Paediatric obesity and metabolic syndrome associations with cognition and the brain in youth: Current evidence and future directions.
Jennifer R SadlerGita ThapaliyaKushi RanganathAndrea GabayLiuyi ChenKimberly R SmithRicardo S OsorioAntonio ConvitSusan CarnellPublished in: Pediatric obesity (2023)
Obesity and components of the metabolic syndrome (MetS) are associated with differences in brain structure and function and in general and food-related cognition in adults. Here, we review evidence for similar phenomena in children and adolescents, with a focus on the implications of extant research for possible underlying mechanisms and potential interventions for obesity and MetS in youth. Current evidence is limited by a relative reliance on small cross-sectional studies. However, we find that youth with obesity and MetS or MetS components show differences in brain structure, including alterations in grey matter volume and cortical thickness across brain regions subserving reward, cognitive control and other functions, as well as in white matter integrity and volume. Children with obesity and MetS components also show some evidence for hyperresponsivity of food reward regions and hyporesponsivity of cognitive control circuits during food-related tasks, altered brain responses to food tastes, and altered resting-state connectivity including between cognitive control and reward processing networks. Potential mechanisms for these findings include neuroinflammation, impaired vascular reactivity, and effects of diet and obesity on myelination and dopamine function. Future observational research using longitudinal measures, improved sampling strategies and study designs, and rigorous statistical methods, promises to further illuminate dynamic relationships and causal mechanisms. Intervention studies targeted at modifiable biological and behavioural factors associated with paediatric obesity and MetS can further inform mechanisms, as well as test whether brain and behaviour can be altered for beneficial outcomes.
Keyphrases
- metabolic syndrome
- white matter
- resting state
- functional connectivity
- insulin resistance
- weight loss
- high fat diet induced
- type diabetes
- multiple sclerosis
- weight gain
- uric acid
- physical activity
- young adults
- adipose tissue
- emergency department
- mental health
- human health
- cardiovascular risk factors
- intensive care unit
- cerebral ischemia
- skeletal muscle
- traumatic brain injury
- body mass index
- optical coherence tomography
- climate change
- blood brain barrier
- working memory
- cardiovascular disease
- drug delivery
- cancer therapy
- prefrontal cortex
- lipopolysaccharide induced