Paediatric obesity and brain functioning: The role of physical activity—A novel and important expert opinion of the European Childhood Obesity Group

Abstract

Obesity is a major public health concern for developed and developing countries. Over the past years, paediatric obesity has more than doubled in children and tripled in adolescents worldwide (1). The consequences of childhood obesity are dramatic, leading to overweight/obesity later in life (2), future morbidity and mortality (3, 4), as well as metabolic, functional, psychosocial or quality of life impairments, among others (5, 6). While most of the time unconsidered, child and adolescent obesity has been also associated with impaired brain health, structure and function (7-10), that can definitely affect individuals' day-to-day social interaction and integration, and even potential occupational success later in life (11).Cognitive functioning effectively represents all the mental processes that allow individuals to properly perform any task, allowing an active role in the processes of receiving, choosing, transforming, storing, processing and retrieval of information. Specifically, executive function refers to the higher cognitive processes that enable forethought and goal-directed action, and involves inhibitory control, working memory and cognitive flexibility (12). In youth, executive functions, in turn, have been suggested to predict academic performance (13). While the association between obesity and impaired executive function has been widely established in adults ( 14), this remains less known in children and adolescents. Indeed, while some studies support the existence of executive function deficits in individuals with overweight/obesity, others fail to observe these differences (9). As such, there is still a clear need to better identify not only the cause-effects relationships between obesity and executive function during childhood and adolescence, but also their underlying brain implications, since healthier

Physical Fitness Plays a Crucial Mediator Role in Relationships Among Personal, Social, and Lifestyle Factors With Adolescents' Cognitive Performance in a Structural Equation Model. The Cogni-Action Project

“…High adipose tissue storage, mainly at the visceral level, promotes a low-grade systemic inflammation related to lower cognitive performance in children ( 58 , 59 ). Cytokines and hormones (i.e., CRP, IL-6, Leptin) play a relevant role in brain functioning; hence paediatric obesity would affect brain structure and function ( 58 , 60 ). However, it has been shown that physical fitness counteracts the effect of obesity meditating on various physiopathological processes, for instance, inducing an anti-inflammatory mechanism at the organic level ( 61 ), and also attenuating the genetic predisposition to obesity in children and adolescents ( 62 , 63 ).…”

Could Physical Fitness Be Considered as a Protective Social Factor Associated with Bridging the Cognitive Gap Related to School Vulnerability in Adolescents? The Cogni-Action Project

“…Thus, this study seems to be the first in showing a “narrowing” in the adolescent’s cognitive gap related to school vulnerability through a modifiable, low-cost, and practical factor, such as physical fitness. Moreover, our analyses include several covariates, but one of them, the BMIz, has been widely related to low cognitive and academic performance in children and adolescents [ 36 , 63 ]. In this way, this methodological approach adds more confidence to our findings, and it is crucial to mention because Chilean children and adolescents present one of the highest rates of overweight and obesity worldwide (54%) [ 64 ].…”

Mediation Role of Physical Fitness and Its Components on the Association Between Distribution-Related Fat Indicators and Adolescents’ Cognitive Performance: Exploring the Influence of School Vulnerability. The Cogni-Action Project

“…An excess of body fat has been associated with a diversity of metabolic, cardiovascular, and mental health conditions (Halfon et al, 2013 ; Sahoo et al, 2015 ). Children and adolescents with overweight or obesity present lower cognitive functioning (Esteban-Cornejo et al, 2020 ) in several cognitive domains such as attention, executive functioning, memory, and visuospatial performance (Liang et al, 2014 ). An adequate cognitive development in childhood is crucial for both short and long-term, due to its future impact on predictors related to socioeconomic status, health, and behavior, which might counteract the adverse effect of children’s social environment (Feinstein and Bynner, 2004 ).…”