Table 2.

Studies examining the neurocognitive correlates of obesity in children and adolescents

Authors	Population	N	Age range (mean, s.d.)	Areas of cognitive functioning assessed (measures)	Findings (abbreviated)
Barrigas and Fragoso67	Children	792	6–12 years	Assessment Tests; academic achievement on Portuguese, Math and Science; reasoning ability (Raven’s Colored Progressive Matrices Test)	ø: Academic achievement
Baxter et al.68	Children	1504	10 years	Academic achievement (standardized Tests in English, math, social studies and science)	ø: Academic achievement
Best et al.70	Children, overweight	241	7–12 years	Relative reinforcing value of food; impulsivity; delay discounting	(−): Relative reinforcing value of food, delay discounting of food
Bonato and Boland33	Children, obese, and healthy weight	40	8–11 years	Inhibition	ø: inhibition
Bonato and Boland40	Children, obese, and healthy weight	40	8–11 years	Delay of gratification	(−): Delay of gratification (edible incentives only)
Bonvin et al.62	Children	529	2–4 years (3.4, 0.6)	Motor skills (Zurich Neuromotor Assessment Test)	ø: Motor skills
Bourget and White31	Children, overweight and healthy weight girls	36	5–9 years (overweight 7.13; healthy weight 7.19)	Delay of gratification, inhibition	ø: Delay of gratification; (+): less effective inhibition strategies
Braet and Crombez47	Children and adolescents	74	9–16 years (obese 13.3, 2; controls 13.9, 2)	Interference (Stroop task, emotional Stroop); language (vocabulary subtest WISC-R)	(−): Lower reading skills; (−): interference (color of food words in Stroop); ø: language level
Bruce et al.102	Children, obese, overweight, and healthy weight	59	8–12 years (10.29, 1.39)	Delay of gratification	(−): Delay of gratification
Castelli et al.65	Children, 3–5 grade public school students	259	(9.5, 0.74)	Academic achievement (ISAT)	(−): BMI and academic, mathematics, and reading achievement; (+): aerobic fitness and academic achievement
Cliff et al.52	Children, overweight and healthy weight	132	6–10 years (8.4, 1.0)	Motor skills (fundamental movement skill mastery)	(−): Motor skills
Cliff et al.53	Children, overweight/obese and healthy weight	153	6–10 years (8.3, 1.1)	Locomotor skills, object-control skills (Test of Gross Motor Development)	(−): Locomotor, object-control, gross motor development skills
Cserjesi et al.39	Children, obese and healthy weight boys	24	obese (12.1, 0.9), healthy weight (12.44, 0.51)	Working memory (digit span on WAIS-III); Logical reasoning (Raven’s progressive matrix); Verbal flexibility and inhibition (semantic verbal fluency Test); Attention and visual scanning (D2 attention endurance Test); and Cognitive flexibility and set-shifting (WCST)	ø: Memory, logic reasoning, verbal fluency; (−): cognitive flexibility and shifting, attention endurance
Datar and Sturm66	Children, kindergarten at T1, third grade at T2	~7000	At T2 (3rd grade: 9.24, 0.34)	Math and reading assessment; teacher-reported behaviors (approaches to learning, self-control, attentiveness, task persistence, flexibility, organization, eagerness to learn, learning independence)	(−): Weight gain and reading/ mathematics (girls only); (−): weight gain over time and reading/ mathematics scores at baseline
Davis and Cooper18	Children, overweight and obese	170	7–11 years (9.3, 1.0)	Cognitive Assessment System, mathematics and reading (Woodcock-Johnson Tests of Achievement II, Broad Reading and Broad Mathematics clusters), parent-reported behaviors (Conner’s Parent Rating Scales-Revised), teacher-reported behaviors (Conner’s Teacher Ratings Scales-Revised)	(−): cognitive performance, attention, math/reading scores; (+): parent-reported cognitive problems/inattention, teacher-reported cognitive problems/ inattention
Delgado-Rico et al.35	Adolescents, overweight	42	12–17 (14.19, 1.38)	Impulsivity (UPPS-P); mental flexibility (letter-number sequencing); inhibition (Stroop); decision-making (Iowa Gambling Task)	(−): weight loss and impulsivity; (+): weight loss and inhibition
Delgado-Rico et al.36	Adolescents, obese, overweight and healthy weight	63	12–17 years	Impulsivity (UPPS-P); mental flexibility (Delis-Kaplan Executive Function System—Color Work Interference Test)	(+): Impulsivity; (−): mental flexibility
D’Hondt et al.60	Children, obese, overweight, and healthy weight	540	5–12.8 years (9.3, 1.6)	Fine motor skills (Movement Assessment Battery for Children)	(−): Fine motor skills
D’Hondt et al.58	Children, overweight, obese, healthy weight	117	5–10 years	Motor skills (Movement Assessment Battery for Children)	(−): Motor skills, balance, ball skills
D’Hondt et al.64	Children, obese, overweight, and healthy weight	72	7–13 years (10.5, 1.4)	Motor coordination (Körperkoordinations Test für Kinder; walking backwards, moving sideways, one-leg hopping, two-leg hopping)	(−): Motor coordination; (+): participation in treatment program and improvement in motor coordination
D’Hondt et al.63	Children, overweight and healthy weight	100	6–10 years	Motor coordination (Körperkoordinations Test für Kinder)	(−): Motor coordination (baseline and 2 years later); (−): motor coordination progress over time
Francis and Susman43	Children	1061	3, 5, 7, 9, 11, and 12 years	Delay of gratification and self-control	(−): Delay of gratification and self-control
Gale et al.19	Children at T1, adults at T2	6147 (1958 cohort); 6445 (1970 cohort)	11 years (1958 cohort time 1); 33 years (1958 cohort time 2); 10 years (1970 cohort time 1); 30 years (1970 cohort time 2)	1958 Cohort had 40 verbal and 40 nonverbal items from National Foundation for Educational Research; 1970 cohort had a modifed version of the British Ability Scales, including word definitions, word similarities, recall digits and recall matrices	(−): Childhood cognitive ability and adult obesity; ø: childhood cognitive ability and childhood BMI; (−): childhood motor coordination and prevelance of obesity in adulthood
Gelleret al.46	Children, obese and healthy weight	48	3rd, 4th, and 5th graders	Delay of gratification paradigm	ø: Delay of gratification
Graziano et al.32	Children, overweight and healthy weight	57	Assessments administered at age 2 and 5.5	Self-regulation (laboratory tasks)	(−): Self-regulation (poorer self-regulation skills at age 2 related to increased risk of obesity at age 5.5)
Guerrieri et al.26	Children, overweight and healthy weight	78	8–10 years (9, 0.60)	Response inhibition (Stop-signal task); Reward sensitivity (Door opening task)	(−): Response inhibition; ø: reward sensitivity
Gunstad et al.21	Children and adolescents, underweight, healthy weight, at risk of overweight and overweight	478	6–19 years (12.45, 3.26)	Estimated intellectual functioning (Spot-the-Word task); Attention (Digit Span Backward); Executive functioning (switching of attention—letter/number); Memory (Verbal Recall), Language (Animal Fluency); and Motor (Finger Tapping)	ø: Cognitive Test performance
Holcke et al.24	Children and adolescents, obese and one overweight	30	8–15 years (12.0)	Motor skills, executive functions, perception, memory, language, learning, social skills and emotional/ behavioral problems (5–15 questionnaire)	(−): Executive function, motor skills, memory, learning, language
Jansen et al.51	Children, overweight and healthy controls	32	9–10 years (overweight–10, 0.89; controls–9.94, 0.68)	Perceptual reasoning (Colored Progressive Matrices Test); Motor skills (DKT; jumping, strength, endruance, flexibility), chronometric mental rotation Test	(−): Motor coordination, mental rotation performance
Kamijo et al.28	Children	126	7 and 9 years	Inhibitory control (Go NoGo Task); Achievement (WRAT-3)	(−): Inhibitory control, achievement
Kantomaa et al.59	Children	8061	8 and 16 years	Parent and child self-report of motor function	(−): Motor function
Krombholz22	Children, overweight and healthy weight	350	Overweight (4.43, 0.8), healthy weight (4.43, 0.6)	Motor skills (Motor Test Battery); verbal ability (Peabody Picture Vocabulary Test); concentration (Frankfurter Test für Fünfjährige—Konzentration); and intelligence (Culture Fair Test)	(−): Motor skills; ø: manual dexterity, verbal ability, concentration, intelligence
Li et al.16	Children and adolescents, healthy weight, at risk overweight, overweight	2519	8–16 years (12.03)	Nonverbal reasoning and visuo- spatial construction (WISC-R) block design Test:); Attention and working memory (digit span); Reading and arithmetic (WRAT-R)	(−): Nonverbal reasoning/visuouspatial construction; (−): academic achievement and cognitive functioning
Lokken et al.29	Adolescents, obese	25	15–19 years (15.88, 1.69)	Academic achievement (WRAT-4); general intellectual functioning (WISC-IV); executive functioning (Computerized Cognitive Test Battery—digit span, continuous performance task, verbal interference, switching of attention, maze task, Go NoGo Task);	Obese adolescents had decreased performance, compared to normative data, on attention, mental flexibility, and disinhibition
London and Castrechini69	Children and adolescents	2735	4th to 7th grade, 6th to 9th grade	Academic achievement (California standardized Test in math and English language arts)	ø: Academic achievement Tests at baseline and over four year period
Lopes et al.61	Children	7175	6–14 years	Motor coordination (Kiphard-Schilling body coordination Test, Körperkoordination-Test-für-Kinder; balance, lateral jumping, hopping one leg, shifting platforms)	(−): Motor coordination (stronger in childhood than early adolescence)
Maayan et al.17	Adolescents, obese and lean	91	14–21 years (obese—17.5, 1.6; lean—17.3, 1.6)	Attention (Trail Making Test Part A); Cognitive Flexibility (Trail Making Test Part B); verbal fluency (COWAT), response inhibition (Stroop Task), Attention/Concentration Index (WRAML) and Working Memory Index (WRAML)	(−): Estimated full-scale IQ; (−): inhibition, cognitive flexibility, verbal fluency, attention and concentration, working memory
Mond et al.20	Children	9415	4–8 years (6.0, 0.37)	Memory and concentration, perserverance, abstraction, visual perception, arithmetic (Bavarian Model for school entry examination)	(−): Perseverance in females; (−): motor skills in males; ø: abstraction, visual perception, arithmetic, memory and concentration, speech
Morano et al.54	Children	80	4.5, 0.5	Locomotor skills, object-control skills (Test of Gross Motor Development)	(−): Locomotor, object-control, gross motor development skills
Nederkoorn et al.13	Children, healthy weight, obese	63	12–15 years	Response perseveration (Door opening task); Inhibitory control (Stop-signal task); Impulsivity (BIS/ BAS scales).	(−): Response perseveration, inhibitory control, impulsivity; (+): weight loss in treatment and inhibitory control
Nederkoorn et al.34	Children, obese	26	8–12 years (9.3, 1.2)	Impulsivity and inhibition (Stop signal task)	(+): Impulsivity (even 12 months post-tx)
Nederkoorn et al.30	Children	89	7–9 years	Inhibition (Stop signal task)	(−) Inhibition (with food cues)
Okely et al.55	Children and adolescents	4363	Grades 4, 6, 8, 10	Motor skills (fundamental movement skills)	(−): Motor skills, advanced locomotor skills, object-control skills
Pauli-Pott et al.38	Children and adolescents, overweight and obese	111	7–15 years (11.1, 2.0)	Inhibitory control and attention (Go-NoGo, attention assessment battery Testbatterie zur Aufmerksamkeitsprufung)	(+): Weight loss and impulsivity (adolescents only)
Poulsen et al.57	Children, overweight and healthy weight	116	overweight (8.75, 1.4), healthy weight (8.25, 1.5)	Motor performance (Bruninks-Oseretsky Test of Motor Performance-2 subtests: bilateral coordination, upper limb coordination, strength, balance, running speed, agility)	(−): Motor skills
Seeyave et al.44	Children	805	4 years T1, 11 years T2	Delay of gratification (Mischel and Ebbesen’s delay of gratification waiting task)	(−): Delay of gratification
Sigal and Adler41	Children (boys only, obese and healthy weight)	64	8–13 years	Delay of gratification (laboratory paradigm)	(−): Delay of gratification
Soetens and Braet48	Adolescents, overweight and healthy weight	87	12–18 years; overweight (14.98, 1.51); healthy weight (14.74, 1.81)	Attention processing (Imbedded word task); free-recall (mazes from WISC-R)	(+): Recall of food words; ø: recall of control words: ø: attention interference effects for food
Staiano et al.25	Adolescents, overweight and obese	54	15–19 years (16.46)	Spatial skills, response inhibition, motor planning, viusal scanning, speed, and flexibility (design fluency and trail making subscales of Delis-Kaplan Executive Function System)	(+): Weight loss and executive function
van Egmond-Froehlich et al.49	Children and adolescents, overweight and obese	394	8–16 years (11.7, 2.0)	Inattention and hyperactivity/ impulsivity (parent report on the Strengths and Difficulties Questionnaire)	(−): Weight loss and inattention, impulsivity
Verbeken et al.23	Children, healthy weight, overweight	81	10–14 years	Verbal inhibition (Opposite worlds Test); Inhibition (Circle drawing task, Stop Task); Motivation inhibition (Door opening task); Delay aversion (Maudsley index of childhood delay aversion)	ø: Verbal inhibition, delay aversion; (+): inhibition circle drawing; (−): inhibition stop task, motivation inhibition
Verdejo-Garcia et al.27	Adolescents, healthy weight, excessive weight	61	13–16 years	Self-report questionnaires of impulsivity and sensitivity; Neuropsychological battery (intelligence, working memory, planning, reasoning, inhibition, set-shifting, self-regulation, decision-making)—see actual article for full list of tests.	ø: Impulsivity, sensitivity to reward/ punishment, working memory, planning; (−): inhibition, flexibility, decision-making, set-shifting
Zhu et al.56	Children	2029	9–10 years (healthy weight 9.42, 0.49; overweight 9.41, 0.49; obese 9.47, 0.50)	Motor coordination (MABC; manual dexterity, ball skills, balance)	(−): Balance; (−): total motor impairment (for girls, effect found only among obese subgroup)

Abbreviations: BMI, Body mass index; BIS/BAS scales, Behavioral Inhibition System/Behavioral Activation System scales; COWAT, Controlled Oral Word Association Test; ISAT, Illinois Standards Achievement Test; MABC, Movement Assessment Battery for Children Test; WISC-R, Wechsler Intelligence Scale for Children—Revised; WAIS-III, Wechsler Abbreviated Intelligence Scale-III; WCST, Wisconsin Card Sort Test; WRAML, Wide Range Assessment of Learning and Memory; WRAT, Wide Range Achievement Test (R, Revised, 3, 3rd edition, 4, 4th edition). ø indicates null findings. (−) indicates inverse correlation between weight and area of cognitive functioning. (+) indicates positive correlation between weight and area of cognitive functioning.