Department of Pediatrics, Division of Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA.
Department of Pediatrics, Division of Pediatric Research Administration, Children's Hospital Los Angeles, Los Angeles, California, USA.
Obesity (Silver Spring). 2023 Nov;31(11):2809-2821. doi: 10.1002/oby.23811. Epub 2023 Sep 20.
The study aim was to determine whether (A) differences in executive function (EF) and cognition precede weight gain or (B) weight gain causes changes to EF and cognition.
Data were gathered from the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0; ages 9-12 years old [N = 2794]; 100% had healthy weight at baseline [i.e., 9/10 years old], 12.4% had unhealthy weight by ages 11/12 years). EF and cognition were assessed across several domains (e.g., impulsivity, inhibitory control, processing speed, memory); BMI was calculated from height and weight. Nested random-effects mixed models examined (A) BMI ~ EF × Time (i.e., variation in EF/cognition precedes weight gain) and (B) EF ~ BMI × Time (weight gain causes changes to EF/cognition) and controlled for sex, puberty, and caregiver education; random effects were site and subject.
Variation in impulsivity, memory, learning, and processing speed was associated with greater increases in BMI trajectories from 9 to 12 years old. Weight gain was associated with a decrease in inhibitory control, but no other associations were observed.
Underlying variation in EF and cognition may be important for weight gain, but 2 years of weight gain may not be enough to have clinical implications for EF and cognition beyond inhibitory control. These findings suggest that more attention should be paid to the inclusion of EF programs in obesity prevention efforts.
本研究旨在确定执行功能（EF）和认知方面的差异是（A）先于体重增加出现，还是（B）体重增加导致 EF 和认知发生变化。
数据来自青少年大脑认知发展研究（ABCD 研究；版本 4.0；年龄 9-12 岁[N=2794]；基线时 100%为健康体重[即 9/10 岁]，12.4%在 11/12 岁时超重）。EF 和认知通过多个领域进行评估（例如，冲动性、抑制控制、加工速度、记忆）；体重指数（BMI）通过身高和体重计算得出。嵌套随机效应混合模型考察了（A）BMIEF×时间（即 EF/认知的变化先于体重增加）和（B）EFBMI×时间（体重增加导致 EF/认知发生变化），并控制了性别、青春期和照顾者教育；随机效应为地点和研究对象。
冲动性、记忆、学习和加工速度的变化与从 9 岁到 12 岁 BMI 轨迹的更大增加相关。体重增加与抑制控制能力下降有关，但未观察到其他关联。
EF 和认知的潜在差异可能对体重增加很重要，但 2 年的体重增加可能不足以对 EF 和认知产生除抑制控制以外的临床影响。这些发现表明，在肥胖预防工作中，应更加关注纳入 EF 计划。
