Associations between obesity and developmental functioning in pre-school children: a population-based study

The Neglected Factor in the Relationship between Executive Functioning and Obesity: The Role of Motor Control

Background: The association between obesity and executive functions (EFs) is highly controversial. It has been suggested that waist circumference (WC), compared to body mass index (BMI), is a better indicator of fat mass and EFs in obesity. Moreover, according to the viewpoint that the brain’s functional architecture meets the need for interactive behavior, we hypothesize that the relationship between EFs and body weight might be mediated by the motor performance. Methods: General executive functioning (frontal assessment battery-15), additional cognitive subdomains (trail making test and digit span backward), and motor performance (finger tapping task) were assessed in a sample that included 330 volunteers (192 females, M age = 45.98 years, SD = 17.70, range = 18–86 years). Results: Hierarchical multiple regression analysis indicated that the FAB15 score and FTT negatively predicted WC but not BMI. A subsequent mediation analysis highlighted that the indirect effect of FAB15 on WC through finger tapping was statistically significant. Conclusions: Our results suggest that WC, as compared to BMI, is a more effective measure for studying the association between EFs and body weight. Still, we found that the motor domain partially mediates the dynamics of such a relationship.

Dysmetabolism and Neurodegeneration: Trick or Treat?

Accumulating evidence suggests the existence of a strong link between metabolic syndrome and neurodegeneration. Indeed, epidemiologic studies have described solid associations between metabolic syndrome and neurodegeneration, whereas animal models contributed for the clarification of the mechanistic underlying the complex relationships between these conditions, having the development of an insulin resistance state a pivotal role in this relationship. Herein, we review in a concise manner the association between metabolic syndrome and neurodegeneration. We start by providing concepts regarding the role of insulin and insulin signaling pathways as well as the pathophysiological mechanisms that are in the genesis of metabolic diseases. Then, we focus on the role of insulin in the brain, with special attention to its function in the regulation of brain glucose metabolism, feeding, and cognition. Moreover, we extensively report on the association between neurodegeneration and metabolic diseases, with a particular emphasis on the evidence observed in animal models of dysmetabolism induced by hypercaloric diets. We also debate on strategies to prevent and/or delay neurodegeneration through the normalization of whole-body glucose homeostasis, particularly via the modulation of the carotid bodies, organs known to be key in connecting the periphery with the brain.

Longitudinal Effects of Excessive Weight and Obesity on Academic Performance of Primary School Boys in Different Socio-Economic Statuses: The NW-CHILD Study

Obesity affects millions of children worldwide and can often impact their academic performance. This longitudinal study, conducted over seven years, determines the effects of excessive weight and obesity on the academic performance of primary school boys, taking into account their socio-economic status (SES). The study forms part of a seven-year (2010–2016) longitudinal study, the North-West Child-Health-Integrated-Learning and Development (NW-CHILD) study, which includes a baseline measurement and two follow-up measurements of the 181 participants from varying areas in the North West Province. Two-way frequency tables, repeated measure ANOVA’s and Spearman rank order correlations were used to analyze the data. The Body Mass Index (BMI) of the participants reported an increase from 2010–2016. Nearly all of the school subjects reported small to large correlations between BMI and academic performance (r ≥ 0.1 and r ≥ 0.3), except for Afrikaans in 2013 (r = −0.06). Only two subjects (English and Language as tested with the ANA test) reported medium effects (r ≥ 0.3), whereas the other subjects only reported small effects (r ≥ 0.1). No statistically significant relationships (p ≥ 0.05) were observed between the BMI values and academic subjects, however SES and school subject scores reported several statistically significant relationships, especially regarding Language (English and First Additional Language) and Mathematics (p = 0.02). Overweight and obese primary school boys in the North West Province of South Africa reported a higher academic performance in comparison to boys of a normal weight, even when SES was taken into consideration. Further studies are recommended to verify current findings regarding weight, obesity and academic performance.

Association of Family Nutrition and Physical Activity with Preschooler's Working Memory: A Cross-Sectional Study among Mexican Children

Healthy eating and active lifestyles are associated with children’s healthy weight and cognitive development. This study examines whether family behaviors relevant for nutrition and activity levels are associated with children’s working memory, independent of their weight status. A convenience sample of child–caregiver dyads (n = 85 dyads) were recruited from a public preschool serving a low-income community in central Mexico. Caregivers reported the frequency of ten family behaviors using the Family Nutrition and Physical Activity screening tool. Children completed a test of their ability to recall four words after a 60-s distraction task, an assessment of working memory. Multiple linear regression models were used to test the association of children’s working memory with each family behavior, adjusting for children’s sex, age, mother’s age and education, and subjective social status and then also adjusting for children’s age- and sex-specific body mass index percentile (BMI-P) and covariates. Higher frequency of breakfast intake was significantly associated with working memory (β = 0.57, p = 0.013). This association was independent of children’s BMI-P. Other family behaviors (frequent family mealtimes, limiting screen time, and others) were not significantly associated with children’s working memory. Frequent breakfast intake could benefit young children’s working memory, regardless of their weight status. This association merits further investigation.

Association between Creativity and Memory with Cardiorespiratory Fitness and Lifestyle among Chilean Schoolchildren

The objective was to investigate the association between creativity and memory with cardiorespiratory fitness (CRF; i.e., CFR classification and V˙O_2max); lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits); and anthropometric measures (i.e., body mass index (BMI), waist circumference (WC)) among Chilean schoolchildren. A total of 248 schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated in the cross-sectional study. Creativity, memory, concentration, and selective attention and lifestyle (PA, ST, sleep duration, and Mediterranean diet (MD) adherence) were measured using a standard questionnaire. CRF (measured by the 20 m shuttle run test and expressed as maximum oxygen consumption (V˙O_2max) and anthropometric measures (BMI and WC) were also included. Creativity showed a positive association with V˙O_2max (mL/kg/min) (β; 0.209, 95% CI; 0.02-0.40, p = p < 0.05) and MD Adherence (score) (β; 0.206, 95% CI; 0.01; 0.74, p = p < 0.05). Long-term memory reported a positive association with CRF (β; 1.076, 95% CI; 0.02-2.13, p = p < 0.05). An increase in CRF levels, together with healthy food habits and normal nutritional status, should be a target for community- and school-based interventions to promote cognitive development in creativity and memory among schoolchildren.

Bidirectional association of neurodevelopment with growth: a prospective cohort study

BACKGROUND

The study aims to use the cross-lagged model and utilize data from the Born in Shenyang Cohort Study to characterize the bidirectional associations of the term-born infants' neurodevelopment in five domains and physical growth in early life.

METHOD

This study consists of 688 mother-child dyads from the Born in Shenyang Cohort Study. Infants' anthropometric (weight and length) and development in neurological outcomes (Gesell Development Scale) were measured at the age of 6 and 12 months. Cross-lagged analyses and multiple linear regression analyses were used to explore the longitudinal relationships in both directions.

RESULTS

In terms of longitudinal studies, the inverse associations between infants' two skills (gross motor and social behavior) at the age of 6 months with BMI Z -scores at the age of 12 months (gross motor: aβ = - 0.20, 95% CI: - 0.31 to- 0.09; social behavior: aβ = - 0.23, 95% CI: - 0.33 to- 0.13) were found. Conversely, a higher infant Z -scored BMI at the age of 6 months predicted a lower gross motor at the age of 12 months (aβ = - 0.08, 95% CI: - 0.12 to- 0.04). In cross-lagged analyses, an adverse association in both directions between gross motor and Z -scored BMI was observed.

CONCLUSION

We found bidirectional relationships between infants' neurodevelopment of gross motor with physical growth and suggested the term-born infants, who are on the edge of the developmental danger, should not be overlooked.

Secular Changes in Body Build and Body Composition in Czech Preschool Children in the Context of Latent Obesity

Changes in lifestyle can be significantly reflected in growth and development. Adaptations to reduced levels of physical activity, together with non-corresponding nutritional intakes, can result in body build and body composition changes at an early age. The present cross-sectional study aimed to evaluate the secular trend of modifications of body composition and body mass index (BMI) in Czech preschoolers over the last two to three decades. Boys and girls (386 boys and 372 girls) aged 4 to 6 years in 2014–2019 were measured. Outcome data were compared with the reference sample of preschoolers from 1990: 911 boys and 896 girls. Body height, BMI, and percentage of body fat, muscle, and bone mass were evaluated. Height and BMI have not changed. Body fat increased in both genders (p < 0.01), and contrarily, a significant reduction of muscle and skeletal mass was revealed (p < 0.001). Significant changes in body composition and unchanged BMI indicate the development of latent obesity during the last few decades. Due to latent obesity in a recent cohort, the differences in the prevalence of overweight and obesity markers according to BMI and fat percentage were tested. The prevalence of overweight and obesity was higher by 7.2% in boys, and by 6.5% in girls, as compared to children evaluated according to only their BMI results. Secular changes in preschoolers’ physical builds over the last 25 years are not reflected in body height and BMI, but in body composition. Insufficient development of active, lean body mass proportionally compensated by increased fat mass was also indicated.

Delayed motor skills associated with pediatric obesity

OBJECTIVE

To review the literature regarding associations between developmental motor delay (DMD) and pediatric obesity. We hope to identify potential interventions that can improve motor coordination at an early age, thereby minimizing the deterring factors of physical activity down the road.

DESIGN

An integrative review was undertaken using search combinations to best identify potential publications. Manuscripts were reviewed, summarized, and discussed in detail. An experienced clinician in pediatric obesity reviewed the final searches for substantive content.

CRITERIA

Inclusion criteria include English language studies or publications, children ≤18 years old, publication/study relates to DMD and pediatric obesity. Excluded publications regarded topics of pediatric obesity that have been extensively studied such as maternal and family histories of obesity, isolated nutritional or physical interventions to improve obesity without discussion of DMD.

RESULTS

21 publications were included for review. Papers fell into three main categories regarding the association between pediatric obesity and DMD: 1) Motor function - negative association with motor function and obesity 2) Motor Development - lower levels of motor function are associated with decreased levels of exercise, and 3) Role of Intervention - specific physical activity intervention showed improvements in motor function.

CONCLUSIONS

Motor function deficits appear to be associated with obesity. However, it is not well understood if children with obesity have delayed motor skills as a consequence of their weight or if the DMD is a risk factor for the development of obesity; existing studies do not provide an answer.

Exclusive Breastfeeding Predicts Higher Hearing-Language Development in Girls of Preschool Age

Cognitive disorders are increasing in prevalence. Nutritional or metabolic stressors during early life, and female sex, are predisposing conditions towards the development of cognitive diseases, including Alzheimer’s disease. Though there is evidence that breastfeeding may play a beneficial role in children’s neurocognitive development, the literature remains controversial. In this study we aimed at assessing the association between exclusive breastfeeding and children’s cognitive development from six months to five years of age, addressing sex differences. In 80 mother-child pairs from the Pisa birth cohort (PISAC), we measured cognitive development in groups of children of 6, 12, 18, 24, 36, and 60 months by Griffiths Mental Development Scales, parents’ intelligence quotient (IQ) by Raven’s progressive matrices, and maternal and infants’ anthropometric parameters. We found that exclusive breastfeeding was associated with higher hearing-language development in five years old girls, independent of maternal IQ, age and BMI (body mass index). Exclusive breastfeeding in the first three months of life seemed sufficient to establish this positive relationship. In conclusion, our data indicate that exclusive breastfeeding is a positive predictor of cognitive development in preschool-age girls, paving the way for the implementation of sex-specific cognitive disease risk detection and prevention strategies from early life. Further studies are warranted to explore causality and longer term effects.

Season of birth and sugary beverages are predictors of Raven's Standard Progressive Matrices Scores in adolescents

To investigate factors associated with cognitive functioning in healthy adolescents, a school-based cross-sectional study was conducted on 1370 adolescents aged 11–16 years that were randomly selected from all governorates of Kuwait. Raven’s Standard Progressive Matrices (SPM), a non-verbal test of intelligence, was used to measure cognitive functioning of the study participants. Data on predictors of cognitive functioning were collected from parents and adolescents. Weight and height of the participants were measured in a standardized manner and blood samples were tested in an accredited laboratory under strict measures of quality control. In multivariable linear regression analysis, factors that showed significant association with the SPM score were gender (p = 0.002), season of birth (p = 0.009), place of residence (p < 0.001), father’s (p < 0.001) and mother’s (p = 0.025) educational level, type of housing (p < 0.001), passive smoking at home (p = 0.031), sleeping hours during weekends (p = 0.017), students’ educational level (p < 0.001) and the frequency of consumption of sugary drinks (p < 0.001). The link between cognitive functioning and season of birth seems to be robust in various geographical locations including the Middle East. The association between sugary drinks and cognitive functioning highlights the importance of diet independently of obesity and support efforts to reduce consumption of sugary drinks among children.

Infant Motor Milestones and Childhood Overweight: Trends over Two Decades in A Large Twin Cohort

BACKGROUND

Poor motor skill competence may influence energy balance with childhood overweight as a result. Our aim was to investigate whether the age of motor milestone achievement has changed over the past decades and whether this change may contribute to the increasing trend observed in childhood overweight.

METHODS

Motor skill competence was assessed in children from the Young Netherlands Twin Register born between 1987 and 2007. Follow-up ranged from 4 up to 10 years. Weight and height were assessed at birth, 6 months, 14 months, and 2, 4, 7, and 10 years.

RESULTS

Babies born in later cohorts achieved their motor milestones 'crawling', 'standing', and 'walking unassisted' later compared to babies born in earlier cohorts (N = 18,514, p < 0.001). The prevalence of overweight at age 10 was higher in later cohorts (p = 0.033). The increase in overweight at age 10 was not explained by achieving motor milestones at a later age and this persisted after adjusting for gestational age, sex, and socioeconomic status.

CONCLUSION

Comparing children born in 1987 to those born in 2007, we conclude that children nowadays achieve their motor milestones at a later age. This does not however, explain the increasing trend in childhood overweight.

Obesity is associated with poor working memory in women, not men: Findings from a nationally representative dataset of U.S. adults

A growing body of research has linked obesity to lower working memory performance. However, sex differences are often found in associations between obesity and cognition, and little work has examined potential sex differences in the association between obesity and working memory. To address this issue, the present research uses data from Wave IV of The National Longitudinal Study of Adolescent to Adult Health (N = 4,769, mean age = 29) to examine whether sex moderated the association between excess weight and working memory. As expected, we found that obesity was associated with poorer working memory, but-importantly-this association was exclusively seen in women, not men. These results held when treating BMI as a continuous or categorical variable (e.g., normal weight, obese), as well as with and without controlling for covariates. The present results therefore indicate that the association between obesity and poorer working memory performance may be sex-dependent. These results suggest that interventions targeted at reducing obesity should be tailored to an individual's sex, as adherence to these interventions often requires working memory.

Level of body fat relates to memory decline and interacts with age in its association with hippocampal and subcortical atrophy

Higher levels of body fat have shown adverse effects on multiple aspects of health, including cognitive and neuroanatomical changes. We tested the relationships of body fat levels and cholesterol to longitudinal age trajectories of subcortical gray matter volume (SCV), hippocampal volume (HCV), and episodic memory. Body fat was indexed by a concerted factor of BMI, visceral adipose tissue, percentage body fat, and total fat mass and was included in the analyses as a cross-sectional measure. We hypothesized that higher level of body fat would be related to steeper age trajectories of SCV, HCV, and memory. The sample consisted of 581 participants (20-83 years) with 942 magnetic resonance imaging and 945 memory examinations. Using generalized additive mixed models, a negative effect of body fat was found on SCV, HCV, and memory. Age and body fat interacted in their association with brain volume change. The results suggest that among cognitively healthy adults, there is a negative effect of higher body fat on SCV, HCV, and memory decline, an effect that increased with age for the neuroanatomical volumes.

Longitudinal associations of gross motor development, motor milestone achievement and weight-for-length z score in a racially diverse cohort of US infants

OBJECTIVES

To investigate longitudinal associations between gross motor development, motor milestone achievement and weight-for-length z scores in a sample of infants. In a secondary aim, we explored potential bidirectional relationships, as higher weight-for-length z scores may impede motor development, and poor motor development may lead to obesity.

DESIGN

The design was an observational birth cohort.

SETTING

We used data from the Nurture study, a birth cohort of predominately black women and their infants residing in the Southeastern USA.

PARTICIPANTS

666 women enrolled their infants in Nurture. We excluded infants with missing data on exposure, outcome or main covariates, leaving a total analytic sample of 425 infants.

PRIMARY OUTCOME

The outcome was weight-for-length z score, measured when infants were 3, 6, 9 12 months.

RESULTS

Among infants, 64.7% were black, 18.8% were white and 16.9% were other/multiple race. Mean (SD) breastfeeding duration was 17.6 (19.7) weeks. Just over one-third (38.5%) had an annual household income of < $20 000. After adjusting for potential confounders, higher motor development score was associated with lower weight-for-length z score (-0.004; 95% CI -0.001 to -0.007; p=0.01), mainly driven by associations among boys (-0.007; 95% CI -0.014 to -0.001; p=0.03) and not girls (0.001; 95% CI -0.005 to 0.008; p=0.62). Earlier crawling was the only milestone associated with a lower weight-for-length z score at 12 months (-0.328; 95% CI -0.585 to 0.072; p=0.012). However, this association appeared to be driven by male infants only (-0.461; 95% CI -0.825 to -0.096; p=0.01). Weight-for-length z score was unrelated to subsequent motor development score and was thus not bidirectional in our sample.

CONCLUSIONS

Higher motor development score and earlier crawling were associated with lower subsequent weight-for-length z score. However, this was primary true for male infants only. These findings contribute to the growing body of evidence suggesting that delayed motor development may be associated with later obesity.

Executive and Reward-Related Function in Pediatric Obesity: A Meta-Analysis

OBJECTIVE

This study examined the effect of pediatric obesity on executive function and reward-related decision-making, cognitive processes that are relevant to obesogenic behaviors, and evaluated their association with sample (e.g., age, gender, intelligence, and socioeconomic status, SES) and study/task (e.g., categorical/continuous variable, food stimuli) characteristics.

METHODS

A random-effects meta-analysis was conducted using Hedge's g effect sizes of published studies from 1960 to 2016, limited to children younger than the age of 21 years without medical comorbidities. Analysis included estimation of heterogeneity (τ²), publication bias (funnel-plot symmetry and fail-safe N), and sensitivity analyses for sample and study/task characteristics.

RESULTS

Across 68 studies with 70 samples, obesity was associated with worse functioning overall (-0.24; 95CI: -0.30 to -0.19; p < 0.001) and for each component process (attention, switching, inhibition, interference, working memory, reward, delay of gratification: -0.19 to -0.38; p's < 0.017), except trait impulsivity (-0.06; 95CI: -0.18 to 0.07). Deficits increased with age and female composition of the sample for inhibition (p = 0.002). No other characteristics moderated effect of obesity.

CONCLUSIONS

Small-to-moderate negative associations with obesity were observed for executive and reward-related performance, but not on reported impulsivity in studies with children younger than the age of 21 years. These results were not moderated by IQ, SES, and study/task characteristics. Age and gender moderated association with inhibition, with a larger obesity-related deficit in older and predominantly female samples. These results suggest cognitive and demographic intervention targets for prevention and mitigation of obesogenic behavior.

Associations of Body Mass Index, Motor Performance, and Perceived Athletic Competence with Physical Activity in Normal Weight and Overweight Children

Children who are overweight and obese display lower physical activity levels than normal weight peers. Measures of weight status, perceived motor competence, and motor skill performance have been identified as potential correlates explaining this discrepancy. 1881 children (955 males; 926 females; 9.9 years) were assessed as part of the Physical Health Activity Study Team project. The age, habitual physical activity participation (PAP), body mass index (BMI), socioeconomic status (SES), motor performance (MP), and perceived athletic competence (PAC) of each child included were assessed. Gender-specific linear regression analyses (main effects model) were conducted to identify the percent variance in PAP explained by the following variables: BMI, MP, and PAC. For males, 18.3% of the variance in PAP was explained by BMI, MP, and PAC. PAC explained 17% of the variance, while MP, BMI, and SES only accounted for 0.6%, 0.7%, and 0.5%, respectively. PAC explained 17.5% of PAP variance in females; MP explained 0.8%. BMI, SES, and chronological age were not significant correlates of PAP in girls. An established repertoire of motor skill performance has been seen as a vehicle to PAP in children; however, this study indicates that PAC should not be overlooked in intervention strategies to promote increased PAP.

Modeling relationships of achievement motivation and physical fitness with academic performance in Japanese schoolchildren: Moderation by gender

The aim of this study was to determine, using structural equation modeling, the comprehensive relationships of achievement motivation (self-fulfillment achievement motivation [SFAM] and competitive achievement motivation [CAM]), daily behaviors (exercise habits, screen time, and learning duration), body mass index [BMI], and cardiorespiratory fitness [CRF]) with academic performance among schoolchildren. Three hundred twenty-five schoolchildren (172 males and 153 females; 12-13 years old) were recruited. Academic performance was assessed using the total grade points in 8 academic subjects (GP8); CRF using the 20-m shuttle run; and achievement motivation, daily behaviors, and socioeconomic status using questionnaires. Socioeconomic status was included as a control variable. In males, two cascade associations of achievement motivation to GP8 were detected: (1) SFAM → screen time/learning duration → GP8, and (2) CAM → exercise habit → CRF → GP8 (χ² = 8.72, p = .19, AGFI = .92). In females, two cascade associations were also detected: (1) SFAM → screen time/learning habit → GP8, and (2) exercise habit → BMI² → GP8 (χ² = 6.17, p = .41, AGFI = .93). Our results suggest that greater achievement motivation is associated with academic success via various physiological/behavioral factors, and that these associations differ by gender.

Gross Motor Development in Children Aged 3-5 Years, United States 2012

Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p < 0.05). However, the mean locomotor standardized scores for both boys and girls fell into the range categorized as "average." There were no other differences by age, race/Hispanic origin, weight status, or income in either of the subtest standardized scores (p > 0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

Secular Changes of Adiposity in Czech Children Aged from 3 to 6 Years: Latent Obesity in Preschool Age

BMI, skinfold thickness, and circumferential measures were assessed in groups of normal healthy Czech boys (n = 1764) and girls (n = 1762) 3-6 years of age in the late 1950s and 1960s (sample C), in the 1990s (sample B), and in 2014-2016 (sample A). During these decades BMI has not changed significantly, and in selected groups (boys 3, 5, and 6, girls 3 and 6 years) it was most recently found to be significantly lower (P ≤ 0.05). Subscapular, suprailiac, triceps, midthigh, and above patella skinfold thicknesses significantly increased in sample A as compared to sample C (P ≤ 0.001). Comparison of the same skinfolds measured in the nineties (sample B) and more recently (sample A) showed similar increase of subcutaneous fat (P ≤ 0.001). The increase of adiposity characterized by skinfolds occurring in spite of not markedly changed BMI indicates significant changes of body composition-latent (also hidden) obesity. The increase of adiposity was relatively greatest on the trunk (P ≤ 0.001)-which is considered a marker of the greatest health risk. The decrease of femoral circumference (P ≤ 0.05) along with simultaneous increase of thigh skinfold (P ≤ 0.01) revealed the decrease of muscle mass in the lower extremity, obviously due to the reduction of weight-transferring physical activity.

Postural control strategies differ in normal weight and overweight infants

BACKGROUND

Evidence suggests obesity can have a negative influence on a child's motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting.

OBJECTIVE

The purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting.

METHODS

29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infant's length and weight were measured at 3 months of age (visit 1). Infant's center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions).

RESULTS

Overweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period.

CONCLUSIONS

These findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.

Childhood Obesity and Academic Performance: The Role of Working Memory

The present study examined the role of working memory in the association between childhood obesity and academic performance, and further determined whether memory deficits in obese children are domain-specific to certain tasks or domain-general. A total of 227 primary school students aged 10-13 years were analyzed for weight and height, of which 159 children (44 "obese," 23 "overweight," and 92 "normal weight") filled out questionnaires on school performance and socioeconomic status. And then, all subjects finished three kinds of working memory tasks based on the digit memory task in 30 trials, which were image-generated with a series of numbers recall trial sets. After each trial set, subjects were given 5 s to recall and write down the numbers which hand appeared in the trial, in the inverse order in which they had appeared. The results showed there were significant academic performance differences among the three groups, with normal-weight children scoring higher than overweight and obese children after Bonferroni correction. A mediation model revealed a partial indirect effect of working memory in the relationship between obesity and academic performance. Although the performance of obese children in basic working memory tests was poorer than that of normal-weight children, they recalled more items than normal-weight children in working memory tasks involving with food/drink. Working memory deficits partially explain the poor academic performance of obese children. Those results indicated the obese children show domain-specific working memory deficits, whereas they recall more items than normal-weight children in working memory tasks associated with food/drink.

Association between Body Composition and Motor Performance in Preschool Children

OBJECTIVE

Being overweight makes physical movement more difficult. Our aim was to investigate the association between body composition and motor performance in preschool children.

METHODS

A total of 476 predominantly normal-weight preschool children (age 3.9 ± 0.7 years; m/f: 251/225; BMI 16.0 ± 1.4 kg/m2) participated in the Swiss Preschoolers' Health Study (SPLASHY). Body composition assessments included skinfold thickness, waist circumference (WC), and BMI. The Zurich Neuromotor Assessment (ZNA) was used to assess gross and fine motor tasks.

RESULTS

After adjustment for age, sex, socioeconomic status, sociocultural characteristics, and physical activity (assessed with accelerometers), skinfold thickness and WC were both inversely correlated with jumping sideward (gross motor task β-coefficient -1.92, p = 0.027; and -3.34, p = 0.014, respectively), while BMI was positively correlated with running performance (gross motor task β-coefficient 9.12, p = 0.001). No significant associations were found between body composition measures and fine motor tasks.

CONCLUSION

The inverse associations between skinfold thickness or WC and jumping sideward indicates that children with high fat mass may be less proficient in certain gross motor tasks. The positive association between BMI and running suggests that BMI might be an indicator of fat-free (i.e., muscle) mass in predominately normal-weight preschool children.

Overweight and obese infants present lower cognitive and motor development scores than normal-weight peers

AIMS

Compare the cognitive and motor development in overweight/obese infants versus normal-weight peers and investigate the correlation of body weight, body length and body mass index with cognitive and motor development.

METHODS

We conducted a cross-sectional study with 28 overweight/obese infants and 28 normal-weight peers between 6 and 24 months of age. Both groups were evaluated with cognitive and motor scales of the Bayley-III infant development test. The t-test for independent samples was performed to compare the groups, and the Spearman correlation was used to verify the association between variables.

RESULTS

Overweight/obese infants showed lower cognitive and motor composite scores than their normal-weight peers. A significant negative association was found of body weight and body length with cognitive development and of body mass index with motor development.

CONCLUSION

This is the first study that found an effect on both cognitive and motor development in overweight/obese infants when compared with normal-weight peers between 6 and 24 months of age.

Associations between different components of fitness and fatness with academic performance in Chilean youths

Objectives

To analyze the associations between different components of fitness and fatness with academic performance, adjusting the analysis by sex, age, socio-economic status, region and school type in a Chilean sample.

Methods

Data of fitness, fatness and academic performance was obtained from the Chilean System for the Assessment of Educational Quality test for eighth grade in 2011 and includes a sample of 18,746 subjects (49% females). Partial correlations adjusted by confounders were done to explore association between fitness and fatness components, and between the academic scores. Three unadjusted and adjusted linear regression models were done in order to analyze the associations of variables.

Results

Fatness has a negative association with academic performance when Body Mass Index (BMI) and Waist to Height Ratio (WHR) are assessed independently. When BMI and WHR are assessed jointly and adjusted by cofounders, WHR is more associated with academic performance than BMI, and only the association of WHR is positive. For fitness components, strength was the variable most associated with the academic performance. Cardiorespiratory capacity was not associated with academic performance if fatness and other fitness components are included in the model.

Conclusions

Fitness and fatness are associated with academic performance. WHR and strength are more related with academic performance than BMI and cardiorespiratory capacity.

Effects of overweight and obesity on motor and mental development in infants and toddlers

BACKGROUND

A consequence of childhood obesity may be poor developmental outcomes.

OBJECTIVES

This study aimed to examine the relationship between weight and developmental delays in young children.

METHODS

We conducted a secondary analysis of the Early Childhood Longitudinal Study Birth Cohort data. Logistic regression models quantified the association between different weight statuses (normal weight <85th, overweight ≥90th, obese ≥95th percentile for weight) and delays in motor and mental development.

RESULTS

Children classified as overweight in both waves had higher percentages of delays in wave 2 (motor [7.5 vs. 6.2-6.4%], mental [8.6 vs. 5.9-6.7%]), as well as wave 1 and/or wave 2 (motor [14.8 vs. 10.9-13.0%], mental [11.9 vs. 9.0-10.1%]), compared with other children. This association was also found in children who were obese at both time points in wave 2 (motor delay [8.9 vs. 4.9-7.3%], mental delay [10.3 vs. 6.0-7.2%]), as well as wave 1 and/or wave 2 (motor delay [14.5 vs. 10.9-12.9%], mental delay [14.1 vs. 9.4-10.1%]). In the adjusted models, children classified as always obese were more likely to have a mental delay in wave 2 (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI]: 1.21-2.95) as well as wave 1 and/or wave 2 (aOR 1.56, 95% CI: 1.08-2.26). These children were also more likely to have motor delay (aOR 1.47, 95% CI: 1.02-2.13) in wave 1 and/or wave 2.

CONCLUSION

Overweight children are more likely than their normal-weight peers to have motor and mental developmental delays. Preventing obesity during infancy may facilitate reducing developmental delays in young children.

The relationship between motor skills, ADHD symptoms, and childhood body weight

BACKGROUND

Research has suggested an important association between motor proficiency and overweight/obesity. Many children with motor difficulties experience ADHD symptoms which have also been linked with overweight/obesity. Previous research has not considered both ADHD and motor performance when investigating their relationship with overweight/obesity.

AIMS

To investigate the relationships between motor performance, ADHD symptoms, and overweight/obesity in children.

METHODS AND PROCEDURES

A cross-sectional study was conducted involving189 children aged six to 10 years. Symptoms of ADHD were identified using the SNAP-IV rating scale. Motor impairment (MI) was identified using the Movement Battery Assessment for Children-2. Body composition was estimated from the Body Mass Index (BMI) based on World Health Organization child growth standards.

OUTCOMES AND RESULTS

Balance was the only motor skill associated with BMI even after controlling for gender and ADHD. Group comparisons revealed that the proportion of overweight ADHD children was significantly less than the proportion of overweight control children and overweight MI children; the proportion of underweight ADHD children was significantly greater than the proportion of underweight MI children.

CONCLUSIONS AND IMPLICATIONS

The results highlight the importance of taking into consideration both ADHD symptoms and motor difficulties in the assessment and intervention of physical health outcomes in children with ADHD and/or movement problems.

Do thin, overweight and obese children have poorer development than their healthy-weight peers at the start of school? Findings from a South Australian data linkage study

Little is known about the holistic development of children who are not healthy-weight when they start school, despite one fifth of preschool-aged children in high income countries being overweight or obese. Further to this, there is a paucity of research examining low body mass index (BMI) in contemporary high-income populations, although evidence from the developing world demonstrates a range of negative consequences in childhood and beyond. We investigated the development of 4-6 year old children who were thin, healthy-weight, overweight, or obese (as defined by BMI z-scores) across the five domains of the Australian Early Development Census (AEDC): Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills, and Communication Skills and General Knowledge. We used a linked dataset of South Australian routinely collected data, which included the AEDC, school enrollment data, and perinatal records (n = 7533). We found that the risk of developmental vulnerability among children who were thin did not differ from healthy-weight children, after adjusting for a range of perinatal and socio-economic characteristics. On the whole, overweight children also had similar outcomes as their healthy-weight peers, though they may have better Language and Cognitive skills (adjusted Risk Ratio [aRR] = 0.73 [95% CI 0.50-1.05]). Obese children were more likely to be vulnerable on the Physical Health and Wellbeing (2.20 [1.69, 2.87]) and Social Competence (1.31 [0.94, 1.83]) domains, and to be vulnerable on one or more domains (1.45 [1.18, 1.78]). We conclude that children who are obese in the first year of school may already be exhibiting some developmental vulnerabilities (relative to their healthy-weight peers), lending further support for strategies to promote healthy development of preschoolers.

Obesity Reduces Cognitive and Motor Functions across the Lifespan

Due to a sedentary lifestyle, more and more people are becoming obese nowadays. In addition to health-related problems, obesity can also impair cognition and motor performance. Previous results have shown that obesity mainly affects cognition and motor behaviors through altering brain functions and musculoskeletal system, respectively. Many factors, such as insulin/leptin dysregulation and inflammation, mediate the effect of obesity and cognition and motor behaviors. Substantial evidence has suggested exercise to be an effective way to improve obesity and related cognitive and motor dysfunctions. This paper aims to discuss the association of obesity with cognition and motor behaviors and its underlying mechanisms. Following this, mechanisms of exercise to improve obesity-related dysfunctions are described. Finally, implications and future research direction are raised.

Impaired Visual Motor Coordination in Obese Adults

Objective. To investigate whether obesity alters the sensory motor integration process and movement outcome during a visual rhythmic coordination task. Methods. 88 participants (44 obese and 44 matched control) sat on a chair equipped with a wrist pendulum oscillating in the sagittal plane. The task was to swing the pendulum in synchrony with a moving visual stimulus displayed on a screen. Results. Obese participants demonstrated significantly (p < 0.01) higher values for continuous relative phase (CRP) indicating poorer level of coordination, increased movement variability (p < 0.05), and a larger amplitude (p < 0.05) than their healthy weight counterparts. Conclusion. These results highlight the existence of visual sensory integration deficiencies for obese participants. The obese group have greater difficulty in synchronizing their movement with a visual stimulus. Considering that visual motor coordination is an essential component of many activities of daily living, any impairment could significantly affect quality of life.

Associations between obesity and cognition in the pre-school years

OBJECTIVE

To test the hypothesis that obesity is associated with impaired cognitive outcomes in the pre-school years.

METHODS

Associations were examined between weight status at age 3-5 years and cognitive performance at age 5 years. Cognitive outcome measures were tests of pattern construction (visuospatial skills), naming vocabulary (expressive language skills), and picture similarity (reasoning skills). The sample was the UK Millennium Cohort Study (n = 12,349 participants).

RESULTS

Boys with obesity at 3 years had significantly lower performance in pattern construction at age 5 years compared to those of a healthy weight, even after controlling for confounders (β = -0.029, P = 0.03). Controlling for confounders, boys who developed obesity between the ages of 3 and 5 years had lower scores in pattern construction (β = -0.03, P = 0.03). "Growing out" of obesity had a positive association with picture similarity performance in girls (β = 0.03, P = 0.04).

CONCLUSIONS

Obesity in the pre-school years was associated with poorer outcomes for some cognitive measures in this study. Stronger relationships between obesity and cognition or educational attainment may emerge later in childhood.

Iron Metabolism Dysregulation and Cognitive Dysfunction in Pediatric Obesity: Is There a Connection?

Obesity and iron deficiency (ID) are two of the most common nutritional disorders in the world. In children both conditions deserve particular attention. Several studies revealed an association between obesity and iron deficiency in children and, in some cases, a reduced response to oral supplementation. The connecting mechanism, however, is not completely known. This review is focused on: (1) iron deficiency in obese children and the role of hepcidin in the connection between body fat and poor iron status; (2) iron status and consequences on health, in particular on cognitive function; (3) cognitive function and obesity; (4) suggestion of a possible link between cognitive dysfunction and ID in pediatric obesity; and implications for therapy and future research.

Weight Gain, Executive Functioning, and Eating Behaviors Among Girls

OBJECTIVE

Executive functioning and excess weight have been associated in cross-sectional and prospective studies, but mechanisms explaining this relationship are unclear. The current study aimed to further explore the longitudinal relationship between executive functioning and changes in body weight and to determine whether binge eating behaviors mediate this relationship.

METHODS

Community-based girls (N = 2450) were assessed by using the behavioral measure of planning, Mazes subtest, and a parent-report measure of impulsivity at age 10; a self-report measure of binge eating at ages 10, 12, and 14; and investigator-measured BMI annually between ages 10 and 16. Regression and bootstrapping analyses explored the relations among age 10 impulsivity and planning, age 12 and age 14 binge eating frequency, and age 10 to 16 BMI changes.

RESULTS

Age 10 impulsivity and planning each independently predicted age 10 to 16 BMI changes, after accounting for demographics, verbal comprehension, and BMI at age 10 (Ps < .001). Binge eating tendencies at age 12 mediated the relation between age 10 impulsivity and age 10 to 16 BMI changes, after controlling for demographics, verbal comprehension, binge eating frequency, and BMI at age 10 (indirect effect estimate = 0.0007; 95% confidence interval = 0.0001-0.0020).

CONCLUSIONS

Results support the hypothesis that poorer executive functioning predicts weight gain from middle childhood through adolescence in girls, and that this effect may be partially explained by binge-eating behaviors in early adolescence.

Physical fitness and overweight in Israeli children with and without developmental coordination disorder: gender differences

Physical fitness and overweight among children has become paramount in the general population and more so in children with developmental coordination disorder (DCD). The purpose of the current study was to examine the association between physical fitness and overweight in a sample of Israeli children in comparison to typical children, and to examine gender differences. DCD was identified through total scores on the movement assessment battery for children 2 (MABC-2) equal to or less than the 16th percentile as well as parents' report that the child's deficits in motor skills interfered with at least two daily life activities. The sample included a group of children with DCD (n=22, M age=8.70 [SD=1.36], 16 boys [73%]) and a control group of typical children (n=47, M age=8.90 [SD=1.52], 34 boys [72%]). Measures included the strength subtest of the Bruininks-Oseretsky test of motor proficiency (BOT-2), the six minutes' walk test (6MWT) with heart rate measure, BMI and the percentage of body fat. Significant differences between DCD and typical children were found on all variables of physical fitness and weight. A two-way analysis of variance (ANOVA) analysis (group/gender) also revealed significant interactions for the percentage of body fat (F=8.51, p<.005) and BMI (F=4.50, p<.038) meaning that less fit children are more obese. The current study supports previous findings that children with DCD are less physically fit and more overweight compared to typically developing children. Moreover, in comparing between the genders, the girls in the study sample weighed more and had a significantly higher percentage of body fat than boys, it is essential to further our understanding of the relationships between obesity, physical fitness and gender among children with and without DCD.

Obesity impairs academic attainment in adolescence: findings from ALSPAC, a UK cohort

OBJECTIVE

While being overweight or obese in adolescence may have detrimental effects on academic attainment, the evidence base is limited by reliance on cross-sectional studies with small sample sizes, failure to take account of confounders and lack of consideration of potential mediators. The present study aimed to address these limitations and examine longitudinal associations between obesity in adolescence and academic attainment.

DESIGN

Associations between weight status at 11 years old and academic attainment assessed by national tests at 11, 13 and 16 years were examined in the Avon Longitudinal Study of Parents and Children. Healthy weight was defined as body mass index (BMI) Z-score <1.04; overweight as BMI Z-score 1.04-1.63; obesity as BMI Z-score ⩾1.64.

PARTICIPANTS

Data from 5966 participants with objectively measured weight status were examined: 71.4% were healthy weight (1935 males; 2325 females), 13.3% overweight (372 males; 420 females) and 15.3% obese (448 males; 466 females).

RESULTS

Girls obese at 11 years had lower academic attainment at 11, 13 and 16 years compared with those of a healthy weight, even after controlling for a wide range of confounders. Associations between obesity and academic attainment were less clear in boys. The potential mediating effects of depressive symptoms, intelligence quotient (IQ) and age of menarche in girls were explored, but when confounders were included, there was no strong evidence for mediation.

CONCLUSIONS

For girls, obesity in adolescence has a detrimental impact on academic attainment 5 years later. Mental health, IQ and age of menarche did not mediate this relationship, suggesting that further work is required to understand the underlying mechanisms. Parents, education and public health policy makers should consider the wide reaching detrimental impact of obesity on educational outcomes in this age group.

Children's executive function and high-calorie, low-nutrient food intake: mediating effects of child-perceived adult fast food intake

OBJECTIVE

This study tested the relationships among child executive function (EF), child-perceived parent fast food intake, and child self-reported subsequent consumption of high-calorie, low-nutrient (HCLN) food.

DESIGN

One year and 6-month longitudinal observation from a larger randomized controlled trial.

SETTING

Southern California elementary schools.

PARTICIPANTS

Fourth- and fifth-grade children (N = 1,005) participating in the Pathways to Health obesity prevention program.

RESULTS

Child EF problems were associated with higher concurrent HCLN intake (B = 0.29, SE = 0.10, p < .001) and had a significant indirect effect through higher perceived frequency of parent fast food intake (indirect effect = 0.17, 95% confidence interval [CI] = [0.11, 0.25], p < .001). Longitudinally, child EF problems did not significantly predict higher HCLN intake a year and a half later (B = 0.01, SE = 0.10, p = .92, n = 848) but did have a significant indirect effect through higher perceived parent fast food intake (indirect effect = 0.05, 95% CI = [0.02, 0.10], p < .001).

CONCLUSIONS

Children's EF difficulties may increase their perception of parent concurrent fast food intake, contributing to their own unhealthy food intake. However, EF problems may not directly affect HCLN intake across time, except when problems are associated with child perception of more frequent parent consumption of convenience foods. Future research is needed to investigate the possibility that helping children perceive and understand role models' convenience food consumption may improve child dietary consumption patterns.

Timing of motor milestones achievement and development of overweight in childhood: a study within the Danish National Birth Cohort

BACKGROUND

Overweight may hinder achievement of gross motor milestones and delayed achievement of milestones may increase the risk of later overweight for reasons involving physical activity and the building of lean body mass.

OBJECTIVE

To investigate whether increased birth weight and body mass index (BMI) at 5 months is associated with the achievement of the ability to sit up and walk and whether delayed achievement of these milestones is associated with overweight at age 7 years.

METHODS

We used data from the Danish National Birth Cohort on 25,148 children born between 1998 and 2003. Follow-up took place from 2003 to 2010. Mean age at follow-up was 7.04 years. We used logistic and linear regression analyses.

RESULTS

Birth weight and BMI at 5 months were marginally associated with earlier achievement of the ability to sit up and walk (regression coefficients between -0.027 months; [CI -0.042; -0.013] and -0.092 months [CI -0.118; -0.066]). Age in months of sitting and walking were not associated with overweight at age 7 years (ORs between 0.97 [CI 0.95-1.00] and 1.00 [CI 0.96-1.04]). Later achievement of sitting and walking predicted lower BMI at age 7 years (ln-BMI -z-scores between -0.023 [CI -0.029; -0.017] and -0.005 [CI -0.015; 0.005)).

CONCLUSIONS

All observed associations were of negligible magnitude and we conclude that birth weight or BMI at age 5 months and motor milestones appear largely independent of each other and that timing of achievement of motor milestones seems not to be associated with later overweight or increased BMI.

The negative effects of obesity and poor glycemic control on cognitive function: a proposed model for possible mechanisms

Obesity has reached epidemic proportions and is a contributor to many adverse health outcomes, including increased risk for dementia and adverse structural and functional brain changes. Milder forms of cognitive impairment in multiple domains can also be found in obese individuals of all ages that are believed to stem from brain abnormalities long prior to onset of neurologic conditions such as dementia. However, the mechanisms for adverse brain changes and subsequent cognitive dysfunction in obesity are complex and poorly understood. This paper proposes a possible etiologic model for obesity associated cognitive impairment with emphasis on the role of poor glycemic control and conditions like type 2 diabetes mellitus. Clinical implications associated with treatment of obesity in persons with cognitive deficits in addition to the cognitive promoting effects of weight loss surgery are also discussed.

Executive function and food approach behavior in middle childhood

Executive function (EF) has long been considered to be a unitary, domain-general cognitive ability. However, recent research suggests differentiating “hot” affective and “cool” cognitive aspects of EF. Yet, findings regarding this two-factor construct are still inconsistent. In particular, the development of this factor structure remains unclear and data on school-aged children is lacking. Furthermore, studies linking EF and overweight or obesity suggest that EF contributes to the regulation of eating behavior. So far, however, the links between EF and eating behavior have rarely been investigated in children and non-clinical populations. First, we examined whether EF can be divided into hot and cool factors or whether they actually correspond to a unitary construct in middle childhood. Second, we examined how hot and cool EF are associated with different eating styles that put children at risk of becoming overweight during development. Hot and cool EF were assessed experimentally in a non-clinical population of 1657 elementary-school children (aged 6–11 years). The “food approach” behavior was rated mainly via parent questionnaires. Findings indicate that hot EF is distinguishable from cool EF. However, only cool EF seems to represent a coherent functional entity, whereas hot EF does not seem to be a homogenous construct. This was true for a younger and an older subgroup of children. Furthermore, different EF components were correlated with eating styles, such as responsiveness to food, desire to drink, and restrained eating in girls but not in boys. This shows that lower levels of EF are not only seen in clinical populations of obese patients but are already associated with food approach styles in a normal population of elementary school-aged girls. Although the direction of effect still has to be clarified, results point to the possibility that EF constitutes a risk factor for eating styles contributing to the development of overweight in the long-term.

Relationship between adiposity and cognitive performance in 9-10-year-old children in South India

BACKGROUND

Studies in high-income countries have shown inverse associations between adiposity and cognitive performance in children. We aimed to examine the relationship between adiposity and cognitive function in Indian children.

METHODS

At a mean age of 9.7 years, height, weight, triceps and subscapular skinfold thicknesses and waist circumference were recorded for 540 children born in Mysore, India. Body fat percentage was estimated using bioimpedance. Cognitive function was assessed using three core tests from the Kaufman Assessment Battery for children-II edition and additional tests measuring learning, short-term memory, reasoning, verbal and visuo-spatial abilities, attention and concentration. Data on the parents' socioeconomic status, education, occupation and income were collected.

RESULTS

According to WHO definitions, 3.5% of the children were overweight/obese (Body Mass Index (BMI)>+1SD) and 27% underweight (BMI<-2SD). Compared to normal children, overweight/obese children scored higher in tests of learning/long-term retrieval, reasoning and verbal ability (unadjusted p<0.05 for all). All the Cognitive Test scores increased with increase in BMI and skinfold thickness, (unadjusted β=0.10-0.20 SD; p<0.05 for all). The effects, though attenuated, remained mainly significant after adjustment for age, sex and socioeconomic factors. Similar associations were found for waist circumference and percentage body fat.

CONCLUSIONS

In this Indian population, in which obesity was uncommon, greater adiposity predicted higher cognitive ability. These associations were only partly explained by socioeconomic factors. Our findings suggest that better nutrition is associated with better cognitive function, and that inverse associations between adiposity and cognitive function in high-income countries reflect confounding by socioeconomic factors.

Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents

Childhood obesity rates have risen dramatically over the past few decades. Although obesity has been linked to poorer neurocognitive functioning in adults, much less is known about this relationship in children and adolescents. Therefore, we conducted a systematic review to examine the relationship between obesity and obesity-related behaviors with neurocognitive functioning in youth. We reviewed articles from 1976 to 2013 using PsycInfo, PubMed, Medline and Google Scholar. Search terms included cognitive function, neurocognitive function/performance, executive function, impulsivity, self-regulation, effortful control, cognitive control, inhibition, delayed gratification, memory, attention, language, motor, visuo-spatial, academic achievement, obesity, overweight, body mass index, waist-hip ratio, adiposity and body fat. Articles were excluded if participants had health problems known to affect cognitive functioning, the study used imaging as the only outcome measure, they were non-peer-reviewed dissertations, theses, review papers, commentaries, or they were non-English articles. Sixty-seven studies met inclusion criteria for this review. Overall, we found data that support a negative relationship between obesity and various aspects of neurocognitive functioning, such as executive functioning, attention, visuo-spatial performance, and motor skill. The existing literature is mixed on the effects among obesity, general cognitive functioning, language, learning, memory, and academic achievement. Executive dysfunction is associated with obesity-related behaviors, such as increased intake, disinhibited eating, and less physical activity. Physical activity is positively linked with motor skill. More longitudinal research is needed to determine the directionality of such relationships, to point towards crucial intervention time periods in the development of children, and to inform effective treatment programs.

A review of the psychological and familial perspectives of childhood obesity

Childhood obesity is on the rise in both industrialized and developing countries. The investigation of the psychosocial aspects of childhood obesity has been the focus of long- standing theoretical and empirical endeavor. Overweight in children and adolescents is associated with a host of psychological and social problems such as reduced school and social performance, less favorable quality of life, societal victimization and peer teasing, lower self-and body-esteem, and neuropsychological dysfunctioning. Whereas community samples of obese youngsters usually do not show elevated psychopathology, clinically-referred overweight children show elevated depression, anxiety, behavior problems, attention deficit hyperactivity disorder and disordered eating. Parents' perceptions of their child's overweight highly influence the well-being of obese children and the way in which they perceive themselves. THE PRESENT REVIEW PAPER AIMS TO BROADEN THE SCOPE OF KNOWLEDGE OF CLINICIANS ABOUT SEVERAL IMPORTANT PSYCHOSOCIAL AND FAMILIAL DIMENSIONS OF CHILDHOOD OBESITY: the psychosocial functioning, self and body esteem and psychopathology of overweight youngsters, the influence of children's perceptions of overweight, including those of the obese children themselves on their well being, and the influence of parental attitudes about weight and eating on the psychological condition of the obese child.

The relationship between executive function and obesity in children and adolescents: a systematic literature review

The objective of this paper is to examine the relationship between the development of executive function (EF) and obesity in children and adolescents. We reviewed 1,065 unique abstracts: 31 from PubMed, 87 from Google Scholar, 16 from Science Direct, and 931 from PsycINFO. Of those abstracts, 28 met inclusion criteria and were reviewed. From the articles reviewed, an additional 3 articles were added from article references (N = 31). Twenty-three studies pertained to EF (2 also studied the prefrontal and orbitofrontal cortices (OFCs); 6 also studied cognitive function), five studied the relationship between obesity and prefrontal and orbitofrontal cortices, and three evaluated cognitive function and obesity. Inhibitory control was most often studied in both childhood (76.9%) and adolescent (72.7%) studies, and obese children performed significantly worse (P < 0.05) than healthy weight controls on various tasks measuring this EF domain. Although 27.3% of adolescent studies measured mental flexibility, no childhood studies examined this EF domain. Adolescents with higher BMI had a strong association with neurostructural deficits evident in the OFC. Future research should be longitudinal and use a uniform method of EF measurement to better establish causality between EF and obesity and consequently direct future intervention strategies.

Age of achievement of gross motor milestones in infancy and adiposity at age 3 years

Early life physical activity may help prevent obesity but is difficult to measure. The purpose of this study was to examine associations of age of achievement of gross motor milestones in infancy with adiposity at age 3 years. Seven forty one mother/infant dyads participated in a longitudinal study in Massachusetts. Exposures were age of attainment of 4 gross motor milestones-rolling over, sitting up, crawling, and walking. Outcomes were 3-year sum of subscapular and triceps skinfold thickness (SS + TR) for overall adiposity, their ratio (SS:TR) for central adiposity, and body mass index (BMI) z-score. We used linear regression models adjusted for confounders to examine motor milestone achievement and later adiposity. Rolling over (0.04, 95% CI: 0.008, 0.07) and sitting up (0.02, 95% CI: 0.001, 0.05) at ≥ 6 months were associated with increased SS:TR compared with attainment before 6 months. Walking at ≥ 15 months was associated with 0.98 mm higher SS + TR (95% CI: 0.05, 1.91) compared with walking before 12 months. Age at crawling was not associated with the outcomes. None of the milestones were associated with BMI z-score. Age of motor milestone achievement was only a modest predictor of adiposity. Later rolling over and sitting up were associated with greater central adiposity, and later age at walking was associated with greater overall adiposity at age 3 years. Although we controlled for birth weight and 6-month weight-for-length in our models, more detailed assessment of early adiposity prior to achievement of motor milestones is needed to help determine causality.

Childhood obesity and human capital accumulation

The prevalence of childhood obesity has tripled in the United States over the last 25 years, and in addition to increased risks of many chronic diseases, obesity may also be linked to lower skill attainment, poor social competency, and poorer labor outcomes. Any causal links between obesity and human capital accumulation could have important consequences for both health and economic well-being over the life course. We investigate the association of obesity and cognitive and non-cognitive outcomes among US children and adolescents aged 5 to 19 using the Child Development Supplement of the Panel Survey of Income Dynamics. We perform OLS and individual fixed effects regressions to address unobserved time invariant heterogeneity in the relationship between overweight/obesity and abilities. Results provide limited support for the hypothesis that obesity negatively affects non-cognitive but not cognitive outcomes and suggest that discrimination rather than a biological mechanism contributes to negative outcomes found in the literature on adults.

Predicting academic and cognitive outcomes from weight status trajectories during childhood

OBJECTIVE

To identify childhood body mass index (BMI) trajectories and to describe their association with subsequent academic and cognitive outcomes.

STUDY DESIGN

Prospective cohort: Height and weight measured annually from 4 to 7 years. A mixture of regressions approach grouped children into BMI trajectories (n=1959 children; n=5754 BMI measures). Academic outcomes included teacher-rated progress and achievement. Cognitive outcomes measured by Kaufman's Assessment Battery for Children. Academic and cognitive outcomes were regressed according to BMI trajectories, controlling for family and individual covariates. Subjects drawn from Quebec Longitudinal Study of Child Development (Canada), a 1998 birth cohort (n=2120).

RESULTS

Four clusters of BMI trajectories emerged: two healthy weight groups, one overweight group and one low weight group. Relative to healthy weight, belonging to the overweight or low weight clusters was negatively associated with cognitive and academic outcomes. With the exception of the low weight cluster, this relationship was insignificant in the adjusted model.

CONCLUSIONS

Results suggest that during childhood being overweight does not increase risk for poor educational outcomes. Instead, being underweight may the increase risk for poorer cognitive outcomes. Further group-based trajectory modeling (GBTM) for BMI development over time is needed to confirm results.

Gross motor skill performance in a sample of overweight and non-overweight preschool children

OBJECTIVE

The aim of the study was to examine the gross motor skill performance of overweight and non-overweight preschool children from South of Italy, and to investigate possible differences by gender.

METHODS

Participants were 38 boys and 42 girls (4.5 ± 0.5 yr) categorized as overweight (n = 38) and non-overweight (n = 42), according to the IOTF body mass index (BMI) cut-off points. The Test of Gross Motor Development was used to assess seven locomotor skills (run, gallop, hop, leap, horizontal jump, skip and slide) and five object-control skills (two-hand strike, stationary bounce, catch, kick and overhand throw). The raw, standard and percentile scores and the Gross Motor Development Quotient (GMDQ) were calculated for each participant. ANOVA 2 (gender) x 2 (group) was conducted on the subtest standard scores and the GMDQ.

RESULTS

No differences in performance were found between boys and girls on the subscale standard scores and the GMDQ. Significant main effects (p < 0.001) were reported for group on the GMDQ, and the standard scores for locomotor and object-control skills, with overweight children reporting lower movement competence than their counterparts. Pearson's correlations revealed relationships (p < 0.001) between BMI and locomotor (r = -0.54) and object-control (r = 20.48) skills, and between BMI and GMDQ (r = 20.54).

CONCLUSIONS

Findings indicate that childhood obesity might have adverse effects on gross motor development. Overweight participants showed poorer performance on locomotor and object-control tasks than their non-overweight peers. Interventions to promote physical activity in overweight children should be directed towards achieving a healthy weight and motor skill improvement.