• A qualitative exploration of park-based physical activity in adults with serious mental illness: Insights from peers and peer counselors

      Besenyi, G.M.; Bramwell, R.C.; Heinrich, K.M.; Mailey, E.L.; McEvoy, J.P.; Davis, C.L.; GEORGIA PREVENTION INSTITUTE (Elsevier, 2022-10)
      Statement of the problem: Park-based physical activity (PA) is associated with positive health outcomes (social support, energy, self-esteem, mood, less depression). Integrating park-based PA into peer-led mental health services is an innovative approach that can address health disparities in persons with serious mental illness (SMI). Yet, to date, few PA interventions capitalize on peer counselor (PC) capacity, and none have focused on park-based PA. The purpose of this qualitative study was to ascertain the perspectives of adults with SMI and their counselors about park-based PA to inform the development of a park-based PA intervention lead by PCs. Methods: In Spring/Summer 2018, we conducted six 1-h focus groups (FGs) with adults with SMI, and four 1-h FGs with PCs and social workers. Using the person-based approach framework, open-ended questions elicited information regarding peer PA behavior and park use, PA participation motives/barriers, and preference for park-based PA. PCs discussed knowledge and promotion of PA in peer group settings, willingness to lead PA activities, and feedback on intervention strategies. Results: Peer FGs averaged 49 ± 8 min. Peer data were coded into three overarching themes: current PA, motivators, and barriers. Peer counselor FGs averaged 60 ± 5 min. Data were coded into five themes: current peer group PA, barriers to peer group PA, motivators for peer group PA, PA intervention recommendations, and implementation barriers. Conclusion: Peers and PCs were interested in participating/leading in outdoor PA. Social support, motivation, PA self-efficacy, health concerns, weather, transportation, and PC training are important considerations for intervention development.
    • DPPFit: Developing and Testing a Technology-Based Adaptation of the Diabetes Prevention Program (DPP) to Address Prediabetes in a Primary Care Setting

      Stewart, Jessica; Hatzigeorgiou, Christos; Davis, Catherine L.; Ledford, Christy J.W. (2022-05)
      Objective: The objective of this study was to adapt the National Diabetes Prevention Program (N-DPP) into a pragmatic tool for primary care settings by using daily text messaging to deliver all N-DPP content, supplemented by Fitbit technology to provide behavioral strategies typically delivered by personnel in traditional programs. Test the mobile health (mHealth), technology-based N-DPP adaptation (DPPFit) in primary care patients with prediabetes using a remote intervention based on the traditional 16 core sessions of the DPP. Methods: A pilot study with pre/post survey analysis of aggregate data were used to determine changes in weight, physical activity, sedentary behavior, and associated diabetes risk outcomes among study participants (n = 33). In this study, participants were issued Fitbit devices and provided the remote intervention over 16 weeks via automated text messaging technology, which followed the content of the DPP core education sessions. Results: Data analysis from baseline to 6-month follow-up demonstrate mean weight loss of 3.3 kg (95% CI: -6.2 to -0.5; P = .026), reduction in body mass index by 1.25 points (95% CI: -2.1 to -0.4; P = .005), a significant average increase of 2 days in self-reported physical activity per week (95% CI: 0.4 to 3.6; P = .015) and an average 10% decrease in sedentary time (P = .007). Conclusions: The remote DPPFit intervention demonstrates a promising and practical approach to the management of prediabetes in a primary care setting. The results support the use of the DPPFit program and application to achieve meaningful outcomes in a population with prediabetes. A randomized controlled trial with a larger sample is warranted. ( J Am Board Fam Med 2022;35:548–558.)
    • Device-Based Movement Behaviors, Executive Function, and Academic Skills among African American Children with ADHD and Disruptive Behavior Disorders

      Santiago-Rodríguez, María; D. Ramer, Jared; Marquez, David; Frazier, Stacy; Davis, Catherine L.; Bustamante, Eduardo; GEORGIA PREVENTION INSTITUTE (2022-04)
      Background: Physical activity (PA) has been identified as a promising intervention to improve executive function (EF) and reduce ADHD symptoms in children. Few African American children with ADHD and Disruptive Behavior Disorders (DBDs) from families with low incomes are represented in this literature. The purpose of this study is to test the relationships between PA and sedentary time (ST), and EF and academic skills among African American children with ADHD and DBD from low-income families. Methods: Children (n = 23, 6–13 years old) wore an ActiGraph for one week to measure PA and ST. EF was measured through parent report and direct neuropsychological tests. Academic skills were measured with the Curriculum-Based Measurement System. Bivariate correlations tested relationships between PA, ST, EF, and academic skills. Results: A significant correlation was observed between vigorous PA time and parent reported EF (r = −0.46, p = 0.040). Light PA and moderate PA were not related to EF or academic skills, and neither was ST. Conclusions: Vigorous PA may prove useful as an adjunct treatment to improve EF in African American children with ADHD and DBD in low-income neighborhoods. Research using experimental and longitudinal designs, and examining qualitative features of PA experiences, will be critical for understanding relationships between PA, academic skills, and EF in this population.
    • Exercise and academic performance among children with attention-deficit hyperactivity disorder and disruptive behavior disorders: A randomized controlled trial

      D. Ramer, Jared (2020-08)
      Purpose: To examine effects of a 10-week after-school physical activity (PA) program on academic performance of 6- to 12-year-old African American children with behavior problems. Methods: Participants were randomized to PA (n = 19) or sedentary attention control (n = 16) programs. Academic records, curriculum-based measures, and classroom observations were obtained at baseline, postintervention, and/or follow-up. Mixed models tested group × time interactions on academic records and curriculum-based measures. One-way analysis of variance or Kruskal–Wallis tested for differences in postintervention classroom observations. Results: Intent-to-treat analyses demonstrated a moderate effect within groups from baseline to postintervention on disciplinary referrals (PA: d = −0.47; attention control: d = −0.36) and a null moderate effect on academic assessments (PA: d = 0.11 to 0.36; attention control: d = 0.05 to 0.40). No significant group × time interactions emerged on direct academic assessments (all Ps ≥ .05, d = −0.23 to 0.26) or academic records (all Ps ≥ .05, d = −0.28 to 0.16). Classroom observations revealed that intervention participants were off-task due to moving at twice the rate of comparative classmates (F = 15.74, P < .001) and were off-task due to talking 33% more often (F = 1.39, P = .257). Conclusion: Academic outcome improvements were small within and between groups and did not sustain at follow-up. Academic benefits of after-school PA programs for children with attention-deficit hyperactivity disorder and/or disruptive behavior disorders were smaller than neurobiological, behavioral, and cognitive outcomes as previously reported.
    • Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT

      Davis, Catherine L.; Litwin, Sheldon E; Pollock, Norman K; Waller, Jennifer L; Zhu, Haidong; Dong, Yanbin; Gaston, Kapuku; Bhagatwala, Jigar; Harris, Ryan A; Looney, Jacob; et al. (2020-05-01)
      INTRODUCTION: Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children. METHODS: One hundred and seventy-five inactive children with overweight or obesity (8-11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day, n = 90) or a sedentary control condition (n = 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8-12 months later. Intent-to-treat analyses were conducted using mixed models. RESULTS: The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VȮ2 peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (-1.8 (-2.4, -1.1) vs. -0.8 (-1.5, -0.1)%), each p = 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. -0.028 (-0.083, 0.023) mmol/L, p < 0.0001). There was no group × time effect on other outcomes at 8 months, or on any outcomes at follow-up. The change in PWV at 8 months correlated with changes in insulin and insulin resistance (both r = 0.32), diastolic BP (r = 0.24), BMI (r = 0.22), and adiposity (r = 0.18). CONCLUSIONS: Eight months of aerobic exercise training improved fitness, adiposity, and HDL-cholesterol levels, but did not reduce arterial stiffness in children with excess weight. PWV improved as a function of insulin resistance, BP, BMI, and adiposity. Weight loss may be required to improve arterial stiffness. Exercise benefits waned after discontinuing the program.
    • Exercise effects on quality of life, mood, and self-worth in overweight children: The SMART randomized controlled trial

      Williams, Celestine F; Bustamante, Eduardo; Waller, Jennifer L; Davis, Catherine L. (2019-05-16)
      Overweight children are at risk for poor quality of life (QOL), depression, self-worth, and behavior problems. Exercise trials with children have shown improved mood and self-worth. Few studies utilized an attention control condition, QOL outcomes, or a follow-up evaluation after the intervention ends. The purpose is to test effects of an exercise program versus sedentary program on psychological factors in overweight children. One hundred seventy-five overweight children (87% black, 61% female, age 9.7 ± 0.9 years, 73% obese) were randomized to an 8 month aerobic exercise or sedentary after-school program. Depressive symptoms, anger expression, self-worth, and QOL were measured at baseline and post-test. Depressive symptoms and QOL were also measured at follow-up. Intent-to-treat mixed models evaluated intervention effects, including sex differences. At post-test, QOL, depression, and self-worth improved; no group by time or sex by group by time interaction was detected for QOL or self-worth. Boys' depressive symptoms improved more and anger control decreased in the sedentary intervention relative to the exercise intervention at post-test. At follow-up, depressive symptoms in boys in the sedentary group decreased more than other groups. Exercise provided benefits to QOL, depressive symptoms, and self-worth comparable to a sedentary program. Sedentary programs with games and artistic activities, interaction with adults and peers, and behavioral structure may be more beneficial to boys' mood than exercise. Some benefits of exercise in prior studies are probably attributable to program elements such as attention from adults. Visit W3Schools.com!
    • The role of DNA methylation in the association between childhood adversity and cardiometabolic disease

      Davis, Catherine L.; Hao, Guang; Youssef, Nagy A; Su, Shaoyong (Elsevier, 2019-05-16)
      Growing evidence suggests that adverse environmental stimuli, especially during sensitive periods in early life, may lead to cardiometabolic disease in later life. However, the underlying biological mechanisms remain a mystery. Recent studies inferred that epigenetic modifications are likely involved. We review recent studies, primarily focused on the findings from human studies, to indicate the role of DNA methylation in the associations between childhood adversity and cardiometabolic disease in adulthood. In particular, we focused on DNA methylation modifications in genes regulating the hypothalamus–pituitary–adrenal axis as well as the immune system.
    • Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models

      Stojek, Monika M.K.; Montoya, Amanda K.; Drescher, Christopher F.; Newberry, Andrew; Sultan, Zain; Williams, Celestine F.; Pollock, Norman K.; Davis, Catherine L.; GEORGIA PREVENTION INSTITUTE (Sage Journals, 2017-11-01)
      Objectives: We used mediation models to examine the mechanisms underlying the relationships among physical fitness, sleep-disordered breathing (SDB), symptoms of depression, and cognitive functioning. Methods: We conducted a cross-sectional secondary analysis of the cohorts involved in the 2003-2006 project PLAY (a trial of the effects of aerobic exercise on health and cognition) and the 2008-2011 SMART study (a trial of the effects of exercise on cognition). A total of 397 inactive overweight children aged 7-11 received a fitness test, standardized cognitive test (Cognitive Assessment System, yielding Planning, Attention, Simultaneous, Successive, and Full Scale scores), and depression questionnaire. Parents completed a Pediatric Sleep Questionnaire. We used bootstrapped mediation analyses to test whether SDB mediated the relationship between fitness and depression and whether SDB and depression mediated the relationship between fitness and cognition. Results: Fitness was negatively associated with depression (B = –0.041; 95% CI, –0.06 to –0.02) and SDB (B = –0.005; 95% CI, –0.01 to –0.001). SDB was positively associated with depression (B = 0.99; 95% CI, 0.32 to 1.67) after controlling for fitness. The relationship between fitness and depression was mediated by SDB (indirect effect = –0.005; 95% CI, –0.01 to –0.0004). The relationship between fitness and the attention component of cognition was independently mediated by SDB (indirect effect = 0.058; 95% CI, 0.004 to 0.13) and depression (indirect effect = –0.071; 95% CI, –0.01 to –0.17). Conclusions: SDB mediates the relationship between fitness and depression, and SDB and depression separately mediate the relationship between fitness and the attention component of cognition.
    • A whole brain volumetric approach in overweight/obese children: Examining the association with different physical fitness components and academic performance. The ActiveBrains project

      Esteban-Cornejo, Irene; Cadenas-Sanchez, Cristina; Contreras-Rodriguez, Oren; Verdejo-Roman, Juan; Mora-Gonzalez, Jose; Migueles, Jairo H.; Henriksson, Pontus; Davis, Catherine L.; Verdejo-Garcia, Antonio; Catena, Andrés; et al. (Elsevier, 2017-10-01)
      Obesity, as compared to normal weight, is associated with detectable structural differences in the brain. To the best of our knowledge, no previous study has examined the association of physical fitness with gray matter volume in overweight/obese children using whole brain analyses. Thus, the aim of this study was to examine the association between the key components of physical fitness (i.e. cardiorespiratory fitness, speed-agility and muscular fitness) and brain structural volume, and to assess whether fitness-related changes in brain volumes are related to academic performance in overweight/obese children. A total of 101 overweight/obese children aged 8–11 years were recruited from Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 T S Magnetom Tim Trio system. Gray matter tissue was calculated using Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra (DARTEL). Academic performance was assessed by the Batería III Woodcock-Muñoz Tests of Achievement. All analyses were controlled for sex, peak high velocity offset, parent education, body mass index and total brain volume. The statistical threshold was calculated with AlphaSim and further Hayasaka adjusted to account for the non-isotropic smoothness of structural images. The main results showed that higher cardiorespiratory fitness was related to greater gray matter volumes (P < 0.001, k = 64) in 7 clusters with β ranging from 0.493 to 0.575; specifically in frontal regions (i.e. premotor cortex and supplementary motor cortex), subcortical regions (i.e. hippocampus and caudate), temporal regions (i.e. inferior temporal gyrus and parahippocampal gyrus) and calcarine cortex. Three of these regions (i.e. premotor cortex, supplementary motor cortex and hippocampus) were related to better academic performance (β ranging from 0.211 to 0.352; all P < 0.05). Higher speed-agility was associated with greater gray matter volumes (P < 0.001, k = 57) in 2 clusters (i.e. the inferior frontal gyrus and the superior temporal gyrus) with β ranging from 0.564 to 0.611. Both clusters were related to better academic performance (β ranging from 0.217 to 0.296; both P < 0.05). Muscular fitness was not independently associated with greater gray matter volume in any brain region. Furthermore, there were no statistically significant negative association between any component of physical fitness and gray matter volume in any region of the brain. In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, may independently be associated with greater volume of numerous cortical and subcortical brain structures; besides, some of these brain structures may be related to better academic performance. Importantly, the identified associations of fitness and gray matter volume were different for each fitness component. These findings suggest that increases in cardiorespiratory fitness and speed-agility may positively influence the development of distinctive brain regions and academic indicators, and thus counteract the harmful effect of overweight and obesity on brain structure during childhood.
    • Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): Study protocol for a randomized controlled trial

      Arenaza, Lide; Medrano, María; Amasene, María; Rodríguez-Vigil, Beatriz; Díez, Ignacio; Graña, Manuel; Tobalina, Ignacio; Maiz, Edurne; Arteche, Edurne; Larrarte, Eider; et al. (2017-08-10)
      Background: The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise. Methods: A total of 84 children, aged 8-12 years, with a high risk of T2D will be included and randomly assigned to control (N=42) or intervention (N=42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry). Discussion: Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity. Trial registration: ClinicalTrials.gov, ID: NCT03027726. Registered on 16 January 2017.
    • Whole-body vibration mimics the metabolic effects of exercise in male leptin receptor-deficient mice

      McGee-Lawrence, Meghan E.; Wenger, Karl H.; Misra, Sudipta; Davis, Catherine L.; Pollock, Norman K.; Elsalanty, Mohammed; Ding, Kehong; Isales, C.M.; Hamrick, Mark W.; Wosiski-Kuhn, Marlena; et al. (Special Metabolism Section, 2017-05-01)
      Whole-body vibration (WBV) has gained attention as a potential exercise mimetic, but direct comparisons with the metabolic effects of exercise are scarce. To determine whether WBV recapitulates the metabolic and osteogenic effects of physical activity, we exposed male wild-type (WT) and leptin receptor-deficient (db/db) mice to daily treadmill exercise (TE) or WBVfor 3 months. Body weights were analyzed and compared with WT and db/db mice that remained sedentary. Glucose and insulin tolerance testing revealed comparable attenuation of hyperglycemia and insulin resistance in db/db mice following TE or WBV. Both interventions reduced body weight in db/ db mice and normalized muscle fiber diameter. TE orWBValso attenuated adipocyte hypertrophy in visceral adipose tissue and reduced hepatic lipid content in db/db mice. Although the effects of leptin receptor deficiency on cortical bone structure were not eliminated by either intervention, exercise and WBV increased circulating levels of osteocalcin in db/db mice. In the context of increased serum osteocalcin, the modest effects of TE and WBV on bone geometry, mineralization, and biomechanics may reflect subtle increases in osteoblast activity in multiple areas of the skeleton. Taken together, these observations indicate that WBV recapitulates the effects of exercise on metabolism in type 2 diabetes.
    • Randomized Controlled Trial of Exercise for ADHD and Disruptive Behavior Disorders

      Esteban Bustamante, Eduardo; Davis, Catherine L.; Frazier, Stacy L; Rusch, Dana; Fogg, Louis F.; Atkins, Marc S; Xavier Marquez, David; GEORGIA PREVENTION INSTITUTE (2016-07-01)
      Purpose The objective of this study is to test the feasibility and impact of a 10-wk after-school exercise program for children with attention deficit hyperactivity disorder and/or disruptive behavior disorders living in an urban poor community. Methods Children were randomized to an exercise program (n = 19) or a comparable but sedentary attention control program (n = 16). Cognitive and behavioral outcomes were collected pre-/posttest. Intent-To-Treat mixed models tested group-Time and group-Time-Attendance interactions. Effect sizes were calculated within and between groups. Results Feasibility was evidenced by 86% retention, 60% attendance, and average 75% maximum HR. Group-Time results were null on the primary outcome, parent-reported executive function. Among secondary outcomes, between-group effect sizes favored exercise on hyperactive symptoms (d = 0.47) and verbal working memory (d = 0.26), and controls on visuospatial working memory (d =-0.21) and oppositional defiant symptoms (d =-0.37). In each group, within-group effect sizes were moderate to large on most outcomes (d = 0.67 to 1.60). A group-Time-Attendance interaction emerged on visuospatial working memory (F[1,33] = 7.42, P < 0.05), such that attendance to the control program was related to greater improvements (r = 0.72, P < 0.01), whereas attendance to the exercise program was not (r = 0.25, P = 0.34). Conclusions Although between-group findings on the primary outcome, parent-reported executive function, were null, between-group effect sizes on hyperactivity and visuospatial working memory may reflect adaptations to the specific challenges presented by distinct formats. Both groups demonstrated substantial within-group improvements on clinically relevant outcomes. Findings underscore the importance of programmatic features, such as routines, engaging activities, behavior management strategies, and adult attention, and highlight the potential for after-school programs to benefit children with attention deficit hyperactivity disorder and disruptive behavior disorder living in urban poverty where health needs are high and services resources few.
    • Physical Activity Interventions for Neurocognitive and Academic Performance in Overweight and Obese Youth: A Systematic Review

      Bustamante, Eduardo; Williams, Celestine F; Davis, Catherine L.; GEORGIA PREVENTION INSTITUTE (Elsevier, 2016-06-01)
    • Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children

      Davis, Catherine L.; Tingen, Martha S.; Jia, Jenny; Sherman, Forrest; Williams, Celestine F; Bhavsar, Kruti; Wood, Nancy; Kobleur, Jessica; Waller, Jennifer L; GEORGIA PREVENTION INSTITUTE (2016-04-01)
      Background: Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE. Methods: Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained. Results: Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p < 0.03). However, PSE was unrelated to prediabetes, insulin resistance, or visceral fat. PSE was linked to poorer cognitive scores (p < 0.04) independent of adiposity, but was not related to sleep-disordered breathing. Conclusions: PSE is associated with fatness and poorer cognition in children. Tailored interventions that target multiple health risk factors including nutrition, physical activity, and tobacco use in children and families are needed to prevent adverse health outcomes related to tobacco use and obesity.
    • The Effect of Regular Exercise on Cognition in Special Populations of Children: Overweight and Attention-Deficit Hyperactivity Disorder

      Bustamante, Eduardo; Krafft, Cynthia E.; Schaeffer, David J; McDowell, Jennifer E.; Davis, Catherine L.; GEORGIA PREVENTION INSTITUTE (Elsevier, 2016-01-01)
      Childhood overweight/obesity and ADHD are common conditions of interest to researchers investigating the relationship between regular physical activity and children's cognition. Children in these populations are less physically active and have lower cognitive function than typically developing children. Research may identify the effects of regular exercise on cognition relevant to parents, clinicians, and educators struggling to respond to the growing needs presented by these conditions. Observational studies provide promising preliminary evidence of a relationship between regular exercise and cognition in these populations, but few rigorous randomized controlled trials have been conducted. Early results are encouraging. Future randomized trials promise to shed further light on the efficacy of different physical activity programs, elucidate neurobiological mechanisms that may guide refinement of interventions, and develop evidence-based interventions suitable for broad dissemination.
    • Antisaccade-related brain activation in children with attention-deficit/hyperactivity disorder - A pilot study

      Schwarz, Nicolette F.; Krafft, Cynthia E.; Chi, Lingxi; Weinberger, Abby L.; Schaeffer, David J; Pierce, Jordan E.; Rodrigue, Amanda L.; Williams, Celestine F; DiBattisto, Caroline H.; Maria, Bernard L.; et al. (2015-11-30)
      While antisaccade paradigms invoke circuitry associated with cognitive control and attention-deficit/hyperactivity disorder (ADHD), there is a dearth of functional magnetic resonance imaging (fMRI) investigations using antisaccade tasks among children with ADHD. Neural correlates associated with antisaccade performance were examined with fMRI in 11 children with ADHD (10 medicated) matched to 11 typically developing children. Significantly greater brain activation in regions in right dorsolateral prefrontal cortex and caudate nucleus was observed in children with ADHD relative to the control group. This pattern separated the children into their respective groups in a taxonomic manner. Sensitivity analyses probing comorbidity and medication-specific effects showed that results were consistent; however, the caudate nucleus difference was only detectable in the full sample, or in subsets with a more relaxed cluster threshold. Antisaccade performance did not significantly differ between the groups, perhaps as a result of greater brain activation or medication effects in the ADHD group. Thus, antisaccade paradigms may have sensitivity and specificity for the investigation of cognitive control deficits and associated neural correlates in ADHD, and may contribute towards the development of new treatment approaches for children with the disorder.
    • Independent associations of organized physical activity and weight status with children's cognitive functioning: A matched-pairs design

      Davis, Catherine L.; Tkacz, Joseph P.; Tomporowski, Phillip D.; Bustamante, Eduardo E. (2015-11)
      Purpose: This study tested whether participation in organized physical activity (active vs. inactive) or weight status (normal weight vs. overweight or obese) independently relate to children's cognition, using a matchedpairs design. Design and Methods: Normal weight, active children (8-11 yrs, 5th-75th percentile BMI) were recruited from extracurricular physical activity programs while normal weight inactive (5th-75th percentile BMI) and overweight inactive children (BMI ≥85th percentile) were recruited from local Augusta, Georgia area schools. Measures included the Cognitive Assessment System, anthropometrics, and parent- and self-report of physical activity. Paired t tests compared cognition scores between matched groups of normal weight active vs. normal weight inactive (N = 24 pairs), normal weight inactive vs. overweight inactive (N = 21 pairs), and normal weight active vs. overweight inactive children (N = 16 pairs). Children in each comparison were matched for race, gender, age, and socioeconomic status. Results: Normal weight active children had higher Planning (M± SD = 109 ± 11 vs. 100 ± 11, p = .011) and Attention scores (108 ± 11 vs. 100 ± 11, p = .013) than overweight inactive children. Normal weight inactive children had higher Attention scores than overweight inactive children (105 ± 13 vs. 93 ± 12, p = .008). When compared with normal weight inactive children, normal weight active children had higher Planning (113 ± 10 vs. 102 ± 13, p = .008) and marginally higher Attention scores (111 ± 11 vs. 104 ± 12, p = .06). Conclusion: Findings suggest independent associations of children's weight status with selective attention, and physical activity with higher-order processes of executive function.
    • Liver enzymes and clustering cardiometabolic risk factors in European adolescents: The HELENA study

      Labayen, I; Ruiz, J.R.; Ortega, F.B.; Davis, Catherine L.; Rodriguez, G; Gonzalez-Gross, M.; Breidenassel, C.; Dallongeville, J.; Marcos, A.; Widhalm, K.; et al. (2015-10-01)
      Objectives This study aimed to explore the associations of liver biomarkers with cardiometabolic risk factors and their clustering, and to provide reference values (percentiles) and cut-off points for liver biomarkers associated with high cardiometabolic risk in European adolescents. Methods Alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase to ALT ratio (AST/ALT), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol and insulin were measured in 1084 adolescents. We computed a continuous cardiometabolic risk score and defined the high cardiometabolic risk. Results Higher ALT and GGT and lower AST/ALT were associated with adiposity and with the number of adverse cardiometabolic risk factors (Ps < 0.05). Higher GGT and lower AST/ALT were associated with higher cardiometabolic risk score (Ps < 0.001) in males and females, and ALT only in males (Ps < 0.001). Gender- and age-specific percentiles for liver biomarkers were provided. Receiver operating characteristic analyses showed a significant discriminatory accuracy of AST/ALT in identifying the low/high cardiometabolic risk (Ps < 0.01) and thresholds were provided. Conclusions Higher GGT and lower AST/ALT are associated with higher cardiometabolic risk factors and their clustering in male and female European adolescents, whereas the associations of ALT were gender dependent. Our results suggest the usefulness of AST/ALT as a screening test in the assessment of adolescents with high cardiometabolic risk and provide gender- and age-specific thresholds that might be of clinical interest.
    • Endothelial health in childhood acute lymphoid leukemia survivors: Pilot evaluation with peripheral artery tonometry

      Ruble, Kathy; Davis, Catherine L.; Han, Hae Ra; Augusta University (2015-03-06)
      Background: Childhood cancer survivors are a growing population at risk for poor cardiac outcomes. Acute lymphoid leukemia (ALL) survivors are among those at increased risk of cardiovascular complications. Early identification of impaired vascular health may allow for interventions to improve these outcomes. The purpose of this study was to evaluate vascular health using peripheral artery tonometry in ALL survivors and compare results with healthy siblings. Procedure: Sixteen ALL survivor, healthy sibling pairs, aged 8 to 20 years, were evaluated for vascular health and cardiovascular risk factors (body mass index, central adiposity, blood pressure, and fitness). One-tailed paired t test was used to compare the groups. Results: Survivors were similar to siblings in cardiovascular risk measures but had poorer vascular health as measured by reactive hyperemia index (survivor RHI 1.54 vs. sibling 1.77; P=0.0474). Conclusion: This study reveals that even among survivors who are comparable to their healthy siblings in other traditional cardiovascular risks, there is evidence of poorer vascular health.
    • Society of Behavioral Medicine position statement: elementary school-based physical activity supports academic achievement

      Buscemi, Joanna; Kong, Angela; Fitzgibbon, Marian L.; Bustamante, Eduardo E.; Davis, Catherine L.; Pate, Russell R.; Wilson, Dawn K.; Augusta University (2014-12)
      The Society of Behavioral Medicine (SBM) urges elementary schools to provide children with ample opportunities to engage in physical activity during school hours. In addition to promoting overall child health, physical activity also supports academic achievement. In addition to improving their aerobic fitness, regular physical activity improves cognitive function, influences the brain, and improves mood in children. Better aerobic fitness and physical activity are associated with increased grade point averages and standardized test scores. Despite the documented relationship between physical activity, fitness, and academic achievement, few schools have implemented physical activity as a tool to improve academic performance. SBM recommends that elementary schools provide children with the recommended 60 min of moderate-to-vigorous physical activity during school hours. Further, SBM urges schools to work with the local school districts and state education departments to mandate minimum physical activity time for elementary school physical education.