Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity

Ortega, Francisco B.; Mora-González, José; Cadenas-Sánchez, Cristina; Esteban‐Cornejo, Irene; Migueles, Jairo H; Solis‐Urra, Patricio; Verdejo‐Román, Juan; Rodriguez‐Ayllon, María; Molina-García, Pablo; Ruiz, Jonatan R.; Martínez‐Vizcaíno, Vicente; Hillman, Charles H.; Erickson, Kirk I.; Kramer, Arthur F.; Labayen, Idoia; Catena, Andrés

doi:10.1001/jamanetworkopen.2022.27893

Cited by 42 publications

(75 citation statements)

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“…NCT02295072) which primary aim was to investigate the effect of a 20-week exercise program on brain health indicators in children with overweight/obesity. 21,22 This study examined the ActiveBrains RCT effects on sleep (secondary outcomes). Details on the design, eligibility, characteristics, and effects on the primary outcomes can be found elsewhere.…”

Section: Methodsmentioning

confidence: 99%

“…Details on the design, eligibility, characteristics, and effects on the primary outcomes can be found elsewhere. 21,22 In brief, 109 children (8-11 years) with overweight/obesity took part in this RCT. 21,22 After baseline data collection, participants were randomly allocated to either the wait-list control group (N=52) or exercise program (N=57) using a computer-based simple randomization procedure in a ratio of 1:1 by a person not involved in the assessments.…”

Section: Methodsmentioning

confidence: 99%

“…21,22 In brief, 109 children (8-11 years) with overweight/obesity took part in this RCT. 21,22 After baseline data collection, participants were randomly allocated to either the wait-list control group (N=52) or exercise program (N=57) using a computer-based simple randomization procedure in a ratio of 1:1 by a person not involved in the assessments. Participants in the wait-list control group continued with their usual routines.…”

Section: Methodsmentioning

confidence: 99%

“…Data were collected from November 2014 to June 2016 in Granada (Spain). The ActiveBrains RCT 21,22 was conducted according to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee on Human Research (CEIH) of the University of Granada.…”

Section: Methodsmentioning

confidence: 99%

“…32 Raw and standardized (z-scores) estimates are provided, with the post-exercise z-scores calculated relative to the baseline mean and SD as an indicative of the change. 21,32 A difference of 0.2 SDs was considered a small, 0.5 SDs medium, and 0.8 SDs large effect sizes. 33 Differences exceeding 0.2 Cohen’s D were interpreted as minimum meaningful effect.…”

Section: Methodsmentioning

confidence: 99%

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Effects of exercise on sleep in children with overweight/obesity: A randomized clinical trial

Torres-Lopez¹,

Migueles

Cadenas‐Sanchez³

et al. 2022

Preprint

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Objectives: To examine 1) the chronic effects of a 20-week physical exercise program on device-assessed sleep and on sleep-disordered breathing (SDB); and 2) whether attending to a session of the exercise program had effects on device-assessed sleep the subsequent night in children with overweight/obesity. Methods: A total of 99 children with overweight/obesity (n=47 in the exercise group) participated in this secondary analysis of the ActiveBrains randomized clinical trial. The exercise program included a combination of aerobic and resistance exercise training, 3-5 days/week (90 min/session). The control group was asked to maintain usual lifestyle. Sleep outcomes were measured using wrist actigraphy and included: total sleep time, total time in bed, sleep efficiency, and wake after sleep onset (WASO) time. SDB was assessed via the Paediatric Sleep Questionnaire. Results: The ActiveBrains exercise program had a statistically significant effect on WASO time (-10.8 min/day, -0.5 standard deviations (SD), P=0.040). Furthermore, we observed a small non-statistically significant effect on sleep efficiency (+2%, 0.4 SD, P=0.1). No other chronic effects were observed on the other sleep outcomes. The nights (at maximum of 4) after attending the ActiveBrains exercise sessions, children showed higher total sleep time (+8 min, P=0.17), sleep efficiency (+1%, P=0.15), and lower WASO time (-6 min, P=0.18) although did not reach statistical significance. Conclusion: A 20-week physical exercise program reduced WASO time in children with overweight/obesity in comparison with control group peers, yet we did not observe effects on SDB. Future randomized trials that include a clinical sample of children with poor sleep health at baseline are needed to better appreciate the role of exercise in sleep health.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Effects of exercise on sleep in children with overweight/obesity: A randomized clinical trial

Torres-Lopez¹,

Migueles

Cadenas‐Sanchez³

et al. 2022

Preprint

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Effects of an Exercise Program on Cardiometabolic and Mental Health in Children With Overweight or Obesity

et al. 2023

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ImportanceChildhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health.ObjectiveTo investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity.Design, Setting, and ParticipantsThis secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context.InterventionThe exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines.Main Outcomes and MeasuresCardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators.ResultsThe 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk score by approximately 0.38 (95% CI, −0.74 to −0.02) SDs; decreased low-density lipoprotein cholesterol level by −7.00 (95% CI, −14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by 0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by −0.59 (95% CI, −1.06 to −0.12), fat mass index by −0.67 (95% CI, −1.01 to −0.33), and visceral adipose tissue by −31.44 (95% CI, −58.99 to −3.90) g; and improved cardiorespiratory fitness by 2.75 (95% CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed on mental health outcomes.Conclusions and RelevanceIn this secondary analysis of a randomized clinical trial, an aerobic plus resistance exercise program improved cardiometabolic health in children with overweight or obesity but had no effect on mental health.Trial RegistrationClinicalTrials.gov Identifier: NCT02295072

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Levels of Physical Activity at Age 10 Years and Brain Morphology Changes From Ages 10 to 14 Years

Estévez-López,

Dall’Aglio,

Rodriguez-Ayllon

et al. 2023

JAMA Netw Open

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ImportancePhysical activity may promote healthy brain development in children, but previous research was predominantly cross-sectional and included small samples, providing limited knowledge.ObjectiveTo investigate the longitudinal associations of physical activity with brain morphology changes.Design, Setting, and ParticipantsA 4-year longitudinal population-based cohort study in Rotterdam, the Netherlands, embedded in Generation R, a cohort from fetal life onward. From the women enrolled during pregnancy, children who had repeated measures of brain structure at ages 10 (range 8 to 12) years and 14 (range 13 to 15) years were included. Data were collected from March 2013 to November 2015 (baseline) and from October 2016 to January 2020 (follow-up). Data were analyzed from April to December 2022.ExposureAt age 10 years, both the child and their primary caregiver reported the child’s levels of physical activity with regard to sport participation, outdoor play, and total physical activity. Primary analyses were based on an average multi-informant report.Main outcomes and measuresBrain morphology was quantified by magnetic resonance imaging. Hypothesized regions of interest were the bilateral amygdala and hippocampal volumes. Global brain measures were studied to test the specificity of the hypothesis.ResultsData were available for 1088 children (566 girls [52%]; 693 [64%] Dutch). Their mean (SD) age at baseline was 10.1 (0.6) years. For amygdala volume change, positive associations with multi-informant reports of total physical activity (β = 2.6; 95% CI, 0.3-4.9) were found. Total physical activity was associated with hippocampal volume increases only when reported by the child (β = 3.1; 95% CI, 0.4-5.8). No robust associations with global brain measures were found.Conclusions and relevanceIn this cohort study of 1088 children, more physical activity at 10 years was consistently associated with an increase in amygdala volume in children aged 10 to 14 years. Physical activity and increases in hippocampal volume were found using child reports of physical activity only. These findings suggest physical activity in late childhood was prospectively associated with volumetric changes in specific subcortical structures, but not to global brain development, from late childhood to early adolescence. These findings may inform the design of future public health interventions to best facilitate neurodevelopment with physical activity.

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Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity

Cited by 42 publications

References 83 publications

Effects of exercise on sleep in children with overweight/obesity: A randomized clinical trial

Effects of exercise on sleep in children with overweight/obesity: A randomized clinical trial

Effects of an Exercise Program on Cardiometabolic and Mental Health in Children With Overweight or Obesity

Levels of Physical Activity at Age 10 Years and Brain Morphology Changes From Ages 10 to 14 Years

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