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OBJECTIVE: To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity. STUDY DESIGN: A total of 109 children with overweight/obesity (mean age, 10.0 ± 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). RESULTS: SDB was positively associated with all clinical scale variables (all ß > 0.197, P ≤ .041) and with lower adaptability and leadership (all ß < -0.226, P < .021). Specifically, the PSQ subscale relating to daytime sleepiness was associated with higher attention problems, depression, anxiety, and retreat (all ß > 0.196, P ≤ .045) and lower adaptability (ß = -0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all ß > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. CONCLUSIONS: Our study suggests that SDB symptoms, but not device-assessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability.

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BACKGROUND: Education and health are crucial topics for public policies as both largely determine the future wellbeing of the society. Currently, several studies recognize that physical activity (PA) benefits brain health in children. However, most of these studies have not been carried out in developing countries or lack the transference into the education field. The Cogni-Action Project is divided into two stages, a cross-sectional study and a crossover-randomized trial. The aim of the first part is to establish the associations of PA, sedentarism, and physical fitness with brain structure and function, cognitive performance and academic achievement in Chilean schoolchildren (10-13 years-old). The aim of the second part is to determinate the acute effects of three PA protocols on neuroelectric indices during a working memory and a reading task. METHODS: PA and sedentarism will be self-reported and objectively-assessed with accelerometers in a representative subsample, whilst physical fitness will be evaluated through the ALPHA fitness test battery. Brain structure and function will be assessed by magnetic resonance imaging (MRI) in a randomized subsample. Cognitive performance will be assessed through the NeuroCognitive Performance Test, and academic achievement by school grades. In the second part 32 adolescents (12-13 year-old) will be cross-over randomized to these condition (i) "Moderate-Intensity Continuous Training" (MICT), (ii) "Cooperative High-Intensity Interval Training" (C-HIIT), and (iii) Sedentary condition. Neuroelectric indices will be measures by electroencephalogram (EEG) and eye-tracking, working memory by n-back task and reading comprehension by a reading task. DISCUSSION: The main strength of this project is that, to our knowledge, this is the first study analysing the potential association of PA, sedentarism, and physical fitness on brain structure and function, cognitive performance, and academic achievement in a developing country, which presents an important sociocultural gap. For this purpose, this project will use advanced technologies in neuroimaging (MRI), electrophysiology (EEG), and eye-tracking, as well as objective and quality measurements of several physical and cognitive health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03894241 Date of register: March 28, 2019. Retrospectively Registered.

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OBJECTIVE: To examine the associations of physical fitness and physical activity with executive function in children with overweight and obesity. STUDY DESIGN: A cross-sectional study involving 100 children with overweight and obesity (10.1 ± 1.1 years old; 58.0% boys). We assessed physical fitness components (ie, muscular strength, speed-agility, and cardiorespiratory fitness) using the ALPHA battery, and physical activity and sedentary time by accelerometry. Cognitive flexibility was measured by the Design Fluency Test and Trail Making Test, inhibition by the Stroop test, and planning ability by the Zoo Map Test. RESULTS: Handgrip strength was positively associated with planning ability (P = .025). Speed-agility was positively related to cognitive flexibility and inhibition (P < .05). Cardiorespiratory fitness and an overall fitness Z-score were positively associated with indicators of cognitive flexibility (P < .05). No associations were found for physical activity and sedentary time with executive function (P ≥ .05). CONCLUSIONS: Muscular strength, speed agility, and cardiorespiratory fitness are associated with executive function in children with overweight and obesity. Cognitive flexibility seems to be more robustly associated with all fitness components, whereas planning ability and inhibition might depend on the component analyzed. The positive associations found in the present study in children with overweight and obesity call for more exercise-based randomized controlled trials in this population.

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The purpose of this study was to describe anthropometric and physical fitness characteristics of low-income Chilean preschool children and to examine whether weight status influences children's performance on fitness tests. A total of 434 preschool children (246 boys; 5.48 ± 0.31 years) participated in our study. Anthropometry (weight, height, body mass index -BMI- and waist circumference) and fitness tests (handgrip strength test, standing long jump and 20 m sprint) were assessed by trained nutritionists and physical education teachers, respectively. Significant differences in anthropometry and fitness tests between boys and girls were found. The prevalence of overweight was higher in girls; in contrast to that of obesity. Compared to normal-weight children, overweight/obese boys and girls were heavier and had greater waist circumference (P < 0.001), were taller (P ≤ 0.002), and showed higher performance in handgrip strength (P ≤ 0.027) but not in standing long jump nor 20 m sprint (P ≥ 0.052). Screening physical fitness levels in overweight/obese preschool children could be an important tool in order to design an efficacy physical activity programme.

El objetivo de este estudio fue describir las características antropométricas y el nivel de condición física de preescolares chilenos de bajo nivel socioeconómico y examinar si el estado ponderal influye en el rendimiento de los niños en las pruebas de condición física. Un total de 434 preescolares (246 niños; 5,48 ± 0,31 años) participaron en nuestro estudio. Antropometría (peso, talla, índice de masa corporal ­IMC­ y perímetro de cintura) y tests de condición física (test de fuerza de prensión manual, test de salto de longitud y 20 m sprint) fueron evaluados por nutricionistas entrenados y profesores de educación física, respectivamente. Se encontraron diferencias significativas en antropometría y tests de condición física entre niños y niñas. La prevalencia de sobrepeso fue mayor en las niñas; en contraste con la de la obesidad. En comparación con los preescolares con normopeso, los niños y niñas con sobrepeso/obesidad pesaron más y tuvieron mayor perímetro de cintura (P < 0.001), eran más altos (P ≤ 0.002) y mostraron mayor rendimiento en el test de fuerza de prensión manual (P ≤ 0.027), pero no en el test de salto de longitud ni en el test de sprint de 20 m (P ≥ 0.052). Detectar los niveles de condición física en preescolares con sobrepeso/obesidad puede ser una herramienta importante para diseñar programas eficaces de actividad física.

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