Association between executive functions and gross motor skills in overweight/obese and eutrophic preschoolers: cross-sectional study.

BACKGROUND: Preschool age (3-5 years old) is a crucial period for children to acquire gross motor skills and develop executive functions (EFs). However, the association between the qualitative gross motor skills and EFs remains unknown in preschoolers, especially among overweight and obese children. METHODS: This was a cross-sectional, exploratory, and quantitative study carried out on 49 preschool children, divided into two subgroups according to their body mass index (overweight/obese: 24; eutrophic [normal weight]: 25). The mean age was 4.59 years. More than half of the sample were boys (55%) and most of the mothers had completed high school (67%) and were class C socioeconomic level (63%). Gross motor skills were assessed using the Test of Gross Motor Development-2, while EFs were evaluated using Semantic verbal fluency (SVF), Tower of Hanoi (TH), Day/Night Stroop, and Delayed Gratification tests. Multiple linear regression models adjusted for sex, age, maternal education, socioeconomic status, quality of the home environment, and quality of the school environment using the stepwise method were executed, considering the cognitive tasks as independent variables and gross motor skills as dependent variable. RESULTS: The overweight/obese preschoolers showed worse locomotor skills than their eutrophic peers and below average gross motor quotient (GMQ). Overweight/obese girls performed worse in OC skills than boys with excess weight. SVF (number of errors) and TH (rule breaks) explained 57.8% of the variance in object control (OC) skills and 40.5% of the variance in GMQ (p < .05) in the overweight/obese children. Surprisingly, there was no significant association between any of the EF tasks and gross motor skills in the eutrophic children. CONCLUSION: A relationship between EF tasks (number of errors in SVF and rule breaks in TH) and gross motor skills (OC and GMQ) was demonstrated in the overweight/obese preschoolers, indicating that worse cognitive flexibility, working memory, planning, and problem solving are associated with worse gross motor skills in this population when compared to eutrophic children.

Determinants of High Fat Mass Index in Preschoolers Living in Brazilian Urban Areas.

OBJECTIVE: Determine the social, environmental, and personal factors associated with high fat mass index in preschoolers. DESIGN: A quantitative, exploratory, and cross-sectional study. SETTING AND PARTICIPANTS: Fifty-one Brazilian preschoolers from public schools living in urban areas. MAIN OUTCOME MEASURE(S): The preschoolers' fat mass index was determined using dual-energy radiological absorptiometry. The quality of home and school environments were accessed using the Early Childhood Home Observation for Measurement of the Environment and Early Childhood Environment Rating Scales. The physical activity levels were recorded by accelerometers. The daily energy intake was recorded and sociodemographic data using the Brazilian Economic Classification criterion. Data on exposure time to screens and parental obesity were collected according to the parents' reports. ANALYSIS: Data analyses were performed using simple and multiple regressions models. RESULTS: Parental obesity (ß, 0.516; 95% confidence interval [CI], 2.078-5.133), high quality of environmental stimulation of home (ß, 0.429; 95% CI, 1.294-4.023), and high exposure time to screens (ß, 0.256; 95% CI, 0.215-2.554) explained 43% of preschoolers' high fat mass index. CONCLUSIONS AND IMPLICATIONS: Identification of parental obesity, high quality of environmental stimulation of home, and high exposure time to screens as the most important determinants of the high fat mass index in preschoolers from Brazilian urban areas.

Determining factors of functioning in hemodialysis patients using the international classification of functioning, disability and health.

BACKGROUND: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. METHODS: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function - handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity - short physical performance battery (SPPB); and Participation - participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. RESULTS: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS (R2 = 0.558); HAP and PTH were associated with 5-STS (R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS (R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB (R2 = 0.689). Finally, only HAP was associated with the participation scale (R2 = 0.067). CONCLUSION: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.