UEF // University of Eastern Finland 31.7.2016 1
Eero Haapala, Ph.D.
Institute of Biomedicine, School of Medicine, University of Eastern Finland
Dept. of Biology of Physical Activity, University of Jyväskylä
Wilhelmina Children’s Hospital, University Medical Center Utrecht
Health Behaviors, Health, and LearningPhysical activity, diet, and adiposity – Effects on cognitive functionsand academic performance during childhood
UEF // University of Eastern Finland
ContentsPhysical activity
Diet/
Nutrition
Body adiposity
Cognition/Learning
UEF // University of Eastern Finland 31.7.2016 3
76%…of Finnishchildren get toomuch saturatedfatty acids fromtheir diet
80%…of Finnishchildren eat toomuch sugar and did not get enoughvitamin D
50%6-8-year-old children eat fishfrequently every week and achieve at least one hour of moderate-to-vigorous physical activity daily
24%…of adolescents aged
14-15 years watch TV more than 4 hours daily
8.6…is the number of hours childrenspend in sedentarybehaviors daily
17%…of adolescents aged 14-16
years meet the physicalactivity recommendations
10-20%…of Finnishchildren is overweight orobese
FINNISH children in numbers
Eloranta et al. 2012; Eloranta et al. Eur J Nutr 2011; Soininen et al. Br J Nutr 2016; Väistö et al. IJBNPA 2014; Tammelin et al. Finnish Med J 2014
UEF // University of Eastern Finland
Is obesogenig enviroment making us stupid?
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Physical inactivity?
Unhealthy diet?
Insufficient sleep?
Obesity?
Poor motor skills?
Poor cardiorespiratory fitness?
year…1970 1980 1990 2000 2010
Children are more often obese, physicallyinactive and have poorer motor skills and fitness
than children few decades ago-
Can these changes have effects on their brains?
UEF // University of Eastern Finland
Physical activity and learning
Can physical activity improve cognition and learning?
The answer is probably yes as“…the running man" dominated the standard for fitness levels, as survival necessitated physical activity in their hunting and gathering excursions.” (Vaynman & Gomez-Pinilla J Neurosci Res 2006)
I think this is a silly question…therefore I put it this way; is physical activity essential for normal development of brain and cognition?
UEF // University of Eastern Finland
Normally developing children…
VS.
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Physical activity and learning – evidence fromRandomized controlled trials
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Increasing physical activity may improve attention, working
memory, and academic performance in children
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Examples of effective interventions
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Kamijo et al. Dev Sci 2011;14:1046-1058.
90 minutes of moderate-to-vigorous motorically challenging physical activity five times per week for nine months improved working memory, attentional inhibition, mental flexibility, and brain activation in 7-9 year old children
Hillman et al. Pediatrics 2014; 134:e1063-e1071.
UEF // University of Eastern Finland
Examples of effective interventions
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Implementing physical activity into academic lessons improved academic performance over two (1) and three (2) years in 7-9-year old children
Spelling
Math speed
Overall math
1. Mullender-Wijsma et al. Pediatrics 2016, 2. Donnelly et al. Prev Med 2009
The results equals to 4 month
learning gains
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Examples of effective interventions – dose-response and type-of-activity issues
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Ardoy et al. Scand J Med Sci Sports 2014;24:52-61.
-20
-10
0
10
20
30Changes in cognitive performance
CG EG1 EG2
PE for 4x/55min/week over five months emphasizing intensity was more effective in improving cognitive functions than non-intensity centered PE for 4x/55min/week or regular PE for 2x/55min/week in children and adolescents aged 12-14 years.
40 minutes of MVPA per day more effective to improve cognition and academic performance than 20 minutes of MVPA or control condition in overweight or obese children aged 9-years over 13 weeks
Davis et al. Health Psychol 2011;30:91-98
UEF // University of Eastern Finland
Examples of effective interventions – dose-response and type-of-activity issues
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Koutsandreou et al. Med Sci Sport Exerc 2016;48:1144-1152.
Three times a week cardiovascular or motor skill training for 10 weeks improved working memory in 9-year-old children. The effects of motor skill training were larger than that of cardiovascular training
Better motor skills, but not cardiorespiratory fitness, were related to better academic achievement (A) and cognition (B) in 6-8-year-old children
B
Haapala et al. Med Sci Sport Exerc 2014;46:1016-24 and 2015;47:2166-2174.
UEF // University of Eastern Finland
…but wait a minute…
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Same study that found positive effects of physically active lessons on academic performance (Mullender-Wijsma et al.) found no effects on executive functions
10
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25
30
35
1 2 3
Changes in inhibition and cognitive
flexibility in intervention and control groups
IG_ Stroop CG_Stroop
0
20
40
60
80
100
1 2
Changes in inhibition and academic performance in intervention and control
groups
IG_Flanker_accuracy CG_Flanker_accuracy
IG_Academic performance CG_Academic performance
Multicomponent 5-month physical activity intervention found no differences in executive functions or academic performance between intervention and control groups
de Greeff et al. Health Educ Res 2016 Tarp et al. PLoS one 2016
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…however, long-term benefits of physically active lifestyle are…
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Higher levels of physical activity at the age of 9, 12, and 15 years
Boys with a combination of low levels of PA and high levels of sedentary time in Grade 1 had poorer reading skills than other boys from Grade 1 to Grade 3
12-25% higher earnings
over 10-year period
Kari et al. MSSE 2016;48:1340-1346
UEF // University of Eastern Finland
…long-term benefits of physically active lifestyle are…
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Boys who participated in daily PE for nine years
We more likely to
qualify to upper-
secondary school than those with regular PE
Ericsson & Karlsson Scand J Med Sci Sport 2012
UEF // University of Eastern Finland
Sedentary behavior, cognition, and academicachievement
31.7.2016 15Haapala ym. Plos One 2014; Syväoja ym. Plos One 2014; Tremblay ym. IJBNPA 2011
Recreational reading has been linkedto better reading skills and academicperformance
High levels of computer & video game playing- Have been related to better arithmetic skills in
boys- Poorer woring memory in 12-year-old children
High levels of TV watching have beenlinked to poorer academicperformance
UEF // University of Eastern Finland
Lessons learned…
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Physicalactivity&
Brain
Physical activity mayimprove learning
Effects may be contextspecific
Effects are small to moderate
Long-term effects are probably larger
The mode of the most efficient intervention needs to be elucidated
At least it does notimpair learning
e.g. learning to read bymoving
Endurance or motor skills– or a combination thereof
But meaningful (e.g. 4 month learning gains)
Brain health, risk of cognitive impairments
Cognitively engaging or simple repetitive movements?
UEF // University of Eastern Finland
Diet and learning
Do we have brain foods?
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UEF // University of Eastern Finland 31.7.2016 18
It’s not all about moving– Kids have to eat too
Building blocks for the brain
Neuralgrowthfactors
Neurogenesis, synaptogenesis
Cognition
Academicachievementand learning
Dietary factors havesimilar effects on
brain than physicalactivity
Bazinet et al. Nat Rev Neurosci 2014; Alles et al. Nutr Res Rev 2012; Nyaradi et al. Front Hum Neurosci 2013
UEF // University of Eastern Finland
Foods, nutrients, cognition, and academicperformance
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A higher dietary intake of dietary fiber and polyunsaturated fatty acids and a lower intake of saturated fatty acids have been linked to better attentional inhibition and working memory, respectively
Khan et al. J Nutr 2015Baym et al. Am J Clin Nutr 2014
UEF // University of Eastern Finland
Foods, nutrients, cognition, and academicperformance
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Higher levels of polyunsaturated fatty acids in plasma have been linked to better cognitionin overweight or obese children
Haapala, Viitasalo et al. Manuscript
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0,05
0,1
0,15
0,2
0,25
0,3
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DHAtg EPAtg EPA/AAtg EPA/AApl
Standardized regression coefficients for the associations of plasma PUFA and cognition in normal weight and overweight
or obese children
Normal weight Overweight or obese
Appreviations: DHA = docosahexaenoic acid, EPA = eicosapentaenoic acid, EPA/AA = eicosapentaenoic acid to arachidonic acid ratio tg = triacylglycerols, PL = phospholipids
UEF // University of Eastern Finland
Dietary patterns, cognition, and academicperformance
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Better adherence to theMediterranean style dietassociated with betteracademic performance in adolescents
Esteban-Cornejo et al. Eur J Nutr 2015
UEF // University of Eastern Finland 31.7.2016 22
Diet quality, cognition, and academicperformance – Finnish perspective
- Boys with the best adherence to the Baltic Sea diet had 12% higher cognitive score than those with the lowest adherence
- <49 grams/d fruit and berries related to poorer cognition
- <62 grams/d vegetables lower cognitive scores
- >103 g processed and red meat related to lower cognitive score
- Overall diet quality had the strongest associations with cognition – one unhealthy choice was not a problem
Haapala ym. British Journal of Nutrition 2015
Better diet quality associated with bettercognitive functions in 6-8-year-old boys
UEF // University of Eastern Finland 31.7.2016 23
Diet quality, cognition, and academicperformance – Finnish perspective
Haapala et al. Eur J Nutr 2016
Healthy diet in Grade 1 wasrelated to better reading skills
in Grades 1-3 in Finnishchildren aged 6-8 years
UEF // University of Eastern Finland 31.7.2016 24
Can we improve cognitive functions and academic performance by diet?
Sørensen et al. Br J Nutr 2015;113:1280-1291
Three month school lunch intervention improved reading skills in 8-11-year-old children
”Feed me better” pilot suggested that improving the quality of school lunches improved academic performance and decreased absenteeism
Belot & James J Health Econ 2011
UEF // University of Eastern Finland
Lessons learned…
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Diet quality&
Brain
Diet high in vegetables, fruit and berries, fish, and whole grains mayimprove learning
Some evidence that PUFAs are beneficial effects on brain health
Whereas diets high in fast foods, processed meat, saturated fat may impair learning
Effects may be larger among children with risk factors
UEF // University of Eastern Finland
Childhood overweight and obesity
Risk for academic performance and brain health?
31.7.2016Esityksen nimi / Tekijä 26
UEF // University of Eastern Finland
Impact of overweight, obesity, and metabolic syndrome
on the brain in children and adolescents
Metabolic disorders has been associated with smaller hippocampal volume in obese adolescents
Obese adolescents without metabolic disorders may have thinner cortex, lower microstructural brain integrity, and poorer cognitive functions compared to their leaner peers
Yau et al. Pediatrics 2012
Yau et al. Obesity 2014
UEF // University of Eastern Finland
Impact of overweight, obesity, and metabolic syndrome on the brain in children and adolescents
Kamijo et al. Psychophysiology 2012;49:1361-1371 Haapala et al. Medicine & Science in Sports & Exercise 2015
Normal weight Overweight
Normal weight children have more efficientbrain processing compared to overweightchildren
Children in the middle sex-spesificthird of BF% have better reasoningskills than other children
UEF // University of Eastern Finland
The negative impact of obesity may be mediated byphysical activity and motor skills
Haapala et al. Medicine & Science in Sports & Exercise 2015
Boys with low- or high body fat percentage along with poor motor skills had the poorest reasoning skills
No statistically significant differences between those with better motor skills
UEF // University of Eastern Finland
Take home messages…
UEF // University of Eastern Finland
• May improve learning and brain health
Versatile physical activities and healthy
diet…
• May impair learning and brain health
Overweight and obesity…
• May counteract against the negative impact of obesity on brain
Physical activity and healthy diet…
Thank you!
@EeroHaapala