Meeting Nutrition and Physical Activity Guidelines at 24-Months-of-Age Is Associated With Executive Function

Abstract

ObjectivesExecutive function (EF) and its constructs, cognitive flexibility (F), inhibitory self-control (ISC), emergent metacognition (EM), have been linked to overweight in older children. However, few studies have investigated toddler-aged children, when rapid neurophysiological development occurs. We hypothesized that the American Academy of Pediatrics (AAP) obesity prevention guidelines for toddlers would provide a useful framework for optimizing EF. Herein, the relationships between weight status, adherence to AAP guidelines and EF at 24 mo was examined. MethodsParents and 24-mo-old children (N = 246) were recruited from the STRONG Kids 2 cohort study. Weight-for-length z-scores (WFLz) were computed and weight status classified per WHO standards. Parents completed the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) to assess EF and reported physical activities per week (Sports, Play, and Active Recretion for Kids Survey), dietary intake (Block Food Frequency Questionnaires), and screen timeCommon Sense Media Survey). Toddlers met AAP recommendations if they consumed at least 5 servings of fruits and vegetables (FV), were physically active (PA), refrained from sugar-sweetened beverages (SSB) and limited screen time (ST) to less than 60 min per day. ResultsUsing age- and sex-standardized scores, toddlers ranged between the 43rd and 46th percentile of EF, ISC, F and EM. 43% of toddlers were at risk of overweight or overweight/obese. Most toddlers met recommendations for PA (66%), ST (50%) and SSB(62%), but only 4% met FV recommendations. There was no significant difference in BRIEF-P based on weight status or FV recommendation adherence. Toddlers that met guidelines for limiting SSB had higher EF (mean difference = –0.329, p = 0.013), ISC (–0.206, p = 0.015) and EM (–0.406, p = 0.018) than those not meeting the guidelines. Toddlers who were physically active had higher EM (–0.235, p = 0.027) than those who were not physically active every day of the week. ConclusionsBeing physically active every day and abstaining from SSB may be of significance for improving EF in toddlers. Funding SourcesSupported by the NIH, the National Dairy Council and a USDA National Needs fellowship (AM).