Executive function and weight status in children: A one-year longitudinal perspective

Early childhood executive control modulates negative affectivity's role in increasing adolescent body mass index trajectories

BACKGROUND

Executive control and temperament have been associated with pediatric obesity. However, interactions between these constructs in relation to future weight outcomes have not been investigated.

OBJECTIVE

This longitudinal study examined early childhood executive control, early temperament (negative affectivity and surgency), and their interactions as predictors of adolescent BMI trajectories.

METHODS

At age 5.25, children (N = 229) completed executive control tasks, and parents completed the Child Behavior Questionnaire to assess temperament. BMI was calculated annually between ages 14-17.

RESULTS

Greater early negative affectivity predicted more positive BMI growth. Although early childhood executive control was not associated with BMI growth, greater negative affectivity predicted greater BMI escalation at average and below average executive control abilities.

CONCLUSIONS

For children without robust executive control abilities early in development, negative affectivity may be a risk factor for accelerated adolescent BMI growth. Targeted assessment of early risk factors may be useful for childhood obesity prevention efforts.

A scoping review on self-regulation and reward processing measured with gambling tasks: Evidence from the general youth population

Aberrant reward processing and poor self-regulation have a crucial role in the development of several adverse outcomes in youth, including mental health disorders and risky behaviours. This scoping review aims to map and summarise the evidence for links between aspects and measures of reward processing and self-regulation among children and adolescents in the general population. Specifically, it examined the direct associations between self-regulation (emotional or cognitive regulation) and reward processing. Studies were included if participants were <18 years and representative of the general population. Quantitative measures were used for self-regulation, and gambling tasks were used for reward processing. Of the eighteen studies included only two were longitudinal. Overall, the direction of the significant relationships identified depended on the gambling task used and the self-regulation aspect explored. Emotional regulation was measured with self-report questionnaires only, and was the aspect with the most significant associations. Conversely, cognitive regulation was mainly assessed with cognitive assessments, and most associations with reward processing were non-significant, particularly when the cognitive regulation aspects included planning and organisational skills. Nonetheless, there was some evidence of associations with attention, cognitive control, and overall executive functioning. More longitudinal research is needed to draw accurate conclusions on the direction of the association between self-regulation and reward processing.

Chronic exercise interventions for executive function in overweight children: a systematic review and meta-analysis

Objectives

To systematically evaluate the effectiveness of chronic exercise in physical activity (PA) as an intervention for executive functions (EFs) in children.

Methods

We conducted a systematic search in the following online databases: Web of Science, Cochrane Library, PubMed, Embase, and EBSCOhost. The timing is from database inception to July 2023, following PRISMA guidelines. Our inclusion criteria required studies reporting executive function (EF) levels in overweight children (age 0-18 years) before and after interventions. The Cochrane risk of bias tool assessed study bias, and Egger's test examined publication bias. Subgroup analyses considered three moderators: intervention duration, weekly frequency, and session length.

Results

The meta-analysis included a total of 10 studies with 843 participants. It revealed a statistically significant yet relatively small overall positive effect (g = 0.3, 95% CI 0.16-0.44, P < 0.01) of chronic exercise on EF in overweight children. Importantly, there was no significant heterogeneity (Q = 11.64, df = 12, P = 0.48; I2 = 0).

Conclusions

Chronic exercise interventions had a consistent positive impact on EF, irrespective of intervention duration, weekly frequency, or session length. However, given limitations in the number and design of studies, further high-quality research is needed to strengthen these conclusions.

Systematic Review Registration

PROSPERO identifier (CRD42023468588).

Children at high familial risk for obesity show executive functioning deficits prior to development of excess weight status

OBJECTIVE

The objective of this study was to determine whether children with healthy weight who vary by familial risk for obesity differ in executive functioning.

METHODS

Children (age 7-8 years) without obesity (n = 93, 52% male) who differed by familial risk for obesity (based on maternal weight status) completed go/no-go and stop-signal tasks to assess inhibitory control and an N-back task to assess working memory. Dual energy x-ray absorptiometry measured adiposity. Linear and mixed-effect models assessed unique effects and relative importance analysis-quantified relative effects of familial risk and percent body fat.

RESULTS

Children at high compared with low familial risk showed worse inhibitory control; however, child adiposity was not associated with inhibitory control. Both high familial risk and greater child adiposity were associated with worse N-back performance when cognitive demand was high (2-back), but not low (0- and 1-back). The relative effect of familial risk on executive functioning was 2.7 to 16 times greater than the relative effect of percent body fat.

CONCLUSIONS

These findings provide initial evidence that deficits in executive functioning may precede the development of obesity in children at high familial risk for this disease. Additional family risk studies are needed to elucidate the pathways through which maternal obesity influences child executive functioning and risk for obesity.

Overweight/obesity and socio-demographic disparities in children's motor and cognitive function

Fundamental motor skills (FMS) and cognitive function are important indicators of development in early childhood. Using a cross-sectional design, the purpose of this study was to investigate obesity (healthy weight vs. overweight/obese) and socio-demographic (i.e., gender, SES) disparities in FMS (locomotor and ball skills) and cognitive function (reaction time [RT] and movement time [MT]), in preschoolers. There were 74 preschoolers (girl = 38; M_age = 4.02 ± 0.73) recruited from two childcare centers and were categorized into healthy weight (n = 58, BMI percentile < 85%) and overweight/obese (n = 16, BMI percentile ≥ 85%) categories. Children's FMS were assessed using the TGMD-3; cognitive function was assessed by the iPad-based CANTAB™ software using the Reaction Time Task (RTI), including reaction time (RT; Simple RT [SRT], choice RT [CRT]) and movement time (MT; simple MT [SMT], choice MT [CMT]). Children presented less FMS proficiency compared to recent data. Both weight groups performed comparably in FMS (ps > 0.05; ball skill Cohen's d = 0.40; locomotor Cohen's d = 0.02). Children in the overweight/obese group performed significantly worse on all cognitive tests compared to healthy weight peers (ps < 0.05; Cohen's d range from -0.93 to -1.43). No significant gender or SES disparities were observed. Maintaining healthy weight status is critical for cognitive development among preschoolers, which may influence their developmental trajectory and school readiness.

Bidirectional Associations Between Adiposity and Cognitive Function and Mediation by Brain Morphology in the ABCD Study

Importance

Most epidemiologic studies examine the brain as an outcome in relation to adiposity (ie, the brain-as-outcome perspective), but it is also a potential risk factor associated with adiposity accumulation over time (ie, the brain-as-risk factor perspective). The bidirectionality hypothesis has not been fully explored in adolescent samples previously.

Objective

To assess bidirectional associations between adiposity and cognitive function in youth and test mediational pathways through brain morphology (specifically the lateral prefrontal cortex [LPFC]), lifestyle behaviors, and blood pressure.

Design, Setting, and Participants

This cohort study uses data (wave 1-3; 2 years of follow-up) from the Adolescent Brain Cognitive Development (ABCD) Study, a long-term longitudinal investigation of brain development in the United States launched in 2015, which recruited 11 878 children aged 9 to 10 years at inception. Data analysis was performed from August 2021 to June 2022.

Main Outcomes and Measures

Multivariate multivariable regression analyses were used to assess bidirectional associations of indicators of cognitive function (eg, executive function, processing speed, episodic memory, receptive vocabulary and reading skills) and adiposity (eg, body mass index z scores [zBMI] and waist circumference [WC]). Mediators considered for this investigation were lifestyle variables (eg, diet and physical activity), blood pressure, and the morphology of the LPFC and its subregions.

Results

A total of 11 103 individuals (mean [SD] age, 9.91 [0.6] years; 5307 females [48%]; 8293 White individuals [75%] and 2264 Hispanic individuals [21%]) were included in the current study. Multivariate multivariable regression analyses revealed that higher baseline zBMI and WC were associated with worse follow-up episodic memory (β, -0.04; 95% CI, -0.07 to -0.01) and better vocabulary (β, 0.03; 95% CI, 0.002 to 0.06) task performance, in covariate adjusted models. Similarly, superior baseline executive function (zBMI: β, -0.03; 95% CI, -0.06 to -0.01; WC: β, -0.04; 95% CI, -0.07 to -0.01) and episodic memory (zBMI: β, -0.04; 95% CI, -0.07 to -0.02; WC: β, -0.03; 95% CI, -0.06 to -0.002) task performance were associated with better follow-up adiposity status in covariate adjusted models. Cross-lagged panel models with latent variable modeling had a bidirectional association with executive function task performance (brain-as-outcome: β, -0.02; 95% CI, -0.05 to -0.001; brain-as-risk factor: β, -0.01; 95% CI, -0.02 to -0.003). The hypothesized associations were statistically mediated by LPFC volume and thickness, physical activity, and blood pressure.

Conclusions and Relevance

In this cohort study, executive function and episodic memory were bidirectionally associated with adiposity indices over time in this adolescent sample. These findings suggest that the brain can be both a risk factor and an outcome of adiposity; this complex bidirectional association should be taken into account in future research and clinical practice.

Interoceptive accuracy is associated with benefits in decision making in children

Introduction

Decision making results not only from logical analyses, but seems to be further guided by the ability to perceive somatic information (interoceptive accuracy). Relations between interoceptive accuracy and decision making have been exclusively studied in adults and with regard to complex, uncertain situations (as measured by the Iowa Gambling Task, IGT).

Methods

In the present study, 1454 children (6-11 years) were examined at two time points (approximately 1 year apart) using an IGT as well as a delay-of-gratification task for sweets-items and toy-items. Interoceptive accuracy was measured using a child-adapted version of the Heartbeat Perception Task.

Results

The present results revealed that children with higher, as compared to lower, interoceptive accuracy showed more advantageous choices in the IGT and delayed more sweets-items, but not toy-items, in a delay-of-gratification task at time point 2 but not at time point 1. However, no longitudinal relation between interoceptive accuracy and decision making 1 year later could be shown.

Discussion

Results indicate that interoceptive accuracy relates to decision-making abilities in situations of varying complexity already in middle childhood, and that this link might consolidate across the examined 1-year period. Furthermore, the association of interoceptive accuracy and the delay of sweets-items might have implications for the regulation of body weight at a later age.

Insomnia attenuates response inhibition: Evidence from Go/NoGo research

OBJECTIVE

Varied cognitive dysfunctions including memory, attention, inputs, processing and filtration have been found in insomnia. Meanwhile, evidence from functional neuroimaging have revealed that the abnormal metabolism in prefrontal cortex was associated with probable deficit of executive function. And in our study, we have detected the response inhibition in insomnia patients by Go/NoGo,an Event-related potentials (ERPs) study, in order to explore the impaired executive function, because response inhibition is a hallmark of executive function.

METHODS

We used polysomnography (PSG) to record such objective PSG parameters. Go/NoGo was performed in sequence, different ERP components have been analyzed such as latency or amplitude between insomnia group and control group. And we used Person correlation coefficient R to make analysis between different ERP components and gender, duration, education, BMI and sleep characteristics.

RESULTS

On the behavioral level, we found a little poor performance insomnia participants. On the electrophysiological level, under Go condition, insomnia participants have prolonged latency and smaller amplitude of N2 or P3. While, under NoGo condition, insomnia participants also have longer latency, but higher amplitude of N2 or P3. another major finding was that different correlation was found between gender,anxiety-depression,duration, education,BMI,sleep characteristics and N2 or P3.

DISCUSSION

Our study has revealed that sleep loss may influence the response inhibition ability in insomnia, not only on behavior level, but also on the electrophysiological level. Abnormal changes in inhibition process or inhibition supervision can be represented as N2/P3 components under Go/No-go condition. Additionally, correlation analysis has been found between gender, anxiety-depression, BMI, education, and sleep structure. Thus, sleep loss attenuates response inhibition and impairs executive function in insomnia participants.

Bidirectional prediction between weight status and executive function in children and adolescents: A systematic review and meta-analysis of longitudinal studies

This study examined the predictability of child weight status on executive function (EF) and vice versa. We searched PubMed, CINAHL, Web of Science, and EMBASE for longitudinal studies conducted in children and adolescents on October 31, 2021. A pairwise meta-analysis was performed using a frequentist random-effects approach. The quality of all included studies was evaluated using Newcastle-Ottawa Scale and GRADE assessments. This study included 18 longitudinal studies (N = 30,101). Overall executive functioning was a significant negative predictor of child weight status (pooled beta coefficient = -0.14; 95% confidence interval [CI] [-0.22 to -0.07]; I²  = 97%). The pooled odds ratio also revealed that high EF children had a significant lower risk for developing overweight/obesity (odds ratio [OR] = 0.72; 95% CI [0.59 to 0.87]; I²  = 72%). Conversely, child weight status was a significant negative predictor of overall executive functioning (pooled beta coefficient = -0.06; 95% CI [-0.12 to -0.01]; I²  = 81%). These results suggest a bidirectional prediction between child weight status and EF. These predictabilities are low but potentially beneficial for implementation in childcare systems.

Context Matters: Preliminary Evidence That the Association between Positive Affect and Adiposity in Infancy Varies in Social vs. Non-Social Situations

Previous studies have suggested that infants high in negative affect have higher levels of adiposity, arising in part via changes in nutrition (e.g., “feeding to soothe”). Few studies have examined whether positive affect shows similar or inverse associations with adiposity. The current study examined cross-sectional and longitudinal relationships between adiposity and observations of positive affect in both a social and a non-social context, using data from infants at four (n = 125) and 12 (n = 80) months of age. Our analyses did not find any cross-sectional associations between positive affect and adiposity (all p > 0.05). However, in the longitudinal analyses, positive affect in a non-social context, when observed at four months of age, was positively associated with weight-for-length at 12 months of age (zWFL; ß = 1.49, SE = 0.67, p = 0.03), while positive affect observed at four months of age in a social context was inversely associated with body fat percentage at 12 months of age (ß = −11.41, SE = 5.44, p = 0.04). These findings provide preliminary evidence that the p positive affect is related to adiposity in infancy and suggest that the direction of association (i.e., direct or inverse) may be specific to the context in which positive affect is measured. Future research should examine the role of nutritional status in any relationships between adiposity and emotion at this early stage.

Weight spectrum and executive function in adolescents: the moderating role of negative emotions

BACKGROUND

While recent works suggested that overweight/obesity may impair executive function (EF), the overweight/obesity-EF relationship has not been well studied in adolescents. Furthermore, no research has investigated adolescent EF impairments across the weight spectrum (e.g., underweight or thinness, normal, overweight/obesity), especially those with underweight condition, with the moderating effect of negative emotions in the weight-EF association being limitedly investigated. We aimed to determine whether overall and abdominal weight spectrum associated with EF impairments and to identity whether negative emotions moderate the weight-EF link in adolescents.

METHODS

We applied a subsample of the SCHEDULE-A project. Adolescents (11-18 years) were recruited using a multi-stage cluster random sampling approach. We measured the overall and abdominal weight spectrum by body mass index z-score and waist-to-height ratio, respectively. We used the Behavior Rating Inventory of Executive Function (BRIEF) to evaluate adolescent EF in nature setting, and utilized the Depression Anxiety and Stress Scales (DASS-21) to assess three types of negative emotional status (i.e., depression, anxiety, and stress).

RESULTS

Of the 1935 adolescents, 963 (49.8%) were male. We observed that abdominal, not overall, overweight was associated with the Global Executive Composite (GEC) impairment (OR = 1.59, 95% CI 1.07-2.35), particularly for inhibit, emotion control, shift, working memory, and monitor domains. Furthermore, depression moderated the abdominal overweight-GEC association (P = 0.032 for interaction term), especially for emotional control, working memory, and initiate dimensions. Moreover, we also found abdominal thinness was associated with the Metacognition Index problem (OR = 1.33, 95% CI 1.04-1.72), particularly for plan and monitor areas.

CONCLUSIONS

Both abdominal overweight and thinness were associated with adolescent EF, and depression would be a modifiable target to improve EF in adolescents with abdominal overweight. Future longitudinal studies are needed to investigate the causal relationship between abdominal weight spectrum and EF, as well as the underlying mechanisms among adolescents suffering from depression.

Longitudinal associations between executive control and body mass index across childhood

BACKGROUND

Childhood obesity remains a prevalent public health concern. Executive control, a set of higher-order cognitive abilities for directing attention and behaviour, has been identified as a malleable factor potentially related to weight outcomes in youth. However, the directionality of this relationship remains unclear.

OBJECTIVES

This study examined reciprocal associations between three executive control components-inhibitory control, working memory and flexible shifting-and BMI (body mass index) percentile during childhood.

METHODS

At four points throughout elementary school, a community sample (N = 294) completed executive control tasks and had their height and weight objectively measured. Controlling for sex and socioeconomic risk status, random intercept cross-lagged panel models were tested.

RESULTS

Better inhibitory control performance predicted lower subsequent BMI at each timepoint, and better working memory and flexible shifting performance in grade three both predicted lower subsequent BMI in grade 4. However, BMI did not predict subsequent executive control performance at any timepoint.

CONCLUSIONS

Executive control abilities, including automatic response modulation, being able to hold and manipulate mental information, and being able to make flexible mental transitions, may be protective against weight problems, particularly in middle childhood when these abilities have had more time to mature and children begin to gain more independence.

Association Between Genetic Risks for Obesity and Working Memory in Children

Introduction: Obesity is highly heritable, and recent evidence demonstrates that obesity is associated with cognitive deficits, specifically working memory. However, the relationship between genetic risks for obesity and working memory is not clear. In addition, whether the effect of these genetic risks on working memory in children is mediated by increased body mass index (BMI) has not been elucidated. Methods: In order to test whether the polygenic risk score (PRS) for obesity in adulthood (adulthood-BMI-PRS) is associated with working memory at 8 years of age, and whether the effect is mediated by childhood BMI, in children from the general population, participants in the Hamamatsu Birth Cohort for Mothers and Children (HBC) study in Hamamatsu, Japan, underwent testing for association of adulthood-BMI-PRS with working memory. HBC data collection began in December 2007 and is ongoing. Adulthood-BMI-PRS values were generated using summary data from the recent genome-wide association study (GWAS) undertaken in Japan, and the significance of thresholds was calculated for each outcome. Outcomes measured included the working memory index (WMI) of Weschler Intelligence Scale-4 (WISC-IV) scores and the BMI at 8 years of age. Gene-set enrichment analysis was conducted to clarify the molecular basis common to adulthood-BMI and childhood-WMI. Mediation analysis was performed to assess whether childhood-BMI of children mediated the association between adulthood-BMI-PRS and working memory. Results: A total of 734 participants (377 males, 357 females) were analyzed. Adulthood-BMI-PRS was associated with lower childhood-WMI (β[SE], -1.807 [0.668]; p = 0.010, corrected) of WISC-IV. Gene-set enrichment analyses found that regulation of neurotrophin Trk receptor signaling (β[SE], -2.020 [6.39]; p = 0.002, corrected), negative regulation of GTPase activity (β[SE], 2.001 [0.630]; p = 0.002, corrected), and regulation of gene expression epigenetic (β[SE], -2.119 [0.664]; p = 0.002, corrected) were enriched in BMI in adulthood and WMI in childhood. Mediation analysis showed that there is no mediation effect of childhood-BMI between the adulthood-BMI-PRS and working memory deficits in children. Conclusion: Adulthood-BMI-PRS was associated with working memory among children in the general population. These genetic risks were not mediated by the childhood-BMI itself and were directly associated with working memory deficits.

Decision-Making Processes Related to Perseveration Are Indirectly Associated With Weight Status in Children Through Laboratory-Assessed Energy Intake

Decision-making contributes to what and how much we consume, and deficits in decision-making have been associated with increased weight status in children. Nevertheless, the relationships between cognitive and affective processes underlying decision-making (i.e., decision-making processes) and laboratory food intake are unclear. We used data from a four-session, within-subjects laboratory study to investigate the relationships between decision-making processes, food intake, and weight status in 70 children 7-to-11-years-old. Decision-making was assessed with the Hungry Donkey Task (HDT), a child-friendly task where children make selections with unknown reward outcomes. Food intake was measured with three paradigms: (1) a standard ad libitum meal, (2) an eating in the absence of hunger (EAH) protocol, and (3) a palatable buffet meal. Individual differences related to decision-making processes during the HDT were quantified with a reinforcement learning model. Path analyses were used to test whether decision-making processes that contribute to children's (a) expected value of a choice and (b) tendency to perseverate (i.e., repeatedly make the same choice) were indirectly associated with weight status through their effects on intake (kcal). Results revealed that increases in the tendency to perseverate after a gain outcome were positively associated with intake at all three paradigms and indirectly associated with higher weight status through intake at both the standard and buffet meals. Increases in the tendency to perseverate after a loss outcome were positively associated with EAH, but only in children whose tendency to perseverate persistedacross trials. Results suggest that decision-making processes that shape children's tendencies to repeat a behavior (i.e., perseverate) are related to laboratory energy intake across multiple eating paradigms. Children who are more likely to repeat a choice after a positive outcome have a tendency to eat more at laboratory meals. If this generalizes to contexts outside the laboratory, these children may be susceptible to obesity. By using a reinforcement learning model not previously applied to the study of eating behaviors, this study elucidated potential determinants of excess energy intake in children, which may be useful for the development of childhood obesity interventions.

Temporal discounting as a candidate behavioral marker of obesity

Although obesity is a result of processes operating at multiple levels, most forms result from decision-making behavior. The aim of this review was to examine the candidacy of temporal discounting (TD) (i.e. the reduction in the value of a reinforcer as a function of the delay to its receipt) as a behavioral marker of obesity. For this purpose, we assessed whether TD has the ability to: identify risk for obesity development, diagnose obesity, track obesity progression, predict treatment prognosis/outcomes, and measure treatment effectiveness. Three databases (Pubmed, PsycINFO, and Web of Science) were searched using a combination of terms related to TD and obesity. A total of 153 papers were reviewed. Several areas show strong evidence of TD's predictive utility as a behavioral marker of obesity (e.g., distinguishing obese from non obese). However, other areas have limited and/or mixed evidence (e.g., predicting weight change). Given the positive relationship for TD in the majority of domains examined, further consideration for TD as a behavioral marker of obesity is warranted.

Do Hot Executive Functions Relate to BMI and Body Composition in School Age Children?

Deficits of 'hot' executive functions (EFs) involving emotional and motivational processes are considered as a risk factor for excessive weight, but few studies have tested the relationship between hot EFs and body composition in children. The aim of the study was to assess the association of the ability to delay gratification and affective decision-making with the body mass index (BMI) and body composition in children with typical neurocognitive development. The sample consisted of 553 Polish children aged between 6-12 y. The delay of gratification task (DGT) was applied to assess the ability to delay gratification. The Hungry Donkey test (HDT) was applied to assess affective decision-making. The indicators of decision-making in the HDT were net score and learning rate. The relationships between hot EFs and BMI, fat mass index (FMI), lean body mass index (LBMI) were tested. The association of the z scores of BMI and FMI, overweight/obesity, and the ability to delay gratification was found insignificant after controlling cofounding factors. Most of the results on affective decision-making and z scores for BMI, FMI and LBMI were insignificant as well. The relationship between the ability to delay gratification, affective decision-making, and adiposity is not pronounced in typically developed children.

Eating behavior as a new frontier in memory research

The study of memory is commonly associated with neuroscience, aging, education, and eyewitness testimony. Here we discuss how eating behavior is also heavily intertwined-and yet considerably understudied in its relation to memory processes. Both are influenced by similar neuroendocrine signals (e.g., leptin and ghrelin) and are dependent on hippocampal functions. While learning processes have long been implicated in influencing eating behavior, recent research has shown how memory of recent eating modulates future consumption. In humans, obesity is associated with impaired memory performance, and in rodents, dietary-induced obesity causes rapid decrements to memory. Lesions to the hippocampus disrupt memory but also induce obesity, highlighting a cyclic relationship between obesity and memory impairment. Enhancing memory of eating has been shown to reduce future eating and yet, little is known about what influences memory of eating or how memory of eating differs from memory for other behaviors. We discuss recent advancements in these areas and highlight fruitful research pursuits afforded by combining the study of memory with the study of eating behavior.

Bridging executive function and disinhibited eating among youth: A network analysis

OBJECTIVE

Poorer executive function (EF) has been linked to disinhibited eating in youth, suggesting poor EF predisposes toward obesity, yet the specific nature and extent of interconnections between facets of these domains is unclear. Network analysis provides a promising framework for elucidating the relationship between poor EF and disinhibited eating, and offers insights into potential maintenance processes.

METHOD

Among youth ages 8-17 years, a regularized partial correlation network of EF and disinhibited eating facets was estimated to examine expected influence centrality and bridge expected influence. Computerized neurocognitive tasks assessed EF variables, including decision-making, general and food-related inhibitory control, delayed gratification, cognitive flexibility, and working memory. Disinhibited eating variables included total carbohydrate-fat intake at a laboratory test meal and self-reported eating in the absence of hunger, emotional eating, and loss-of-control eating severity.

RESULTS

In the current sample (N = 248; Mage = 12.5; 54.8% female; 43.5% non-Hispanic White; 25.8% non-Hispanic Black; BMI %ile = 65.8 ± 27.8), emotional eating in response to depressive symptoms emerged as a central symptom in the network. Carbohydrate-fat intake had the highest bridge expected influence and was most strongly connected to general inhibitory control (part r = .14).

DISCUSSION

The link between general inhibitory control and objective palatable food intake may be particularly salient in maintaining maladaptive eating behavior. Interventions targeting behavioral disinhibition may disrupt associations among a network of disinhibited eating facets in youth and should be targets for longitudinal research.

The Relationship between Overweight/Obesity and Executive Control in College Students: The Mediating Effect of BDNF and 5-HT

The main aim of this study was to explore the association between overweight/obesity and executive control (EC) in young adults, and to further analyze the mediating effect of brain-derived neurotrophic factor (BDNF) and serotonin (5-hydroxytryptamine (5-HT)) on the relationship between overweight/obesity and EC. A total of 449 college students aged between 18 and 20 years were recruited for the study between March and December 2019. Their height and weight were then measured professionally. Subsequently, body mass index (BMI) was calculated as weight (kg) divided by the square of height (m). The EC of the participants was then estimated using the Flanker task, while their serum BDNF levels and 5-HT levels were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Finally, the multiple intermediary models in SPSS were used to analyze the mediating effect of 5-HT and BDNF between overweight/obesity and EC. The result show that the overweight/obesity of college students was positively correlated with the response of EC (p ≤ 0.005). However, it was negatively correlated with BDNF (p ≤ 0.05) and 5-HT (p ≤ 0.05). Moreover, BDNF (p ≤ 0.001) and 5-HT (p ≤ 0.001) were negatively correlated with the response of EC. The BDNF level played a partial mediating role between overweight/obesity and EC that accounted for 7.30% of the total effect value. Similarly, the 5-HT of college students played a partial mediating role between overweight/obesity and EC that accounted for 8.76% of the total effect value. Gender and age had no regulatory effect on the relationship between overweight/obesity, BDNF, 5-HT, and EC. This study provides the evidence that 5-HT and BDNF mediated the association between overweight/obesity and executive control. It is indicated that 5-HT and BDNF might be the biological pathways underpinning the link between overweight/obesity and executive control.

Systolic blood pressure mediates the association between body mass index and inhibitory control in children

Here, we examine whether systolic blood pressure (SBP) mediates the relationship between body mass index (BMI) and inhibitory control in children. Twenty children with high blood pressure (HBP) were approximately matched with twenty children with low blood pressure (LBP) by fitness, BMI, somatic maturation, sex and age. Inhibitory control was measured by a cognitive Go/Nogo task, where number of commission errors during Nogo trials and reaction time during Go trials were used as performance. We compared performance between the two groups and conducted a mediation analysis using SBP as mediator of the relationship between BMI and commission errors. Results revealed that HBP children presented higher number of commission errors, compared to LBP children. Moreover, SBP mediated the relation between BMI and number of errors. Thus, early exposure to high levels of SBP can negatively impact inhibitory control and SBP acts as a mediator between BMI and inhibitory functioning in children.

Executive functioning and disinhibited eating in children and adolescents

BACKGROUND

Executive functioning (EF) difficulties may be associated with problems regulating eating behaviours. Few studies have evaluated this question in youth using diverse measures of EF or objective measures of energy intake.

METHODS

The current study used neuropsychological tasks and a laboratory test meal to evaluate the links between EF and youth's disinhibited eating patterns. Two-hundred-five nontreatment seeking youth (M age = 13.1 ± 2.8 years; M BMIz = 0.6 ± 1.0; 33.2% overweight; 54.1% female) completed tasks measuring decision making, general and food-specific behavioural disinhibition, willingness to delay gratification for food and money, cognitive flexibility, and working memory. Age (children vs adolescents) was examined as a moderator. All analyses adjusted for demographic factors, pubertal status, lean mass (kg), fat mass (%), height, general intellectual functioning, and depressive symptoms.

RESULTS

After adjusting for multiple comparisons, more general behavioural disinhibition was associated with greater total energy intake (P = .02), and poorer cognitive flexibility was associated with more fat intake (P = .03) across all ages. Poorer decision making in children (P = .04), but not adolescents (P = .24), was associated with greater fat intake. Food-specific behavioural disinhibition, the ability to delay gratification for both food and monetary rewards, and working memory were not significantly associated with youth's disinhibited eating patterns during a single meal.

CONCLUSIONS

Most domains of EF were not associated with youth's disinhibited eating. Significant associations may highlight the need to target specific cognitive processes, particularly behavioural disinhibition, decision making, and cognitive flexibility, in potential intervention strategies for children's disinhibited eating.

Associations Among Body Mass Index, Cortical Thickness, and Executive Function in Children

IMPORTANCE

A total of 25.7 million children in the United States are classified as overweight or obese. Obesity is associated with deficits in executive function, which may contribute to poor dietary decision-making. Less is known about the associations between being overweight or obese and brain development.

OBJECTIVE

To examine whether body mass index (BMI) is associated with thickness of the cerebral cortex and whether cortical thickness mediates the association between BMI and executive function in children.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, cortical thickness maps were derived from T1-weighted structural magnetic resonance images of a large, diverse sample of 9 and 10-year-old children from 21 US sites. List sorting, flanker, matrix reasoning, and Wisconsin card sorting tasks were used to assess executive function.

MAIN OUTCOMES AND MEASURES

A 10-fold nested cross-validation general linear model was used to assess mean cortical thickness from BMI across cortical brain regions. Associations between BMI and executive function were explored with Pearson partial correlations. Mediation analysis examined whether mean prefrontal cortex thickness mediated the association between BMI and executive function.

RESULTS

Among 3190 individuals (mean [SD] age, 10.0 [0.61] years; 1627 [51.0%] male), those with higher BMI exhibited lower cortical thickness. Eighteen cortical regions were significantly inversely associated with BMI. The greatest correlations were observed in the prefrontal cortex. The BMI was inversely correlated with dimensional card sorting (r = -0.088, P < .001), list sorting (r = -0.061, P < .003), and matrix reasoning (r = -0.095, P < .001) but not the flanker task. Mean prefrontal cortex thickness mediated the association between BMI and list sorting (mean [SE] indirect effect, 0.014 [0.008]; 95% CI, 0.001-0.031) but not the matrix reasoning or card sorting task.

CONCLUSIONS AND RELEVANCE

These results suggest that BMI is associated with prefrontal cortex development and diminished executive functions, such as working memory.

[Formula: see text] Addressing the neurodevelopmental needs of children and adolescents with congenital heart disease: A review of the existing intervention literature

Congenital heart disease (CHD) is among the most prevalent birth defects in the United States. Given that children with CHD are at risk for differences with development, learning, and psychosocial functioning, effective intervention becomes a central tenant of recommendations following neuropsychological consultation and evaluation. The primary focus of this review is to summarize available interventions for children and adolescents with CHD. The existing CHD literature has concentrated on early developmental services, psychopharmacological treatment, and need for academic supports. The literature is limited with regard to intervention studies that target cognitive deficits and psychosocial difficulties. To address this discrepancy, efficacious interventions that have been used to mitigate these concerns within other medical groups are also discussed in an effort to provide options for alternative recommendations and services. The current paper is intended to facilitate comprehensive care for cardiac patients by providing clinicians with a review of the available intervention literature, as well as potential interventions that may serve as supplemental strategies in the interim.

Impact of Early-Life Weight Status on Cognitive Abilities in Children

OBJECTIVE

Whether obesity is associated with childhood cognition is unknown. Given the sensitivity of the developing brain to environmental factors, this study examined whether early-life weight status was associated with children's cognition.

METHODS

Using data from mother-child pairs enrolled in the Health Outcomes and Measures of the Environment (HOME) Study (2003-2006), children's early-life weight status was assessed using weight-for-length/height standard deviation (SD) scores. A battery of neuropsychological tests was administered to assess cognition, executive function, and visual-spatial abilities at ages 5 and 8 years. Using linear mixed models, associations between early-life weight status and cognition were estimated.

RESULTS

Among 233 children, 167 were lean (≤1 SD) and 48 were nonlean (>1 SD). After covariate adjustment, the results suggest that full-scale intelligence quotient scores decreased with a 1-unit increase in weight-for-height SD score (β = -1.4, 95% CI: -3.0 to 0.1). For individual component scores, with a 1-unit increase in weight-for-height SD score, perceptual reasoning (β = -1.7, 95% CI: -3.3 to 0.0) and working memory (β: -2.4, CI: -4.4 to -0.4) scores decreased. Weight status was generally not associated with other cognition measures.

CONCLUSIONS

Within this cohort of typically developing children, early-life weight status was inversely associated with children's perceptual reasoning and working memory scores and possibly with full-scale intelligent quotient scores.

Development of hot and cool executive functions in middle childhood: Three-year growth curves of decision making and working memory updating

Although middle childhood is an important period for the development of hot and cool executive functions (EFs), longitudinal studies investigating trajectories of childhood EF development are still limited and little is known about predictors for individual developmental trajectories. The current study examined the development of two typical facets of cool and hot EFs over a 3-year period during middle childhood, comparing a younger cohort (6- and 7-year-olds at the first wave [T1]; n = 621) and an older cohort (8- and 9-year-olds at T1; n = 975) of children. "Cool" working memory updating (WM) was assessed using a backward digit span task, and "hot" decision making (DM) was assessed using a child variant of the Iowa Gambling Task. Linear latent growth curve analyses revealed evidence for developmental growth as well as interindividual variance in the initial level and rate of change in both EF facets. Initial level of WM was positively associated with age (both between and within cohorts), socioeconomic status, verbal ability, and processing speed, whereas initial levels of DM were, in addition to a (potentially age-related) cohort effect, exclusively predicted by gender, with boys outperforming girls. None of the variables predicted the rate of change, that is, the developmental trajectories. However, younger children, as compared with older children, had slightly steeper WM growth curves over time, hinting at a leveling off in the development of WM during middle childhood. In sum, these data add important evidence to the understanding of hot and cool EF development during middle childhood.

The relationship between executive functioning and weight loss and maintenance in children and parents participating in family-based treatment for childhood obesity

We examined the relationship between executive function and weight loss among children (8-12 years) and parents enrolled in a behavioral weight-loss program. 150 overweight/obese children and their parents participated in a 6-month family-based weight-loss intervention and completed baseline (month 0), post-treatment (month 6) and 18-month follow-up assessments (month 24), which included Digit Span (DS), Stop Signal Task (SST), and Wisconsin Card Sorting Test (WCST). Anthropometrics were additionally measured at mid-treatment (month 3) and 6-month follow-up (month 12). Children with more baseline WCST perseverative errors regained more weight (p = .002) at 18-month follow-up. Change in child BMIz was not associated with change in child executive function (p > .05) or parent executive function (p > .05). Among parents, baseline measure of DS-backward (p < .001) and post-treatment changes in WCST perseverative errors (p < .001) were associated with post-treatment changes in parent BMI. SST was not related to parent or child weight loss. Thus, children's baseline set-shifting was associated with weight regain during follow-up whereas changes in parent set-shifting was associated with changes in parent weight. Future research is needed to examine the relationship between executive function and weight loss and how this translates to intervention success for both overweight/obese children and participating parents.

Cognitive Control of Eating: the Role of Memory in Appetite and Weight Gain

PURPOSE OF REVIEW

The present review organises the recent literature on the role of memory in eating behaviours and provides an overview of the current evidence relating to the associations between memory and weight gain.

RECENT FINDINGS

Research over the last few years has highlighted working memory as an important cognitive process that underpins many aspects of appetite control. Recent work on episodic memory and appetite has replicated work showing that manipulating memory for recent eating affects later consumption and extended this work to examine associations between individual differences in memory and eating behaviours. Poorer episodic memory ability is related to a reduced sensitivity to internal states of hunger and satiety and a tendency towards uncontrolled eating. There is also recent evidence to suggest that working memory and episodic memory impairments are related to weight gain and high BMI. Working memory and episodic memory are core cognitive processes that are critical for food-related decision-making, and disruption to these processes contributes to problems with appetite control and weight gain, which suggests that weight loss programmes might be improved by the addition of cognitive training.

Executive functioning in a racially diverse sample of children who are overweight and at risk for eating disorders

Difficulties with executive functioning may underlie both overweight and loss of control (LOC) eating behavior across the age spectrum, but there is a relative paucity of research in children with both conditions. This study aimed to characterize general executive functioning among children with overweight and LOC eating as compared to their overweight and normal-weight peers. Participants were 75 racially diverse children (58.7% female; 81.3% African-American), aged 9-12y (M age = 10.5 ± 1.1), of whom 26 were overweight/obese and endorsed LOC eating (OW-LOC), 34 were overweight controls (OW-CON), and 15 were normal-weight controls (NW-CON). All children completed interview-based measures of eating pathology, and behavioral measures of executive functioning. Parents reported on behavioral facets of children's executive functioning. Groups were compared across parent-report measures and behavioral tasks using analyses of covariance (ANCOVAs) and multivariate analyses of covariance (MANCOVAs) which adjusted for general intellectual functioning. Significant group differences were revealed on a behavioral measure of planning, the Tower of London task [F (5,65) = 3.52; p = 0.007], and a behavioral measure of working memory, the List Sorting task [F (2,71) = 6.45; p = 0.003]. Post-hoc tests revealed that OW-LOC and OW-CON performed worse than NW-CON on the Tower of London, with relative decrements in accuracy rather than performance time. Further, OW-LOC performed worse than both OW-CON and NW-CON on the List Sorting task. Overweight with or without concomitant LOC eating in children may characterize a unique pattern of executive dysfunction. Interventions for eating- and weight-related problems in youth should address underlying deficits in planning and working memory.

Leptin status in adolescence is associated with academic performance in high school: a cross-sectional study in a Chilean birth cohort

OBJECTIVE

Leptin is a pleiotropic hormone associated with learning and memory via brain receptors. However, elevated plasma leptin levels may impair cognitive and memory functions. Since individual differences in memory performance affect students' ability to learn, we aimed to study the relation between leptin status in adolescence and school performance.

DESIGN AND SETTING

We studied 568 adolescents aged 16-17 years from Santiago. A cross-sectional analysis was carried out on a birth cohort conducted in Santiago (Chile).

PRIMARY AND SECONDARY OUTCOME MEASURES

We measured serum leptin concentration using an enzyme-linked immunosorbent assay. Cut-offs from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study for 16-year-olds were used to define abnormally high leptin levels (hyperleptinaemia). Academic performance was measured using high-school grades and grade point average (GPA). Data were collected in 2009-2012; data analysis was performed in 2014.

RESULTS

15% of participants had hyperleptinaemia. They had significantly lower school grades and GPA compared with participants with normal leptin levels (eg, GPA mean difference=33.8 points). Leptin levels were negative and significantly correlated with school grades in 9th, 10th and 12th. Similarly, it was negatively correlated with high-school GPA. After controlling for health, sociodemographic and education confounders, the chances of having a performance ≥75th centile in students having hyperleptinaemia were 32% (95% CI 0.19% to 0.89%) that of students having normal serum leptin concentration.

CONCLUSIONS

In high school students, abnormally high levels of leptin were associated with poorer academic performance. These findings support the idea of a relationship between leptin and cognition. Further research is needed on the cognitive effects of leptin in younger populations.