Health behaviors, cognition and learning 2016

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


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


Is obesogenig enviroment making us stupid?

31.7.2016 431.7.2016 4

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?


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?


Normally developing children…

VS.


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


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.


Examples of effective interventions

9

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


Examples of effective interventions – dose-response and type-of-activity issues

31.7.2016 10

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


Examples of effective interventions – dose-response and type-of-activity issues

31.7.2016 11

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.


…but wait a minute…

31.7.2016 12

Same study that found positive effects of physically active lessons on academic performance (Mullender-Wijsma et al.) found no effects on executive functions

10

15

20

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


…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


…long-term benefits of physically active lifestyle are…

31.7.2016 14

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


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


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?


Diet and learning

Do we have brain foods?

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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


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


Foods, nutrients, cognition, and academicperformance

31.7.2016 20

Higher levels of polyunsaturated fatty acids in plasma have been linked to better cognitionin overweight or obese children

Haapala, Viitasalo et al. Manuscript

0

0,05

0,1

0,15

0,2

0,25

0,3

0,35

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


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


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


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


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


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


Childhood overweight and obesity

Risk for academic performance and brain health?

31.7.2016Esityksen nimi / Tekijä 26


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


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


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


Take home messages…


• 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

Health & Medicine

Health behaviors, cognition and learning 2016