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D'Cruz AFL, D'Souza NJ, Downing KL, Smith C, Sciberras E, Hesketh KD. Association between physical activity and self-regulation in early childhood: A systematic review. Obes Rev 2024; 25:e13657. [PMID: 38049177 DOI: 10.1111/obr.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 09/18/2023] [Accepted: 10/01/2023] [Indexed: 12/06/2023]
Abstract
Physical activity and self-regulation are important predictors of pediatric overweight and obesity. Young children (0-5 years) with lower physical activity levels and poorer self-regulation skills are at greater risk for overweight. Despite growing evidence that the two constructs are interrelated, their association remains unclear in young children. This review systematically summarized associations between physical activity and self-regulation in early childhood and explored the directionality of associations. Searches were run in six electronic databases. Forty-seven papers met inclusion criteria. Only three studies investigated all three domains of self-regulation (behavioral, cognitive, and emotional). Overall, findings were inconclusive; studies reported weak to moderate positive associations (n = 17), inverse associations (n = 5), mixed associations (n = 15), null association (n = 2), and negative (n = 1) between physical activity and self-regulation. Compared with the emotional and cognitive domains, physical activity was most consistently positively associated with behavioral self-regulation. Only one study assessed bidirectional associations, reporting a positive association. The three studies that included global self-regulation showed contradicting findings. There is some evidence that physical activity dose and sex potentially confound these associations; however, further research is needed given the paucity of studies. This review highlights the need for more in-depth investigation of the complex association between physical activity and global self-regulation.
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Affiliation(s)
- Abhigale F L D'Cruz
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Cynthia Smith
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Emma Sciberras
- Center for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Zheng M, D'Souza NJ, Atkins L, Ghobadi S, Laws R, Szymlek-Gay EA, Grimes C, Baker P, He QQ, Campbell KJ. Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Adv Nutr 2024; 15:100152. [PMID: 37977327 PMCID: PMC10714232 DOI: 10.1016/j.advnut.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Ninoshka J D'Souza
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Linda Atkins
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Saeed Ghobadi
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Philip Baker
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, Republic of China
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Watson A, D'Souza NJ, Timperio A, Cliff DP, Okely AD, Hesketh KD. Longitudinal associations between weight status and academic achievement in primary school children. Pediatr Obes 2023; 18:e12975. [PMID: 36128712 PMCID: PMC10078458 DOI: 10.1111/ijpo.12975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Evidence for longitudinal associations between childhood weight status and academic achievement remains unclear due to considerable heterogeneity in study design, measures of academic achievement and appropriate categorization of weight status. OBJECTIVE To examine longitudinal associations between childhood weight status (underweight, healthy weight, overweight/obese) and academic achievement in the transition from preschool to primary (elementary) school among Australian school children. METHODS Data were from the Healthy Active Preschool and Primary Years study. Height and weight, for calculating BMI were measured at baseline (preschool age 3-5 years; 2008/9) and follow-up (primary school age 6-8 years; 2011/12). Academic achievement was measured at age 9 years. RESULTS No associations between BMI z-score or weight category in the preschool years and later NAPLAN scores were found for boys. For girls, having a higher BMI z-score (B = -13.68, 95%CI: -26.61, -0.76) and being affected by overweight (B = -33.57, 95%CI: -61.50, -5.24) in preschool was associated with lower language scores. Remaining affected by overweight from preschool to primary school was associated with lower numeracy (B = -25.03, 95%CI: -49.74, -0.33), spelling (B = -33.5, 95%CI: -63.43, -3.58), language (B = -37.89, 95%CI: -72.75, -3.03) and total achievement scores (B = -24.24, 95%CI: -44.85, -3.63) among girls. For boys, becoming affected by overweight was associated with lower spelling (B = -38.76, 95%CI: -73.59, -3.93) and total achievement scores (B = -27.70, 95%CI: -54.81, -0.58). CONCLUSIONS Associations between being affected by overweight/obesity and poorer academic achievement were more pronounced in girls than boys, indicating potentially inequitable impacts of excess weight and highlighting the greater need for intervention among girls. However, stronger study designs are needed to confirm our findings.
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Affiliation(s)
- Amanda Watson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Dylan P Cliff
- Early Start, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Anthony D Okely
- Early Start, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
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D'Souza NJ, Zheng M, Abbott G, Lioret S, Hesketh KD. Differing associations with childhood outcomes using behavioural patterns derived from three data reduction techniques. Int J Epidemiol 2022; 52:577-588. [PMID: 35830330 PMCID: PMC10114100 DOI: 10.1093/ije/dyac142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/20/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Behavioural patterns help to understand the influence of multiple health behaviours on childhood outcomes. Behavioural patterns derived using different data reduction techniques can be non-identical and may differentially associate with childhood outcomes. This study aimed to compare associations of behavioural patterns derived from three methods with three childhood outcomes. METHODS Data were from the Healthy Active Preschool and Primary Years study when children were 6-8 years old (n = 432). Cluster analysis (CA), latent profile analysis (LPA) and principal component analysis (PCA) were used to derive behavioural patterns from children's diet, physical activity, sedentary behaviour and sleep data. Behavioural data were obtained through parent report and accelerometry. Children's height, weight and waist circumference were measured by trained study staff. Health-related quality of life data were obtained using the Pediatric Quality of Life Inventory and academic performance scores were from a national test. Associations between derived patterns from each method and each of the outcomes were tested using linear regression (adjusted for child age and sex and parent education). RESULTS Three patterns were each derived using CA and LPA, and four patterns were derived using PCA. Each method identified a healthy, an unhealthy and a mixed (comprising healthy and unhealthy behaviours together) pattern. Differences in associations were observed between pattern groups from CA and LPA and pattern scores from PCA with the three outcomes. CONCLUSIONS Discrepancies in associations across pattern derivation methods suggests that the choice of method can influence subsequent associations with outcomes. This has implications for comparison across studies that have employed different methods.
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Affiliation(s)
- Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics, Université de Paris, INSERM, INRA, Paris, France
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
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D'Souza NJ, Kuswara K, Zheng M, Leech R, Downing KL, Lioret S, Campbell KJ, Hesketh KD. A systematic review of lifestyle patterns and their association with adiposity in children aged 5-12 years. Obes Rev 2020; 21:e13029. [PMID: 32297464 DOI: 10.1111/obr.13029] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/11/2022]
Abstract
Diet, physical activity, sedentary behaviour and sleep are typically examined independently with childhood adiposity; however, their combined influence remains uncertain. This review aims to systematically summarize evidence on the clustering of these behaviours through lifestyle patterns and evaluate associations with adiposity in children aged 5-12 years. Search strategies were run in six databases. Twenty-eight papers met the inclusion criteria, six of which included all four behaviours. A range of lifestyle patterns were identified (healthy, unhealthy and mixed). Mixed patterns were most frequently reported. Unhealthy patterns comprising low physical activity and high sedentary behaviour were also frequently observed. Mixed patterns comprising healthy diets, low physical activity and high sedentary behaviour were more commonly seen in girls, whereas boys were more physically active, similarly sedentary and had unhealthier diets. Children from lower socio-economic backgrounds tended to more frequently display unhealthy patterns. Unhealthy lifestyle patterns were more often associated with adiposity risk than healthy and mixed patterns. With few studies including all four behaviours, it is difficult to establish a clear picture of their interplay and associations with adiposity. Nonetheless, reliance on lifestyle patterns is likely more beneficial than individual behaviours in targeting adiposity and improving understanding of how these behaviours influence health.
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Affiliation(s)
- Ninoshka J D'Souza
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Rebecca Leech
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sandrine Lioret
- Research Center in Epidemiology and Biostatistics (CRESS), Universite de Paris, INSERM, INRA, 75004, Paris, France
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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