Does Physical Activity Improve Cognition and Academic Performance in Children? A Systematic Review of Randomized Controlled Trials

Is adherence to the 24-h movement guidelines associated with greater academic-related outcomes in children and adolescents? A systematic review and meta-analysis

The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10-0.24, I2 = 49%) was found compared to those who did not adhere to any recommendations.   Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship.   Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.

Planetary health diet versus usual diet in adolescents. How do food and physical activity influence academic performance?

Introduction

Objective: to analyze the relationship of the similarity of planetary health diet and habitual diet with the practice of physical activity on the academic performance of adolescent high school students by gender. Method: 877 adolescents were evaluated. The diet is reviewed through the 24-hour reminder. Physical activity was classified according to type of activity, frequency, duration, and intensity using the APALQ questionnaire. The caloric intake of adolescents was compared with the proposal of the EAT-LANCET commission, and the relationship between physical activity and diet with academic performance was again established. Results: Mexican adolescents do not comply with the proposal of a planetary health diet. No relationship was found between physical activity and academic performance. On the other hand, animal proteins rich in fats are consumed doubly according to the recommendation; these and whole grains, both are inversely related to better academic performance. Conclusions: Mexican adolescents are far from consuming a planetary health diet. Physical activity was not related to academic performance, but there is an inverse relationship between fat-rich animal proteins and whole grains in relation to subjects that contribute to academic performance, which suggests that a healthy diet such as the planetary diet proposal could have an impact on environmental sustainability and favorably impact the academic performance of adolescents.

Associations between Gross and Fine Motor Skills, Physical Activity, Executive Function, and Academic Achievement: Longitudinal Findings from the UK Millennium Cohort Study

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor-cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The sample was 3188 children from the United Kingdom Millennium Cohort Study, followed at 9 months and 5, 7, and 11 years. Early motor skills were examined at 9 months. Children's daily physical activity level was measured using accelerometers at 7 years and a questionnaire was conducted at 11 years. Cognitive skills, including executive function and academic achievement, were measured at age 11. The results suggest that gross motor skills were positively associated with spatial working memory, whereas fine motor skills were predictive of good English and science outcomes. Moderate-to-vigorous activity was found to be negatively associated with English performance, although self-reported activity frequency was positively linked to math. Our results highlight the significant role of both gross and fine motor skills in cognitive development. This study also elucidates the limitations of using activity intensity to assess the impact of motor activity on children's cognitive development, suggesting that attention to the effects of specific types of physical activity would better elucidate the motor/cognition link.

Acute effect of physical activity on academic outcomes in school-aged youth: A systematic review and multivariate meta-analysis

BACKGROUND

There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the last two decades. We aimed to systematically determine the acute effects of physical activity on academic outcomes in school-aged youth and to examine possible moderators.

METHODS

We conducted a systematic search using PubMed, Web of Science, SPORTDiscus, and PsycINFO databases (from inception to 11th January 2023) for studies assessing the acute effects of physical activity on academic performance-related outcomes in school-aged youth. A univariate and multivariate meta-analysis was conducted based on a random-effects model with restricted maximum likelihood used to pool the academic outcomes results (Hedge's g).

RESULTS

We included 11 articles (803 children and adolescents [range: 6-16 years]) in the systematic review. Overall, acute physical activity increased academic outcomes (Hedge's g = 0.35, 95% CI: 0.20-0.50). Multivariate meta-analyses revealed that physical activity increased academic performance in mathematics (Hedge's g = 0.29, 95% CI: 0.16-0.42) and language (Hedge's g = 0.28, 95% CI: 0.09-0.47). Only behavior change techniques (Hedge's g = 0.54, 95% CI, 0.18-0.90, p < 0.001) played a significant role in this relationship.

CONCLUSIONS

A single bout of physical activity can improve academic outcomes in school-aged youth, which may serve as a complementary tool for the educational field. However, the observed heterogeneity in the results indicates that we should interpret the findings obtained with caution.

Factors associated with implemented teacher-led movement and physical activity in early childhood education and care

Movement and physical activity (MoPA) is critical for children's development and health. This study aimed to explore early childhood education and care (ECEC) educators' reported frequency of implemented gross motor and physical activities (MoPA) among children in ECEC, as well as the educators' reported personal physical activity (PA) levels in leisure time. A cross-sectional survey was performed in 68 preschools in southern Sweden. Data were obtained from questionnaires completed by 359 ECEC educators. The participation rate was 61%. About two thirds offered MoPA once a week or more seldom, while one quarter offered MoPA at least every other day. Educators who reported personal PA three times or more per week, offered MoPA for the children at least every other day to a higher extent (37%) compared to colleagues who reported personal PA once or twice a week (26%) or colleagues who reported that they were never or seldom active (18%) (p = 0.034). The results from multiple logistic regression analysis showed that reported implemented MoPA among children in ECEC was significantly associated with the educators' perceptions that free play improved children's gross motor skills (OR 2.7), the educators' perceptions of needed curricular guidelines for MoPA (OR 2.1), the educators' own leisure PA level (OR 2.0) and the educators' perceptions that adequate gross motor skills were not learned at home (OR 0.4). Teacher-led MoPA occurs sparingly during the preschool day and the teachers believe that the children get sufficient MoPA in free play. The children are expected to develop their motor skills to a sufficient extent during the short moments of offered outdoor play. Teachers who are physically active in their leisure-time seem to offer gross motor training for the children to a higher extent than less active or inactive colleagues.

The effects of 9 months of formulated whole-egg or milk powder food products as meal or snack replacements on executive function in preadolescents: A randomized, placebo-controlled trial

BACKGROUND

Elevated brain choline is associated with better executive functions in preadolescents. Manipulating dietary choline prospectively in preadolescents using egg supplementation could improve executive functions via effects on brain cellular and neurotransmitter functions.

OBJECTIVES

We tested the 9-month impacts of egg supplementation on executive functions. It was hypothesized that preadolescents who consumed meal or snack replacement products containing powder made from whole eggs would have the largest improvements in executive functions after 9 months compared to those consuming similar products with either added milk powder or gelatin as a placebo.

METHODS

A randomized, parallel-group, double-blinded, placebo-controlled trial design was used. The executive functions of 122 preadolescents (58 females) aged 9-13 were analyzed before and after the 9-month intervention. The primary outcomes were 3 NIH Toolbox-Cognitive Battery measures of executive function: mental flexibility, working memory, and selective attention and inhibitory control. Participants were randomized to consume food products with either: 1) whole egg powder; 2) milk powder; or 3) gelatin as a placebo, all matched on macronutrient content and used as replacements for commonly consumed foods (i.e., waffles, pancakes, macaroni and cheese, ice cream, and brownies). Hypothesis testing used mixed-effects models that included physical activity and sleep scores as covariates.

RESULTS

A statistically significant group × time interaction for selective attention and inhibitory control was found (P = 0.049) for the milk group. This interaction resulted from no change for the placebo group and an improvement in selective attention and inhibitory control performance for the milk group by a T-score of 5.8; the effect size (d) was 0.44 SD units. Other comparisons were statistically insignificant.

CONCLUSIONS

Consumption of foods with added milk powder as a replacement for snacks or meals for 9 months improves selective attention and inhibitory control in preadolescents. Replacement of foods with added whole egg powder does not impact 9-month changes in preadolescent executive functions. This trial was registered at clinicaltrials.gov as NCT03739424.

Sport Participation and Academic Performance in Young Elite Athletes

Strong evidence supports physical activity and fitness levels being positively associated with cognitive performance and overall academic performance in youth. This also applies to sports participation. However, whether participation in sports at the elite level is associated with greater academic performance remains unknown. Thus, the present study aimed to compare the academic performance of young elite athletes to that of control students, as well as to analyze whether the type of sport mediates these results. Between 2010 and 2019, all students from the last Baccalaureate course of the Spanish Elite Sport High School-which also includes non-elite athletes and recreational athlete students, who were categorized as controls-participated in this study. Academic performance was assessed through both the grade point average of the two last Baccalaureate courses and through the average grades from the University Entrance Examinations. Athletes were categorized attending to different sport classifications. A total of 1126 adolescents (570 girls, 18.2 ± 0.6 years) participated in the study, of which 483 and 643 were categorized as elite athletes and control students, respectively. Elite athletes attained a lower overall academic performance than controls (p < 0.001), which was confirmed for both sexes (p < 0.001). These differences were separately confirmed for most academic subjects (p < 0.05), as well as when attending to different sport classifications (all p > 0.05). Young elite athletes attained a lower academic performance than their non-elite peers, regardless of their type of sport. These findings highlight the importance of programs aimed at facilitating dual careers among young elite athletes.

Dose-Related Effects of Endurance, Strength and Coordination Training on Executive Functions in School-Aged Children: A Systematic Review

This systematic review aims to evaluate previous findings on the dose-related effects of short- and long-term physical activities (PA) on executive functions (EF) using a new approach by considering the success of experimental manipulation. Eight electronic databases were searched between May 2021 and September 2021. Randomized control trials among healthy children (6-12 years) were screened. Data extraction included the measurement of experimental manipulations and pre-post measurements of physical fitness. After identifying 1774 records, 17 studies were included (nine short-term PA and eight long-term PA). The overall results suggest that a single 20-min PA may be overwhelming for short-term EF in children up to 9 years of age but may be beneficial for children 9 years and older. A dose-related relationship between PA and EF could not be verified in long-term studies, which is possibly due to insufficient fitness gains and participation in the intervention. Short- and long-term endurance and coordination training could improve children's executive functions, but so far, there is no specific evidence on the duration, frequency, and intensity of PA. Not quantity but quality of intervention seems to be important in this context. Further intervention studies are needed that control for the characteristics of the experimental manipulation.

Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study

Background

Lifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents.

Methods

This was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities.

Results

The 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain.

Conclusions

A screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.

Do Physical Fitness and Executive Function Mediate the Relationship between Physical Activity and Academic Achievement? An Examination Using Structural Equation Modelling

Background: Physical activity health benefits are widely known. However, the association between physical activity, physical fitness, executive function, and academic performance need further investigation. Additionally, one of the literature gaps reveals scarce and mixed findings on what mediators of physical activity may affect academic achievement. Purpose: This investigation aims to provide knowledge about the mediation role of physical fitness and executive function in the association of physical activity with academic achievement in a cohort of Spanish schoolchildren using a structural equation modelling approach. Methods: The data for this cross-sectional study were collected from a convenience sample of children from Spain (Balearic Islands) aged between 9 and 13 years. Physical activity levels were self-reported with the Physical Activity Questionnaire for Children; physical fitness was assessed using the International Fitness Scale; executive function was assessed with the Trail Making Test, and children’s achievements were collected from the school records. Structural equation modelling was used to explore the relationship between physical activity, physical fitness, executive function, and academic achievement. Findings: Statistically significant positive direct associations were observed between physical activity and physical fitness (β = 0.46, 95% CI [0.29, 0.64]), physical fitness and executive function (β = 0.28, 95% CI [0.04, 0.52]), and executive function and academic achievement (β = 0.46, 95% CI [0.28, 0.65]), while adjusting for the confounding effects of sex and body mass index. Furthermore, indirect associations were observed between physical activity and executive function mediated by physical fitness (β = 0.13, bias-corrected 95% CI [0.02, 0.31]) and between physical fitness and academic achievement through executive function (β = 0.13, bias-corrected 95% CI [0.03, 0.32]). Conclusions: This investigation adds to the literature with evidence supporting the idea that regular PA leads to improvements in physical fitness and may support cognitive skills and academic performance in children.

Objectively measured physical activity and academic performance in school-aged youth: The UP&DOWN longitudinal study

To examine the longitudinal relationships between objectively measured total volume and specific intensities of physical activity (PA) with academic performance in a large sample of youth aged 6-18 years. A longitudinal study of 1046 youth (10.04 ± 3.10 years) from Spain was followed over 2 years. PA (volume and intensity) was measured by accelerometry. Academic performance was assessed through grades reported on the transcript at the end of the academic year (Mathematics, Language, an average of these two core subjects, and grade point average [GPA]). Longitudinal relationships between PA and four indicators of academic performance were examined using covariance and regression analyses, adjusted for a variety of confounders. Youth Quartile 2 for PA volume at baseline obtained better scores than those who participated in Quartiles 1 or 4 volumes of PA in GPA 2 years later (p = 0.006). There were generally no longitudinal associations between specific PA intensities and any of the academic performance indicators (all p > 0.170). However, a change in light PA over 2 years was inversely associated with three academic indicators in youth (β_range , -.103 to - 090; all P < 040). Findings suggest that participants in Quartile 2 volume of PA had a better GPA in comparison with Quartiles 1 and 4 volumes of PA during youth, but there was no association with changes in PA volume over time. PA intensity was generally unrelated to academic performance during youth. However, there was an inverted u-shape relationship between light PA changes and GPA.