Background: No review to date has evaluated the association between physical fitness and health-related quality of life (HRQoL) in healthy children and adolescents. The aims of this systematic review and meta-analysis were to examine the relationship between both cardiorespiratory fitness (CRF) and muscular fitness (MF) and HRQoL in healthy subjects under 18 years of age and to describe the dimensions of HRQoL in which these relationships are more robust. Methods: The Medline, Embase, Cochrane Library, SCIELO, SPORTDiscus and PEDro databases were systematically searched to collect observational studies that examined the relationship between CRF and HRQoL and between MF and HRQoL in participants under 18 years of age without any diagnosed medical condition. Pooled effect sizes (ES) were estimated for the associations between both CRF and MF and the various HRQoL dimensions. Results: The pooled ES (95% CI) estimates for the relationship between CRF and HRQoL were as follows: 0.19 (0.10 to 0.27) for physical well-being, 0.19 (0.07 to 0.32) for psychological well-being, 0.20 (− 0.14 to 0.55) for perceived health status, 0.10 (0.00 to 0.20) for self-perception/self-esteem, 0.07 (− 0.05 to 0.19) for quality of family relationship, 0.14 (0.04 to 0.25) for quality of peer relationship, 0.17 (0.04 to 0.29) for everyday functioning at school and 0.20 (0.12 to 0.28) for total HRQoL score. The pooled ES (95% CI) estimates for the relationship between MF and HRQoL were: 0.25 (0.12 to 0.37) for physical well-being, 0.11 (0.04 to 0.17) for psychological well-being, 0.08 (0.01 to 0.15) for quality of family relationship, 0.14 (0.03 to 0.25) for quality of peer relationship, and 0.09 (0.03 to 0.14) for total HRQoL score. Conclusions: Our data suggest that both CRF and MF are positively associated with HRQoL, mainly in physical, psychological and peer relationships. Moreover, CRF is positively associated with school dimensions and MF is positively associated with family relationships. Trail registration Protocol PROSPERO registration number: CRD42015025823.

Background: Physical activity has a beneficial effect on the brain’s development process and cognitive function. However, no review to date has evaluated the effects of active commuting to and from school (ACS) on cognitive performance and academic achievement. The aim of this systematic review and meta-analysis was to evaluate the link between ACS and cognitive performance and academic achievement in children and adolescents. Methods: We systematically searched MEDLINE, EMBASE, Web of Science and PsycINFO databases for all observational studies published until May 2019 that examined the association between ACS and cognitive performance or academic achievement. Studies were classified into two groups according to their measured outcomes: cognitive performance (nonexecutive cognitive functions, core executive functions, and metacognition) and academic achievement (marks of different areas). A pooled effect size (ES) was estimated using the DerSimonian and Laird random-effects method for cognitive performance and each area of academic achievement. Results: Twelve studies that evaluated the relationship between ACS and cognitive performance or academic achievement were included in the systematic review: four studies analyzed both cognitive performance and academic achievement, one study provided data regarding cognitive performance and seven provided data on academic achievement. Finally, nine of 12 studies provided enough data for inclusion in the meta-analysis. Our findings suggest that ACS was not significantly associated with cognitive performance (ES = −0.02; 95% CI: −0.06 to 0.03) or academic achievement (ES = −0.33; 95% CI: −0.83 to 0.17 for mathematics-related skills; ES = −0.37; 95% CI: −0.88 to 0.15 for language-related skills). Conclusions: There was insufficient evidence regarding the relationship between ACS and cognitive performance and academic achievement. Future studies should include potential confounders in their analyses and consider the use of standardized self-reports or objective measures of ACS.

Although physical activity (PA) integrated in schools’ classrooms have shown a positive effect on children’s behaviors, its effectiveness on cognitive functions, PA levels and other health variables remains unclear. This article outlines the rationale and methods of two classroom-based PA interventions (MOVI-da10!) on improving adiposity, executive function and motor competence in preschool children. A three-arm cluster-randomized controlled trial (RCT) was carried out including eight schools (rural and urban areas) from Cuenca province, Spain. The schools were allocated to one of three groups: MOVI-da10-Enriched! intervention (n = 3), MOVI-da10-Standard! intervention, (n = 2), and the control group (n = 3). Around 900 children aged 4 to 6 years old were assesed at baseline (September 2017) and at the end (June 2018) of the intervention. The primary outcomes were changes in body fat by bioimpedance, executive function and motor competence. During a school year (from October 2017 to May 2018), children belonging to the MOVI-da10-Enriched! group performed enriched PA integrated into the academic curriculum including two active breaks lasting 10 min, 5 days/week. The children belonging to the MOVI-da10-Standard! group performed PA breaks (with low cognitive demand, where curricular contents were not reinforced) including two active breaks lasting 10 min, 5 days/week. In the control group, regular PA continued. To our knowledge, MOVI-da10! is the first RCT to examine the effectiveness of two programs (enriched PA integrated into the academic curriculum and PA breaks only) versus a control group on improving adiposity, executive function and motor competence in preschool children. NCT03236363 (clinicaltrials.gov), 31st July 2017.

Previous research has studied the influence of physical fitness on academic achievement through executive functions. However, the nature of this relationship remains unclear. This study aimed to analyze how cardiorespiratory fitness (CRF) and executive functions are associated with academic achievement and to examine whether the relationship between CRF and academic achievement is mediated by executive functions in schoolchildren. This was a cross-sectional study including 570 schoolchildren, aged 8 to 11 years, from Cuenca, Spain. Data were collected from September to October 2017. Sociodemographic variables, family socioeconomic status, pubertal status, academic achievement, CRF (20-meter shuttle run test) and executive functions (inhibition, cognitive flexibility and working memory, NIH Toolbox battery in Spanish, v 1.8; iPad Pro, Apple, Inc.) were measured. Overall, ANCOVA models controlling for age, gender and mother educational level showed higher scores in language and mathematics in children in higher categories of CRF, inhibition, cognitive flexibility and working memory than in children in lower categories. The effect sizes were moderate (p < 0.05, partial eta squared: from 0.05 to 0.12). Moreover, the mediation analysis showed that inhibition partially mediated the relationship between CRF and language (c’ = 0.058; IC = [0.005; 0.028]) and mathematics (c’ = 0.064; IC = [0.005; 0.030]) grades. Similarly, cognitive flexibility mediated CRF’s relationship with language (c’ = 0.059; IC = [0.003; 0.028]) and with mathematics (c’ = 0.066; IC = [0.003; 0.029]); however, a significant relationship remained. For working memory, mediation analysis showed no significant results (c′ = 0.92; IC = [-0.002;0.025] P > 0.05 in language; c′ = 0.103; IC = [-0.002;0.029] P > 0.05 in mathematics). Mediation ranged from 13.38% to 36%. Children in higher categories of both CRF and executive function showed higher grades in mathematics and language. The findings indicated that a significant proportion of the positive influence of CRF on academic achievement was mediated by improvements in inhibition and cognitive flexibility. Thus, this study supports the hypothesis that improvements in CRF may contribute to increasing academic achievement not only through a direct mechanism but also through improvements in executive functions.

Cross-sectional study aimed to analyse differences in cognitive performance across fitness components categories (cardiorespiratory fitness [CRF], speed-agility and muscular fitness [MF]) and weight status in children, and to determine whether physical fitness mediates the association between body mass index (BMI) and cognitive performance. Fitness components and BMI were measured using standard procedures in 630 children aged 5-to-7 years from the provinces of Cuenca and Ciudad Real, Spain. BADyG was used to assess cognitive performance. We used ANCOVA models to test mean differences in cognition scores by BMI and fitness categories. Hayes’s PROCESS macro was used for mediation analyses. Children with normal weight scored better in spatial factor and general intelligence than their overweight/obese peers (p < 0.05), but differences were attenuated when controlling for CRF (p > 0.05). Children with better results in CRF and speed-agility scored better in all cognitive dimensions even after controlling for BMI (p < 0.05). Similarly, children with high MF obtained better scores in verbal factor (p < 0.05). All fitness components acted as mediators of the relationship between BMI and general intelligence (p < 0.05). These findings highlight the crucial role of fitness in minimising the negative effect of excess weight on children’s cognition. Abbreviations: BMI: Body mass index; CRF: Cardiorespiratory fitness; MF: Muscular fitness; BADyG E1: Battery of general and differential aptitudes; SES: Socioeconomic status; SD: Standard deviation; IE: Indirect effect