Externalizing behavior in early childhood and body mass index from age 2 to 12 years longitudinal analyses of a prospective cohort study.docVIP
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Externalizing behavior in early childhood and body mass index from age 2 to 12 years longitudinal analyses of a prospective cohort study
Anderson et al. BMC Pediatrics 2010, 10:49
/1471-2431/10/49
RESEARCH ARTICLE
Open Access
Externalizing behavior in early childhood and body Research article
mass index from age 2 to 12 years: longitudinal
analyses of a prospective cohort study
Sarah E Anderson*1, Xin He2, Sarah Schoppe-Sullivan3 and Aviva Must4
Abstract
Background: Some evidence suggests that obesity and behavior problems are related in children, but studies have
been conflicting and have rarely included children under age 4. An association between behavior problems in early
childhood and risk for obesity could suggest that a common set of factors contribute to both. Our research objectives
were to determine the extent to which externalizing behavior in early childhood is related to body mass index (BMI) in
early childhood and through age 12, and to evaluate whether these associations differ by sex and race.
Methods: Data from the NICHD Study of Early Child Care and Youth Development were analyzed. Externalizing
behaviors at 24 months were assessed by mothers using the Child Behavior Checklist. BMI was calculated from
measured height and weight assessed 7 times between age 2 and 12 years. Linear mixed effects models were used to
assess associations between 24 month externalizing behavior and BMI from 2 to 12 years, calculate predicted
differences in BMI, and evaluate effect modification.
Results: Externalizing behavior at 24 months was associated with a higher BMI at 24 months and through age 12.
Results from a linear mixed effects model, controlling for confounding variables and internalizing behavior, predicted a
difference in BMI of approximately 3/4 of a unit at 24 months of age comparing children with high levels of
externalizing behavior to children with low levels of externalizing behavior. There was some evidence of effect
modification by race; among white children, the average BMI difference remained stable through age 12, but it
doubled to 1.5 BMI units among children w
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