Independent and combined influence of healthy lifestyle factors on academic performance in adolescents: DADOS Study

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents

INTRODUCTION

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval.

METHODS

A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities.

RESULTS

Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05).

CONCLUSION

Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

Direct and indirect effects of physiological, psychological and cognitive variables on academic achievement in children

BACKGROUND

Associations between cardiorespiratory fitness (CRF), screen time, psychological well-being, executive functions, and academic achievement have been reported, however, few studies have analysed models considering the effect of all these variables on academic achievement. This study aims to analyse the direct and indirect associations of mothers' education level, CRF, screen time, psychological well-being, executive functions, with academic achievement in schoolchildren, by sex.

METHODS

This was a cross-sectional analysis of MOVI-daFit! study including 519 schoolchildren (49.52% girls) aged 9-11 years old. Executive functions were assessed with the NIH Toolbox, CRF with the 20-m shuttle run test, academic achievement through the final academic grades in language and mathematics and mother's education level, screen time and well-being by questionnaires.

RESULTS

Structural equation modelling revealed that in boys cognitive flexibility had a significant direct effect on academic achievement and screen time a total significant effect on academic achievement. In girls, CRF was associated with inhibition and psychological well-being, and this was associated with academic achievement.

CONCLUSIONS

Physiological, psychological, and behavioural variables act together to impact academic achievement, and that differences by sex might exist. Thus, strategies to enhance academic achievement in schoolchildren should consider psychological well-being, CRF, screen time, and sex differences.

IMPACT

Physiological, psychological, and behavioural variables, such as cardiorespiratory fitness, screen time, psychological well-being, and cognition all together have an impact on academic achievement, with differences by sex. Previous studies have demonstrated the separate effect of these variables, however, to date, this is the first study that analyses all together in the same model their impact on academic achievement, by sex. This study shows that in boys cognitive flexibility and screen time impact academic achievement. In girls, cardiorespiratory fitness is highly associated with psychological well-being, and this, in turn, was associated with academic achievement.

Prevalence of Disordered Eating and Its Associated Factors From a Socioecological Approach Among a Sample of Spanish Adolescents: The EHDLA Study

Objectives: The aim of this study was twofold: a) to establish the prevalence of adolescents with disordered eating and b) to determine the factors associated with this prevalence in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain).

Methods: This cross-sectional study analyzed data from 730 adolescents (56.2% girls) from the EHDLA study. To determine the prevalence of disordered eating, the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used. A socioecological approach was used to identify individual-, interpersonal-, or organizational-level factors associated with disordered eating.

Results: The prevalence of disordered eating was 30.1%. This condition was associated with female sex (odds ratio [OR] = 2.60; 95% confidence interval [CI], 1.81–3.73), immigrant status (OR = 2.22; 95% CI, 1.51–3.25), or excess weight (OR = 2.74; 95% CI, 1.93–3.89). Furthermore, for each additional hour slept, lower odds of having disordered eating were found (OR = 0.81; 95% CI, 0.67–0.98).

Discussion: Almost one-third of the sample of Spanish adolescents analyzed reported disordered eating. Female sex, immigrant status and excess weight are individual aspects that seem to be related to disordered eating among Spanish adolescents.

The bidirectional longitudinal association between health-related quality of life and academic performance in adolescents: DADOS study

PURPOSE

Although previous evidence has suggested a relationship between health-related quality of life (HRQoL) and academic performance, the directionality of this association is understudied and remains to be clarified. Thus, the primary objective of this study was to explore the bidirectional association between HRQoL and academic performance in adolescents between two timepoints with a 24-month interval. A secondary aim was to analyze whether this association varies between boys and girls.

METHODS

This is a bidirectional longitudinal analysis with 257 adolescents (13.9 ± 0.3 years at baseline) from the DADOS study. HRQoL was measured using the KIDSCREEN-10 questionnaire. Academic performance was assessed through academic grades and the Spanish version of the Science Research Associates Test of Educational Ability.

RESULTS

Cross-lagged analyses revealed that HRQoL at baseline was not associated with academic performance 24 months later, while all the academic grades and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up in adolescents. Results of the stratified analyses by sex were largely similar. Specifically, in girls, math, language, physical education, and grade point average at baseline were positively associated with HRQoL 24 months later, while in boys, all the academic grades indicators (except physical education), numeric ability, and the overall score of academic abilities at baseline were positively associated with HRQoL at follow-up.

CONCLUSION

These findings suggest that academic performance in early adolescence may predict HRQoL 24 months later. Health and education professionals could benefit from collaborating to achieve both improved academic performance and HRQoL in youth.

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.

A lifestyle score in childhood and adolescence was positively associated with subsequently measured fluid intelligence in the DONALD cohort study

PURPOSE

Lifestyle scores which combine single factors such as diet, activity, or sleep duration showed associations with cognitive decline in adults. However, the role of a favourable lifestyle in younger age and the build-up of cognitive reserve is less clear, which is why we investigated longitudinal associations between a lifestyle score in childhood and adolescence and fluid intelligence obtained on average 6 years later.

METHODS

In the DONALD cohort, a lifestyle score of 0 to 4 points including healthy diet and duration of moderate-to-vigorous physical activity, sedentary behaviour and sleep was repeatedly assessed in participants aged 5 and 19 years. Data on fluid intelligence were assessed via a German version of the culture fair intelligence test (CFT), using CFT 1-R in children 8.5 years of age or younger (n = 62) or CFT 20-R in participants older than 8.5 years (n = 192). Multivariable linear regression models were used to investigate prospective associations between the lifestyle score and the fluid intelligence score.

RESULTS

Mean lifestyle score of all participants was 2.2 (0.7-4) points. A one-point increase in the lifestyle score was associated with a higher fluid intelligence score (4.8 points [0.3-7.3], p = 0.0343) for participants completing the CFT 20-R. Furthermore, each additional hour of sedentary behaviour was associated with a lower fluid intelligence score (- 3.0 points [- 5.7 to - 0.3], p = 0.0313). For younger participants (CFT 1-R), no association was found in any analysis (p > 0.05).

CONCLUSION

A healthy lifestyle was positively associated with fluid intelligence, whereby sedentary behaviour itself seemed to play a prominent role.

Longitudinal Associations of Healthy Behaviors on Fitness in Adolescents: DADOS Study

INTRODUCTION

This study aims to investigate the individual and combined associations of physical activity, sedentary time, diet, and sleep at baseline on cardiorespiratory fitness at 24-month follow-up in adolescents.

METHODS

The DADOS (Deporte, ADOlescencia y Salud) prospective cohort study was performed between 2015 and 2017. Analyses were conducted in 2020 and included 189 adolescents aged 13.9 (SD=0.3) years at baseline. Vigorous physical activity, total sedentary time, and sleep duration were evaluated by GENEActiv accelerometer. Sleep quality and adherence to a Mediterranean diet were evaluated by questionnaires. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. A healthy lifestyle index was created by including positive scores for each individual behavior, and 3 categories of achievement (≤1, 2, ≥3) were established.

RESULTS

Performing high vigorous physical activity and low screen time at baseline were individually associated with the likelihood of achieving high cardiorespiratory fitness at follow-up (OR=3.33 and 3.09, respectively). ANCOVA indicated that adolescents with a healthy lifestyle index ≥3 at baseline showed higher cardiorespiratory fitness at follow-up than those with a healthy lifestyle index of 2 and ≤1 (74.4 [SE=1.5] vs 68.9 [SE=1.4] and 67.8 [SE=1.5] laps, respectively; p<0.01). Adolescents with a healthy lifestyle index ≥3 at baseline were more likely to have high cardiorespiratory fitness at follow-up (OR=3.10) than their peers with ≤1.

CONCLUSIONS

The results showed a cumulative impact of baseline health-related behaviors on cardiorespiratory fitness at 24-month follow-up in adolescents. These findings underline the key role of promoting a healthy lifestyle to improve adolescents' health.

Identifying the views of adolescents in five European countries on the drivers of obesity using group model building

Background

To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond individual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was to use the group model building (GMB) method to identify young people’s perceptions of the drivers of adolescent obesity in five European countries, as part of the EU-funded Co-Create project.

Methods

We used GMB with four groups of 16–18-year-olds in schools in each of the five European countries (The Netherlands, Norway, Poland, Portugal and the UK) to create causal loop diagrams (CLDs) representing their perceptions of the drivers of adolescent obesity. The maps were then merged into one, using a new protocol.

Results

Two hundred and fifty-seven participants, aged 16–18 years, engaged in 20 separate system mapping groups, each of which generated 1 CLD. The findings were largely congruent between the countries. Three feedback loops in the merged diagram particularly stand out: commercial drivers of unhealthy diets; mental health and unhealthy diets; social media use, body image and motivation to exercise.

Conclusions

GMB provides a novel way of eliciting from young people the system-based drivers of obesity that are relevant to them. Mental health issues, social media use and commercial practices were considered by the young people to be key drivers of adolescent obesity, subjects that have thus far had little or no coverage in research and policy.