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Background: Frequent switching between foods at a snack has been associated with greater intake and higher weight status in children; however, it is unknown if switching behavior predicts adiposity gains over time. Thus, we examined the association between switching behavior and adiposity gains over 1 year in children varying in familial risk of obesity. Methods: Children primarily of healthy-weight (34F, 7-8 years at baseline) were classified as having high-familial risk (n = 28; maternal BMI: >29 kg/m2) or low-familial risk (n = 39; maternal BMI: 18-25 kg/m2) for obesity. Baseline and 1-year follow-up fat mass were assessed via dual x-ray absorptiometry (DXA). Fat mass index (FMI; fat mass, kg/height, m2) was used to account for variations in height across time. Across 4 visits at baseline, children were videotaped while consuming ad libitum meals of chicken, pasta, grapes, and broccoli varying in portion size. Each shift between foods was counted as a switch. Switch number was consistent within children across portions (ICCs from 0.64 to 0.81 across meals); thus, switching behavior was defined as the average number of switches across meals. Results: A linear regression adjusting for baseline FMI and age, food liking, sex, and time between DXA tested the effect of switching behavior on change in FMI. Switching (Mean ± SD = 11.4 ± 8.4) was positively associated with FMI change (ß = 0.02, p = 0.03). For a child at average height, each additional 10 switches was associated with an increase in fat mass of ~1 lb. Further, there was an interaction between obesity risk and switching (p = 0.02); switching was more strongly associated with increased FMI among high-risk (ß = 0.06, n < 0.01) than low-risk (ß = 0.02, n = 0.02) children. Conclusions: Switching behavior predicted 1-year increases in FMI, particularly in children at high familial risk of obesity. Frequent switching facilitates dynamic exposure to various sensory properties which may delay sensory-specific satiety and increase intake. Over time, this may contribute to adiposity gains.