Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status

Background/objectives: Childhood obesity rates have increased in recent years. The effectiveness of future public health interventions to reduce childhood obesity will be enhanced by a better understanding of behavioral factors that influence adiposity in children as they transition from childhood to adolescence. The purpose of this study was to examine whether initial weight status modifies the longitudinal associations of physical activity, sedentary behavior, and diet quality with changes in adiposity over time.Subjects/methods: A total of 658 children (45% boys) were stratified into 3 groups based on 5th grade BMI percentiles ( < 85th, 85-95th, > 95th) and followed from 5th grade to 6th and/or 7th grade. Study variables, including fat-mass-index (FMI), moderate-to-vigorous physical activity (MVPA), diet quality, and sedentary behavior, were measured at 5th, 6th, and/or 7th grades. Separate growth curve models were conducted within each weight status group to examine the associations between MVPA, sedentary behavior, diet quality and adiposity, operationalized as FMI. All models controlled for sex, maturity offset, race, and parent education.Results: Of the 658 children, 53% were classified with normal weight at baseline, 18% with overweight, and 29% with obesity. Associations between MVPA, sedentary behavior, diet quality and FMI varied within each weight status group. MVPA was negatively associated with adiposity (FMI) for all weight status groups. Diet quality and sedentary behavior were associated with adiposity only in children with obesity at baseline; neither diet quality nor sedentary behavior was associated with FMI for those with overweight.Conclusions: MVPA was negatively associated with adiposity (FMI) in all weight status groups, suggesting that MVPA may protect against higher adiposity. Sedentary behavior and diet quality were associated with adiposity only in children with obesity at baseline; neither sedentary behavior nor diet quality was associated with FMI for children with overweight.