The Relationship between Executive Function and Obesity in Children and Adolescents: A Systematic Literature Review

The objective of this paper is to examine the relationship between the development of executive function (EF) and obesity in children and adolescents. We reviewed 1,065 unique abstracts: 31 from PubMed, 87 from Google Scholar, 16 from Science Direct, and 931 from PsycINFO. Of those abstracts, 28 met inclusion criteria and were reviewed. From the articles reviewed, an additional 3 articles were added from article references (N=31). Twenty-three studies pertained to EF (2 also studied the prefrontal and orbitofrontal cortices (OFCs); 6 also studied cognitive function), five studied the relationship between obesity and prefrontal and orbitofrontal cortices, and three evaluated cognitive function and obesity. Inhibitory control was most often studied in both childhood (76.9%) and adolescent (72.7%) studies, and obese children performed significantly worse (P<0.05) than healthy weight controls on various tasks measuring this EF domain. Although 27.3% of adolescent studies measured mental flexibility, no childhood studies examined this EF domain. Adolescents with higher BMI had a strong association with neurostructural deficits evident in the OFC. Future research should be longitudinal and use a uniform method of EF measurement to better establish causality between EF and obesity and consequently direct future intervention strategies

Associations between inhibitory control, eating behaviours and adiposity in 6 year-old children

BackgroundLower inhibitory control has been associated with obesity. One prediction is that lower inhibitory control underlies eating behaviours that promote increased energy intakes. This study examined the relationships between children’s inhibitory control measured using the Stop Signal Task (SST), body composition and eating behaviours, which included self-served portion size, number of servings, eating rate, and energy intake at lunch and in an eating in the absence of hunger (EAH) task.MethodsThe sample included 255 6-year-old children from an Asian cohort. Stop-signal reaction time (SSRT) was used as an index of inhibitory control. Children participated in a recorded self-served lunchtime meal, followed by the EAH task where they were exposed to energy-dense snacks. Behavioural coding of oral processing was used to estimate eating rates (g/min). BMI, waist circumference and skinfolds were used as indices of adiposity.ResultsChildren with lower inhibitory control tended to self-serve larger food portions (p = 0.054), had multiple food servings (p = 0.006) and significantly faster eating rates (p = 0.041). Inhibitory control did not predict energy intake at lunch (p = 0.17) or during the EAH task (p = 0.45), and was unrelated to measures of adiposity (p &gt; 0.32). Twenty percent of the children in the sample had problems focusing on the SST and were described as ‘restless’. Post-hoc analysis revealed that these children had lower inhibitory control (p &lt; 0.001) and consumed more energy during the EAH task (p = 0.01), but did not differ in any other key outcomes from the rest of the sample (p &gt; 0.1).ConclusionsChildren with lower inhibitory control showed a trend to select larger food portions, had multiple food servings and faster eating rates, but were equally as responsive to snacks served in the absence of hunger as children with better inhibitory control. Inhibitory control may impact a number of eating behaviours, not limited to energy-dense snacks.</p