title: The association between overweight and internalizing and externalizing behavior in early childhood.
abstract: The 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.
  
  
  
  Longitudinal 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.
  
  
  
  Both 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.
  
  
  
  Behavior 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.
authors.affiliation: Centre for Child and Family Studies, Leiden University, The Netherlands.
authors.forename: Roxanna
authors.initials: R
authors.lastname: Camfferman
authors.affiliation: Institute of Psychology, Erasmus University Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC/Sophia, The Netherlands.
authors.forename: Pauline W
authors.initials: PW
authors.lastname: Jansen
authors.affiliation: Centre for Child and Family Studies, Leiden University, The Netherlands.
authors.forename: Ralph C A
authors.initials: RC
authors.lastname: Rippe
authors.affiliation: Centre for Child and Family Studies, Leiden University, The Netherlands. Electronic address: mesmanj@fsw.leidenuniv.nl.
authors.forename: Judi
authors.initials: J
authors.lastname: Mesman
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC/Sophia, The Netherlands; The Generation R Study Group, Erasmus MC/Sophia, The Netherlands.
authors.forename: Ivonne P M
authors.initials: IP
authors.lastname: Derks
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC/Sophia, The Netherlands; Department of Epidemiology, Erasmus MC/Sophia, The Netherlands.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.affiliation: The Generation R Study Group, Erasmus MC/Sophia, The Netherlands; Department of Epidemiology, Erasmus MC/Sophia, The Netherlands; Department of Pediatrics, Erasmus MC/Sophia, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jaddoe
authors.affiliation: Centre for Child and Family Studies, Leiden University, The Netherlands.
authors.forename: Shelley M C
authors.initials: SM
authors.lastname: van der Veek
mesh_terms: D050154:Adiposity; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002652:Child Behavior / Q000208:ethnology / Q000523:psychology*; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology / Q000208:ethnology; D050177:Overweight / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D012307:Risk Factors
keywords: Adiposity rebound; Early childhood; Externalizing behavior problems; Internalizing behavior problems; Longitudinal study; Overweight; The Netherlands