The extended relationship between child cardiovascular risks and academic performance measures

Nut consumption and academic performance among adolescents: the EHDLA study

PURPOSE

The aim of this study was to examine the relationship between nut consumption and academic performance in Spanish adolescents and to explore the role of sociodemographic, anthropometric, and lifestyle covariates on this association.

METHODS

A cross-sectional study was carried out using a food frequency questionnaire for estimating nut consumption in the number of 20-30 g servings per week, and academic performance data were obtained from school records. Analyses of covariance were adjusted for sociodemographic, anthropometric and lifestyle covariates, including total energy intake.

RESULTS

Among the 846 adolescents included in the analyses (55.3% girls, age range from 12 to 17 years), the mean ± standard deviation consumption of nuts was 2.7 ± 2.8 servings per week, while the mean of all school grades recorded was 6.5 ± 2.0. Furthermore, compared to no consumption, the consumption of ≥ 3 nut servings per week was consistently associated with higher grades in language (p for trend = 0.005), combination of language and math (p for trend = 0.026), grade point average (p for trend = 0.039), and combination of all school records (p for trend = 0.046). These associations were observed regardless of all covariates considered, although sex and socioeconomic level played a significant role in the completely adjusted models.

CONCLUSION

Nut consumption is associated with higher academic performance in a representative sample of Spanish adolescents. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Relationship between Physical Fitness and Academic Performance in University Students

Several studies involving students have been developed with the objective to analyse the influence of different factors on academic performance. Nevertheless, all these studies were focused on stress and sympathetic modulation response instead of contemplating other physiological parameters that may affect academic performance. The aim of the present study was to analyse body composition, cardiovascular, sleep habits and physical activity factors related to the academic performance of university students. Two hundred and sixty-one students with bachelor's degrees in physical activity and sports science participated in the present study (age: 22.49 ± 3.84 years; weight: 73.94 ± 11.4 kg; height: 176.28 ± 7.68 cm; 87.7% males). Participants were divided into two groups according to their academic performance: low academic performance group (LAPG) and high academic performance group (HAPG). Body composition, blood pressure, physical activity and sleep habits were measured, and maximum oxygen uptake was estimated by the Cooper's 12 min run test. The results show that students with a high academic performance presented a higher VO₂ max than the LAPG (LAPG = 40.32 ± 6.07; HAPG = 47.91 ± 6.89 mL/kg/min; p < 0.001), as well as lower diastolic blood pressure (LAPG = 72.44 ± 14.27; HAPG = 67.48 ± 13.50 mmHg; p < 0.01) and insomnia levels caused by breathing problems (LAPG = 0.37 ± 0.8; HAPG = 0.13 ± 0.42 a.u.; p = 0.046). Therefore, we found a relevant association between academic performance and VO₂ max, diastolic blood pressure, and insomnia caused by breathing problems. These results highlight the importance of applying different programmes that may improve these factors, especially those related to physical activity and sleep habits in order to improve academic achievement.

Effect of Obesity on Arithmetic Processing in Preteens With High and Low Math Skills: An Event-Related Potentials Study

Preadolescence is an important period for the consolidation of certain arithmetic facts, and the development of problem-solving strategies. Obese subjects seem to have poorer academic performance in math than their normal-weight peers, suggesting a negative effect of obesity on math skills in critical developmental periods. To test this hypothesis, event-related potentials (ERPs) were collected during a delayed-verification math task using simple addition and subtraction problems in obese [above 95th body mass index (BMI) percentile] and non-obese (between 5th and 90th BMI percentile) preteens with different levels of math skill; thirty-one with low math skills (14 obese, mean BMI = 26.40, 9.79 years old; 17 non-obese, BMI = 17.45, 9.76 years old) and thirty-one with high math skills (15 obese, BMI = 26.90, 9.60 years old; 16 non-obese, BMI = 17.13, 9.63 years old). No significant differences between weight groups were observed in task accuracy regardless of their mathematical skill level. For ERPs, electrophysiological differences were found only in the subtraction condition; participants with obesity showed an electrophysiologic pattern associated with a reduced ability to allocate attention resources regardless of their math skill level, these differences were characterized by longer P300 latency than their normal-weight peers. Moreover, the participants with obesity with high math skills displayed hypoactivity in left superior parietal lobule compared with their normal-weight peers. Additionally, obese preteens with low math skills displayed smaller arithmetic N400 amplitude than non-obese participants, reflecting difficulties in retrieving visual, semantic, and lexical information about numbers. We conclude that participants with obesity are less able than their normal-weight peers to deploy their attention regardless of their behavioral performance, which seems to have a greater effect on obese participants with low math skills because they also show problems in the retrieval of solutions from working memory, resulting in a delay in the development of mathematical skills.

Fitness, Fatness, and Academic Attainment in Male Schoolchildren from a Soccer Academy

This investigation explored the association between anthropometric measures, fitness, and academic attainment (mathematics and science grade point average [GPA]) in male schoolchildren from a soccer academy. Thirty-one males (age: 10.3 ± 1.19 years; body mass: 41.7 ± 6.5 kg; height: 1.43 ± 0.07 m; body mass index (BMI): 20.2 ± 2.8 kg/m2) participated. Body mass, body fat percentage (%BF), and BMI were used as measures of anthropometry. The Yo-Yo Intermittent Recovery Test (level 1), squat and counter-movement jumps (SJ and CMJ), static balance, 10 and 15 m sprint, and a T-half test for change-of-direction (CoD) performance were used to measure fitness parameters. The GPA of mathematics and science determined academic attainment. All physical performance tests showed excellent relative reliability. ICC was between 0.87 (10 m sprint) and 1.00 (15 m sprint, CMJ). Regarding correlations between fatness and academic attainment, we found three correlations of practical value (r > 0.5), but only for mathematics (BMI: r = 0.540, subscapular skinfold: r = 0.589, body fat: r = 0.560). Mathematics was relevantly correlated with 15 m sprint (r = 0.574) and Yo-Yo IR1 test (r = 0.770). Only static balance (r = 0.428) did not reach the relevance criteria (r > 0.5). Science only showed large correlations with static balance (r = 0.620) and Yo-Yo IR1 test (r = 0.730). In conclusion, fatness and fitness are related to academic attainment in schoolchildren. In addition, except for static balance, all physical performance parameters were relevantly (r > 0.5) correlated with mathematics.

Kindergarten Obesity and Academic Achievement: The Mediating Role of Weight Bias

This study draws the attention towards the importance of reducing weight discrimination against children for their educational success, as an issue of social justice. We investigate the consequences of early-onset obesity identifying the mediating mechanisms in the relationship between childhood obesity and academic achievement. To do so, we employ the Early Childhood Longitudinal Study-Kindergarten Cohort (kindergarten to fifth grade) in the US (ECLS-K: 2011) and apply a parallel process latent growth model with a combination of quasi-experiments and econometrics. The results of this study suggest that teachers may serve as a significant source of weight bias, especially for girls (B = -0.09, 95% BC CI [-2.37 to -0.46]).

'Fat black sheep': Educational penalties of childhood obesity in an emerging country

OBJECTIVE

This article explores the relationship between childhood obesity and educational outcomes in Mexico, a country where excess weight is predominant.

DESIGN

Using complementary multivariate estimators, we empirically investigate the association between childhood excess weight, measured in 2002, and schooling attainment measured 10 years later. Non-linear specifications are tested, and heterogeneous effects according to gender, living area and economic backgrounds are investigated.

SETTING

To fill the literature gap, this study focuses on the understudied context of emerging countries such as Mexico.

PARTICIPANTS

Panel data from the Mexican Family Life Survey (2002-2012) are used. We restricted the sample to adolescent individuals who had between 9 and 15 years old in 2002 (attended primary or secondary school in 2002). The survey provides an accurate follow-up information on weight, height and waist circumference for each individual.

RESULTS

Controlling for a comprehensive set of covariates, we find that the relationship is non-linear in Mexico. While weight-based childhood obesity and abdominal adiposity are significantly associated with lower school attainment, at least in urban settings, no schooling gap is found between overweight students and their normal-weight counterparts. Along with rural-urban heterogeneity, obesity-based educational penalties appear to be stronger for girls and students from privileged economic backgrounds.

CONCLUSIONS

These results emphasise the co-occurrence of anti-fat and pro-fat social norms in Mexican schools: while anti-fat norms may particularly concern female, richer and urban students, pro-fat norms might persist among male, poorer and rural students. These findings have important implications for public policy, namely about awareness anti-obesity programmes.

Benefits of normal body mass index on physical fitness: A cross-sectional study among children and adolescents in Xinjiang Uyghur Autonomous Region, China

OBJECTIVE

To assess the association between body mass index (BMI) and physical fitness index (PFI) among children and adolescents in Xinjiang Uyghur Autonomous Region, China.

METHODS

In total, 17,618 children and adolescents aged 7-18 years from the selected region were enrolled in this cross-sectional study (8,800 boys and 8,818 girls). Participants were stratified by age and sex and divided into five groups by BMI percentiles: very low (BMI <5th percentile); low, (5th ≤ BMI < 15th percentile); normal (15th ≤ BMI < 85th percentile); high (85th ≤ BMI < 95th percentile); and very high (BMI ≥95th percentile). PFI was assessed by height, weight, and five health-related fitness indicators (grip strength, standing long jump, sit and reach, 50 m dash, and endurance run).

RESULTS

BMI was significantly associated with PFI during adolescence (13-18 years) in boys and pre-adolescence (7-12 years) in girls. Between the ages of 13 and 18 years, an increase in BMI had a greater impact on PFI in boys than girls. PFI showed a parabolic curvilinear relationship with BMI.

CONCLUSION

Children and adolescents in China's Xinjiang Uyghur Autonomous Region with a normal BMI demonstrated good physical fitness. A BMI below or above the normal range may contribute to poor physical fitness. The relationship between BMI and PFI shows an inverted U-shaped curve.

Prevalence of physical fitness in Chinese school-aged children: Findings from the 2016 Physical Activity and Fitness in China-The Youth Study

PURPOSE

This study was to present the 2016 prevalence estimates of Chinese school-aged children meeting physical fitness standards and to examine differences by sex and residence locales in children who did not meet fitness standards.

METHODS

We conducted cross-sectional analyses of 171,991 children and adolescents (boy: 50.0%, Grades 1-12) who participated in the 2016 Physical Activity and Fitness in China-The Youth Study. The main outcomes were fitness measures, assessed by the 2014 revised Chinese National Student Physical Fitness Standard (CNSPFS), covering areas of aerobic capacity, upper body strength, flexibility, body mass index, abdominal strength, and trunk strength. Children's overall physical fitness performance was categorized, per CNSPFS standards, as excellent, good, pass, or no pass. Data on the prevalence of physical fitness categories and not meeting fitness standards (i.e., among children who received a "no pass" mark) were analyzed, through logistic regression, by sex (boy, girl) and residence locales (urban, rural) across 3 school grades (primary, junior middle, and junior high).

RESULTS

In 2016, 5.95% of Chinese children and adolescents achieved an "excellent" mark, 25.80% received a "good" rating, 59.90% received a "pass", and 8.35% received a "no pass". Overall, boys were more likely to not pass the fitness standards compared with girls (adjusted odds ratio (aOR) = 1.710; 95% confidence interval (CI): 1.708-1.712) and children living in urban areas were more likely to not pass the standards than those living in rural areas (aOR = 1.298; 95%CI: 1.296-1.299). Consistent patterns of not meeting fitness standards were also found by sex and residence locales across all 3 school grades.

CONCLUSION

In the Chinese school-aged population, about 3 in 10 children achieved an "excellent" or "good" fitness standard in 2016, and about 8% of this population did not meet CNSPFS standards. Children living in urban areas were more likely to not meet minimum fitness performance levels, and boys in school were more likely to not meet minimum fitness performance levels than girls.

The association between obesity and academic performance in youth: a systematic review

Previous studies have found that obesity could influence academic performance. The aim of this study was to systematically review the scientific evidence on the association between obesity and academic performance in school children. A systematic review of English articles was undertaken by using databases PubMed/Medline, ERIC, LILACS, SciELO and Web of Science. Cross-sectional and longitudinal studies examining the association between obesity and academic performance in children and adolescents, published between January 1990 and December 2016, were included. Risk of bias was assessed by using Strengthening the Reporting of Observational Studies in Epidemiology. Thirty-four studies (23 cross-sectional and 11 longitudinal) matched all inclusion criteria and were included. Seven studies were classified as low risk of bias, 23 as medium risk and four as high risk. After controlling for covariates such as socio-economic status, parental education and physical activity, the association between obesity and academic performance becomes uncertain for most of the studies (55.9%). Therefore, at present, there is insufficient evidence to support a direct link between obesity and poor academic performance in school age children. In order to clarify this issue, we need more longitudinal studies with adequate sample sizes and that control for potential confounders.

Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review

BACKGROUND

The relationship among physical activity (PA), fitness, cognitive function, and academic achievement in children is receiving considerable attention. The utility of PA to improve cognition and academic achievement is promising but uncertain; thus, this position stand will provide clarity from the available science.

OBJECTIVE

The purpose of this study was to answer the following questions: 1) among children age 5-13 yr, do PA and physical fitness influence cognition, learning, brain structure, and brain function? 2) Among children age 5-13 yr, do PA, physical education (PE), and sports programs influence standardized achievement test performance and concentration/attention?

STUDY ELIGIBILITY CRITERIA

This study used primary source articles published in English in peer-reviewed journals. Articles that presented data on, PA, fitness, or PE/sport participation and cognition, learning, brain function/structure, academic achievement, or concentration/attention were included.

DATA SOURCES

Two separate searches were performed to identify studies that focused on 1) cognition, learning, brain structure, and brain function and 2) standardized achievement test performance and concentration/attention. PubMed, ERIC, PsychInfo, SportDiscus, Scopus, Web of Science, Academic Search Premier, and Embase were searched (January 1990-September 2014) for studies that met inclusion criteria. Sixty-four studies met inclusion criteria for the first search (cognition/learning/brain), and 73 studies met inclusion criteria for the second search (academic achievement/concentration).

STUDY APPRAISAL AND SYNTHESIS METHODS

Articles were grouped by study design as cross-sectional, longitudinal, acute, or intervention trials. Considerable heterogeneity existed for several important study parameters; therefore, results were synthesized and presented by study design.

RESULTS

A majority of the research supports the view that physical fitness, single bouts of PA, and PA interventions benefit children's cognitive functioning. Limited evidence was available concerning the effects of PA on learning, with only one cross-sectional study meeting the inclusion criteria. Evidence indicates that PA has a relationship to areas of the brain that support complex cognitive processes during laboratory tasks. Although favorable results have been obtained from cross-sectional and longitudinal studies related to academic achievement, the results obtained from controlled experiments evaluating the benefits of PA on academic performance are mixed, and additional, well-designed studies are needed.

LIMITATIONS

Limitations in evidence meeting inclusion criteria for this review include lack of randomized controlled trials, limited studies that are adequately powered, lack of information on participant characteristics, failure to blind for outcome measures, proximity of PA to measurement outcomes, and lack of accountability for known confounders. Therefore, many studies were ranked as high risk for bias because of multiple design limitations.

CONCLUSIONS

The present systematic review found evidence to suggest that there are positive associations among PA, fitness, cognition, and academic achievement. However, the findings are inconsistent, and the effects of numerous elements of PA on cognition remain to be explored, such as type, amount, frequency, and timing. Many questions remain regarding how to best incorporate PA within schools, such as activity breaks versus active lessons in relation to improved academic achievement. Regardless, the literature suggests no indication that increases in PA negatively affect cognition or academic achievement and PA is important for growth and development and general health. On the basis of the evidence available, the authors concluded that PA has a positive influence on cognition as well as brain structure and function; however, more research is necessary to determine mechanisms and long-term effect as well as strategies to translate laboratory findings to the school environment. Therefore, the evidence category rating is B. The literature suggests that PA and PE have a neutral effect on academic achievement. Thus, because of the limitations in the literature and the current information available, the evidence category rating for academic achievement is C.

Challenges and Lessons Learned From a Prevention Research Center Partnership

For more than a decade, the West Virginia Prevention Research Center, Mid-Ohio Valley Health Department, and the Wood County Schools have built and sustained a partnership to reduce health disparities and promote population health. Specifically, this partnership has contributed significantly to the peer-reviewed literature on children's physical activity, fitness, and academic achievement, as well as identifying possible areas for physical activity interventions (within the school and community settings) that would improve health and academic outcomes. This case study describes the partnership among a University Prevention Research Center, a local health department, and a local school system. In the description of the partnership, this paper sequentially explores characteristics of the partnership that were advantageous or challenging over time. It details the interface among state and local partner interest, resources, and goals all directed toward enhancing children's physical activity, fitness, cardiovascular risk, and academic improvement. The paper concludes with lessons learned that may contribute to the science and practice of multilevel collaborations in child health.

Socioeconomic Factors Influence Physical Activity and Sport in Quebec Schools

BACKGROUND

School environments providing a wide selection of physical activities and sufficient facilities are both essential and formative to ensure young people adopt active lifestyles. We describe the association between school opportunities for physical activity and socioeconomic factors measured by low-income cutoff index, school size (number of students), and neighborhood population density.

METHODS

A cross-sectional survey using a 2-stage stratified sampling method built a representative sample of 143 French-speaking public schools in Quebec, Canada. Self-administered questionnaires collected data describing the physical activities offered and schools' sports facilities. Descriptive and bivariate analyses were performed separately for primary and secondary schools.

RESULTS

In primary schools, school size was positively associated with more intramural and extracurricular activities, more diverse interior facilities, and activities promoting active transportation. Low-income primary schools were more likely to offer a single gym. Low-income secondary schools offered lower diversity of intramural activities and fewer exterior sporting facilities. High-income secondary schools with a large school size provided a greater number of opportunities, larger infrastructures, and a wider selection of physical activities than smaller low-income schools.

CONCLUSIONS

Results reveal an overall positive association between school availability of physical and sport activity and socioeconomic factors.

Relationships among fitness, obesity, screen time and academic achievement in Japanese adolescents

PURPOSE

Students who study intensively in one of Japan's 'cram schools' and/or spend excess time on electronic devices such as video games are in a sedentary state much of the time, and this may affect their physical fitness. We investigated whether there are relationships among obesity, physical fitness and academic achievement in Japanese students after controlling for socioeconomic and behavioral confounding factors.

METHODS

The data of 315 students (152 females [48%], 163 males [52%]; 12-13yrs old) were analyzed. Academic achievement was assessed by the total grade points on eight school subjects (GP8). Students with a body mass index at or above the 85th percentile of each gender were classified as the overweight/obese group. Physical fitness was evaluated by the total score on eight fitness tests. Socioeconomic and behavioral confounders including the mother's educational background, household income, cram school utilization and time spent on video games/mobile phones were used as covariates.

RESULTS

The GP8 of the overweight/obese students was significantly lower than that of the normal weight students (27.2 vs. 29.0 points, respectively). After adjusting for the confounders, the physical fitness score was found to be a significant factor for determinants of GP8 in boys (β=0.324), but not in girls. The obesity status was a factor for GP8 in the girls (β=-0.160) but not in the boys.

CONCLUSION

These results suggest that physical fitness in boys and obesity status in girls could be important factors not only for health status but also for academic achievement, independent of socioeconomic and behavioral backgrounds.

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.

Independent Associations of Organized Physical Activity and Weight Status with Children's Cognitive Functioning: A Matched-Pairs Design

PURPOSE

This study tested whether participation in organized physical activity (active vs. inactive) or weight status (normal weight vs. overweight or obese) independently relate to children's cognition, using a matched-pairs design.

DESIGN AND METHODS

Normal weight, active children (8-11 yrs, 5th-75th percentile BMI) were recruited from extracurricular physical activity programs while normal weight inactive (5th-75th percentile BMI) and overweight inactive children (BMI ≥85th percentile) were recruited from local Augusta, Georgia area schools. Measures included the Cognitive Assessment System, anthropometrics, and parent- and self-report of physical activity. Paired t tests compared cognition scores between matched groups of normal weight active vs. normal weight inactive (N = 24 pairs), normal weight inactive vs. overweight inactive (N = 21 pairs), and normal weight active vs. overweight inactive children (N = 16 pairs). Children in each comparison were matched for race, gender, age, and socioeconomic status.

RESULTS

Normal weight active children had higher Planning (M± SD = 109 ± 11 vs. 100 ± 11, p = .011) and Attention scores (108 ± 11 vs. 100 ± 11, p = .013) than overweight inactive children. Normal weight inactive children had higher Attention scores than overweight inactive children (105 ± 13 vs. 93 ± 12, p = .008). When compared with normal weight inactive children, normal weight active children had higher Planning (113 ± 10 vs. 102 ± 13, p = .008) and marginally higher Attention scores (111 ± 11 vs. 104 ± 12, p = .06).

CONCLUSION

Findings suggest independent associations of children's weight status with selective attention, and physical activity with higher-order processes of executive function.

Relation of intelligence quotient and body mass index in preschool children: a community-based cross-sectional study

OBJECTIVE

Overweight and obesity in children is a global problem. Besides physical effects, obesity has harmful psychological effects on children.

METHODS

We carried out cross-sectional community-based study to investigate the relation between body mass index (BMI) and cognitive functioning in preschool children. Thirteen socioeconomical elements of 1151 children were measured and analyzed based on their intelligence quotient (IQ) test results. Thirteen out of 33 provinces were selected randomly, and schools were selected as clusters in rural and urban areas. Descriptive statistics, t-test, analysis of variance and regression were used when appropriate.

RESULTS

Our analysis showed that IQ was associated with household income, place of residence, delivery type, type of infant feeding and father's and mother's education level (P<0.001 for all). Using penalized linear regression for eliminating the impact of confounding factor, our study shows that, living in metropolitan (β=2.411) and urban areas (β=2.761), the level of participants' father's education (β=5.251) was positively and BMI (β=-0.594) was negatively related with IQ test results.ConclusionsThe findings of the present study showed that a lower IQ score is associated with higher BMI. However, this relation appears to be largely mediated when the socioeconomic status was considered.

VII. The history of physical activity and academic performance research: informing the future

The study of physical activity, physical fitness, and academic performance research are reviewed from a historical perspective, by providing an overview of existing publications focused on children and adolescents. Using rigorous inclusion criteria, the studies were quantified and qualified using both meta-analytic and descriptive evaluations analyses, first by time-period and then as an overall summary, particularly focusing on secular trends and future directions. This review is timely because the body of literature is growing exponentially, resulting in the emergence of new terminology, methodologies, and identification of mediating and moderating factors. Implications and recommendations for future research are summarized.

The effects of changes in physical fitness on academic performance among New York City youth

PURPOSE

To evaluate whether a change in fitness is associated with academic outcomes in New York City (NYC) middle-school students using longitudinal data and to evaluate whether this relationship is modified by student household poverty.

METHODS

This was a longitudinal study of 83,111 New York City middle-school students enrolled between 2006-2007 and 2011-2012. Fitness was measured as a composite percentile based on three fitness tests and categorized based on change from the previous year. The effect of the fitness change level on academic outcomes, measured as a composite percentile based on state standardized mathematics and English Language Arts test scores, was estimated using a multilevel growth model. Models were stratified by sex, and additional models were tested stratified by student household poverty.

RESULTS

For both girls and boys, a substantial increase in fitness from the previous year resulted in a greater improvement in academic ranking than was seen in the reference group (girls: .36 greater percentile point improvement, 95% confidence interval: .09-.63; boys: .38 greater percentile point improvement, 95% confidence interval: .09-.66). A substantial decrease in fitness was associated with a decrease in academics in both boys and girls. Effects of fitness on academics were stronger in high-poverty boys and girls than in low-poverty boys and girls.

CONCLUSIONS

Academic rankings improved for boys and girls who increased their fitness level by >20 percentile points compared to other students. Opportunities for increased physical fitness may be important to support academic performance.

Cognitive performance and BMI in childhood: Shared genetic influences between reaction time but not response inhibition

OBJECTIVE

The aim of this work is to understand whether shared genetic influences can explain the association between obesity and cognitive performance, including slower and more variable reaction times (RTs) and worse response inhibition.

METHODS

RT on a four-choice RT task and the go/no-go task, and commission errors on the go/no-go task for 1,312 twins ages 7-10 years were measured. BMI was measured at 9-12 years. Biometric twin models were run to give an estimate of the genetic correlation (rG ) between body mass index (BMI) and three cognitive measures: mean RT (MRT), RT variability (RTV; the standard deviation of RTs), and commission errors (a measure of response inhibition).

RESULTS

Genetic correlations indicated that 20%-30% of the genes underlying BMI were shared with both RT measures. However, only small phenotypic correlations between MRT and RTV with later BMI (rPh  = ∼0.1) were observed. Commission errors were unassociated with later BMI (rPh  = -0.03, ns).

CONCLUSIONS

Our results are the first to demonstrate significant shared genetic effects between RT performance and BMI. Our findings add biological support to the notion that obesity is associated with slower and more variable RTs. However, our results also emphasize the small nature of the association, which may explain previous negative findings.

The influence of cardiorespiratory fitness on strategic, behavioral, and electrophysiological indices of arithmetic cognition in preadolescent children

The current study investigated the influence of cardiorespiratory fitness on arithmetic cognition in forty 9-10 year old children. Measures included a standardized mathematics achievement test to assess conceptual and computational knowledge, self-reported strategy selection, and an experimental arithmetic verification task (including small and large addition problems), which afforded the measurement of event-related brain potentials (ERPs). No differences in math achievement were observed as a function of fitness level, but all children performed better on math concepts relative to math computation. Higher fit children reported using retrieval more often to solve large arithmetic problems, relative to lower fit children. During the arithmetic verification task, higher fit children exhibited superior performance for large problems, as evidenced by greater d' scores, while all children exhibited decreased accuracy and longer reaction time for large relative to small problems, and incorrect relative to correct solutions. On the electrophysiological level, modulations of early (P1, N170) and late ERP components (P3, N400) were observed as a function of problem size and solution correctness. Higher fit children exhibited selective modulations for N170, P3, and N400 amplitude relative to lower fit children, suggesting that fitness influences symbolic encoding, attentional resource allocation and semantic processing during arithmetic tasks. The current study contributes to the fitness-cognition literature by demonstrating that the benefits of cardiorespiratory fitness extend to arithmetic cognition, which has important implications for the educational environment and the context of learning.

Educational attainment and obesity: a systematic review

Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.

Fitness change and subsequent academic performance in adolescents

BACKGROUND

This study examined the association between fitness change and subsequent academic performance in Taiwanese schoolchildren from 7th grade to 9th grade.

METHODS

The 7th graders from 1 junior high school district participated in this study (N = 669). Academic performance was extracted from school records at the end of each grade. Cardiovascular (CV) fitness, sit-and-reach flexibility, bent-leg curl-ups, and height and weight for calculating body mass index (BMI) were assessed at the start of each grade.

RESULTS

The results showed that improvement in CV fitness, but not muscular endurance or flexibility, is significantly related to greater academic performance. A weak and nonsignificant academic-BMI relationship was seen.

CONCLUSION

CV fitness exhibits stronger longitudinal associations with academic performance than other forms of fitness or BMI for adolescents.

There is no relationship between academic achievement and body mass index among fourth-grade, predominantly African-American children

School-based initiatives to combat childhood obesity may use academic performance to measure success. This cross-sectional study investigated the relationship between academic achievement and body mass index percentile, socioeconomic status (SES), and race by linking existing datasets that are not routinely linked. Data from a school-based project (with National Institutes of Health funding) concerning dietary recall accuracy were linked with data from the state's Department of Education through the state's Office of Research and Statistics. Data were available on 1,504 fourth-grade, predominantly African-American children from 18 schools total in one district in South Carolina during the 2004-2005, 2005-2006, and 2006-2007 school years. School staff administered standardized tests in English, math, social studies, and science. Researchers measured children's weight and height. Children were categorized as low-SES, medium-SES, or high-SES based on eligibility for free, reduced-price, or full-price school meals, respectively. Results from marginal regression analyses for each sex for the four academic subjects, separately and combined, showed that test scores were not related to body mass index percentile, but were positively related to SES (P values <0.0001), and were related to race, with lower scores for African-American children than children of other races (P values <0.0039). Cost-efficient opportunities exist to create longitudinal data sets to investigate relationships between academic performance and obesity across kindergarten through 12th-grade children. State agencies can house body mass index data in state-based central repositories where staff can use globally unique identifiers and link data across agencies. Results from such studies could potentially change the way school administrators view nutrition and physical education.

Primary hypertension and neurocognitive and executive functioning in school-age children

Data on neurocognitive function in hypertensive children are limited. In this review, we summarize recent preliminary, early studies that suggest that children with elevated blood pressure demonstrate evidence of worse performance on direct neurocognitive testing, as well as evidence of executive dysfunction based on parent ratings, compared with matched normotensive comparison groups. Furthermore, hypertensive children may have increased prevalence of learning disabilities as well as a blunted cerebrovascular reactivity compared with normotensive controls. Larger, prospective studies are needed to confirm and further explore these emerging but preliminary findings.

Impact of a school-based pediatric obesity prevention program facilitated by health professionals

BACKGROUND

This study evaluated a school-based obesity intervention for elementary school children (N = 835) where health professionals assisted teachers with the integration of healthy messages into the school curriculum.

METHODS

Schools were randomized into a professional-facilitated intervention (PFI; N = 4) or a self-help (SH; N = 3) condition. Changes in weight-based outcomes were assessed in students enrolled in the second grade from all 7 schools (overall: N = 835 students; PFI: N = 509 students, SH: N = 326 students). Students were between ages 7 and 9 and from diverse ethnic backgrounds (Asian = 25.3%, Black = 23.3%, Hispanic = 23.1%, White = 28.3%). The sample included 321 overweight/obese (BMI ≥ 85th percentile), 477 normal-weight (BMI ≥ 5th percentile and <85th percentile), and 37 underweight (BMI < 5th percentile) students.

RESULTS

After 2 years, children who were overweight/obese in the PFI condition significantly reduced their standardized BMI (zBMI) compared to children in the SH condition (Wald χ(2)  = 28.7, p < .001). End-of-year grades decreased for overweight/obese students in both conditions; however, students in the PFI exhibited a smaller decrease in grades compared to the SH condition (Wald χ(2)  = 80.3, p < .001).

CONCLUSION

The results indicate that an obesity prevention program where health professionals assist teachers by integrating healthy messages into existing curriculum was effective in reducing zBMI compared to the SH condition.

Health and school outcomes during children's transition into adolescence

PURPOSE

Normative biopsychosocial stressors that occur during entry into adolescence can affect school performance.As a set of resources for adapting to life's challenges, good health may buffer a child from these potentially harmful stressors. This study examined the associations between health (measured as well-being, functioning, symptoms, and chronic conditions) and school outcomes among children aged 9-13 years in 4th-8th grades.

METHODS

We conducted a prospective cohort study of 1,479 children from 34 schools followed from 2006 to 2008. Survey data were obtained from children and their parents, and school records were abstracted. Measures of child self-reported health were dichotomized to indicate presence of a health asset. Outcomes included attendance, grade point average, state achievement test scores, and child-reported school engagement and teacher connectedness.

RESULTS

Both the transition into middle school and puberty had independent negative influences on school outcomes. Chronic health conditions that affected children's functional status were associated with poorer academic achievement. The number of health assets that a child possessed was positively associated with school outcomes. Low levels of negative stress experiences and high physical comfort had positive effects on teacher connectedness, school engagement, and academic achievement, whereas bullying and bully victimization negatively affected these outcomes. Children with high life satisfaction were more connected with teachers, more engaged in schoolwork, and earned higher grades than those who were less satisfied.

CONCLUSIONS

As children enter adolescence, good health may buffer them from the potentially negative effects of school and pubertal transitions on academic success.

Associations of physical activity and dietary behaviors with children's health and academic problems

BACKGROUND

We examined the associations of physical activities and dietary behaviors with children's health and academic-behavioral problems.

METHODS

We employed a Community-wide Children's Health Assessment and Planning Survey to examine physical activity, healthy meals, health status, and academic-behavioral problems in 3708 children 7 to 14 years of age. Statistical associations were examined with chi-square test and logistic regression analysis; we calculated odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Among these children, 30.2% were overweight-obese, 11.0% had academic problems, and 7.9% had behavioral problems. Children classified as healthy eaters were more likely to exercise ≥4 days/week (79.1% vs 64.6%, OR: 2.08, 95% CI: 1.14 to 2.49), less likely to be overweight-obese (27.7% vs 44.6%, OR: 0.48, CI: 0.31 to 0.73), less likely to have academic problems (9.1% vs 16.1%, OR: 0.57, 95% CI: 0.41 to 0.79) and behavioral problems (6.9% vs 13.9%, OR: 0.46, 95% CI: 0.32 to 0.66) compared with their less healthy eating peers. Physical activity and healthy meals were associated with an improved health status (p < .001). However, the proportions of children taking unhealthy meals or choosing sedentary lifestyle increased as the cohorts progressed (p < .05) from childhood (7 to 8 years) to adolescence (13 to 14 years).

CONCLUSIONS

Healthy (or unhealthy) lifestyle behaviors are significantly interrelated. Children who take healthy meals and exercise often are associated with better health and fewer academic and behavioral problems. Unfortunately, taking unhealthy meals and sedentary lifestyle characterize a growing proportion of young adolescents. Thus, curbing unhealthy lifestyle behaviors should start in early childhood.

Children's aerobic fitness and academic achievement: a longitudinal examination of students during their fifth and seventh grade years

OBJECTIVES

We assessed children's potential differences in academic achievement based on aerobic fitness over a 2-year period.

METHODS

The longitudinal study sample included 3 cohorts of students (n = 1725; 50.1% male) enrolled in a West Virginia public school system. Students received baseline fitness and academic assessments as fifth graders and at a 2-year follow-up assessment. We used FitnessGram to assess fitness in aerobic capacity and WESTEST, a criterion-based assessment, for academic performance.

RESULTS

Students who stayed in the healthy fitness zone (HFZ) had significantly higher WESTEST scores than did students who stayed in the needs improvement zone (NIZ). Students who moved into or out of the HFZ occasionally had significantly higher WESTEST scores than did students who stayed in the NIZ, but they were rarely significantly lower than those of students who stayed in the HFZ.

CONCLUSIONS

Students' aerobic capacity is associated with greater academic achievement as defined by standardized test scores. This advantage appears to be maintained over time, especially if the student stays in the HFZ.

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.

Association between increased BMI and severe school absenteeism among US children and adolescents: findings from a national survey, 2005-2008

OBJECTIVE

School absenteeism may be an underlying cause of poor school performance among overweight and obese children. We examined the associations between school absenteeism and body mass index (BMI) in a nationally representative sample.

DESIGN AND SUBJECTS

We analyzed the data of 1387 children (6-11 years) and 2185 adolescents (12-18 years), who completed an interview and anthropometric measurement as a part of the National Health and Nutrition Examination Survey, 2005-2008. The CDC 2000 growth chart was used to categorize BMI status, and the number of school days missed during the past 12 months was assessed by asking the proxies or interviewees.

RESULTS

The prevalence of obesity and overweight were 18.96±1.44% (s.e.) and 16.41±0.78%, respectively, among study populations. The means of school days missed in the last 12 months were not statistically different between the normal-weight, overweight and obese groups, 3.79±0.56, 3.86±0.38 and 4.31±0.01 days, respectively. However, when >2 days missed per school month was defined as severe absence, the prevalence of severe absence were 1.57%, 2.99% and 4.94% respectively, among 6-11-year-old children with normal, overweight and obese. The adjusted odds of severe school absence were 2.27 (95% confidence interval=0.64-8.03) and 3.93 (1.55-9.95), respectively, among overweight and obese children compared with normal-weight peers (P for trend test <0.01). No significant association was found among adolescents.

CONCLUSION

Increased body weight is independently associated with severe school absenteeism in children but not adolescents. Future research is needed to determine the nature, and academic and social significance of this association.

School outcomes of children with special health care needs

OBJECTIVE

To examine the associations between having a special health care need and school outcomes measured as attendance, student engagement, behavioral threats to achievement, and academic achievement.

PARTICIPANTS AND METHODS

A total of 1457 children in the fourth through sixth grades from 34 schools in 3 school districts and their parents provided survey data; parents completed the Children With Special Health Care Needs Screener. School records were abstracted for attendance, grades, and standardized achievement test scores.

RESULTS

Across 34 schools, 33% of children screened positive for special health care needs. After adjusting for sociodemographic and school effects, children with special health care needs had lower motivation to do well in school, more disruptive behaviors, and more frequent experiences as a bully victim. They experienced significantly lower academic achievement, as measured by grades, standardized testing, and parental-assessed academic performance. These findings were observed for children who qualified as having a special health care need because they had functional limitations attributed to a chronic illness or a behavioral health problem but not for those who qualified only because they took prescription medications.

CONCLUSIONS

Specific subgroups of children with special health care needs are at increased risk for poor school outcomes. Health and school professionals will need to collaborate to identify these children early, intervene with appropriate medical and educational services, and monitor long-term outcomes.

Fitness, fatness, cognition, behavior, and academic achievement among overweight children: do cross-sectional associations correspond to exercise trial outcomes?

BACKGROUND

This study examined associations of fitness and fatness with cognitive processes, academic achievement, and behavior, independent of demographic factors, at the baseline of an exercise trial.

METHODS

Overweight, sedentary but otherwise healthy 7-11 year olds (N=170) participated in a study of health, cognition and achievement in the Augusta, GA area from 2003-2006. Children underwent evaluations of fatness and fitness, psychological assessments of cognition and academic achievement, and behavior ratings by parents and teachers. Partial correlations examined associations of fitness and fatness with cognitive and achievement scores and behavior ratings, controlling for demographic factors.

RESULTS

Fitness was associated with better cognition, achievement and behavior, and fatness with worse scores. Specifically, executive function, mathematics and reading achievement, and parent ratings of child behavior were related to fitness and fatness. Teacher ratings were related to fitness.

CONCLUSION

These results extend prior studies by providing reliable, standardized measures of cognitive processes, achievement, and behavior in relation to detailed measures of fitness and fatness. However, cross-sectional associations do not necessarily indicate that improving one factor, such as fatness or fitness, will result in improvements in factors that were associated with it. Thus, randomized clinical trials are necessary to determine the effects of interventions.

Relationship of nutrition and physical activity behaviors and fitness measures to academic performance for sixth graders in a midwest city school district

BACKGROUND

To support curriculum and policy, a midwest city school district assessed the association of selected categories of nutrition and physical activity (NUTR/PA) behaviors, fitness measures, and body mass index (BMI) with academic performance (AP) for 800 sixth graders.

METHODS

Students completed an adapted Youth Risk Behavior Surveillance Survey (NUTR/PA behaviors), fitness assessments (mile run, curl-ups, push-ups, height, and weight) with results matched to standardized scores (Measures of Academic Progress [MAP]), meal price status, and gender. Differences in mean MAP scores (math and reading) were compared by selected categories of each variable utilizing 1-way analysis of variance. Associations were determined by stepwise multiple regression utilizing mean MAP scores (for math and for reading) as the dependent variable and NUTR/PA behaviors, fitness, and BMI categories as independent variables. Significance was set at α = 0.05.

RESULTS

Higher MAP math scores were associated with NUTR (more milk and breakfast; less 100% fruit juice and sweetened beverages [SB]) and PA (increased vigorous PA and sports teams; reduced television), and fitness (higher mile run performance). Higher MAP reading scores were associated with NUTR (fewer SB) and PA (increased vigorous PA, reduced television). Regression analysis indicated about 11.1% of the variation in the mean MAP math scores and 6.7% of the mean MAP reading scores could be accounted for by selected NUTR/PA behaviors, fitness, meal price status, and gender.

CONCLUSION

Many positive NUTR/PA behaviors and fitness measures were associated with higher MAP scores supporting the school district focus on healthy lifestyles. Additional factors, including meal price status and gender, contribute to AP.

Health-related fitness in children and adolescents

PURPOSE

The American Physical Therapy Association Section on Pediatrics developed a task force to summarize fitness guidelines for children and adolescents. The purposes of this article were to review components, measurement methods, and consequences of physical fitness, and to summarize evidence-based activity recommendations for youth.

SUMMARY OF KEY POINTS

Health-related fitness is comprised of body composition, flexibility, cardiorespiratory endurance, and muscular strength and endurance. Each of these components is reviewed in terms of definition, assessment, normative values, and recommendations.

CONCLUSIONS

The task force supports the guidelines of the US Department of Health and Human Services, which state that to promote overall health and wellness, youth should participate in 60 minutes or more of physical activity every day.

RECOMMENDATIONS FOR CLINICAL PRACTICE

Physical therapists should apply research relevant to health-related fitness when treating youth. Promoting fitness, health, and wellness in our communities is a responsibility all therapists should assume.

The association of health-related fitness with indicators of academic performance in Texas schools

This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school grades. Mixed-model regression analyses revealed modest associations between fitness and academic achievement after controlling for potentially confounding variables. The effects of fitness on academic achievement were positive but small. A separate logistic regression analysis indicated that higher fitness rates increased the odds of schools achieving exemplary/recognized school status within the state. School fitness attainment is an indicator of higher performing schools. Direction of causality cannot be inferred due to the cross-sectional nature of the data.

School performance as a predictor of adulthood obesity: a 21-year follow-up study

We examined the impact of school performance measured in terms of grade point averages (GPAs) in early and middle adolescence (ages 9, 12, and 15), and the impact of school performance throughout the different school stages on adult obesity. The participants were 732 healthy women and men derived from a population-based Cardiovascular Risk in Young Finns Study. GPAs were measured at the ages of 9, 12, and 15. The body mass index (BMI; kg/m(2)), and the waist circumference (WC) were conducted participants being aged 27 or 30. Birth weight, childhood BMI, adulthood physical activity, maternal and paternal BMI, and maternal education were controlled for. The results showed that low GPAs in each measurement and low GPAs throughout the comprehensive school were a risk factor of adulthood obesity, but only among women. The association remained when controlling for potential confounding variables (p-values in the fully adjusted models 0.026, 0.007, and 0.004 at the ages of 9, 12, and 15, respectively). The results were similar when the BMI was used as a dichotomous variable (BMI > or = 30 and BMI < 30). Low school performance has previously been associated with higher rates of smoking and alcohol consumption later in life. Our result underscores that low school performance is a health risk factor that should be taken seriously in preventive health education.

Research Quarterly for Exercise and Sport lecture. Statewide physical fitness testing: a big waist or a big waste?

Statewide physical fitness testing is gaining popularity in the United States because of increased childhood obesity levels, the relations between physical fitness and academic performance, and the hypothesized relations between adult characteristics and childhood physical activity, physical fitness, and health behaviors. Large-scale physical fitness testing can be fraught with problems unless properly planned and conducted. Legislators, administrators, teachers, and parents should consider the following 10 essential issues when conducting large-scale physical fitness testing purpose of testing, proper planning, training, quality of the data, reporting support, costs, interpretation, programmatic matters, and policies and politics.