TY - JOUR
T1 - Adolescent body mass index and cognitive performance
T2 - A nationwide study of 2.48 million Israeli adolescents
AU - Simchoni, Maya
AU - Derazne, Estela
AU - Pinhas-Hamiel, Orit
AU - Cukierman-Yaffe, Tali
AU - Bendor, Cole D.
AU - Bardugo, Aya
AU - Chodick, Gabriel
AU - Tzur, Dorit
AU - Endevelt, Ronit
AU - Gerstein, Herzel C.
AU - Afek, Arnon
AU - Twig, Gilad
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - IMPORTANCE: The increased incidence of adolescent obesity over recent decades may be associated with lower cognitive performance than the expected potential.OBJECTIVE: We aimed to assess the association between adolescent body mass index (BMI) and cognitive function.DESIGN: A nationwide, cross-sectional, population-based study.SETTING: Pre-recruitment evaluation for military service during 1967-2018.PARTICIPANTS: All Israeli-born adolescents, 1 459 522 males and 1 027 953 females aged 16 to ≤20 years.EXPOSURES: Weight and height were measured to calculate BMI.MAIN OUTCOME: Cognitive performance was assessed by using a validated intelligence-quotient-equivalent test and was standardized to the year- and sex-Z-score. For 445 385 persons, parental cognitive scores could be identified. Multinomial logistic regression models were applied.RESULTS: Among male adolescents with severe obesity, 29.4% achieved a cognitive score below the 25th percentile, compared with 17.7% among their normal-weight (50th-84th percentile) counterparts. A J-shaped relation was observed between BMI and the odds ratio (OR) for a low cognitive score among male adolescents: underweight, 1.45 (1.43-1.48); overweight, 1.13 (1.12-1.15); mild obesity, 1.36 (1.33-1.39); and severe obesity, 1.58 (1.52-1.64). Similar findings were observed in females. For both sexes, point estimates were overall consistent in models adjusted for sociodemographic confounders, coexisting morbidities, and parental cognitive scores. Examinees with abnormal BMI had higher ORs for a lower-than-expected cognitive score, based on their parents' data as adolescents, in a manner that depends on obesity severity.CONCLUSION AND RELEVANCE: Obesity, is associated with increased odds for a lower cognitive performance, and the inability to fully achieve cognitive potential, regardless of sociodemographic background.
AB - IMPORTANCE: The increased incidence of adolescent obesity over recent decades may be associated with lower cognitive performance than the expected potential.OBJECTIVE: We aimed to assess the association between adolescent body mass index (BMI) and cognitive function.DESIGN: A nationwide, cross-sectional, population-based study.SETTING: Pre-recruitment evaluation for military service during 1967-2018.PARTICIPANTS: All Israeli-born adolescents, 1 459 522 males and 1 027 953 females aged 16 to ≤20 years.EXPOSURES: Weight and height were measured to calculate BMI.MAIN OUTCOME: Cognitive performance was assessed by using a validated intelligence-quotient-equivalent test and was standardized to the year- and sex-Z-score. For 445 385 persons, parental cognitive scores could be identified. Multinomial logistic regression models were applied.RESULTS: Among male adolescents with severe obesity, 29.4% achieved a cognitive score below the 25th percentile, compared with 17.7% among their normal-weight (50th-84th percentile) counterparts. A J-shaped relation was observed between BMI and the odds ratio (OR) for a low cognitive score among male adolescents: underweight, 1.45 (1.43-1.48); overweight, 1.13 (1.12-1.15); mild obesity, 1.36 (1.33-1.39); and severe obesity, 1.58 (1.52-1.64). Similar findings were observed in females. For both sexes, point estimates were overall consistent in models adjusted for sociodemographic confounders, coexisting morbidities, and parental cognitive scores. Examinees with abnormal BMI had higher ORs for a lower-than-expected cognitive score, based on their parents' data as adolescents, in a manner that depends on obesity severity.CONCLUSION AND RELEVANCE: Obesity, is associated with increased odds for a lower cognitive performance, and the inability to fully achieve cognitive potential, regardless of sociodemographic background.
KW - Adolescent
KW - Body Mass Index
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Israel/epidemiology
KW - Male
KW - Obesity, Morbid
KW - Overweight/epidemiology
KW - Pediatric Obesity/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85164978219&partnerID=8YFLogxK
U2 - 10.1093/ejendo/lvad075
DO - 10.1093/ejendo/lvad075
M3 - Article
C2 - 37406222
AN - SCOPUS:85164978219
SN - 0804-4643
VL - 188
SP - 67
EP - 77
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 7
ER -
