University of Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Faculty of Medicine, Providencia Talca, Chile.
University of Castilla-La Mancha, Social and Health Care Research Center, Cuenca, Spain; Universidad Politécnica y Artística de Paraguay, Asunción, Paraguay.
J Pediatr. 2021 Apr;231:231-238.e1. doi: 10.1016/j.jpeds.2020.12.062. Epub 2020 Dec 26.
To evaluate the fat but fit conceptual model, testing whether this paradigm for body mass index (BMI) and maximum rate of oxygen consumption (VO) exists in schoolchildren and whether executive functions mediate the relationship between fat but fit categories and academic achievement.
Cluster cross-sectional analyses of data from 554 children aged 9-11 from Cuenca, Spain. BMI, VO, core executive functions (inhibition, working memory, and cognitive flexibility) and academic achievement (language and mathematics).
Cluster analysis of BMI and VO z-scores resulted in a 4-cluster solution that could be interpreted according to fat unfit, unfat unfit, fat fit, and unfat fit categories. ANCOVA models confirmed an increasing trend by cluster category in terms of VO levels and, conversely, a decreasing trend in terms of adiposity variables. These models also confirmed that children in the fat fit and unfat fit categories scored higher than their peers in the fat unfit and unfat unfit categories. Mediation analyses using fat but fit clusters as multicategory independent variable, executive functions as mediators, and academic achievement as outcome variable showed that the positive association between the BMI-VO clusters and academic achievement was mediated by inhibition levels in fat fit and unfat fit individuals, by working memory levels only in those classified as fat fit, and by cognitive flexibility only in unfat fit individuals.
This study confirms the validity of the 4-cluster conceptual model regarding BMI and VO and reinforces the predictive validity, proving that fitness levels are able to counteract the detrimental effect of obesity on academic achievement.
评估肥胖但健康的概念模型，检验该模型是否适用于儿童的体重指数（BMI）和最大耗氧量（VO），以及执行功能是否在肥胖健康类别与学业成绩之间的关系中起中介作用。
对西班牙昆卡 554 名 9-11 岁儿童的数据进行聚类横断面分析。BMI、VO、核心执行功能（抑制、工作记忆和认知灵活性）和学业成绩（语言和数学）。
BMI 和 VO z 分数的聚类分析产生了一个 4 聚类解决方案，可以根据肥胖不健康、非肥胖不健康、肥胖健康和非肥胖健康类别进行解释。ANCOVA 模型证实，根据聚类类别，VO 水平呈上升趋势，而肥胖变量则呈下降趋势。这些模型还证实，肥胖健康和非肥胖健康类别的儿童比肥胖不健康和非肥胖不健康类别的儿童在学业成绩上得分更高。使用肥胖健康和非肥胖健康聚类作为多类别自变量、执行功能作为中介、学业成绩作为因变量的中介分析表明，BMI-VO 聚类与学业成绩之间的正相关关系，是由肥胖健康和非肥胖健康个体的抑制水平中介的，仅在归类为肥胖健康的个体中由工作记忆水平中介，仅在非肥胖健康个体中由认知灵活性水平中介。
本研究证实了 BMI 和 VO 的 4 聚类概念模型的有效性，并增强了其预测有效性，证明了健康水平能够抵消肥胖对学业成绩的不利影响。
