Longitudinal weight status, cardiorespiratory fitness, and academic achievement in elementary schoolchildren Open Access
Elish, Paul (Spring 2021)
Abstract
Introduction
Childhood overweight and obesity have a well-established negative impact on children’s health. Overweight and obesity might also negatively impact children’s academic performance, but existing literature on this association is inconclusive. This study uses a longitudinal design in a large, diverse elementary school sample to rigorously test the association between longitudinal weight status and academic achievement. Analyses also investigate moderation by sex, race/ethnicity, and cardiorespiratory fitness (CRF), as well as mediation by CRF, school-day moderate-to-vigorous physical activity (MVPA), school-day sedentary time, and attendance.
Methods
In a large suburban school district, 4,936 Grade 4 students were recruited. Demographic, course grade, and standardized test data were collected from school records for Grades 3 to 5, and body mass index (BMI) and CRF were assessed each year. Students wore accelerometers during the school day for up to 15 days across three semesters (Grade 4 Fall and Spring, Grade 5 Fall) to objectively measure physical activity. Multiple imputation addressed missing data and multilevel analyses controlled for student demographics.
Results
Unadjusted multilevel models found small negative associations for persistent overweight/obesity with course grades and standardized test scores, but these associations largely disappeared when controlling for demographic characteristics. Residual associations for math and writing course grades were attenuated when controlling for CRF, though some marginal negative associations for math and writing remained for students who became overweight/obese during follow up. There was no evidence of moderation by sex or race/ethnicity. For students who were persistently overweight/obese, mediation analyses found a small significant positive indirect effect through lower school-day MVPA (e.g., 0.110, 95% CI: 0.046, 0.184 for math course grades) and a larger negative indirect effect through lower CRF (e.g., -0.643, 95% CI: -0.871, -0.416 for math course grades). Persistently obese students also had a small negative indirect effect through lower attendance. There was no significant indirect effect through school-day sedentary time.
Conclusion
Analyses suggest that there were very small associations between overweight/obesity and academic achievement that were largely explained by CRF. The findings align with growing evidence that increasing CRF is more important than losing weight for boosting children’s cognition and academic achievement.
Table of Contents
I. Background……………………………………………………………………..1
II. Methods
a. Study Design………………………………………………………………..8
b. Data Sources………………………………………………………………..11
c. Study Measures…………………………………………………………….13
d. Analysis……………………………………………………………………...17
III. Results
a. Descriptive Statistics………………………………………………………..20
b. Multi-level Models – Longitudinal Overweight/Obesity Status…...22
c. Multi-level Models – Longitudinal Obesity Status……………………23
d. Mediation Analyses………………………………………………………....24
IV. Discussion………………………………………………………………………26
V. References……………………………………………………………………….32
VI. Tables
a. Table 1……………………………………………………………………...43
b. Table 2……………………………………………………………………...46
c. Table 3……………………………………………………………………...51
d. Table 4……………………………………………………………………...55
e. Table 5……………………………………………………………………...56
f. Table 6……………………………………………………………………...58
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