Skip to main content

01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study

BMC Public Health > Ausgabe 1/2015
Krystallia Mantziki, Achilleas Vassilopoulos, Gabriella Radulian, Jean-Michel Borys, Hugues Du Plessis, Maria João Gregório, Pedro Graça, Stefaan De Henauw, Svetoslav Handjiev, Tommy LS Visscher, Jacob C Seidell
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2540-5) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare no competing interests

Authors’ contributions

All authors participated to the design of the study. AV, MJG, PG, GR, SH, JMB, HdP, TLSV and SH were responsible for monitoring the data collection process. KM and AV conducted the statistical analysis. KM prepared the initial draft of the manuscript. All authors contributed to the writing of the manuscript and critically revised the manuscript. JCS supervised the data analysis and writing of the manuscript. All authors approved the final version of the manuscript.



Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status.


This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6–8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann–Whitney U test and Pearson’s chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country.


Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large.


Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied.
Additional file 1: Median values and quartiles(q1-q3)for determinants of the child’s environment and fruit/vegetable consumption. (DOCX 25 kb)
Additional file 2: Median values and quartiles(q1-q3)for determinants of the child’s social environment and fruit juices consumption. (DOCX 21 kb)
Additional file 3: Median values and quartiles(q1-q3)for determinants of the child’s social environment and soft drinks consumption. (DOCX 20 kb)
Additional file 4: Median values and quartiles(q1-q3)for determinants of the child’s social environment and screen exposure. (DOCX 27 kb)
Additional file 5: Median values and quartiles(q1-q3)for determinants of the child’s physical environment and energy-balance related behaviours. (DOCX 34 kb)
Additional file 6: Corrected criticalp-values after adjustment for multiple testing. (DOCX 28 kb)
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

BMC Public Health 1/2015 Zur Ausgabe