6.3 The interwoven relationships between physical activity, physical performance,
6.3.2 Adiposity and physical performance: Their interrelationships and relevance
Study IV was one of the first studies on the associations of body fat percentage assessed by DXA with cardiorespiratory fitness and neuromuscular performance. The results of the study suggest that body adiposity hampers performance in tests that require supporting and moving body mass and in manual dexterity and balance tests. There were particularly strong inverse associations of body fat percentage with a 15-meter sprint run and standing long jump performance but somewhat weaker associations of body fat percentage with a 50-meter shuttle run and number of sit-ups.
Earlier studies have shown a decreased endurance performance assessed by field tests, such as 20-meter endurance shuttle run and 1.6-mile distance run tests, with increasing BMI in children and adolescents (51,53). However, these differences are largely dependent on the differences in fat mass and not stroke volume or cardiac output (23,51). To avoid confounding due to adiposity, measures of cardiorespiratory fitness divided by lean body mass have been suggested as a gold standard for measuring cardiorespiratory fitness, because the amount of lean mass is close to that of the skeletal muscle that is the metabolically active tissue during exercise (23). Accordingly, Ekelund et al. (58) found no differences in VO2max scaled by lean body mass between normal weight and obese adolescents. However, Study IV was one of the first studies investigating the relationship between body fat percentage assessed by DXA and cardiorespiratory fitness among children. Body fat percentage had a weak inverse association with maximal workload using continuous variables after adjustment for lean body mass. Additionally, boys with a body fat of ≥25% had a much lower lean mass adjusted maximal workload than boys with a body fat of <10%. Nevertheless, differences between boys with lower and higher levels of adiposity were explained by physical activity. One reason for this finding may be that
children with a higher body fat percentage do not engage in the higher-intensity physical activity that has been observed to improve cardiorespiratory fitness in children (65).
These results have also implications to the results of Studies I, II, and III. The results reviewed in Study I showed that motor performance was directly related to inhibition, short-term memory, and academic achievement. Among the research reviewed in Study I, there was no systematic evaluation of the effects of adiposity on these associations. Thus, it is possible that children with higher adiposity had worse motor performance than leaner children. In Study II worse motor performance in Grade 1 was related to poorer reading and arithmetic skills in Grades 1–3 independent of adiposity. However, it is possible that academic achievement in subsequent years is not only associated with motor performance but also physical activity and adiposity. For example, Kantomaa and associates (148) found that motor problems at the age of eight were related to lower levels of physical activity and a higher incidence of obesity at the age of 16. Moreover, adolescents with lower levels of physical activity and who were obese had also poorer academic achievement than more physically active and normal-weight adolescents. Accordingly, the relationships between adiposity, motor performance, physical activity, and academic achievement are multifaceted and complicated and need more research in cross-sectional and longitudinal settings. Whereas better motor performance may drive for higher levels of physical activity and lower levels of body adiposity, higher levels of body adiposity may decrease the levels of physical activity and thereby hamper the development of motor performance (71). The earlier this circle begins, the higher the possibility is that it will affect cognitive development. Obese children will not move and explore their environments as much as leaner children and may therefore have delays in physical and psychological development (140).
7 Conclusions
Based on the results of Studies I and II it can be concluded that better motor performance is associated with better cognitive functions and academic achievement in children. In addition, Study I´s narrative review provides some evidence that better cardiorespiratory fitness is beneficial for cognition and academic achievement. However, Study II did not confirm these findings. Study III suggests that higher levels of physical activity during recess are related to better reading skills and any sports engagement is associated with better arithmetic skills in children. Furthermore, the results of Study III suggest that the associations of physical activity and sedentary behavior with academic achievement are different in boys than in girls with more physical activity improving academic achievement in boys, whereas the associations seems to be more complicated in girls. Moreover, sedentary behavior related to academic skills was associated with better reading and arithmetic skills, particularly in boys. Computer use and video game playing was also directly related to arithmetic skills in boys. However, the associations between physical activity and academic achievement may partly be explained by adiposity, cardiorespiratory fitness, and motor performance. The results of Study IV suggest that adiposity decreases physical performance in tests requiring moving and supporting body mass. These results also suggest that body fat percentage decreases manual dexterity and balance in children.
The results of Study IV further suggest that body fat percentage is inversely associated with cardiorespiratory fitness in boys but that the association is not completely independent of physical activity.
In summary, the findings of this thesis suggest that children with a higher motor competence have better cognitive performance and academic achievement compared with children with lower motor competence. Although motor performance should be seen as a product of chronic physical activity engagement, measures of physical activity and motor performance may have independent cross-sectional associations with academic achievement. Moreover, increased body adiposity appears to be related to worsened neuromuscular and motor performance and may have long-term adverse health and academic consequences in children.
8 Implications and future directions
The results of this study show that better physical performance, physical activity and certain sedentary behaviors are associated with better academic achievement particularly in boys. These results highlight the need for appropriate physical activity and adequate motor performance to improve academic achievement in children. Moreover, ways to increase recess physical activity should be investigated and promoted (237). In addition, children with poor motor competence in Grade 1 should be followed and interventions to improve motor performance and reading and arithmetic skills should be started whenever necessary.
The results of this study suggest that the relationships of physical activity, sedentary behavior, cardiorespiratory fitness, and motor performance with academic achievement in children are multidimensional and can never be fully separated. Thus, there is a need for investigations that explore possible interactions of these constructs in relation to cognition and academic achievement in children. Moreover, there is a lack of knowledge of possible mediators for these associations. In future studies it is important to investigate plausible biological and psychosocial mechanisms that could explain the associations of physical activity, cardiorespiratory fitness, motor performance, and adiposity with cognition and academic achievement. Further studies on the sex-differences on the associations of physical activity, physical performance, and adiposity with cognition and academic achievement are required. More research on the associations of cardiorespiratory fitness and endurance performance with cognition and academic achievement, assessed by a variety of different ergometers and field tests with adequate scaling, to get a full picture of the determinants of brain functions. In addition, interventions with different settings and cohort studies are amply warranted.
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