The association between overweight and internalizing and externalizing behavior in early childhood

- The prospective association between body mass and behavior problems was examined.
- In- and externalizing problem behavior in toddlers relates to later overweight.
- Overweight in early childhood is not related to later problem behavior.
- Only in Western children does problem behavior relate to prospective overweight.
- An early adiposity rebound relates to early behavior problems and overweight.

ObjectiveThe aim of this study was to examine bidirectional associations between overweight and behavior problems during early childhood taking into account the adiposity rebound, which is the turning point in the nonlinear development of Body Mass Index in early childhood.MethodsLongitudinal data from 6624 Dutch children in the Generation R Study were used to analyze the association between measured overweight and scores on the internalizing and externalizing scale of the Child Behavior Checklist between one-and-a-half, three and six years. The adiposity rebound was determined for each child by estimating the lowest point in their growth curve. Cross-lagged modeling was used to test (bi)directional associations.ResultsBoth body mass and behavior problems were modest to highly stable from age one-and-a-half to six years. Externalizing and internalizing behavior were both associated with later overweight, although effect sizes were small (βs ranged between 0.06 and 0.07, ps < 0.05). No significant associations in the other direction were found. Controlling for adiposity rebound did not change the pattern of associations. There was a moderating effect of gender, and ethnicity, and timing of adiposity rebound.ConclusionBehavior problems in early childhood may put children at risk for overweight at a later age. This implies that young children with behavior problems may benefit from careful monitoring of eating behavior and weight development. Future studies should take the adiposity rebound into account.