level and anthropometrics were available from 643 children (4.5 ± 0.82 years, 52.7% male) and their parents of which 46.5% (n = 299) had a tertiary educational background. The groups (tertiary vs. non-tertiary educational level) differ significantly in overweight prevalence (3.7% vs. 11.9%, p ≤ 0.001). Odds of overweight were two times higher in children with non-tertiary educational background (OR: 2.123, CI: 1.010-4.461, p < 0.05), adjusted for parental BMI., Conclusion: Children from families with low educational background have an elevated risk of overweight, already at a very young age. Education in general (not explicitly health education) seems to play a tremendous role in the prevention of overweight and obesity and should therefore be implied in policies enhancing health equity., Trial Registration: DRKS-ID: DRKS00010089., (© 2024. The Author(s).)

Background: Sedentary behaviour in children is related to different health consequences such as overweight and cardio-metabolic diseases that can track into adulthood. Previous studies have shown that children spend hours being sedentary, but no data of sedentary time (ST) among German children has been available, yet. Therefore, this study investigated objectively measured amounts and correlates of ST in a sample of German primary school children., Methods: Children's physical activity (PA) was objectively assessed for 6 days using a multi-sensor device (Actiheart®; CamNtech, Cambridge, UK). Activity levels were categorized on the basis of energy expenditure (MET) into sedentary, light PA (LPA), and moderate to vigorous PA (MVPA). ST excluding sleeping hours was assessed for 231 children (7.1 ± 0.6 years, male: 45.9%) and analysed for independent groups. Examined factors (parental education, household income, and migration background) were assessed by parental questionnaire. Children's weight, height and gender were collected in schools. Weight status was calculated on the basis of BMI percentiles., Results: On average, children spent 3.5 ± 1.5 h daily being sedentary, excluding sleeping hours. Significantly higher ST was found in girls ( t  = -4.6; p  < 0.01), in children with migration background ( t  = -6.9; p  < 0.01), at the weekend ( t  = -2.8; p  < 0.01), and among inactive children ( t  = 6.8; p  < 0.01). Additionally, significant correlations with ST in this sample were identified for MVPA (B = -0.99; [-1.09;-0.88], p  < 0.01), LPA (B = -0.89; [-0.97;-0.82], p  < 0.01), migration background (B = -17.64; [5.24;30.04], p  < 0.01), gender (B = -13.48; [-25.94;-1.01], p  < 0.05) and household income (B = -4.80; [-9.07; -0.53], p  < 0.05)., Conclusion: Girls, children with migration background, and inactive children were identified as potential risk groups. A higher income was associated with less ST. In general, ST was higher at the weekend. Furthermore, as PA was found to be negatively correlated to ST, these activities may replace each other. Therefore, these findings should be considered in future health interventions., Trial Registration: German Clinical Trials Register (DRKS), DRKS-ID: DRKS00000494 DATE: 25/08/2010.