The Relationship between Executive Function and Obesity in Children and Adolescents: A Systematic Literature Review

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Abstract

The objective of this paper is to examine the relationship between the development of executive function (EF) and obesity in children and adolescents. We reviewed 1,065 unique abstracts: 31 from PubMed, 87 from Google Scholar, 16 from Science Direct, and 931 from PsycINFO. Of those abstracts, 28 met inclusion criteria and were reviewed. From the articles reviewed, an additional 3 articles were added from article references ( N = 31). Twenty-three studies pertained to EF (2 also studied the prefrontal and orbitofrontal cortices (OFCs); 6 also studied cognitive function), five studied the relationship between obesity and prefrontal and orbitofrontal cortices, and three evaluated cognitive function and obesity. Inhibitory control was most often studied in both childhood (76.9%) and adolescent (72.7%) studies, and obese children performed significantly worse ( P < 0.05) than healthy weight controls on various tasks measuring this EF domain. Although 27.3% of adolescent studies measured mental flexibility, no childhood studies examined this EF domain. Adolescents with higher BMI had a strong association with neurostructural deficits evident in the OFC. Future research should be longitudinal and use a uniform method of EF measurement to better establish causality between EF and obesity and consequently direct future intervention strategies.

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Most cited references 51

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The Dimensional Change Card Sort (DCCS): a method of assessing executive function in children.

Philip Zelazo (2006)

The dimensional change card sort (DCCS) is an easily administered and widely used measure of executive function that is suitable for use with participants across a wide range of ages. In the standard version, children are required to sort a series of bivalent test cards, first according to one dimension (e.g., color), and then according to the other (e.g., shape). Most 3-year-olds perseverate during the post-switch phase, exhibiting a pattern of inflexibility similar to that seen in patients with prefrontal cortical damage. By 5 years of age, most children switch when instructed to do so. Performance on the DCCS provides an index of the development of executive function, and it is impaired in children with disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism. We describe the protocol for the standard version (duration = 5 min) and the more challenging border version (duration = 5 min), which may be used with children as old as 7 years.

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Structural and functional brain development and its relation to cognitive development.

B.J. Casey, Jay Giedd, Kathleen M. Thomas (2000)

Despite significant gains in the fields of pediatric neuroimaging and developmental neurobiology, surprisingly little is known about the developing human brain or the neural bases of cognitive development. This paper addresses MRI studies of structural and functional changes in the developing human brain and their relation to changes in cognitive processes over the first few decades of human life. Based on post-mortem and pediatric neuroimaging studies published to date, the prefrontal cortex appears to be one of the last brain regions to mature. Given the prolonged physiological development and organization of the prefrontal cortex during childhood, tasks believed to involve this region are ideal for investigating the neural bases of cognitive development. A number of normative pediatric fMRI studies examining prefrontal cortical activity in children during memory and attention tasks are reported. These studies, while largely limited to the domain of prefrontal functioning and its development, lend support for continued development of attention and memory both behaviorally and physiologically throughout childhood and adolescence. Specifically, the magnitude of activity observed in these studies was greater and more diffuse in children relative to adults. These findings are consistent with the view that increasing cognitive capacity during childhood may coincide with a gradual loss rather than formation of new synapses and presumably a strengthening of remaining synaptic connections. It is clear that innovative methods like fMRI together with MRI-based morphometry and nonhuman primate studies will transform our current understanding of human brain development and its relation to behavioral development.

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Executive Functions after Age 5: Changes and Correlates.

John R. Best, Patricia H Miller, Lara L Jones (2009)

Research and theorizing on executive function (EF) in childhood has been disproportionately focused on preschool age children. This review paper outlines the importance of examining EF throughout childhood, and even across the lifespan. First, examining EF in older children can address the question of whether EF is a unitary construct. The relations among the EF components, particularly as they are recruited for complex tasks, appear to change over the course of development. Second, much of the development of EF, especially working memory, shifting, and planning, occurs after age 5. Third, important applications of EF research concern the role of school-age children's EF in various aspects of school performance, as well as social functioning and emotional control. Future research needs to examine a more complete developmental span, from early childhood through late adulthood, in order to address developmental issues adequately.

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Author and article information

Journal

Journal ID (nlm-ta): J Obes

Journal ID (iso-abbrev): J Obes

Journal ID (publisher-id): JOBES

Title: Journal of Obesity

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2090-0708

ISSN (Electronic): 2090-0716

Publication date (Print): 2013

Publication date (Electronic): 21 February 2013

Volume: 2013

Electronic Location Identifier: 820956

Affiliations

¹Medical Student at the Medical University of South Carolina, 169 Ashley Avenue, Charleston, SC 29403, USA

²Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Avenue, 2nd Floor, Nashville, TN 37212, USA

³Diabetes Research and Training Center, Vanderbilt University School of Medicine, 1211 Medical Center Drive, Nashville, TN 37212, USA

Author notes

*Shari L. Barkin: shari.barkin@ 123456vanderbilt.edu

Academic Editor: Ajay K. Gupta

Article

DOI: 10.1155/2013/820956

PMC ID: 3595670

PubMed ID: 23533726

SO-VID: 4e5b533b-cf72-4ad9-a7fb-c82e10bdb3e5

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 15 November 2012

Date revision received : 7 January 2013

Date accepted : 21 January 2013

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