Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children

Abstract

Background: Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE.Methods: Overweight or obese children (n = 222) aged 7-11 (9.4 -1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year Results: Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children ( p < 0.03). However, PSE was unrelated to prediabetes, insulin resistance, or visceral fat. PSE was linked to poorer cognitive scores ( p < 0.04) independent of adiposity, but was not related to sleep-disordered breathing.Conclusions: PSE is associated with fatness and poorer cognition in children. Tailored interventions that target multiple health risk factors including nutrition, physical activity, and tobacco use in children and families are needed to prevent adverse health outcomes related to tobacco use and obesity.

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight

“…One study was a non-randomised trial (Halberstadt 2017);Seven studies did not report the disaggregated data for children with obesity or overweight (Donnelly 2009; Donnelly 2013; Gentile 2009; Hillman 2014; Murray 2008; Puder 2011; Reed 2010);Two studies employed lifestyle interventions without the intention to prevent or reduce obesity (Crova 2014; Pesce 2016b);Eight studies used non-eligible tools to assess school or cognitive outcomes (e.g. self-reported or parent-reported questionnaires) (Gee 2014; Goldfield 2012; Muzaffar 2014; Naar-King 2016; Pentz 2011; Salmoirago-Blotcher 2015; Smith 2015; Wong 2016).…”

“…Two studies employed lifestyle interventions without the intention to prevent or reduce obesity (Crova 2014; Pesce 2016b);…”

“…Five RCTs were included in the review, of which we include four in this Cochrane Review (Davis 2011b; Huang 2015; Krafft 2014; Staiano 2012). We did not include the remaining RCT (Crova 2014) because the study did not aim to modify body weight status and so was not eligible for inclusion. The quasi-experimental studies included in Bustamante 2016 were uncontrolled single-group trials, case-control studies or short, single-session (acute bout) physical activity interventions, which we did not consider eligible for inclusion in this review.…”

“…Although these systematic reviews may include some children with obesity or overweight, they lack a separate analysis of the effect estimates in our population groups of interest. Research suggests a greater benefit of obesity-related health behaviour interventions in children with obesity or overweight compared to children with healthy weight (Crova 2014; Grieco 2009; Vazou 2014). These reviews are therefore not directly comparable with our review.…”

Tobacco, e-cigarettes, and child health

“…A study in a Danish population determined that maternal prenatal smoking or use of nicotine replacement therapy was more strongly associated to an increased risk of ADHD in children than paternal tobacco use [29*]. A recent study in overweight and obese children found an association between plasma cotinine levels and poorer cognitive scores [30**], suggesting that environmental tobacco smoke exposure during childhood can impact brain development.…”