human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To examine the link between childhood overweight status and elementary school outcomes . Design : Prospect i ve study design : multivariate regression models examining the association between changes in overweight status and school outcomes between kindergarten entry and end of third grade , after controlling for various child , family and school characteristics . Subjects : Nationally representative sample of US children who entered kindergarten in 1998 , with longitudinal data on body mass index ( BMI ) and school outcomes at kindergarten entry and end of third grade . Measurements : Wide range of elementary school outcomes collected in each wave including academic achievement ( math and reading st and ardized test scores ) ; teacher reported internalizing and externalizing behavior problems ( BP ) , social skills ( self-control , interpersonal skills ) and approaches to learning ; school absences ; and grade repetition . Measurements of height and weight in each wave were used to compute BMI and indicators of overweight status based on CDC growth charts . A rich set of control variables capturing child , family , and school characteristics . Results : Moving from not-overweight to overweight between kindergarten entry and end of third grade was significantly associated ( P<0.05 ) with reductions in test scores , and teacher ratings of social-behavioral outcomes and approaches to learning among girls . However , this link was mostly absent among boys , with two exceptions – boys who became overweight had significantly fewer externalizing BPs ( P<0.05 ) , but more absences from school compared to boys who remained normal weight . Being always-overweight was associated with more internalizing BP among girls but fewer externalizing BPs among boys . Conclusion : Change in overweight status during the first 4 years in school is a significant risk factor for adverse school outcomes among girls but not boys . Girls who become overweight during the early school years and those who start school being overweight and remain that way may need to be monitored carefully Inhibitory control and performance monitoring are critical executive functions of the human brain . Lesion and imaging studies have shown that the inferior frontal cortex plays an important role in inhibition of inappropriate response . In contrast , specific brain areas involved in error processing and their relation to those implicated in inhibitory control processes are unknown . In this study , we used a r and om effects model to investigate  error‐related brain activity  associated with failure to inhibit response during a  Go/NoGo task .  Error‐related brain activation was observed in the rostral aspect of the right anterior cingulate ( BA 24/32 ) and adjoining medial prefrontal cortex , the left and right insular cortex and adjoining frontal operculum ( BA 47 ) and left precuneus/posterior cingulate ( BA 7/31/29 ) . Brain activation related to response inhibition and competition was observed bilaterally in the dorsolateral prefrontal cortex ( BA 9/46 ) , pars triangularis region of the inferior frontal cortex ( BA 45/47 ) , premotor cortex ( BA 6 ) , inferior parietal lobule ( BA 39 ) , lingual gyrus and the cau date , as well as in the right dorsal anterior cingulate cortex ( BA 24 ) . These findings provide evidence for a distributed error processing system in the human brain that overlaps partially , but not completely , with brain regions involved in response inhibition and competition . In particular , the rostal anterior cingulate and posterior cingulate/precuneus as well as the left and right anterior insular cortex were activated only during error processing , but not during response competition , inhibition , selection , or execution . Our results also suggest that the brain regions involved in the error processing system overlap with brain areas implicated in the formulation and execution of articulatory plans . Hum . Brain Mapping 12:131–143 , 2001 . © 2001 Wiley‐Liss , OBJECTIVES To determine if limited ability to delay gratification ( ATDG ) at age 4 years is independently associated with an increased risk of being overweight at age 11 years and to assess confounding or moderation by child body mass index z score at 4 years , self-reported maternal expectation of child ATDG for food , and maternal weight status . DESIGN Longitudinal prospect i ve study . SETTING Ten US sites . PARTICIPANTS Participants in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development . Main Exposure Ability to delay gratification at 4 years , measured as pass or fail on a vali date d task . OUTCOME MEASURES Overweight at 11 years , defined as a body mass index greater than or equal to the 85th percentile based on measured weight and height . RESULTS Of 805 children , 47 % failed the ATDG task . Using multiple logistic regression , children who failed the ATDG task were more likely to be overweight at 11 years ( relative risk , 1.29 ; 95 % confidence interval , 1.06 - 1.58 ) , independent of income to needs ratio . Body mass index z score at 4 years and maternal expectation of child ATDG for food did not alter the association , but maternal weight status reduced the association significantly . CONCLUSIONS Children with limited ATDG at age 4 years were more likely to be overweight at age 11 years , but the association was at least partially explained by maternal weight status . Further underst and ing of the association between the child 's ATDG and maternal and child weight status may lead to more effective obesity intervention and prevention programs The purpose of this study was to investigate the associations between obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder ( DCD ) . 2029 children ( 1078 boys , 951 girls ) aged nine to ten years were chosen r and omly from 14 elementary schools across Taiwan . We used bioelectrical impedance analysis to measure percentage of body fat ( PBF ) and the Movement Assessment Battery for Children test ( MABC test ) to evaluate the motor coordination ability . Using cut-off points based on PBF from past studies , boys and girls were divided into obese , overweight and normal-weight groups , respectively . In boys , total impairment scores and scores on balance subtest in the MABC were significantly higher in the obese and overweight groups when compared against the normal-weight group . Girls in the obese and the overweight groups had higher balance impairment scores than those of the normal-weight group . Among boys , the prevalence of obesity was highest in the DCD group , when compared to the borderline DCD and TD boys . A higher percentage of DCD girls were overweight and obese than TD girls . Obesity may be associated with poor motor coordination ability among boys and girls , and particularly in relation to balance ability . Children with DCD may have a higher risk to be overweight or obese in Taiwan We report 10-year treatment outcomes for obese children in 4 r and omized treatment studies . At 10 years , 34 % decreased percentage overweight by 20 % or more , and 30 % were not obese . Significant effects were observed when parents and children were targeted and reinforced for weight loss in comparison with nontargeted controls and for children given lifestyle or aerobic exercise in comparison with a calisthenics control . Thirty-four percent of the variance in change in percentage overweight was predicted from sex , baseline percentage overweight , self-monitoring weight , meals eaten at home , and family and friends ' support for eating and exercise . Results show long-term changes in children depend on the treatment , and evidence converges on the importance of the family and other sources of support for eating and activity change Obese ( n = 20 ) and normal weight ( n = 20 ) children ( 8 - 11 years ) were compared using the delay of gratification paradigm . All children were asked to choose between an immediate reward or a larger delayed ( one day ) reward . Half the children were offered an edible incentive and half a non-edible incentive . Results showed that the obese choose immediate rewards more often than normals only when the incentive was edible . This suggests that deficits in delay of gratification shown by obese children are not generalized dispositions but are specific to food . A second aspect of the study examined preference for food vs non-food items and activities . Normals showed a much stronger preference for non-food items , nutritious foods and non-food related activities than the obese . This suggests that the deficits in delay of gratification shown by the obese children for food related items may be due to the stronger incentive value of these items for them Exergames are videogames that require gross motor activity , thereby combining gaming with physical activity . This study examined the role of competitive versus cooperative exergame play on short-term changes in executive function skills , following a 10-week exergame training intervention .  Fifty-four low-income overweight and obese African American adolescents were r and omly assigned to a competitive exergame condition , a cooperative exergame condition , or a no-play control group . Youths in the competitive exergame condition improved in executive function skills more than did those in the cooperative exergame condition and the no-play control group . Weight loss during the intervention was also significantly positively correlated with improved executive function skills . The findings link competitive exergame play to beneficial cognitive outcomes for at-risk ethnic minority adolescents Background Over the last decades , a decline in motor skills and in physical activity and an increase in obesity has been observed in children . However , there is a lack of data in young children . We tested if differences in  motor skills and in physical activity  according to weight or gender were already present in 2- to 4-year-old children . Methods Fifty-eight child care centers in the French part of Switzerl and were r and omly selected for the Youp'là bouge study .  Motor skills were assessed by an obstacle course including 5 motor skills , derived from the Zurich Neuromotor Assessment test . Physical activity was measured with accelerometers ( GT1 M , Actigraph , Florida , USA ) using age-adapted cut-offs .  Weight status was assessed using the International Obesity Task Force criteria ( healthy weight vs overweight ) for body mass index ( BMI ) . Results Of the 529 children ( 49 % girls , 3.4 ± 0.6 years , BMI 16.2 ± 1.2 kg/m2 ) , 13 % were overweight . There were no significant weight status-related differences in the single skills of the obstacle course , but there was a trend ( p = 0.059 ) for a lower performance of overweight children in the overall motor skills score . No significant weight status-related  differences in child care-based physical activity  were observed . No gender-related differences were found in the overall motor skills score , but boys performed better than girls in 2 of the 5 motor skills ( p ≤ 0.04 ) . Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12 - 25 % higher and sedentary activity 5 % lower in boys compared to girls ( all p < 0.01 ) . Conclusions At this early age , there were no significant weight status- or gender-related differences in global motor skills . However , in accordance to data in older children , child care-based physical activity  was higher in boys compared to girls . These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children OBJECTIVE This present study examined time spent in the target heart zone ( THZ ) and its relationship to tasks requiring variable amounts of executive control function in prepubescent children participating in a 9-month r and omized controlled physical activity program .  METHODS A sample of 59 participants performed the Stroop Color-Word Test and the Comprehensive Trail Making Test cognitive assessment s.  Heart rate data were collected during participation in the physical activity program using E600 heart rate monitors ( Polar , Finl and ) . RESULTS There was a significant difference , F(1 , 58)=7.44 , p < .009 , between males and females for relative VO2max , but not absolute ( p=.69 ) or percent VO2max ( p=.73 ) . Regression analysis identified KBIT , age , and mean time above the THZ as significant predictors of performance in the  Stroop Color-Word condition , F(1 , 56)=5.21 , p=.02 . KBIT and mean time above the THZ were significant predictors for Trails B , F(1 , 56)=7.60 . CONCLUSIONS These results suggest that heart rate , as a measure of physical activity intensity , should be closely monitored during research that is intended to make inferences about its effects on cognitive performance as participation in vigorous activities may have specific benefits over lower intensities among prepubescent children OBJECTIVE Deficits in executive functioning , including working memory ( WM ) deficits , have been suggested to be important in attention-deficit/hyperactivity disorder ( ADHD ) . During 2002 to 2003 , the authors conducted a multicenter , r and omized , controlled , double-blind trial to investigate the effect of improving WM by computerized , systematic practice of WM tasks . METHOD Included in the trial were 53 children with ADHD ( 9 girls ; 15 of 53 inattentive subtype ) , aged 7 to 12 years , without stimulant medication . The compliance criterion ( > 20 days of training ) was met by 44 subjects , 42 of whom were also evaluated at follow-up 3 months later . Participants were r and omly assigned to use either the treatment computer program for training WM or a comparison program . The main outcome measure was the span-board task , a visuospatial WM task that was not part of the training program . RESULTS For the span-board task , there was a significant treatment effect both post-intervention and at follow-up . In addition , there were significant effects for secondary outcome tasks measuring verbal WM , response inhibition , and complex reasoning . Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity , both post-intervention and at follow-up . CONCLUSIONS This study shows that WM can be improved by training in children with ADHD . This training also improved response inhibition and reasoning and result ed in a reduction of the parent-rated inattentive symptoms of ADHD Objective To assess whether a physical activity intervention reduces body mass index in young children . Design Cluster r and omised controlled single blinded trial over 12 months . Setting Thirty six nurseries in Glasgow , Scotl and . Participants 545 children in their pr 
    Output:
    
agent
Overall , we found data that support a negative relationship between obesity and various aspects of neurocognitive functioning , such as executive functioning , attention , visuo-spatial performance , and motor skill .
The existing literature is mixed on the effects among obesity , general cognitive functioning , language , learning , memory , and academic achievement .
Executive dysfunction is associated with obesity-related behaviors , such as increased intake , disinhibited eating , and less physical activity .
Physical activity is positively linked with motor skill .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To examine the link between childhood overweight status and elementary school outcomes . Design : Prospect i ve study design : multivariate regression models examining the association between changes in overweight status and school outcomes between kindergarten entry and end of third grade , after controlling for various child , family and school characteristics . Subjects : Nationally representative sample of US children who entered kindergarten in 1998 , with longitudinal data on body mass index ( BMI ) and school outcomes at kindergarten entry and end of third grade . Measurements : Wide range of elementary school outcomes collected in each wave including academic achievement ( math and reading st and ardized test scores ) ; teacher reported internalizing and externalizing behavior problems ( BP ) , social skills ( self-control , interpersonal skills ) and approaches to learning ; school absences ; and grade repetition . Measurements of height and weight in each wave were used to compute BMI and indicators of overweight status based on CDC growth charts . A rich set of control variables capturing child , family , and school characteristics . Results : Moving from not-overweight to overweight between kindergarten entry and end of third grade was significantly associated ( P<0.05 ) with reductions in test scores , and teacher ratings of social-behavioral outcomes and approaches to learning among girls . However , this link was mostly absent among boys , with two exceptions – boys who became overweight had significantly fewer externalizing BPs ( P<0.05 ) , but more absences from school compared to boys who remained normal weight . Being always-overweight was associated with more internalizing BP among girls but fewer externalizing BPs among boys . Conclusion : Change in overweight status during the first 4 years in school is a significant risk factor for adverse school outcomes among girls but not boys . Girls who become overweight during the early school years and those who start school being overweight and remain that way may need to be monitored carefully Inhibitory control and performance monitoring are critical executive functions of the human brain . Lesion and imaging studies have shown that the inferior frontal cortex plays an important role in inhibition of inappropriate response . In contrast , specific brain areas involved in error processing and their relation to those implicated in inhibitory control processes are unknown . In this study , we used a r and om effects model to investigate  error‐related brain activity  associated with failure to inhibit response during a  Go/NoGo task .  Error‐related brain activation was observed in the rostral aspect of the right anterior cingulate ( BA 24/32 ) and adjoining medial prefrontal cortex , the left and right insular cortex and adjoining frontal operculum ( BA 47 ) and left precuneus/posterior cingulate ( BA 7/31/29 ) . Brain activation related to response inhibition and competition was observed bilaterally in the dorsolateral prefrontal cortex ( BA 9/46 ) , pars triangularis region of the inferior frontal cortex ( BA 45/47 ) , premotor cortex ( BA 6 ) , inferior parietal lobule ( BA 39 ) , lingual gyrus and the cau date , as well as in the right dorsal anterior cingulate cortex ( BA 24 ) . These findings provide evidence for a distributed error processing system in the human brain that overlaps partially , but not completely , with brain regions involved in response inhibition and competition . In particular , the rostal anterior cingulate and posterior cingulate/precuneus as well as the left and right anterior insular cortex were activated only during error processing , but not during response competition , inhibition , selection , or execution . Our results also suggest that the brain regions involved in the error processing system overlap with brain areas implicated in the formulation and execution of articulatory plans . Hum . Brain Mapping 12:131–143 , 2001 . © 2001 Wiley‐Liss , OBJECTIVES To determine if limited ability to delay gratification ( ATDG ) at age 4 years is independently associated with an increased risk of being overweight at age 11 years and to assess confounding or moderation by child body mass index z score at 4 years , self-reported maternal expectation of child ATDG for food , and maternal weight status . DESIGN Longitudinal prospect i ve study . SETTING Ten US sites . PARTICIPANTS Participants in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development . Main Exposure Ability to delay gratification at 4 years , measured as pass or fail on a vali date d task . OUTCOME MEASURES Overweight at 11 years , defined as a body mass index greater than or equal to the 85th percentile based on measured weight and height . RESULTS Of 805 children , 47 % failed the ATDG task . Using multiple logistic regression , children who failed the ATDG task were more likely to be overweight at 11 years ( relative risk , 1.29 ; 95 % confidence interval , 1.06 - 1.58 ) , independent of income to needs ratio . Body mass index z score at 4 years and maternal expectation of child ATDG for food did not alter the association , but maternal weight status reduced the association significantly . CONCLUSIONS Children with limited ATDG at age 4 years were more likely to be overweight at age 11 years , but the association was at least partially explained by maternal weight status . Further underst and ing of the association between the child 's ATDG and maternal and child weight status may lead to more effective obesity intervention and prevention programs The purpose of this study was to investigate the associations between obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder ( DCD ) . 2029 children ( 1078 boys , 951 girls ) aged nine to ten years were chosen r and omly from 14 elementary schools across Taiwan . We used bioelectrical impedance analysis to measure percentage of body fat ( PBF ) and the Movement Assessment Battery for Children test ( MABC test ) to evaluate the motor coordination ability . Using cut-off points based on PBF from past studies , boys and girls were divided into obese , overweight and normal-weight groups , respectively . In boys , total impairment scores and scores on balance subtest in the MABC were significantly higher in the obese and overweight groups when compared against the normal-weight group . Girls in the obese and the overweight groups had higher balance impairment scores than those of the normal-weight group . Among boys , the prevalence of obesity was highest in the DCD group , when compared to the borderline DCD and TD boys . A higher percentage of DCD girls were overweight and obese than TD girls . Obesity may be associated with poor motor coordination ability among boys and girls , and particularly in relation to balance ability . Children with DCD may have a higher risk to be overweight or obese in Taiwan We report 10-year treatment outcomes for obese children in 4 r and omized treatment studies . At 10 years , 34 % decreased percentage overweight by 20 % or more , and 30 % were not obese . Significant effects were observed when parents and children were targeted and reinforced for weight loss in comparison with nontargeted controls and for children given lifestyle or aerobic exercise in comparison with a calisthenics control . Thirty-four percent of the variance in change in percentage overweight was predicted from sex , baseline percentage overweight , self-monitoring weight , meals eaten at home , and family and friends ' support for eating and exercise . Results show long-term changes in children depend on the treatment , and evidence converges on the importance of the family and other sources of support for eating and activity change Obese ( n = 20 ) and normal weight ( n = 20 ) children ( 8 - 11 years ) were compared using the delay of gratification paradigm . All children were asked to choose between an immediate reward or a larger delayed ( one day ) reward . Half the children were offered an edible incentive and half a non-edible incentive . Results showed that the obese choose immediate rewards more often than normals only when the incentive was edible . This suggests that deficits in delay of gratification shown by obese children are not generalized dispositions but are specific to food . A second aspect of the study examined preference for food vs non-food items and activities . Normals showed a much stronger preference for non-food items , nutritious foods and non-food related activities than the obese . This suggests that the deficits in delay of gratification shown by the obese children for food related items may be due to the stronger incentive value of these items for them Exergames are videogames that require gross motor activity , thereby combining gaming with physical activity . This study examined the role of competitive versus cooperative exergame play on short-term changes in executive function skills , following a 10-week exergame training intervention .  Fifty-four low-income overweight and obese African American adolescents were r and omly assigned to a competitive exergame condition , a cooperative exergame condition , or a no-play control group . Youths in the competitive exergame condition improved in executive function skills more than did those in the cooperative exergame condition and the no-play control group . Weight loss during the intervention was also significantly positively correlated with improved executive function skills . The findings link competitive exergame play to beneficial cognitive outcomes for at-risk ethnic minority adolescents Background Over the last decades , a decline in motor skills and in physical activity and an increase in obesity has been observed in children . However , there is a lack of data in young children . We tested if differences in  motor skills and in physical activity  according to weight or gender were already present in 2- to 4-year-old children . Methods Fifty-eight child care centers in the French part of Switzerl and were r and omly selected for the Youp'là bouge study .  Motor skills were assessed by an obstacle course including 5 motor skills , derived from the Zurich Neuromotor Assessment test . Physical activity was measured with accelerometers ( GT1 M , Actigraph , Florida , USA ) using age-adapted cut-offs .  Weight status was assessed using the International Obesity Task Force criteria ( healthy weight vs overweight ) for body mass index ( BMI ) . Results Of the 529 children ( 49 % girls , 3.4 ± 0.6 years , BMI 16.2 ± 1.2 kg/m2 ) , 13 % were overweight . There were no significant weight status-related differences in the single skills of the obstacle course , but there was a trend ( p = 0.059 ) for a lower performance of overweight children in the overall motor skills score . No significant weight status-related  differences in child care-based physical activity  were observed . No gender-related differences were found in the overall motor skills score , but boys performed better than girls in 2 of the 5 motor skills ( p ≤ 0.04 ) . Total physical activity as well as time spent in moderate-vigorous and in vigorous activity during child care were 12 - 25 % higher and sedentary activity 5 % lower in boys compared to girls ( all p < 0.01 ) . Conclusions At this early age , there were no significant weight status- or gender-related differences in global motor skills . However , in accordance to data in older children , child care-based physical activity  was higher in boys compared to girls . These results are important to consider when establishing physical activity recommendations or targeting health promotion interventions in young children OBJECTIVE This present study examined time spent in the target heart zone ( THZ ) and its relationship to tasks requiring variable amounts of executive control function in prepubescent children participating in a 9-month r and omized controlled physical activity program .  METHODS A sample of 59 participants performed the Stroop Color-Word Test and the Comprehensive Trail Making Test cognitive assessment s.  Heart rate data were collected during participation in the physical activity program using E600 heart rate monitors ( Polar , Finl and ) . RESULTS There was a significant difference , F(1 , 58)=7.44 , p < .009 , between males and females for relative VO2max , but not absolute ( p=.69 ) or percent VO2max ( p=.73 ) . Regression analysis identified KBIT , age , and mean time above the THZ as significant predictors of performance in the  Stroop Color-Word condition , F(1 , 56)=5.21 , p=.02 . KBIT and mean time above the THZ were significant predictors for Trails B , F(1 , 56)=7.60 . CONCLUSIONS These results suggest that heart rate , as a measure of physical activity intensity , should be closely monitored during research that is intended to make inferences about its effects on cognitive performance as participation in vigorous activities may have specific benefits over lower intensities among prepubescent children OBJECTIVE Deficits in executive functioning , including working memory ( WM ) deficits , have been suggested to be important in attention-deficit/hyperactivity disorder ( ADHD ) . During 2002 to 2003 , the authors conducted a multicenter , r and omized , controlled , double-blind trial to investigate the effect of improving WM by computerized , systematic practice of WM tasks . METHOD Included in the trial were 53 children with ADHD ( 9 girls ; 15 of 53 inattentive subtype ) , aged 7 to 12 years , without stimulant medication . The compliance criterion ( > 20 days of training ) was met by 44 subjects , 42 of whom were also evaluated at follow-up 3 months later . Participants were r and omly assigned to use either the treatment computer program for training WM or a comparison program . The main outcome measure was the span-board task , a visuospatial WM task that was not part of the training program . RESULTS For the span-board task , there was a significant treatment effect both post-intervention and at follow-up . In addition , there were significant effects for secondary outcome tasks measuring verbal WM , response inhibition , and complex reasoning . Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity , both post-intervention and at follow-up . CONCLUSIONS This study shows that WM can be improved by training in children with ADHD . This training also improved response inhibition and reasoning and result ed in a reduction of the parent-rated inattentive symptoms of ADHD Objective To assess whether a physical activity intervention reduces body mass index in young children . Design Cluster r and omised controlled single blinded trial over 12 months . Setting Thirty six nurseries in Glasgow , Scotl and . Participants 545 children in their pr 
    Output:
    