A 4-Yr Mixed Longitudinal Study of Health Behaviors and Fat Mass Accrual during Adolescence and Early Adulthood

Jennifer McConnell-Nzunga, Leigh Gabel, Heather M. MacDonald, Ryan E. Rhodes, Scott M. Hofer, Patti Jean Naylor, Heather A. McKay

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose Physical activity (PA), sedentary time (SED), and energy intake (EI) are associated with fat mass accrual in children and youth. Previous studies relied primarily on cross-sectional designs and proxy measures of body composition such as body mass index. We aimed to prospectively investigate associations between PA, SED, EI, and total body fat mass accrual using dual-energy x-ray absorptiometry. Methods This analysis of the mixed longitudinal Healthy Bones III Study included data from 312 participants (138 boys age 9 to 21 yr at baseline). For each participant, we acquired a maximum of four annual total body dual-energy x-ray absorptiometry scans from which we determined fat mass (in kilograms; n = 748 observations). We assessed total PA, moderate-to-vigorous PA (MVPA) and SED with accelerometers (ActiGraph GT1M) and measured EI via 24-h dietary recall. We fit sex-specific multilevel models adjusting for maturity (years from age at peak height velocity (APHV)), weight status, ethnicity, total PA, MVPA, SED, and EI. Results Boys and girls demonstrated divergent trajectories of fat mass accrual; rate of fat mass accrual in girls was four times greater than boys at APHV and increased across adolescence, whereas boys' fat mass plateaued after APHV. In boys, within-person change in MVPA negatively predicted fat mass independent of SED; each annual increase in MVPA of 6 min·d-1 was associated with a 0.21-kg lower fat mass. In girls, between-person average MVPA negatively predicted fat mass accrual independent of SED; greater MVPA of 4 min·d-1 across adolescence was associated with a 0.31-kg lower fat mass. Conclusions MVPA demonstrates an independent and negative effect on fat mass in boys and girls. Given different trajectories of fat mass accrual and movement behaviors between boys and girls, PA interventions aimed at preventing obesity in youth may benefit from a sex and gendered approach.

Original languageEnglish (US)
Pages (from-to)2178-2187
Number of pages10
JournalMedicine and science in sports and exercise
Issue number12
StatePublished - Dec 1 2022



ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine


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