Fitness and fatness in relation with attention capacity in European adolescents: The HELENA study

Assessment of physical activity among adolescents: a guide to the literature

Purpose

The aim of this article is to systematically review articles and annual reports concerning young peoples' physical activity (PA) and linking this to considerations of the state and national defense.

Method

A systematic search of the literature included an analysis of publications accessible in global databases and other available books, student papers, and projects. The articles and reports were categorized based on year of publication, methods used, age of respondents, sample size, country, and digital object identifier (DOI).

Results

The result of this search is an overview of the extent and manner in which the worldwide scientific community is addressing the current situation and the long-term development of the physical fitness of adolescents. This publication also maps to what extent professional publications and articles are addressing PA from the perspective of the needs of armies and armed forces of various countries around the world.

Conclusions

The article provides a systematic overview of methods used to measure PA, and an overview of articles dealing with assessing PA. The examined articles indicate that from the perspective of not only national defense, but also health and overall quality of life, in particular, we need initiatives to encourage and motivate young people to increase their everyday PA. The research therefore also includes an overview of factors that may considerably influence PA. The results ascertained in this publication will be used, i.a. for investigating a longitudinal defense research project of the Ministry of Defense of the Czech Republic in which the authors are participating.

Physical Fitness Plays a Crucial Mediator Role in Relationships Among Personal, Social, and Lifestyle Factors With Adolescents' Cognitive Performance in a Structural Equation Model. The Cogni-Action Project

Background: The beneficial relationship between physical fitness and cognitive performance is affected and modulated by a wide diversity of factors that seem to be more sensitive during the development stage, particularly during early adolescence. This study aimed to examine the role of physical fitness considering the multivariate association between age, health-related quality of life (HRQOL), school vulnerability index (SVI), body mass index z-score (BMIz), physical activity, and sleep problems with the cognitive performance in boys and girls. Method: Participants were 1,196 adolescents aged 10-14 years (50.7% of boys) from Chile. Three physical fitness components and eight cognitive tasks were measured. BMIz was determined using growth references by age and sex, whereas questionaries were used to assess sleep problems, physical activity, and HRQOL. SVI was established according to the score given by the Chilean Government to educational establishments. We performed a structural equation model (SEM) to test multivariate associations among study' variables by sex. Results: Fitness was positively associated with boys' and girls' cognitive performance (β = 0.23 and β = 0.17; p = 0.001, respectively). Moreover, fitness presented a significant mediator role in the relationships between BMIz, SVI, and physical activity with cognitive performance (indirect effect). Additionally, SVI showed a negative association both direct and indirect effect in all three fitness components and all cognitive tasks, being this relationship stronger in girls than in boys. Conclusion: Our findings suggest that physical fitness and all its components play a crucial mediator role in the associations between several factors associated with adolescents' cognitive performance. Thereby, educational and health strategies should prioritise improving physical fitness through physical activity. They also should address other factors such as school vulnerability, obesity, and the early gender gap in a comprehensive approach boosting cognitive performance among early adolescents. Trial registration: Research Registry (ID: researchregistry5791).

Physical fitness and its association with cognitive performance in Chilean schoolchildren: The Cogni-Action Project

This study aimed to establish the association and differences in a diversity of cognitive domains according to cardiorespiratory fitness (CRF), muscular fitness (MF), and speed-agility fitness (S-AF) level in a large sample of Chilean schoolchildren. 1171 Chilean schoolchildren aged 10-14 years participated. CRF, MF, and S-AF were assessed through the ALPHA-fitness test battery. Cognition was evaluated through the NeuroCognitive Performance Test, which involved eight tests related to four main domains: cognitive flexibility (CF), working memory (WM), inhibitory control (IC), and intelligence (IN). Both global (multivariate) and individual (univariate) analyses were performed to determine the differences in cognitive functioning according to low-, middle-, and high-fitness level. The global analyses showed a significant main effect for CRF, F_(16,940)  = 3.08, p ≤ .001 and MF groups, F_(16,953)  = 2.30, p = .002, but not for S-AF, F_(16,948)  = 1.37, p = .105. CRF shows a significant main effect in seven of eight tests, involving CF, WM, IC, and IN domains, whereas MF shows a significant main effect in five of eight tests without association with IN. SA-F shows a significant main effect only with IC. Statistical differences were found between the low- and middle/high-fitness groups but not between the middle- and high-fitness groups. At a global level, both CRF and MF seem to be associated with a higher cognitive profile in scholars; however, at an individual level, all fitness components show a favorable relationship to some cognitive domine. Then, future cognitive developing strategies should consider all fitness components, prioritizing those low-fitness schoolchildren.

Association between cardiorespiratory fitness and depressive symptoms in children and adolescents: A systematic review and meta-analysis

Background Higher cardiorespiratory fitness (CRF) is associated with lower depressive symptoms in adults. However, no systematic review with meta-analysis assessed the cross-sectional associations between CRF and depressive symptoms in children and adolescents. Therefore, this meta-analysis assessed the relationship between CRF and depressive symptom in these populations. Methods Cross-sectional data evaluating the correlation between CRF and depression were searched, from database inception through 21/05/2020, on PubMed, PsycINFO, Web of Science, and SPORTDiscus. Age, sex, CRF and depression assessments, and correlations were extracted. A random-effects meta-analysis was conducted, and the potential sources of heterogeneity were also explored through meta-regression analysis. Results Across 14 effects of 11 unique studies, including a total of 7,095 participants (median age=12.49) with nearly equal sex distribution (median=53% females), it was found that higher CRF was associated with lower depressive symptoms in children and adolescents (r =-0.174, 95%CI -0.221 to -0.126, p<0.001, I²=75.09, Q value=52.19). No moderators were identified. Conclusion Available evidence supports the notion that higher CRF is inversely associated with depressive symptoms in children and adolescents. Physical activity and exercise interventions targeting improving CRF should be promoted for these populations. Further studies, including clinical populations, should be conducted to assess objective measures of aerobic fitness and body composition, while controlling for puberty status, to better characterize this association.

Physical activity and aerobic fitness show different associations with brain processes underlying anticipatory selective visuospatial attention in adolescents

Current knowledge about the underlying brain processes of exercise-related benefits on executive functions and the specific contributions of physical activity and aerobic fitness during adolescence is inconclusive. We explored whether and how physical activity and aerobic fitness are associated with the oscillatory dynamics underlying anticipatory spatial attention. We studied whether the link between physical exercise level and cognitive control in adolescents is mediated by task-related oscillatory activity. Magnetoencephalographic alpha oscillations during a modified Posner's cueing paradigm were measured in 59 adolescents (37 females and 22 males, 12-17 years). Accelerometer-measured physical activity and aerobic fitness (20-m shuttle run test) were used to divide the sample into higher- and lower-performing groups. The interhemispheric alpha asymmetry during selective attention was larger in the high than in the low physical activity group, but there was no difference between the high and low aerobic fitness groups. Exploratory mediation analysis suggested that anticipatory interhemispheric asymmetry mediates the association between physical activity status and drift rate in the selective attention task. Higher physical activity was related to increased cue-induced asymmetry, which in turn was associated with less efficient processing of information. Behaviorally, more physically active males showed stronger dependence on the cue, while more fit females showed more efficient processing of information. Our findings suggest that physical activity may be associated with a neural marker of anticipatory attention in adolescents. These findings might help to explain the varying results regarding the association of physical activity and aerobic fitness with attention and inhibition in adolescents.

Physical Fitness, Selective Attention and Academic Performance in a Pre-Adolescent Sample

The purpose of the current study is to analyze the relationships between physical fitness, selective attention, and academic performance in pre-teens. The sample here consists of 135 participants between the ages of 10 and 12 (M = 11.05; SD = 0.61), with 39.26% female (n = 53) and 60.74% male (n = 82) participants. Horizontal and vertical jump distances, speed, and cardio-respiratory fitness were evaluated to assess physical fitness. The d2 Test of Attention was used to evaluate selective attention. In addition, data were obtained regarding participant academic performance by analyzing the academic performance. The results show significant relationships between the measures analyzed, highlighting positive associations between physical fitness, cognitive functioning, and academic performance. Thus, participants who were fitter scored better on tests of attention (Z₁₃₃ = −4.07; p < 0.00007, Cohen’s d = 0.75, 95% CI (0.39, 1.11)) and concentration (t₁₃₃ = −3.84; p < 0.0007, Cohen’s d = 0.69, 95% CI (0.33, 1.05)), as well as having higher academic performance (Z₁₃₃ = −2.84; p < 0.0035, Cohen’s d = 0.39, 95% CI (0.04, 0.75)). Cardiorespiratory fitness was the measure of physical fitness that best explained these relationships. The results suggest that maintaining and improving the physical fitness of children and adolescents may help their brain function develop better.

Association of Physical Fitness with Intelligence and Academic Achievement in Adolescents

Physical fitness, intelligence and academic achievement are being studied from a multidisciplinary perspective. In this line, studies to advance our understanding of intelligence and academic achievement could be relevant for designing school-based programs. Our study analyzed the relationship between components of physical fitness including cardiorespiratory fitness, muscular strength and flexibility and general intelligence and academic achievement in adolescents. We recruited 403 adolescents (53.6% boys) with a mean age of 13.7 ± 1.2 years from a secondary school in Spain with a medium socioeconomic status, during the 2015/2016 school year. Cardiorespiratory fitness was assessed by the 20-m shuttle run, muscular strength with the standing long jump test and flexibility with the sit-and-reach test. General intelligence was measured by both the D48 and the Raven tests. School grades were used to determine academic achievement. Linear regression analyses showed that cardiorespiratory fitness was positively associated with intelligence in both the D48 (all β ≥ 0.184, p ≤ 0.016) and the Raven tests (all β ≥ 0.183, p ≤ 0.024). Muscular strength, flexibility and overall fitness were not associated with intelligence (all β ≤ 0.122, p ≥ 0.139). Cardiorespiratory fitness, muscular strength and flexibility were positively associated with academic achievement (all β ≥ 0.089, p ≤ 0.038), except muscular strength, which was not significantly associated with Spanish language or mathematics, (all β ≤ 0.050, p ≥ 0.200). Overall, cardiorespiratory fitness was positively associated with intelligence and academic achievement.

Physical Exercise, Fitness, Cognitive Functioning, and Psychosocial Variables in an Adolescent Sample

The objective of this paper was to evaluate the relationship between physical exercise and physical fitness with cognitive and psychosocial functioning in a group of adolescents. 167 teenagers between 14 and 15 years old (M = 14.53; SD = 0.50) from the city of Malaga (Spain) participated in the study. This research used a comparative and predictive type of design. The Tanita® Body Composition Monitor BC-601, some Eurofit battery tests, the D2 Attention Test, the WISC-IV Scale Symbols and Keys tests, the Form 5 Self-Concept Questionnaire (AF5), the General Self-Efficacy Scale (GSE) and the General Health Questionnaire (GHQ-28) were used to evaluate the study variables. The results found in this research pointed to a positive relationship between physical exercise and physical fitness with cognitive and psychosocial functioning in the adolescents analyzed. For example, adolescents who practiced more physical exercise had better scores on variables such as selective attention (p < 0.001; η2 = 0.10), processing speed (p < 0.001; η2 = 0.09) or general self-efficacy (p < 0.001; η2 = 0.15). In addition, cardiorespiratory fitness was the best predictor of test scores to assess cognitive ability and psychosocial variables. These findings suggest the need to promote physical exercise among young people because of its implications for various facets of their health and development.

48-Hour Effects of Monitored Cooperative High-Intensity Interval Training on Adolescent Cognitive Functioning

Physical activity has been positively related to better cognitive performance though the effects of varied exercise type and intensity and the duration of cognitive benefits are unclear. This study analyzed the effect of 16 minutes of monitored cooperative high-intensity interval training (monitored C-HIIT) at the start of the school day, on various cognitive variables over the next 24-48 hours. We randomly assigned 158 participants either to a control group ( n = 81) that engaged only in static stretching or to an experimental group ( n = 77) that performed monitored C-HIIT. We assessed cognitive functioning before the exercise, immediately afterward, and for five follow-up time points over the next two days (i.e., at 2, 3, 4, 24, and 48 hours). We analyzed age, sex, body mass index, and moderate-to-vigorous physical activity as potential confounder variables. Adolescents in the monitored C-HIIT group increased selective attention by 17.39% during the next hour ( p = .015) and increased concentration by 20.31% and 15.26% during the first ( p = .022) and second ( p = .059) subsequent hours, respectively. This positive short-term benefit of monitored C-HIIT during immediate subsequent hours is an important finding with implications for the school curricula and schedule.

Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial

Background

A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia.

Methods/design

Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program.

Discussion

The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.

Trial registration

ClinicalTrials.gov, NCT02753231. Registered on 21 April 2016.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2721-5) contains supplementary material, which is available to authorized users.

Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial

BACKGROUND

The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD.

METHODS

This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-β = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up.

DISCUSSION

This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00011666. Registered on 9 February 2017. ClinicalTrials.gov, NCT03371810. Registered on 13 December 2017.

Fitness Level Modulates Intraocular Pressure Responses to Strength Exercises

Purpose/Aim: The execution of strength exercises has demonstrated to increase the intraocular pressure (IOP) levels, and it may have a negative impact on the ocular health. We aimed to explore the influence of fitness level on the acute IOP response to strength exercises performed under different loading conditions, as well as to test whether the IOP responses differ between the bench press and jump squat when performed against the same relative loads.

MATERIALS AND METHODS

Forty military personnel males were divided in two subgroups (20 high-fit and 20 low-fit) based on their relative to body mass one-repetition maximum (1-RM). Participants performed an incremental loading test in the bench press and jump squat exercises, and IOP was assessed before and after each repetition by rebound tonometry.

RESULTS

IOP increased immediately after executing both exercises (p < 0.01 in both cases), being the magnitude of the IOP increment positively and linearly associated with the increment of the load in both groups (i.e., high-fit and low-fit) and in both exercises (R² range: 0.81-1.00). Higher fitness level attenuated the IOP rise produced by both exercises (p < 0.01 in both cases). The bench press induced higher IOP increments than the jump squat for both groups at relative loads of ~50%1-RM and ~60%1-RM (p < 0.01 in all cases).

CONCLUSIONS

These data indicate that IOP increases as a consequence of performing strength exercises, being the increment accentuated with the increase of the load and in the bench press compared to the jump squat exercise. Of special importance would be that the IOP responses were significantly reduced in high-fit individuals. These findings should be addressed in glaucoma patients.

Attention capacity in European adolescents: role of different health-related factors. The HELENA study

We compared the level of attention capacity between adolescents from the center and south of Europe. The study included 627 European adolescents (54% girls), aged 12.5-17.5 years, who participated in the HELENA Study. The d2 Test of Attention was administered to assess attention capacity. The main results showed that adolescents from the south of Europe had significantly higher score in attention capacity compared with adolescents from central Europe (score + 8.1; 95%CI, 2.44-13.61) after adjustment for age, sex, socioeconomic indicators, body mass index, cardiorespiratory fitness and diet quality index (p = 0.012).

CONCLUSION

Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from central Europe independently of sociodemographic and health-related factors. These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities. What is Known? • Attention is a crucial capacity during adolescence. • Several health-related factors (i.e., physical activity, fitness or fatness) may influence attention capacity in adolescents. What is New? • Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from the center, after accounting for socioeconomic factors, fitness, fatness and quality of diet. • These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student's capacities.

Diet quality and attention capacity in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

Adolescence represents an important period for the development of executive functions, which are a set of important cognitive processes including attentional control. However, very little is known regarding the associations of nutrition with components of executive functions in adolescence. Thus, the aim of this study was to investigate associations of dietary patterns and macronutrient composition with attention capacity in European adolescents. This cross-sectional study included 384 (165 boys and 219 girls) adolescents, aged 12·5-17·5 years, from five European countries in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Attention capacity was examined using the d2 Test of Attention. Dietary intake was assessed through two non-consecutive 24 h recalls using a computer-based self-administered tool. Three dietary patterns (diet quality index, ideal diet score and Mediterranean diet score) and macronutrient/fibre intakes were calculated. Linear regression analysis was conducted adjusting for age, sex, BMI, maternal education, family affluence scale, study centre and energy intake (only for Mediterranean diet score). In these adjusted regression analyses, higher diet quality index for adolescents and ideal diet score were associated with a higher attention capacity (standardised β=0·16, P=0·002 and β=0·15, P=0·005, respectively). Conversely, Mediterranean diet score or macronutrient/fibre intake were not associated with attention capacity (P>0·05). Our results suggest that healthier dietary patterns, as indicated by higher diet quality index and ideal diet score, were associated with attention capacity in adolescence. Intervention studies investigating a causal relationship between diet quality and attention are warranted.