Kate Lambourne

Classroom-based physical activity, cognition, and academic achievement.

BACKGROUND There is increasing evidence for the association between physical activity, cardiovascular fitness, fatness, and cognitive function during childhood and adolescence. Evidence also suggests that these variables are linked to academic achievement. Classroom-based physical activity provides a viable approach to improve fitness, body mass index (BMI), cognitive function, and ultimately academic achievement. METHODS Studies examining the relation between physical activity, fitness, fatness, cognitive function, and academic achievement are described. The results of a large-scale, longitudinal, cluster randomized trial to examine the impact of classroom based physical activity on body mass index and academic achievement will be presented. RESULTS Overall, the data support the link between physical activity, cognitive function, and academic achievement. The role of physical activity in the classroom was also supported by the Physical Activity Across the Curriculum (PAAC) project. Physically active academic lessons of moderate intensity improved overall performance on a standardized test of academic achievement by 6% compared to a decrease of 1% for controls (p<0.02). Body mass index increased less from baseline to 3 years in students with greater than 75 minutes of PAAC lessons per week (1.8 BMI) compared to students with less than 75 minutes of PAAC per week (2.4 BMI), p<0.00. CONCLUSIONS Future research examining the effects of physically active academic instruction is warranted. The impact of physically active academic lessons of greater intensity may provide larger benefits for body mass index and academic achievement.

Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review.

BACKGROUND The relationship among physical activity (PA), fitness, cognitive function, and academic achievement in children is receiving considerable attention. The utility of PA to improve cognition and academic achievement is promising but uncertain; thus, this position stand will provide clarity from the available science. OBJECTIVE The purpose of this study was to answer the following questions: 1) among children age 5-13 yr, do PA and physical fitness influence cognition, learning, brain structure, and brain function? 2) Among children age 5-13 yr, do PA, physical education (PE), and sports programs influence standardized achievement test performance and concentration/attention? STUDY ELIGIBILITY CRITERIA This study used primary source articles published in English in peer-reviewed journals. Articles that presented data on, PA, fitness, or PE/sport participation and cognition, learning, brain function/structure, academic achievement, or concentration/attention were included. DATA SOURCES Two separate searches were performed to identify studies that focused on 1) cognition, learning, brain structure, and brain function and 2) standardized achievement test performance and concentration/attention. PubMed, ERIC, PsychInfo, SportDiscus, Scopus, Web of Science, Academic Search Premier, and Embase were searched (January 1990-September 2014) for studies that met inclusion criteria. Sixty-four studies met inclusion criteria for the first search (cognition/learning/brain), and 73 studies met inclusion criteria for the second search (academic achievement/concentration). STUDY APPRAISAL AND SYNTHESIS METHODS Articles were grouped by study design as cross-sectional, longitudinal, acute, or intervention trials. Considerable heterogeneity existed for several important study parameters; therefore, results were synthesized and presented by study design. RESULTS A majority of the research supports the view that physical fitness, single bouts of PA, and PA interventions benefit childrens cognitive functioning. Limited evidence was available concerning the effects of PA on learning, with only one cross-sectional study meeting the inclusion criteria. Evidence indicates that PA has a relationship to areas of the brain that support complex cognitive processes during laboratory tasks. Although favorable results have been obtained from cross-sectional and longitudinal studies related to academic achievement, the results obtained from controlled experiments evaluating the benefits of PA on academic performance are mixed, and additional, well-designed studies are needed. LIMITATIONS Limitations in evidence meeting inclusion criteria for this review include lack of randomized controlled trials, limited studies that are adequately powered, lack of information on participant characteristics, failure to blind for outcome measures, proximity of PA to measurement outcomes, and lack of accountability for known confounders. Therefore, many studies were ranked as high risk for bias because of multiple design limitations. CONCLUSIONS The present systematic review found evidence to suggest that there are positive associations among PA, fitness, cognition, and academic achievement. However, the findings are inconsistent, and the effects of numerous elements of PA on cognition remain to be explored, such as type, amount, frequency, and timing. Many questions remain regarding how to best incorporate PA within schools, such as activity breaks versus active lessons in relation to improved academic achievement. Regardless, the literature suggests no indication that increases in PA negatively affect cognition or academic achievement and PA is important for growth and development and general health. On the basis of the evidence available, the authors concluded that PA has a positive influence on cognition as well as brain structure and function; however, more research is necessary to determine mechanisms and long-term effect as well as strategies to translate laboratory findings to the school environment. Therefore, the evidence category rating is B. The literature suggests that PA and PE have a neutral effect on academic achievement. Thus, because of the limitations in the literature and the current information available, the evidence category rating for academic achievement is C.

Physical activity interventions and children's mental function: An introduction and overview

BACKGROUND This review provides a historical overview of physical activity interventions designed by American educators and an evaluation of research that has assessed the effects of exercise on childrens mental function. METHOD Historical descriptions of the emergence of American physical education doctrine throughout the 20th century were evaluated. Prior reviews of studies that assessed the effects of single acute bouts of exercise and the effects of chronic exercise training on childrens mental function were examined and the results of recent studies were summarized. RESULTS Physical activity interventions designed for American children have reflected two competing views: activities should promote physical fitness and activities should promote social, emotional, and intellectual development. Research results indicate that exercise fosters the emergence of childrens mental function; particularly executive functioning. The route by which physical activity impacts mental functioning is complex and is likely moderated by several variables, including physical fitness level, health status, and numerous psycho-social factors. CONCLUSION Physical activity interventions for children should be designed to meet multiple objectives; e.g., optimize physical fitness, promote health-related behaviors that offset obesity, and facilitate mental development.

Aerobic exercise alone results in clinically significant weight loss for men and women: Midwest Exercise Trial-2

Exercise is recommended by public health agencies for weight management; however, the role of exercise is generally considered secondary to energy restriction. Few studies exist that have verified completion of exercise, measured the energy expenditure of exercise, and prescribed exercise with equivalent energy expenditure across individuals and genders.

Does Increased Exercise or Physical Activity Alter Ad-Libitum Daily Energy Intake or Macronutrient Composition in Healthy Adults? A Systematic Review

Background The magnitude of the negative energy balance induced by exercise may be reduced due to compensatory increases in energy intake. Objective To address the question: Does increased exercise or physical activity alter ad-libitum daily energy intake or macronutrient composition in healthy adults? Data Sources PubMed and Embase were searched (January 1990–January 2013) for studies that presented data on energy and/or macronutrient intake by level of exercise, physical activity or change in response to exercise. Ninety-nine articles (103 studies) were included. Study Eligibility Criteria Primary source articles published in English in peer-reviewed journals. Articles that presented data on energy and/or macronutrient intake by level of exercise or physical activity or changes in energy or macronutrient intake in response to acute exercise or exercise training in healthy (non-athlete) adults (mean age 18–64 years). Study Appraisal and Synthesis Methods Articles were grouped by study design: cross-sectional, acute/short term, non-randomized, and randomized trials. Considerable heterogeneity existed within study groups for several important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and presented by study design. Results No effect of physical activity, exercise or exercise training on energy intake was shown in 59% of cross-sectional studies (n = 17), 69% of acute (n = 40), 50% of short-term (n = 10), 92% of non-randomized (n = 12) and 75% of randomized trials (n = 24). Ninety-four percent of acute, 57% of short-term, 100% of non-randomized and 74% of randomized trials found no effect of exercise on macronutrient intake. Forty-six percent of cross-sectional trials found lower fat intake with increased physical activity. Limitations The literature is limited by the lack of adequately powered trials of sufficient duration, which have prescribed and measured exercise energy expenditure, or employed adequate assessment methods for energy and macronutrient intake. Conclusions We found no consistent evidence that increased physical activity or exercise effects energy or macronutrient intake.

The Role of Physical Activity in Pediatric Obesity

This article provides an overview of the benefits of physical activity in children, including the effects on obesity, cognitive development, academic achievement and cognition, and health. The recommendations of health organizations are also outlined, and practical recommendations are provided for parents and educators.

Does increased prescribed exercise alter non-exercise physical activity/energy expenditure in healthy adults? A systematic review

Prescribed physical activity/exercise training may reduce non‐exercise physical activity resulting in no change in total daily energy expenditure and no or minimal exercise‐induced weight loss. This systematic review evaluated cross‐sectional, short‐term (2–14 d), randomized and non‐randomized trials which reported on the effect of prescribed physical activity/exercise on non‐exercise physical activity/energy expenditure in healthy adults. PubMed and Embase were searched (from January 1990 to March 2013) for articles that presented data on the change in non‐exercise physical activity/energy expenditure in response to prescribed physical activity/exercise training. Thirty‐one articles were included in this review. One‐hundred per cent of cross‐sectional studies (n = 4), 90% of short‐term studies (n = 10), 50% of non‐randomized trials (n = 10) and 100% of randomized trials (n = 7) reported no reductions in non‐exercise physical activity/energy expenditure in response to prescribed physical activity/exercise training. We found minimal evidence to support the hypothesis that prescribed physical activity/exercise training results in decreased non‐exercise physical activity/energy expenditure in healthy adults. However, this literature is limited by the lack of adequately powered trials designed specifically to evaluate this hypothesis which have included assessments of both the energy expenditure of prescribed exercise and non‐exercise energy expenditure using state‐of‐the‐art techniques, i.e. indirect calorimetry and doubly labelled water, respectively.

Physical activity and academic achievement across the curriculum (A + PAAC): rationale and design of a 3-year, cluster-randomized trial

BackgroundImproving academic achievement and reducing the rates of obesity in elementary school students are both of considerable interest. Increased physical activity during academic instruction time during school offers a potential intervention to address both issues. A program titled “Physical Activity Across the Curriculum” (PAAC) was developed in which classroom teachers in 22 elementary schools were trained to deliver academic instruction using physical activity with a primary aim of preventing increased BMI. A secondary analysis of data assessed the impact of PAAC on academic achievement using the Weschler Individual Achievement Test-II and significant improvements were shown for reading, math and spelling in students who participated in PAAC. Based on the results from PAAC, an adequately powered trial will be conducted to assess differences in academic achievement between intervention and control schools called, “Academic Achievement and Physical Activity Across the Curriculum (A + PAAC).”Methods/designSeventeen elementary schools were cluster randomized to A + PAAC or control for a 3-year trial. Classroom teachers were trained to deliver academic instruction through moderate-to-vigorous physical activity with a target of 100+ minutes of A + PAAC activities per week. The primary outcome measure is academic achievement measured by the Weschler Individual Achievement Test-III, which was administered at baseline (Fall 2011) and will be repeated in the spring of each year by assessors blinded to condition. Potential mediators of any association between A + PAAC and academic achievement will be examined on the same schedule and include changes in cognitive function, cardiovascular fitness, daily physical activity, BMI, and attention-to-task. An extensive process analysis will be conducted to document the fidelity of the intervention. School and student recruitment/randomization, teacher training, and baseline testing for A + PAAC have been completed. Nine schools were randomized to the intervention and 8 to control. A random sample of students in each school, stratified by gender and grade (A + PAAC = 370, Control = 317), was selected for outcome assessments from those who provided parental consent/child assent. Baseline data by intervention group are presented.DiscussionIf successful, the A + PAAC approach could be easily and inexpensively scaled and disseminated across elementary schools to improve both educational quality and health. Funding source: R01- DK85317. Trial registration: US NIH Clinical Trials, http://NCT01699295.

Aerobic Capacity and Cognitive Control in Elementary School-Age Children

PURPOSE The current study examined the relationship between childrens performance on the Progressive Aerobic Cardiovascular Endurance Run subtest of the FitnessGram® and aspects of cognitive control that are believed to support academic success. METHODS Hierarchical linear regression analyses were conducted on a sample of second- and third-grade children (n = 397) who completed modified versions of a flanker task and spatial n-back task to assess inhibitory control and working memory, respectively. RESULTS Greater aerobic fitness was significantly related to shorter reaction time and superior accuracy during the flanker task, suggesting better inhibitory control and the facilitation of attention in higher-fit children. A similar result was observed for the n-back task such that higher-fit children exhibited more accurate target detection and discrimination performance when working memory demands were increased. CONCLUSIONS These findings support the positive association between aerobic fitness and multiple aspects of cognitive control in a large sample of children, using a widely implemented and reliable field estimate of aerobic capacity. Importantly, the current results suggest that this relationship is consistent across methods used to assess fitness, which may have important implications for extending this research to more representative samples of children in a variety of experimental contexts.

Equivalent weight loss for weight management programs delivered by phone and clinic.

Face‐to‐face (FTF) weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by FTF clinic or group conference calls (phone).