| 1. |
- Bangsbo, Jens, et al.
(författare)
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The Copenhagen Consensus Conference 2016 : children, youth, and physical activity in schools and during leisure time
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 50:19, s. 1177-1178
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- From 4 to 7 April 2016, 24 researchers from 8 countries and from a variety of academic disciplines gathered in Snekkersten, Denmark, to reach evidence-based consensus about physical activity in children and youth, that is, individuals between 6 and 18 years. Physical activity is an overarching term that consists of many structured and unstructured forms within school and out-of-school-time contexts, including organised sport, physical education, outdoor recreation, motor skill development programmes, recess, and active transportation such as biking and walking. This consensus statement presents the accord on the effects of physical activity on children's and youth's fitness, health, cognitive functioning, engagement, motivation, psychological well-being and social inclusion, as well as presenting educational and physical activity implementation strategies. The consensus was obtained through an iterative process that began with presentation of the state-of-the art in each domain followed by plenary and group discussions. Ultimately, Consensus Conference participants reached agreement on the 21-item consensus statement.
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| 2. |
- Cadenas-Sanchez, Cristina, et al.
(författare)
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Differences in Brain Volume between Metabolically Healthy and Unhealthy Overweight and Obese Children : The Role of Fitness
- 2020
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine whether metabolically healthy overweight/obese children have greater global and regional gray matter volumes than their metabolically unhealthy peers. We further examined the association between gray matter volume and academic achievement, along with the role of cardiorespiratory fitness in these associations. A total of 97 overweight/obese children (10.0 +/- 1.2 years) participated. We classified children as metabolically healthy/unhealthy based on metabolic syndrome cut-offs. Global and regional brain volumes were assessed by magnetic resonance imaging. Academic achievement was assessed using the Woodcock-Munoz standardized test. Cardiorespiratory fitness was assessed by the 20 m shuttle run test. Metabolically healthy overweight/obese (MHO) children had greater regional gray matter volume compared to those who were metabolically unhealthy (MUO) (all p <= 0.001). A similar trend was observed for global gray matter volume (p = 0.06). Global gray matter volume was positively related to academic achievement (beta = 0.237, p = 0.036). However, all the associations were attenuated or disappeared after adjusting for cardiorespiratory fitness (p > 0.05). The findings of the present study support that metabolically healthy overweight/obese children have greater gray matter volume compared to those that are metabolically unhealthy, which is in turn related to better academic achievement. However, cardiorespiratory fitness seems to explain, at least partially, these findings.
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| 3. |
- Cadenas-Sanchez, Cristina, et al.
(författare)
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Fitness, physical activity and academic achievement in overweight/obese children
- 2020
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Ingår i: Journal of Sports Sciences. - : TAYLOR & FRANCIS LTD. - 0264-0414 .- 1466-447X. ; 38:7, s. 731-740
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the associations of fitness and physical activity with academic achievement in children with overweight/obesity. A total of 106 (10.0 +/- 1.1y, 61 boys) children participated. The fitness components were assessed by field and laboratory-based tests. Physical activity was measured via accelerometry. The academic achievement was assessed by a standardised test and school-grades. Field-based cardiorespiratory fitness was associated with language skills (ss-standardised- ranging from 0.281 to 0.365, p amp;lt; 0.01). The field-based muscular strength was associated with grade point average, natural and social sciences, and foreign language (ss = 0.280-0.326, all p amp;lt;= 0.01). Speed-agility was associated with some language-related skills (ss = 0.325-0.393, all p amp;lt;= 0.01). The laboratory-based muscular strength also showed an association with mathematics skills (ss = 0.251-0.306, all p amp;lt;= 0.01). Physical activity did not show significant association with academic achievement (p amp;gt; 0.01). Overall, the significant associations observed for muscular strength and speed/agility were attenuated and disappeared in many cases after additional adjustments for body mass index and cardiorespiratory fitness, indicating that these associations are inter-dependent. Our study contributes by indicating that other fitness components apart from cardiorespiratory fitness, such as muscular strength and speed-agility, are positively associated with academic achievement. However, these associations appear to be dependent on body mass index and cardiorespiratory fitness.
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| 4. |
- Ekblom, Maria, 1974-, et al.
(författare)
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Physical activity for cognitive health across the lifespan: when, what and how?
- 2023
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Konferensbidrag (populärvet., debatt m.m.)abstract
- Physical activity for cognitive health across the lifespan: when, what and how?Physical activity appears crucial to wellbeing, and is commonly linked to our physical health. Increasingly however, physical activity is acknowledged to also play a crucial role for mental, cognitive, and brain health throughout the lifespan. Speakers in this session will address the role of physical activity across three broad life stages, childhood, adulthood and older age. The session will present the evidence around physical activity for cognitive and brain health, and considerations for what and how physical activity can be delivered for optimal outcomes at different life stages.Physical activity may benefit mental, cognitive, and brain health through several mechanisms. Reducing potential harm through chronic disease reduction, transiently improving mood via alterations at the cellular and molecular levels, providing a means for skill development and social interaction, and bathing the brain in a rich neurotropic environment are the main means through which cognitive benefits from physical activity are proposed.The impact of physical activity on cognitive and brain function can be also considered from both an acute and chronic perspective. Beneficial chronic adaptations may come from the repeated exposure to positive acute physical activity responses, but how should physical activity be dosed for these important long-term benefits? This session will provide the latest updates in the area and suggest future directions for the field to emerge.Speaker 1Title: Physical activity effects on cognitive and brain health in school age children Speaker Last Name: HillmanSpeaker First Name: CharlesSex: MaleAcademic title: ProfessorUniversity: Northeastern UniversityDepartment: Psychology; Physical Therapy, Movement, & Rehabilitation SciencesCountry: USAEmail: c.hillman@northeastern.eduPhysical activity (PA) can improve physical, mental, cognitive, and brain health throughout the lifespan. During childhood, the benefits of PA for cognitive and brain health have been increasingly studied, with evidence indicating enhanced executive function and improved academic performance, along with adaptations to underlying brain structure and function in specific regions and networks that support these aspects of cognition. Such findings are especially relevant given that there is a growing public health burden of unhealthy behaviors (e.g., physical inactivity, excessive energy intake) among children of industrialized nations. In recent years, children have become increasingly inactive, leading to concomitant increases in the prevalence of being overweight and unfit. Poor PA behaviors during childhood often track throughout life and have implications for the prevalence of several chronic diseases during adulthood. Particularly troubling is the absence of public health concern for the effect of physical inactivity on cognitive and brain health. It is curious that this has not emerged as a larger societal issue, given its clear relation to childhood obesity and other health disorders that have captured public attention. Relative to cognitive and brain health, the literature has predominantly focused on preadolescent children, with a comparatively smaller body of evidence in preschool age and adolescent children. Such a contrast is even more striking relative to the use of neuroimaging tools to assess PA on brain health. To date, the vast majority of neuroimaging studies have investigated preadolescent children, using electroencephalography and functional magnetic resonance imaging, and found that PA and aerobic fitness benefit neural structures and networks that support executive function and memory, including the prefrontal cortex and hippocampus. Such findings have been linked to cognitive outcomes including aspects of executive function such as inhibition, working memory, and mental flexibility as well as other cognitive outcomes including relational memory and academic achievement.Despite evidence that PA promotes cognitive and brain health during development, a growing number of schools have minimized PA opportunities across the school day. Accordingly, this generation of children have become increasingly inactive, contributing to public health and educational concerns. By dedicating time to active play, sports, physical education, and other forms of PA, children are best-positioned to thrive in both the physical and cognitive domains. Such discoveries are timely and important for public health concerns related to chronic disease prevention as a function of childhood inactivity and obesity. These findings link pervasive societal concerns with brain health and cognition, and have implications for the educational environment and the context of learning.Speaker 2Title: Building a cognitive reserve during adulthood: what is the prescription? Speaker Last Name: RattraySpeaker First Name: BenSex: MaleAcademic title: ProfessorUniversity: University of CanberraDepartment: Sport and Exercise ScienceCountry: AustraliaEmail: ben.rattray@canberra.edu.au During adulthood, healthy individuals typically report few cognitive complaints. As a result, the role of physical activity in cognitive health either receives little attention or finds very few relationships. This is likely also a result of the cognitive engagement many adults have through education, vocational, and social settings. There are however observations that physical activity during adulthood does impact later life. Physical activity for cognitive health during early and middle adulthood therefore focuses on general health, reducing the potential harm to brain structures and processes that are associated with several lifestyle-related diseases.Outside of reducing harm through physical health, physical activity may play a crucial role in building a cognitive reserve, potentially improving cognitive performance, but importantly protecting against later-life declines. Taking advantage of physical activity benefits, such as increases in cerebral blood flow and neurotrophic factors, offers an opportunity to maximise neural plasticity. In this session optimising the dose characteristics of physical activity will be discussed.Interventions that specifically attempt to take advantage of plasticity-supporting physical activity are those that ensure cognitive activity is in close temporal proximity. Sequentially- or concurrently-programming physical exercise with a cognitive intervention are gaining popularity, with most evidence currently in older adults. This session will provide an update on the latest evidence for concurrent training in healthy adulthood.It is hypothesized that an increased availability of factors such as brain-derived neurotrophic factor during targeted cognitive interventions improve the gains that such training can provide. However, depending on the outcome, some propose that concurrent activity may also work through the combination of effortful behaviours impacting individuals’ capacity, or tolerance for work. This fatigue-linked pathway may also impact cognitive health when engaged over longer periods, or when individuals are asked to report subjective cognitive complaints. These potential pathways will also be discussed in terms of informing the when, what, and how of physical activity interventions for cognitive health.Speaker 3Title: How physical activity affects cognitive health in older adultsSpeaker Last Name: EkblomSpeaker First Name: MariaSex: FemaleAcademic title: ProfessorUniversity: Swedish School of Sport and Health SciencesDepartment: Physical Activity and HealthCountry: SwedenEmail: maria.ekblom@gih.se There is consistent evidence to suggest that being more fit in young adulthood is associated to having better cognitive function in both young and older adulthood. We also know that being aerobically high fit is associated with having executive abilities that make it easier to attain and sustain healthy habits. While such information may be interesting, it tells us very little on whether physical activity promotion among low fit inactive individuals might have a positive influence on their future cognitive health. In midlife, lack of time is a commonly perceived barrier towards physical activity. Still, as we retire, individuals who were inactive in midlife tend to stay inactive after retiring, despite now having more spare time at hand. When preaching that it is never too late, we need to take care not to shame those whose shoes we have not walked in. Remember, that although we have all equal human value, we have different opportunities, both genetically and in terms of socioeconomic circumstances. When we compare the brain health of senior athletes to that of their less active peers, this is not helping anyone. That is why I prefer randomized controlled trials for the purpose of figuring out what type of exercise might work for whom. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability evaluated whether a 2-year multicomponent intervention with exercise, cognitive training, diet and vascular risk monitoring could slow down the cognitive decline in an at-risk population. They show that such intervention actually can have small effects on the trajectories of cognitive decline, but we are still not close to understanding what the active component is. Large scale exercise RCTs using advanced neuroimaging to investigate neurophysiological mechanisms are under way, but these are very expensive. Major breakthroughs in plasma biomarkers of neurodegenerative disease progression have been exposed recently. Such new techniques should be exploited in future RCTs by researchers who want to investigate if support to increased physical activity can really change the cognitive trajectories of physically inactive individuals who want to spare their brain health. This presentation will explore our current understanding of how and phy
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| 5. |
- Esteban-Cornejo, Irene, et al.
(författare)
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Fitness, cortical thickness and surface area in overweight/obese children: The mediating role of body composition and relationship with intelligence
- 2019
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Ingår i: NeuroImage. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 1053-8119 .- 1095-9572. ; 186, s. 771-781
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Tidskriftsartikel (refereegranskat)abstract
- Cortical thickness and surface area are thought to be genetically unrelated and shaped by independent neurobiological events suggesting that they should be considered separately in morphometric analyses. Although the developmental trajectories of cortical thickness and surface area may differ across brain regions and ages, there is no consensus regarding the relationships of physical fitness with cortical thickness and surface area as well as for its subsequent influence on intelligence. Thus, this study examines: (i) the associations of physical fitness components (i.e., cardiorespiratory fitness, speed-agility and muscular fitness) with overall and regional cortical thickness and surface area; (ii) whether body composition indicators (i.e., body mass index, fat-free mass index and fat mass index) mediate these associations; and (iii) the association of physical fitness and cortical thickness with intelligence in overweight/obese children. A total of 101 overweight/obese children aged 8-11 years were recruited in Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 Tesla Siemens Magnetom Tim Trio system. We used FreeSurfer software version 5.3.0 to assess cortical thickness (mm) and surface area (mm(2)). The main results showed that cardiorespiratory fitness and speed-agility were related to overall cortical thickness (beta = 0.321 and beta = 0.302, respectively; both P amp;lt; 0.05), and in turn, cortical thickness was associated with higher intelligence (beta = 0.198, P amp;lt; 0.05). Muscular fitness was not related to overall cortical thickness. None of the three physical fitness components were related to surface area (p amp;gt; 0.05). The associations of cardiorespiratory fitness and speed-agility with overall cortical thickness were mediated by fat mass index (56.86% amp; 62.28%, respectively). In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, are associated with overall cortical thickness, and in turn, thicker brain cortex is associated with higher intelligence in overweight/obese children. Yet, none of the three physical fitness components were related to surface area. Importantly, adiposity may hinder the benefits of cardiorespiratory fitness and speed-agility on cortical thickness. Understanding individual differences in brain morphology may have important implications for educators and policy makers who aim to determine policies and interventions to maximize academic learning and occupational success later in life.
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| 6. |
- Hou, Meijun, et al.
(författare)
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Human dopaminergic system in the exercise-cognition link
- 2024
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Ingår i: Trends in Molecular Medicine. - : Elsevier. - 1471-4914 .- 1471-499X.
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Tidskriftsartikel (refereegranskat)abstract
- While the dopaminergic system is important for cognitive processes, it is also sensitive to the influence of physical activity (PA). We summarize current evidence on whether PA-related changes in the human dopaminergic system are associated with alterations in cognitive performance, discuss recent advances, and highlight challenges and opportunities for future research.
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| 7. |
- Ortega, Francisco B., et al.
(författare)
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Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity The ActiveBrains Randomized Clinical Trial
- 2022
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Ingår i: JAMA Network Open. - : American Medical Association. - 2574-3805. ; 5:8
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, -0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, -0.17 [95% CI, -0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, -0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, -0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified.
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| 8. |
- Palmer, Nicholette D, et al.
(författare)
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A genome-wide association search for type 2 diabetes genes in African Americans.
- 2012
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Ingår i: PloS one. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; 7:1, s. e29202-
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Tidskriftsartikel (refereegranskat)abstract
- African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P<0.0071), were directionally consistent in the Replication cohort and were associated with T2DM in subjects without nephropathy (P<0.05). Meta-analysis in all cases and controls revealed a single SNP reaching genome-wide significance (P<2.5×10(-8)). SNP rs7560163 (P = 7.0×10(-9), OR (95% CI) = 0.75 (0.67-0.84)) is located intergenically between RND3 and RBM43. Four additional loci (rs7542900, rs4659485, rs2722769 and rs7107217) were associated with T2DM (P<0.05) and reached more nominal levels of significance (P<2.5×10(-5)) in the overall analysis and may represent novel loci that contribute to T2DM. We have identified novel T2DM-susceptibility variants in the African-American population. Notably, T2DM risk was associated with the major allele and implies an interesting genetic architecture in this population. These results suggest that multiple loci underlie T2DM susceptibility in the African-American population and that these loci are distinct from those identified in other ethnic populations.
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| 9. |
- Singh, Amika S, et al.
(författare)
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Effects of physical activity interventions on cognitive and academic performance in children and adolescents : a novel combination of a systematic review and recommendations from an expert panel
- 2019
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 53, s. 640-647
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations. DESIGN: Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality. DATA SOURCES: PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: PA-intervention studies in children with at least one cognitive or academic performance assessment. RESULTS: Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes.Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics. CONCLUSION: There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis. PROSPERO REGISTRATION NUMBER: CRD42017082505.
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| 10. |
- Torres-Lopez, Lucia V, et al.
(författare)
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Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?
- 2022
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Ingår i: European Journal of Pediatrics. - : Springer. - 0340-6199 .- 1432-1076. ; 181, s. 2055-2065
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 4-11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8-12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Munoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all vertical bar beta vertical bar> 0.160, P > 0.076), yet it was associated with the school grade point average (beta = -0.226, P = 0.007) and natural and social science grades (beta = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all beta < -0.188, P > 0.065) or brain volumes (all P > 0.05). Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone.
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