(1) Background: Few studies have examined the relationship between neighborhood socioeconomic deprivation (SED) and weight-related outcomes in youth, controlling for weight-related behaviors. Hence, the purpose of this study was to examine the association between neighborhood SED, weight status, and fat mass in a diverse sample of youth, before and after controlling for physical activity and diet. (2) Methods: The sample included 828 youth from the Transitions and Activity Changes in Kids study. Neighborhood SED was expressed as an index score at the census tract of residence. Height, weight, and body composition were measured and used to calculate fat mass index (FMI) and weight status. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (min/h) were measured via accelerometry. Diet quality was assessed via the Block Food Screener for Kids. Multilevel regression models were employed to examine these relationships. (3) Results: Neighborhood SED was significantly associated with FMI and weight status before and after controlling for MVPA, sedentary behavior, and diet. Notably, youth residing in the most deprived neighborhoods had significantly higher FMI and were 30% more likely to be overweight/obese (OR = 1.30; 95% CI = 1.03–1.65). (4) Conclusions: Greater neighborhood SED was consistently and significantly associated with higher fat mass index and increased likelihood of overweight/obesity among youth.
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