The purpose of this study was to identify eating and physical activity patterns associated with overweight elementary school children in Fort Worth, Tex, by comparing those with the US Department of Agriculture (USDA) dietary guidelines and National Association for Sport and Physical Activity guidelines for children. Among 1018 participants, 56% were girls; the percentages of normal, risk of overweight, and overweight were 69.3%, 15.4%, and 14.9%, respectively. Most of the children were Hispanic (56.1%). Only 25% and 8.7% of all children met the USDA guidelines for fruits and vegetables, respectively. More girls met USDA guidelines for fruit and vegetable servings than boys, whereas more boys met the National Association for Sport and Physical Activity guidelines than girls. Engaging in physical activity more than 1 hour a day significantly decreased the likelihood of being at risk for overweight or overweight (adjusted odds ratio for overweight, 0.59; risk of overweight, 0.66). African American children were almost twice more likely to be overweight than white children (odds ratio, 1.98). © 2005 Elsevier Inc. All rights reserved.