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Background: Assessment of diet and physical activity and their determinants still remains a demanding task, especially when the objective is to evaluate the efficacy of lifestyle interventions. In the context of the Feel4Diabetes study (a European community based intervention study in families with school aged children and at high risk of developing diabetes), we aimed to develop questionnaires for the assessment of food-frequency and eating behaviors, and physical activity and sedentary behaviors in both parents and school-aged children and a questionnaire for overall family's energy balance-related behaviors. Methods: Questionnaires were developed to be used in 6 countries under standardized harmonization procedures and included questions regarding not only food intake and physical activity, but also questions of their determinants. A reliability study was conducted in 191 pairs of parents and their children (N = 191). Parents completed the questionnaires on two occasions, within a 1-2 week interval. Reliability was tested by the intra-class correlation coefficients (ICC) of testretest. Results: Most of the questions in all questionnaires had excellent reliability, assessed as an ICC of > 0.810. Mean ICCs for food-frequency and eating behaviors questionnaires were 0.838 and 0.787, and for physical activity and sedentary behaviors questionnaires were 0.734 and 0.793, in adults and children respectively. Mean ICC for overall family's energy balance-related behaviors and their determinants was 0.659. Conclusion: The developed questionnaires showed acceptable reliability and may be valuable tools in the assessment of children's and parents' behaviors related to diet, physical activity, sedentary behavior and overall energy balance in school-and community-based interventions.

Energy balance-related behaviours (EBRB) are established in childhood and seem to persist through to adulthood. A lower parental educational level was associated with unhealthy behavioural patterns. The aim of the study is to identify clusters of EBRB and examine their association with preschool children's BMI and maternal, paternal and parental education. A subsample of the ToyBox study (n 5387) conducted in six European countries was used. Six behavioural clusters ('healthy diet and low activity', 'active', 'healthy lifestyle', 'high water and screen time; low fruits and vegetables (F&V) and physical activity (PA)', 'unhealthy lifestyle' and 'high F&V consumers') emerged. The healthiest group characterised by high water and F&V consumption and high PA z scores ('healthy lifestyle') was more prevalent among preschool children with at least one medium-or higher-educated parent and showed markedly healthier trends for all the included EBRB. In the opposite, the 'unhealthy lifestyle' cluster (characterised by high soft drinks and screen time z scores, and low water, F&V and PA z scores) was more prevalent among children with lower parental, paternal and maternal education levels. OR identified that children with lower maternal, paternal and parental education levels were less likely to be allocated in the 'healthy lifestyle' cluster and more likely to be allocated in the 'unhealthy lifestyle' cluster. The 'unhealthy lifestyle' cluster was more prevalent among children with parents in lower parental educational levels and children who were obese. Therefore, parental educational level is one of the key factors that should be considered when developing childhood obesity prevention interventions. Key words: Clustering: Energy balance-related behaviours: Preschool children: Parental education levelsChildhood obesity is an important public health issue, as it affects health, educational attainment and long-term quality of life (1) . In addition, childhood obesity seems to track into later life (1)(2)(3) . It is estimated that 40-70 % of the variation in BMI is heritable according to classic genetic analyses (4) . Environmental contribution, however, seems to also have a major role in the obesity epidemic (5) . Weight gain has been associated with various lifestyle behaviours related to diet, physical activity (PA) and sedentary behaviours, referred to collectively as energy balance-related behaviours (EBRB) (6) . Such behaviours are established in early childhood and persist into adulthood (7)(8)(9) . A systematic review of the association between EBRB and overweight and obesity in preschool children reported a strong inverse association between total PA and being overweight and a moderate positive association between sedentary behaviour (especially television viewing) and overweight but provided insufficient evidence for the association between dietary behaviours and overweight (10) . Consumption of sugar-sweetened beveragesAbbreviations: EBRB, energy balance-related behaviours; F&V, fruits and vegetables; PA, ...

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