Cuypers et al. BMC Public Health 2012, 12:820 http://www.biomedcentral.com/1471-2458/12/820 Page 6 of 10 6 . 4 . 2 . 0 2 . - 4 . - 5 6 . 4 . 2 . 0 2 . - 4 . - 5 10 zbmi_high zbmi_low GPS12 15 Fitted values Fitted values 20 Figure 1 Z-scores of BMI with different genetic predisposition scores in low versus high culturally active individuals. Discussion Our data showed that adolescent girls who participated in cultural activities had less central adiposity eleven years later compared to girls who did not participate in such activities. However, participation in social leisure time activities predicted increased central adiposity in both girls and boys. In adolescent boys particularly, par- ticipation in social leisure time activities predicted higher overall adiposity at follow-up. Additionally, highly culturally active adolescents seemed to be better pro- tected against the effect of obesity-susceptibility genes when measured in young adulthood. Strengths of the present study are a general population sample and the 11 year follow-up of adolescents into adulthood (Additional file 1: Tables S2 and S3). The great mobility in this age group and consequently loss of follow-up participants was a challenge. However, com- parison of baseline data between participants and non- participants in the follow-up showed no essential differ- ences, suggesting no systematic selection bias (data not shown). Socio-economy might have an important influ- ence on participation in cultural and social activities, though adjusting for the socio-economic status in adult- hood did not change the results. Regression to the mean (RTM) in the two subsequent measurements may occur. In this way, the RTM-effect may have decreased the observed association. Although, a certain possible measurement error was likely to 10 zwaist_high zwaist_low GPS12 15 Fitted values Fitted values 20 Figure 2 Z-scores of Waist circumference with different genetic predisposition scores in low versus highly culturally active individuals.