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Stager LM, Watson CS, Cook EW, Fobian AD. Effect of Sleep Restriction on Adolescent Cognition by Adiposity: A Randomized Crossover Trial. JAMA Neurol 2024; 81:712-721. [PMID: 38767872 PMCID: PMC11106714 DOI: 10.1001/jamaneurol.2024.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/22/2024] [Indexed: 05/22/2024]
Abstract
Importance Pediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function. Objective To determine the effects of adiposity and sleep on adolescent cognitive function. Design, Setting, and Participants This single-blind randomized crossover trial was conducted from September 2020 to October 2022. Parents or caregivers provided demographic information for adolescent participants. Body mass index percentile and bioelectrical impedance analysis assessed adiposity. Adolescents completed 2 actigraphy-confirmed sleep conditions, adequate and restricted, followed by in-person cognitive assessment. No additional follow-up was provided. Data collection for this population-based study took place in a behavioral medicine clinic in Birmingham, Alabama. A total of 323 participants were assessed for eligibility (ages 14-19 years and healthy). Of the 244 eligible adolescents, 157 declined participation. Eighty-seven were randomized and 26 dropped out postenrollment. The final sample included 61 adolescents, 31 with healthy weight and 30 with overweight or obesity. Data were analyzed from April to October 2023. Interventions Following a 2-day washout period of adequate sleep, adolescents completed 2 sleep conditions: adequate (mean [SD] duration, 8 hours, 54 minutes [58.0 minutes]) and restricted (mean [SD] duration, 4 hours, 12 minutes [50.7 minutes]). Main Outcomes and Measures The National Institutes of Health Cognitive Toolbox assessed global and fluid cognition, cognitive flexibility, working and episodic memory, attention, and processing speed. The Stroop Task assessed inhibition. Results The final sample included 61 adolescents (mean [SD] age, 16.3 [1.6] years; 35 [57.4%] female). Restricted sleep predicted poorer global cognition scores (restricted mean [SD], 98.0 [2.8]; adequate mean [SD], 103.2 [2.9]), fluid cognition scores (restricted mean [SD], 94.5 [3.2]; adequate mean [SD], 102.0 [3.6]), and cognitive flexibility scores (restricted mean [SD], 84.8 [3.0]; adequate mean [SD], 92.8 [3.0]) for adolescents with overweight or obesity. No differences emerged for adolescents with healthy weight. Adolescents with overweight or obesity also had poorer attention scores (mean [SD], 80.0 [2.3]) compared to adolescents with healthy weight (mean [SD], 88.4 [SD, 2.3]) following restricted sleep. No differences emerged following adequate sleep. Findings were similar for total body fat percentage (TBF%); however, for adolescents with TBF% above 42, restricted sleep also predicted poorer processing speed, and the association between sleep and attention did not vary based on TBF%. Conclusions and Relevance Adolescents with overweight or obesity may be more vulnerable to negative cognitive effects following sleep restriction. Improved sleep hygiene and duration in this group may positively impact their cognitive health. Trial Registration ClinicalTrials.gov Identifier: NCT04346433.
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Affiliation(s)
| | | | - Edwin W. Cook
- Department of Psychology, University of Alabama at Birmingham
| | - Aaron D. Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
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Smith PJ, Whitson HE, Merwin RM, O’Hayer CV, Strauman TJ. Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW). Front Aging Neurosci 2023; 15:1256430. [PMID: 38076541 PMCID: PMC10702760 DOI: 10.3389/fnagi.2023.1256430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/20/2023] [Indexed: 02/12/2024] Open
Abstract
Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.
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Affiliation(s)
- Patrick J. Smith
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Heather E. Whitson
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - Rhonda M. Merwin
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
| | - C. Virginia O’Hayer
- Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, PA, United States
| | - Timothy J. Strauman
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
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Hu X, Peng J, Tang W, Xia Y, Song P. A circadian rhythm-restricted diet regulates autophagy to improve cognitive function and prolong lifespan. Biosci Trends 2023; 17:356-368. [PMID: 37722875 DOI: 10.5582/bst.2023.01221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Diet and circadian rhythms have been found to have a profound impact on health, disease, and aging. Skipping breakfast, eating late, and overeating have adverse effects on the body's metabolism and increase the risk of cardiovascular and metabolic diseases. Disturbance of circadian rhythms has been associated with increased risk of atherosclerosis, Alzheimer's disease, Parkinson's disease, and other diseases. Abnormal deposition of amyloid β (Aβ) and tau proteins in the brain and impaired synaptic function are linked to cognitive dysfunction. A restrictive diet following the circadian rhythm can affect the metabolism of lipids, glucose, and amino acids such as branched chain amino acids and cysteine. These metabolic changes contribute to autophagy through molecular mechanisms such as adenosine monophosphate-activated protein kinase (AMPK), rapamycin (mTOR), D-β-hydroxybutyrate (D-BHB), and neuropeptide Y (NPY). Autophagy, in turn, promotes the removal of abnormally deposited proteins and damaged organelles and improves cognitive function, ultimately prolonging lifespan. In addition, a diet restricted to the circadian rhythm induces increased expression of brain-derived neurotrophic factor (BDNF) in the forebrain region, regulating autophagy and increasing synaptic plasticity, thus enhancing cognitive function. Consequently, circadian rhythm-restricted diets could serve as a promising non-pharmacological treatment for preventing and improving cognitive dysfunction and prolonging lifespan.
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Affiliation(s)
- Xiqi Hu
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jun Peng
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
| | - Wei Tang
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ying Xia
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
| | - Peipei Song
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Fernández-Aranda F, Granero R, Jiménez-Murcia S. Editorial: Neurological, psychological and endocrine markers of eating disorders and obesity. Front Nutr 2023; 10:1289370. [PMID: 37899820 PMCID: PMC10613052 DOI: 10.3389/fnut.2023.1289370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Fernando Fernández-Aranda
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Roser Granero
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Szabo-Reed AN, Martin LE, Savage CR, Washburn RA, Donnelly JE. Pre-post intervention exploring cognitive function and relationships with weight loss, intervention adherence and dropout. Health Psychol Behav Med 2023; 11:2162528. [PMID: 36632603 PMCID: PMC9828788 DOI: 10.1080/21642850.2022.2162528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the association between baseline cognitive function, intervention dropout, adherence and 3-month weight loss (WL) when controlling for confounding demographic variables. Methods 107 (Mage = 40.9 yrs.), BMI in the overweight and obese range (BMI = 35.6 kg/m2), men (N = 17) and women (N = 90) completed a 3-month WL intervention. Participants attended weekly behavioral sessions, comply with a reduced calorie diet, and complete 100 min of physical activity (PA)/wk. Cognitive function tasks at baseline included Flanker (attention), Stroop (executive control) and working memory, demographics, body weight and cardiovascular fitness were assessed at baseline. Session attendance, adherence to PA and diet were recorded weekly. Results Baseline attention was positively correlated with age (p < .05), education (p < .05), attendance (p < .05), diet (p < .05) and PA (p < .05). Baseline executive control (p < .05) and working memory (p < .05) were each associated with % WL. Baseline executive control (p < .01) and working memory (p < .001) were also each associated with education. ANOVA indicated that baseline attention (p < .01) was associated with WL, specifically for comparing those who achieved 5-10% WL (p < .01) and those who achieved greater than 10% WL (p < .01) to those who dropped. Significance Results suggest that stronger baseline attention is associated with completion of a 3-mo. WL intervention. Executive control and working memory are associated with amount of WL achieved. NCT registration US NIH Clinical Trials, NCT01664715.
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Affiliation(s)
- Amanda N. Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas, KS, USA, Amanda N. Szabo-Reed Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas, KS66160, USA
| | - Laura E. Martin
- Department of Population Health, University of Kansas Medical Center, Kansas, KS, USA
| | - Cary R. Savage
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Richard A. Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas, KS, USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas, KS, USA
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Tan CS, Nasir H, Pheh KS, Cong CW, Tay KW, Cheong JQ. The Mediating Role of Work Engagement in the Relationship between Executive Functioning Deficits and Employee Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13386. [PMID: 36293965 PMCID: PMC9602681 DOI: 10.3390/ijerph192013386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/24/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Executive functioning and its related components have been found to promote well-being. However, there is a limited understanding of the underlying mechanism. Drawing from the job demands-resources and PERMA models, the present study examined the hypothetical mediating role of work engagement in the relationship between executive functioning deficit and well-being among 314 working adults in Malaysia. Participants answered a survey consisting of the Executive Skills Questionnaire-Revised (ESQ-R; a new measure of executive functioning deficits for working adults), Utrecht Work Engagement Scale, Employee Well-Being Scale, and Self-Rated Creativity Scale. Pearson correlation analysis showed that the ESQ-R score was negatively associated with all other target variables, while the latter was positively related to each other. Moreover, supporting the hypotheses, the results of mediation analysis using PROCESS macro found that work engagement mediated the negative relationship between executive functioning deficits and well-being after statistically controlling for the creativity score. The findings not only replicate the beneficial role of executive functioning in employees' well-being but also shed light on the underlying process of the relationship. Implications and directions for future studies are discussed.
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Affiliation(s)
- Chee-Seng Tan
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Universiti Tunku Abdul Rahman, Kampar 31900, Perak, Malaysia
| | - Hira Nasir
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Universiti Tunku Abdul Rahman, Kampar 31900, Perak, Malaysia
| | - Kai-Shuen Pheh
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Universiti Tunku Abdul Rahman, Kampar 31900, Perak, Malaysia
| | - Chin Wen Cong
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Universiti Tunku Abdul Rahman, Kampar 31900, Perak, Malaysia
| | - Kok-Wai Tay
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, Universiti Tunku Abdul Rahman, Kampar 31900, Perak, Malaysia
| | - Jia-Qi Cheong
- Faculty of Business, Economics and Accountancy, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
- Centre for Economic Development and Policy, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
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Executive Function-Related Improvements on a Commercial CBT-Based Weight Management Intervention: Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148763. [PMID: 35886615 PMCID: PMC9320503 DOI: 10.3390/ijerph19148763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/06/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022]
Abstract
Executive functioning is a key component involved in many of the processes necessary for effective weight management behavior change (e.g., setting goals). Cognitive behavioral therapy (CBT) and third-wave CBT (e.g., mindfulness) are considered first-line treatments for obesity, but it is unknown to what extent they can improve or sustain executive functioning in a generalized weight management intervention. This pilot randomized controlled trial examined if a CBT-based generalized weight management intervention would affect executive functioning and executive function-related brain activity in individuals with obesity or overweight. Participants were randomized to an intervention condition (N = 24) that received the Noom Weight program or to a control group (N = 26) receiving weekly educational newsletters. EEG measurements were taken during Flanker, Stroop, and N-back tasks at baseline and months 1 through 4. After 4 months, the intervention condition evidenced greater accuracy over time on the Flanker and Stroop tasks and, to a lesser extent, neural markers of executive function compared to the control group. The intervention condition also lost more weight than controls (−7.1 pounds vs. +1.0 pounds). Given mixed evidence on whether weight management interventions, particularly CBT-based weight management interventions, are associated with changes in markers of executive function, this pilot study contributes preliminary evidence that a multicomponent CBT-based weight management intervention (i.e., that which provides both support for weight management and is based on CBT) can help individuals sustain executive function over 4 months compared to controls.
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Clark DO, Keith NR, Ofner S, Hackett J, Li R, Agarwal N, Tu W. Environments and situations as correlates of eating and drinking among women living with obesity and urban poverty. Obes Sci Pract 2022; 8:153-163. [PMID: 35388340 PMCID: PMC8976545 DOI: 10.1002/osp4.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/29/2022] Open
Abstract
Objective One path to improving weight management may be to lessen the self-control burden of physical activity and healthier food choices. Opportunities to lessen the self-control burden might be uncovered by assessing the spatiotemporal experiences of individuals in daily context. This report aims to describe the time, place, and social context of eating and drinking and 6-month weight change among 209 midlife women (n = 113 African-American) with obesity receiving safety-net primary care. Methods Participants completed baseline and 6-month weight measures, observations and interviews regarding obesogenic cues in the home environment, and up to 12 ecological momentary assessments (EMA) per day for 30 days inquiring about location, social context, and eating and drinking. Results Home was the most common location (62%) at times of EMA notifications. Participants reported "yes" to eating or drinking at the time of nearly one in three (31.1% ± 13.2%) EMA notifications. Regarding social situations, being alone was significantly associated with less frequent eating and drinking (OR = 0.75) unless at work in which case being alone was significantly associated with a greater frequency of eating or drinking (OR = 1.43). At work, eating was most common late at night, whereas at home eating was most frequent in the afternoon and evening hours. However, eating and drinking frequency was not associated with 6-month weight change. Conclusions Home and work locations, time of day, and whether alone may be important dimensions to consider in the pursuit of more effective weight loss interventions. Opportunities to personalize weight management interventions, whether digital or human, and lessen in-the-moment self-control burden might lie in identifying times and locations most associated with caloric consumption. Clinical trial registration: NCT03083964 in clinicaltrials.gov.
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Affiliation(s)
- Daniel O. Clark
- Indiana University Center for Aging ResearchIndianapolisIndianaUSA
- Regenstrief Institute, Inc.IndianapolisIndianaUSA
- Department of MedicineDivision of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisIndianaUSA
| | - NiCole R. Keith
- Indiana University Center for Aging ResearchIndianapolisIndianaUSA
- Regenstrief Institute, Inc.IndianapolisIndianaUSA
| | - Susan Ofner
- Department of BiostatisticsIndiana University Richard M. Fairbanks School of Public HealthIndianapolisIndianaUSA
| | | | - Ruohong Li
- Department of BiostatisticsIndiana University Richard M. Fairbanks School of Public HealthIndianapolisIndianaUSA
| | - Neeta Agarwal
- Department of MedicineDivision of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Wanzhu Tu
- Regenstrief Institute, Inc.IndianapolisIndianaUSA
- Department of MedicineDivision of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisIndianaUSA
- Department of BiostatisticsIndiana University Richard M. Fairbanks School of Public HealthIndianapolisIndianaUSA
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Hawkins MA, Keirns NG, Baraldi AN, Layman HM, Stout ME, Smith CE, Gunstad J, Hildebrand DA, Vohs KD, Lovallo WR. Baseline associations between biomarkers, cognitive function, and self-regulation indices in the Cognitive and Self-regulatory Mechanisms of Obesity Study. Obes Sci Pract 2021; 7:669-681. [PMID: 34877006 PMCID: PMC8633928 DOI: 10.1002/osp4.537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Understanding how biological, cognitive, and self-regulatory factors are related to obesity, and weight regulation is clearly needed to optimize obesity prevention and treatment. The objective of this investigation was to understand how baseline biological, cognitive, and self-regulatory factors are related to adiposity at the initiation of a behavioral weight loss intervention among treatment-seeking adults with overweight/obesity. METHODS Participants (N = 107) in the Cognitive and Self-regulatory Mechanisms of Obesity Study (Identifier-NCT02786238) completed a baseline assessment with anthropometric, cardiometabolic, inflammatory, cognitive function, and self-regulation measures as part of a larger on-going trial. Data were analyzed with linear regression. RESULTS At baseline, body mass index, body fat percentage, and waist circumference (WC) were positively associated with fasting insulin and insulin resistance. Higher WC was related to higher fasting glucose and hemoglobin A1c (HbA1c). Higher glucose and insulin resistance levels were related to lower list sorting working memory. Higher glucose and HbA1c levels were negatively associated with reading scores. Cognitive function and self-regulation indices were unrelated. CONCLUSIONS In adults with overweight/obesity entering a weight loss treatment study: (1) elevated WC and associated glycemic impairment were negatively associated with cognition, (2) poorer executive function and reading abilities were associated with poorer glycemic control, and (3) objectively measured cognitive functions were unrelated to self-reported/behavioral measures of self-regulation. Such findings increase understanding of the relationships between adiposity, biomarkers, cognition, and self-regulation at treatment initiation and may ultimately inform barriers to successful obesity treatment response.
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Affiliation(s)
| | - Natalie G. Keirns
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Amanda N. Baraldi
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Harley M. Layman
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Madison E. Stout
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Caitlin E. Smith
- Department of PsychologyOklahoma State UniversityStillwaterOklahomaUSA
- Department of Psychiatry & Behavioral SciencesMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - John Gunstad
- Department of Psychological SciencesKent State UniversityKentOhioUSA
| | - Deana A. Hildebrand
- Department of Nutritional SciencesOklahoma State UniversityStillwaterOklahomaUSA
| | - Kathleen D. Vohs
- Carlson School of ManagementUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - William R. Lovallo
- Oklahoma City VA Medical CenterOklahoma CityOklahomaUSA
- Department of Psychiatry and Behavioral SciencesUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
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Soldevila-Domenech N, Forcano L, Vintró-Alcaraz C, Cuenca-Royo A, Pintó X, Jiménez-Murcia S, García-Gavilán JF, Nishi SK, Babio N, Gomis-González M, Corella D, Sorlí JV, Fernandez-Carrión R, Martínez-González MÁ, Marti A, Salas-Salvadó J, Castañer O, Fernández-Aranda F, Torre RDL. Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial. Clin Nutr 2021; 40:5221-5237. [PMID: 34474192 DOI: 10.1016/j.clnu.2021.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Some cognitive profiles might facilitate successful weight loss and its maintenance. Also, weight reductions may result in cognitive benefits. However, little work to date has examined the interactions between cognition and weight changes in the context of interventions with the Mediterranean diet (MedDiet). We studied the within-subject longitudinal relationships between cognition, body mass index (BMI), physical activity (PA), and quality of life (QoL), in older adults following a MedDiet. METHODS The PREDIMED-Plus is a primary prevention trial testing the effect of a lifestyle intervention program with an energy-restricted MedDiet (er-MedDiet), weight-loss goals and PA promotion on cardiovascular disease. The PREDIMED-Plus-Cognition sub-study included 487 participants (50% women, mean age 65.2 ± 4.7 years), with overweight/obesity, metabolic syndrome and normal cognitive performance at baseline. A comprehensive neurocognitive test battery was administered at baseline and after 1 and 3 years. RESULTS Baseline higher performance in verbal memory (OR = 1.5; 95%CI 1.0, 2.1), visuoconstructive praxis and attention (OR = 1.5; 95%CI 0.9, 2.3), and inhibition (OR = 1.3; 95%CI 0.9, 1.9) were associated with a higher odd of achieving at least 8% weight loss after 3 years follow-up in participants randomized to the intervention group. There were moderate improvements in specific tests of memory and executive functions during follow-up. Higher adherence to the er-MedDiet was associated with greater improvements in memory. Women exhibited lower rates of change in global cognition, PA and QoL. Moreover, improvements in memory correlated with reductions in BMI after 1 year (βSTD = -0.14) and with improvements in PA after 3 years (βSTD = 0.13). Finally, participants who experienced greater improvements in executive functions and global cognition also experienced greater improvements in their QoL. CONCLUSIONS This study refines the understanding of the determinants and mutual interrelationships between longitudinally-assessed cognitive performance and weight loss, adding further evidence to the cognitive benefits associated with better adherence to a MedDiet. Our results also suggest that weight loss interventions tailored to the cognitive profile and gender of participants are promising avenues for future studies.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003, Barcelona, Spain.
| | - Laura Forcano
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Cristina Vintró-Alcaraz
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Aida Cuenca-Royo
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.
| | - Xavier Pintó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Jesús F García-Gavilán
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Stephanie K Nishi
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Nancy Babio
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Maria Gomis-González
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.
| | - Dolores Corella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Jose V Sorlí
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Rebeca Fernandez-Carrión
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra's Health Research Institute (IdiSNA), Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Amelia Marti
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Navarra's Health Research Institute (IdiSNA), Pamplona, Spain; University of Navarra, Department of Nutrition, Food Sciences and Physiology, Pamplona, Spain.
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Olga Castañer
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Endocrinology Service. Institut Hospital Del Mar D'Investigacions Mèdiques (IMIM), 08003, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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11
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Targeting executive function for weight loss in adults with overweight or obesity. Physiol Behav 2021; 240:113540. [PMID: 34331958 DOI: 10.1016/j.physbeh.2021.113540] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/09/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
Obesity is associated with a multitude of negative health sequalae. Behavioral weight loss (BWL) is currently the recommended behavioral treatment for obesity; however, it is not effective for approximately half of the individuals who participate. BWL requires individuals to carry out many tasks requiring executive function (EF; i.e., higher order cognitive functions such as planning and problem solving) in order to be successful. Growing research supports that lower EF may be associated with attenuated weight loss following BWL, and targeting EF in treatment could improve outcomes. This paper aims to describe the rationale for the development of Novel Executive Function Training for Obesity (NEXT), which adapts Compensatory Cognitive Training to be delivered in conjunction with BWL. We summarize evidence relating EF to obesity and reduced weight loss following BWL, as well as the past success of cognitive training on EF. Then we describe the treatment model for NEXT followed by initial data suggesting that NEXT is feasible and acceptable and may impact EF and weight. Obesity treatments incorporating cognitive training, especially those that train compensatory strategies, may improve weight-loss outcomes and provide a more durable treatment than traditional interventions, but larger randomized control trials are necessary.
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12
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Hawkins MA, Colaizzi JM, Cole AB, Keirns NG, Smith CE, Stout M, Chaney J, Sawhney M, Gahn D. Pilot Trial of Acceptance-Based Behavioral Weight Loss and Neurocognition Among American Indians. Behav Ther 2021; 52:350-364. [PMID: 33622505 PMCID: PMC8694275 DOI: 10.1016/j.beth.2020.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
Acceptance-based behavioral therapies (ABTs) for obesity may be superior to standard behavioral therapies but have not been adequately tested with American Indians (AIs). Neurocognitive function is also unexamined in relation to behavioral weight loss among AIs despite findings that neurocognition predicts outcomes in general samples, may help explain some of the benefits of ABTs, and may be relevant to marginalized groups. The primary objective of this pilot was to examine the feasibility/acceptability of ABT in an AI sample. Exploratory analyses examined the relationship between neurocognition and weight loss. Forty-eight AI adults with overweight/obesity (ages 43.3 ± 10.3 years, 85% female; baseline body mass index = 36.8 ± 4.4 kg/m2) enrolled in a 6-month open ABT weight loss trial. Feasibility indices, including screening/enrollment, session attendance, retention rates for posttreatment assessments, and program acceptability were examined. Percent weight loss (%WL) was assessed as well as fluid and crystalized neurocognition (National Institutes of Health Toolbox Cognition Battery [NIHTB-CB]). We enrolled 79% of the eligible sample and retained 75% (N = 36) at posttreatment assessments. Program completers lost an average of 5.2 ± 4.9% of initial body weight (dz = 1.14), whereas intent-to-treat analyses show a mean loss of 4.1 ± 4.7%. Participants reported high satisfaction, effectiveness, and cultural appropriateness. Exploratory analyses of neurocognitive domains suggested that crystalized cognition was higher among completers, and higher baseline cognitive flexibility predicted greater %WL (β = .34, p = .05). ABT resulted in clinically significant weight loss in an AI sample. A controlled trial of ABT in a larger, more diverse sample is warranted to determine whether (a) the findings are robust, generalizable, and/or superior to other treatments and (b) neurocognitive factors moderate outcomes.
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13
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Du Z, Li J, Huang J, Ma J, Xu X, Zou R, Xu X. Executive Functions in Predicting Weight Loss and Obesity Indicators: A Meta-Analysis. Front Psychol 2021; 11:604113. [PMID: 33584440 PMCID: PMC7876286 DOI: 10.3389/fpsyg.2020.604113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
While previous studies have suggested that there exists a relationship between obesity and executive function (EF), the mechanisms and causal relationship between them remain unclear. There are important clinical implications of determining whether EF can predict and treat obesity. We conducted a multilevel meta-analysis of randomized controlled trials (RCTs) and longitudinal studies. Specifically, we investigate (a) whether EF interventions have an effect on weight loss, (b) whether baseline EF can be a predictor of future weight loss through obesity intervention, and (c) whether early-life EF can predict future weight loss. Eight RCTs and 17 longitudinal studies with a total of 11,393 participants were identified. We found that (a) EF interventions may not have an effect on weight loss, (b) baseline inhibition (β = 0.259, p = 0.03) and delay discounting (β = −0.17, p = 0.04) significantly predict future weight loss through obesity intervention, (c) age (F = 13.666, p = 0.005) moderates the relationship between working memory and weight loss through intervention, but not weight status, type of intervention, and percentage of female, and (d) early life inhibition (β = 0.185, p = 0.07) is a marginally significant predictor of future weight loss. Our results seem to support the assumption that the relationship between EF and obesity is not direct, and a higher-order factor, such as genes, may link obesity and EF. Building on the preliminary findings, further studies focusing on EF and obesity are needed in the future.
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Affiliation(s)
- Zhongquan Du
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Jingjing Li
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Jiaai Huang
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Jing Ma
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Xiaoyu Xu
- Graduate School, Wuhan Sports University, Wuhan, China
| | - Rong Zou
- College of Health Science, Wuhan Sport University, Wuhan, China
| | - Xia Xu
- College of Health Science, Wuhan Sport University, Wuhan, China.,Hubei Key Laboratory of Sport Training and Monitoring, Wuhan Sports University, Wuhan, China
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14
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Szabo-Reed AN, Donnelly JE. Cognitive Training: Associations and Implications for Weight Management and Translational Research. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021; 6. [PMID: 34017915 DOI: 10.1249/tjx.0000000000000151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Behavioral weight loss programs combining energy restriction and increased physical activity (PA) are generally successful in producing clinically significant weight loss (≥5%) over 3-6 mos. However, weight maintenance (≥ 2 yrs.) continues to be problematic, due in part to an inability of individuals to continue adherence to diet and PA recommendations. It is hypothesized that neurocognitive processes, specifically executive functions (EFs, i.e., inhibition, working memory, mental flexibility), underlie self-regulation, self-efficacy, and are essential for the adoption and maintenance of health behaviors. Behavioral weight loss programs generally attempt to improve self-regulation; however, these skills are difficult to implement long-term. Strengthening EFs through cognitive training may improve weight maintenance by improving self-efficacy and self-regulation, resulting in improved program attendance and improved adherence to dietary and PA recommendations. Although randomized trials have not been conducted to specifically evaluate this hypothesis, results from the available literature suggest the potential for cognitive training to improve weight maintenance.
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Affiliation(s)
- Amanda N Szabo-Reed
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Joseph E Donnelly
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
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15
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Arigo D, Mogle JA, Brown MM, Roberts SR, Pasko K, Butryn ML, Downs DS. Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers. Menopause 2020; 27:559-567. [PMID: 32049926 PMCID: PMC7903971 DOI: 10.1097/gme.0000000000001498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory). METHODS Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano). RESULTS Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day. CONCLUSIONS Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method. : Video Summary:http://links.lww.com/MENO/A545.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Megan M. Brown
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Kristen Pasko
- Department of Psychology, Rowan University, Glassboro, NJ
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16
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Martinelli MK, Godfrey KM, Martinez M, Forman EM, Butryn ML. Physical discomfort intolerance as a predictor of weight loss and physical activity in a lifestyle modification program. J Behav Med 2020; 43:1041-1046. [PMID: 32246292 DOI: 10.1007/s10865-020-00150-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/24/2020] [Indexed: 11/26/2022]
Abstract
This study examined physical discomfort intolerance (DI) as a baseline predictor of weight loss and physical activity outcomes, and assessed whether changes in DI during the initial phase of weight loss prospectively predicted long-term treatment outcomes among adults enrolled in a group-based lifestyle modification program for obesity. DI was measured at baseline and 6 months, and weight and accelerometer-measured physical activity were assessed at baseline, 6 months, and 12 months. Baseline DI was not related to weight loss or physical activity at either timepoint. Change in DI during the first 6 months of treatment was not related to concurrent (i.e., 6-month) weight loss and physical activity, but was significantly predictive of weight loss and physical activity at 12 months. Assessing early changes in DI may help to identify individuals at risk for suboptimal outcomes. Future research should evaluate behavioral weight loss interventions designed to target DI.
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Affiliation(s)
- Mary K Martinelli
- Department of Psychology, Drexel University, 3141 Chestnut St., Stratton Hall 119, Philadelphia, PA, 19104, USA.
| | - Kathryn M Godfrey
- Department of Psychology, Drexel University, 3141 Chestnut St., Stratton Hall 119, Philadelphia, PA, 19104, USA
| | - Monica Martinez
- Department of Psychology, Drexel University, 3141 Chestnut St., Stratton Hall 119, Philadelphia, PA, 19104, USA
| | - Evan M Forman
- Department of Psychology, Drexel University, 3141 Chestnut St., Stratton Hall 119, Philadelphia, PA, 19104, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, 3141 Chestnut St., Stratton Hall 119, Philadelphia, PA, 19104, USA
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17
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Abstract
Self-control has been defined as the mental capacity of an individual to alter, modify, change or override their impulses, desires, and habitual responses. In this review, we will discuss the bi-directional nature of the relationship between self-control and exercise. In brief, higher levels of trait self-control have been associated with greater exercise performance and adherence; whilst the depletion of state self-control has been shown to decrease performance and persistence on subsequent exercise tasks requiring self-control. In the opposite direction, long-term participation in exercise (and improved physical fitness) has been demonstrated to enhance self-control. Furthermore, an acute bout of exercise has been shown to enhance subsequent self-control, particularly when the exercise is of a moderate intensity and requires some degree of cognitive engagement. Throughout, when discussing each of these relationships, evidence will be drawn from other aspects of the review, where appropriate, to enhance our understanding of the observed effects. Finally, recommendations for future research will be made; including the importance of considering the bi-directional nature of the relationship, given that this has implications for our understanding of both self-control and exercise performance and adherence.
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Affiliation(s)
- Ruth Boat
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, UK
| | - Simon B Cooper
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, UK
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