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OBJECTIVE: This study assessed predictors of change in girls' body mass index (BMI) between ages 5 and 7 y and familial aggregation of risk factors associated with childhood overweight. METHOD: Participants included 197 5-y-old girls and their parents, of whom 192 were reassessed when girls were 7-y-old. Three classes of predictors of girls' change in BMI were assessed including girls' and parents' weight status, dietary intake and physical activity. Girls' and parents' BMI and change in BMI were calculated based on height and weight measurements. Girls' dietary intake was assessed using three 24 h recalls; parents' intake was assessed using a food frequency questionnaire. Girls and mothers provided reports of girls' physical activity; parents' frequency and enjoyment of activity were assessed using a self-administered questionnaire. RESULTS: The most effective model predicting girls' change in BMI between ages 5 and 7 included both child and parent characteristics, specifically girls' BMI at age 5, mothers' change in BMI, fathers' energy intake, fathers' enjoyment of activity, and girls' percentage of energy from fat. In addition, results showed substantial intra-familial associations in weight status and dietary intake and to a lesser extent physical activity, and the presence of multiple risk factors within families. Associations were also noted between girls' and parents' change in BMI. CONCLUSIONS: Results from this study highlight the centrality of the family in the etiology of childhood overweight and the necessity of incorporating parents in the treatment of childhood overweight.
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