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Summary: Background: North–south differences in the prevalence of obesity and fitness levels have been found in European adolescents, yet it is unknown if such differences already exist in very young children. Objectives: This study aims to compare the prevalence of overweight/obesity and fitness levels in preschool children aged 4 years from Sweden (north of Europe) and Spain (south of Europe). Methods: The sample consisted of 315 Swedish and 128 Spanish preschoolers. Anthropometry (weight, height, waist circumference) and fitness (strength, speed–agility, balance and cardiorespiratory fitness) were assessed. Analysis of covariance adjusted for age, sex and height/body mass index (BMI) was used. Results: Preschool children from Sweden had lower prevalence of overweight/obesity than their peers from Spain (World Obesity Federation, mean difference, MD = −9%, P = 0.010; World Health Organization, MD = −11%, P = 0.011). Concerning fitness, preschoolers from Spain were more fit in terms of upper‐muscular strength (MD = +0.4 kg, P = 0.010), speed–agility (MD = −1.9 s, P = 0.001), balance (MD = +4.0 s, P = 0.001) and cardiorespiratory fitness (MD = boys = +6.6 laps, girls = +2.3 laps; P < 0.001 for all), yet they had worse lower‐muscular strength (MD = −7.1, P ≤ 0.001) than those from Sweden. Differences in upper‐muscular strength were largely explained by differences in BMI, and differences in cardiorespiratory fitness should be interpreted cautiously due to some methodological deviations. Conclusions: These findings suggest that a higher prevalence of overweight/obesity in Spain compared with Sweden is present already at early childhood, while differences in physical fitness components showed mixed findings. [ABSTRACT FROM AUTHOR]

The aim of the study is to investigate the association of cardiorespiratory fitness (CRF) and muscular strength indicators with gray matter volume (GMV) and to study whether fitness-related regions of GMV are associated to executive function (EF) in cognitively normal older adults. Ninety-one cognitively normal older adults (71.69 ± 3.91 years; 57.14% females) participated in this study from the AGUEDA trial. CRF was measured by a 2-km walking test and a 6-min walking test. Muscular strength was measured by handgrip, biceps curl, squats, and isokinetic strength tests. T1-weigthed images were obtained through a magnetic resonance scan. GMV was determined by voxel-based morphometric analysis. Standardized EF tests were performed. CRF did not show any positive association with GMV. Handgrip strength was positively associated with GMV (p < 0.001) in nine regions (β from 0.6 to 0.8 and k from 106 to 1927) and knee extension strength in three regions (β from 0.4 to 0.5 and k from 76 to 2776). Squats strength was negatively associated with GMV (p < 0.001) in two regions (β = -0.3, k = 1102 and k = 152) and the 2-km walking test in one region (β = -0.4, k = 99). Only handgrip strength-related GMV was associated with cognitive flexibility (p = 0.039, β = 0.215) and spatial working memory (p < 0.03, β 0.247-0.317), but not with EF score (p > 0.05). Muscular strength, but no CRF, may be positively related to GMV in cortical and subcortical regions, with implications for specific cognitive domains rather than the overall EF score. Specifically, handgrip strength was the indicator most associated with higher GMV, while squats strength and CRF were negatively related to GMV. ClinicalTrials.gov identifier: NCT05186090., (© 2024 The Author(s). Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Introduction: Patients with coronary artery disease (CAD) have a higher risk of developing cognitive impairment and mental health disorders compared to the general population. Physical exercise might improve their brain health. The overall goal of the HEART-BRAIN randomized controlled trial (RCT) is to investigate the effects of different types of exercise on brain health outcomes in patients with CAD, and the underlying mechanisms., Methods: This three-arm, single-blinded RCT will include 90 patients with CAD (50-75 years). Participants will be randomized into: (1) control group-usual care ( n  = 30), (2) aerobic high-intensity interval training (HIIT) ( n  = 30), or (3) HIIT combined with resistance exercise training ( n  = 30). The 12-week intervention includes 3 supervised sessions (45-min each) per week for the exercise groups. Outcomes will be assessed at baseline and post-intervention. The primary outcome is to determine changes in cerebral blood flow assessed by magnetic resonance imaging. Secondary outcomes include changes in brain vascularization, cognitive measures (i.e., general cognition, executive function and episodic memory), and cardiorespiratory fitness. Additional health-related outcomes, and several potential mediators and moderators will be investigated (i.e., brain structure and function, cardiovascular and brain-based biomarkers, hemodynamics, physical function, body composition, mental health, and lifestyle behavior)., Conclusion: The HEART-BRAIN RCT will provide novel insights on how exercise can impact brain health in patients with CAD and the potential mechanisms explaining the heart-brain connection, such as changes in cerebral blood flow. The results may have important clinical implications by increasing the evidence on the effectiveness of exercise-based strategies to delay cognitive decline in this high-risk population., Clinical Trial Registration: ClinicalTrials.gov, identifier [NCT06214624]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Toval, Solis-Urra, Bakker, Sánchez-Aranda, Fernández-Ortega, Prieto, Alonso-Cuenca, González-García, Martín-Fuentes, Fernandez-Gamez, Olvera-Rojas, Coca-Pulido, Bellón, Sclafani, Sanchez-Martinez, Rivera-López, Herrera-Gómez, Peñafiel-Burkhardt, López-Espinosa, Corpas-Pérez, García-Ortega, Vega-Cordoba, Barranco-Moreno, Morales-Navarro, Nieves, Caro-Rus, Amaro-Gahete, Mora-Gonzalez, Vidal-Almela, Carlén, Migueles, Erickson, Moreno-Escobar, García-Orta, Esteban-Cornejo and Ortega.)

Objective: To examine the associations between muscular strength and mental health., Design: We used baseline data of 91 cognitively healthy older adults (71.69 ± 3.91 years old, 57 % women) participating in the AGUEDA randomized controlled trial., Methods: Muscular strength was assessed using both objective (i.e., handgrip strength, biceps curl, squats, and isokinetic test) and perceived (i.e., International Fitness Scale) indicators. Psychological ill-being indicators: anxiety, depression, stress, and loneliness; and psychological well-being indicators: satisfaction with life, self-esteem, and emotional well-being) were assessed using a set of valid and reliable self-reported questionnaires. Linear regression analyses were performed adjusting for sex, age, years of education, body mass index , alcohol, diet, and smoking (model 1), and additionally by cardiorespiratory fitness (model 2)., Results: Elbow extension was positively associated with stress in model 1 ( β = 0.252, 95 % Confidence Interval [95 % CI] = 0.007 to 0.497, p = 0.044), and even after further adjustment for cardiorespiratory fitness ( β = 0.282, 95 % CI = 0.032 to 0.532, p = 0.028). Perceived strength was negatively associated with depressive symptoms in model 1 ( β = -0.271, 95 % CI = -0.491 to -0.049, p = 0.017) and model 2 reported associations tending towards significant ( β = -0.220, 95 % CI = -0.445 to 0.005, p = 0.055). Handgrip strength was positively associated with self-esteem in model 1 ( β = 0.558, 95 % CI = 0.168 to 0.949, p = 0.006) and model 2 ( β = 0.546, 95 % CI = 0.135 to 0.956, p = 0.010). No further associations were found among other muscular strength and mental health variables., Conclusion: Handgrip had a moderate association with self-esteem and there was a small association between perceived strength with depressive symptoms and elbow extension with stress. No other associations were observed between muscular strength and mental health outcomes in cognitively normal older adults., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)

Background: College students are particularly susceptible to developing mental health problems. Gamification can be a powerful teaching strategy to favor motivation and behavioral changes for the improvement of psychological well-being. Purpose: To analyze the effect of a 14-week gamification-based physical education teaching program on psychological well-being of college students. Materials and Methods: A total of 112 college students (21.22 ± 2.55 years) were recruited and assigned to a gamification-based group or a control group. The intervention group participated in a gamification-based program under the framework of "STAR WARS" science fiction sage. Participants from this group used a mobile app with a countdown timer and the way for them to gain lifetime was by doing physical activity (PA) and formative challenges. The control group did not experience the gamification approach itself as their classes were based on traditional methodology. They were asked to maintain their usual lifestyle and were not required to do PA. Emotional intelligence, personal initiative, entrepreneurial attitude, resilience, and self-efficacy were self-reported. Results: The gamification-based group showed a significantly higher improvement of emotional intelligence ( P  ≤ 0.006), personal initiative ( P  ≤ 0.033), entrepreneurial attitude ( P  < 0.001), resilience ( P  = 0.002), and self-efficacy ( P  < 0.001), compared with the control group. Overall effect sizes were of medium magnitude for emotional intelligence and personal initiative, large magnitude for entrepreneurial attitude, and small magnitude for resilience and self-efficacy. Conclusion: Gamification and the use of mobile apps may become powerful teaching strategies to motivate college students toward healthier lifestyle behaviors that have psychological well-being benefits.

Objective: The objective of this study was to examine the chronic effects of a 20-week exercise training program on device-assessed sleep and sleep-disordered breathing; and to determine whether participating in a session of the exercise program had effects on device-assessed sleep the subsequent night in children with overweight/obesity., Methods: A randomized clinical trial was conducted from November 2014 to June 2016. A total of 109 children (age 8-11 years) with overweight/obesity were randomized into an exercise training or control group. The exercise program included aerobic and resistance training 3 to 5 days/week. The control group participants continued their usual lifestyle. Device-assessed sleep outcomes were measured using wrist-worn actigraphy at baseline, in the middle of the exercise program (10th week), and at postintervention for seven consecutive days (24 h/day), and sleep-disordered breathing was measured via the Pediatric Sleep Questionnaire., Results: The exercise training program had a statistically significant effect on wake after sleep onset time (-10.8 min/day, -0.5 SDs, p = 0.040). No other chronic or acute effects (i.e., the subsequent night of attending a session of the exercise training program) were observed on the remaining sleep outcomes., Conclusions: A 20-week exercise training program reduced wake after sleep onset time in children with overweight/obesity. Future randomized trials that include a sample of children with poor sleep health at baseline are needed to better appreciate the role of exercise in sleep health., (© 2023 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.)

Background: Emerging research supports the idea that physical activity benefits brain development. However, the body of evidence focused on understanding the effects of physical activity on white matter microstructure during childhood is still in its infancy, and further well-designed randomized clinical trials are needed., Aim: This study aimed: (i) to investigate the effects of a 20-week physical activity intervention on global white matter microstructure in children with overweight or obesity, and (ii) to explore whether the effect of physical activity on white matter microstructure is global or restricted to a particular set of white matter bundles., Methods: In total, 109 children aged 8 to 11 years with overweight or obesity were randomized and allocated to either the physical activity program or the control group. Data were collected from November 2014 to June 2016, with diffusion tensor imaging (DTI) data processing and analyses conducted between June 2017 and November 2021. Images were pre-processed using the Functional Magnetic Resonance Imaging (MRI) of the Brain´s Software Library (FSL) and white matter properties were explored by probabilistic fiber tractography and tract-based spatial statistics (TBSS)., Results: Intention-to-treat analyses were performed for all children who completed the pre-test and post-test DTI assessment, with good quality DTI data ( N  = 89). Of them, 83 children (10.06±1.11 years, 39 % girls, intervention group=44) met the per-protocol criteria (attended at least 70 % of the recommended sessions). Our probabilistic fiber tractography analysis did not show any effects in terms of global and tract-specific fractional anisotropy (FA) and mean diffusivity (MD) in the per-protocol or intention-to-treat analyses. Additionally, we did not observe any effects on the voxel-wise DTI parameters (i.e., FA and MD) using the most restricted TBSS approach (i.e., per protocol analyses and p-corrected image with a statistical threshold of p  < 0.05). In the intention-to-treat analysis, we found that our physical activity program had a borderline effect ( p -corrected image with a statistical threshold of p  < 0.1) on 7 different clusters, including a cluster in the corpus callosum., Conclusion: We conclude that a 20-week physical activity intervention was not enough to induce changes in global and tract-specific white matter during childhood. The effects of physical activity on white matter microstructure could be restricted to local changes in several white matter tracts (e.g., the body of the corpus callosum). However, our results were not significant, and more interventions are needed to determine whether and how physical activity affects white matter microstructure during childhood., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Objective: To investigate whether a 20-week aerobic and resistance exercise program induces changes in brain current density underlying working memory and inhibitory control in children with overweight/obesity., Methods: A total of 67 children (10.00 ± 1.10 years) were randomized into an exercise or control group. Electroencephalography (EEG)-based current density (μA/mm 2 ) was estimated using standardized low-resolution brain electromagnetic tomography (sLORETA) during a working memory task (Delayed non-matched-to-sample task, DNMS) and inhibitory control task (Modified flanker task, MFT). In DNMS, participants had to memorize four stimuli (Pokemons) and then select between two of them, one of which had not been previously shown. In MFT, participants had to indicate whether the centered cow (i.e., target) of five faced the right or left., Results: The exercise group had significantly greater increases in brain activation in comparison with the control group during the encoding phase of DNMS, particularly during retention of second stimuli in temporal and frontal areas (peak t = from 3.4 to 3.8, cluster size [k] = from 11 to 39), during the retention of the third stimuli in frontal areas (peak t = from 3.7 to 3.9, k = from 15 to 26), and during the retention of the fourth stimuli in temporal and occipital areas (peak t = from 2.7 to 4.3, k = from 13 to 101). In MFT, the exercise group presented a lower current density change in the middle frontal gyrus (peak t = -4.1, k = 5). No significant change was observed between groups for behavioral performance (p ≥ 0.05)., Conclusion: A 20-week exercise program modulates brain activity which might provide a positive influence on working memory and inhibitory control in children with overweight/obesity., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Background: We previously demonstrated that a heuristic (i.e., evidence-based, rounded yet practical) cadence threshold of ≥ 100 steps/min was associated with absolutely-defined moderate intensity physical activity (i.e., ≥ 3 metabolic equivalents [METs]) in older adults 61-85 years of age. Although it was difficult to ascertain achievement of absolutely-defined vigorous (6 METs) intensity, ≥ 130 steps/min was identified as a defensible threshold for this population. However, little evidence exists regarding cadence thresholds and relatively-defined moderate intensity indicators, including ≥ 64% heart rate [HR] maximum [HR max = 220-age], ≥ 40% HR reserve [HRR = HR max -HR resting ], and ≥ 12 Borg Scale Rating of Perceived Exertion [RPE]; or vigorous intensity indicators including ≥ 77%HR max , ≥ 60%HRR, and ≥ 14 RPE., Purpose: To analyze the relationship between cadence and relatively-defined physical activity intensity and identify relatively-defined moderate and vigorous heuristic cadence thresholds for older adults 61-85 years of age., Methods: Ninety-seven ostensibly healthy adults (72.7 ± 6.9 years; 49.5% women) completed up to nine 5-min treadmill walking bouts beginning at 0.5 mph (0.8 km/h) and progressing by 0.5 mph speed increments (with 2-min rest between bouts). Directly-observed (and video-recorded) steps were hand-counted, HR was measured using a chest-strapped monitor, and in the final minute of each bout, participants self-reported RPE. Segmented mixed model regression and Receiver Operating Characteristic (ROC) curve analyses identified optimal cadence thresholds associated with relatively-defined moderate (≥ 64%HR max , ≥ 40%HRR, and ≥ 12 RPE) and vigorous (≥ 77%HR max , ≥ 60%HRR, and ≥ 14 RPE) intensities. A compromise between the two analytical methods, including Youden's Index (a sum of sensitivity and specificity), positive and negative predictive values, and overall accuracy, yielded final heuristic cadences., Results: Across all relatively-defined moderate intensity indicators, segmented regression models and ROC curve analyses identified optimal cadence thresholds ranging from 105.9 to 112.8 steps/min and 102.0-104.3 steps/min, respectively. Comparable values for vigorous intensity indicators ranged between126.1-132.1 steps/min and 106.7-116.0 steps/min, respectively. Regardless of the relatively-defined intensity indicator, the overall best heuristic cadence threshold aligned with moderate intensity was ≥ 105 steps/min. Vigorous intensity varied between ≥ 115 (greater sensitivity) or ≥ 120 (greater specificity) steps/min., Conclusions: Heuristic cadence thresholds align with relatively-defined intensity indicators and can be useful for studying and prescribing older adults' physiological response to, and/or perceived experience of, ambulatory physical activity., Trial Registration: Clinicaltrials.gov NCT02650258. Registered 24 December 2015., (© 2023. The Author(s).)

We investigated the interaction between a genetic score and an exercise intervention on brain health in children with overweight/obesity. One hundred one children with overweight/obesity (10.0 ± 1.5 yr, 59% girls) were randomized into a 20-wk combined exercise intervention or a control group. Several cognitive and academic outcomes were measured with validated tests. Hippocampal volume was quantified using magnetic resonance imaging. Six brain health-related polymorphisms [rs6265 ( BDNF ), rs2253206 ( CREB1 ), rs2289656 ( NTRK2 ), rs4680 ( COMT ), rs429358, and rs7412 ( APOE )] were genotyped. Cognitive flexibility and academic skills improved significantly more in the exercise than in the control group only in the children with a "favorable" genetic profile [mean z -score, 0.41-0.67 (95% CI 0.11 to 1.18)], yet not in those with "less favorable" genetic profile. An individual response analysis showed that children responded to exercise in cognitive flexibility only in the "genetically favorable" group [i.e., 62% of them had a meaningful (≥0.2 Cohen d ) increase in the exercise group compared with only 25% in the control group]. This finding was consistent in per-protocol and intention-to-treat analyses ( P = 0.01 and P = 0.03, respectively). The results were not significant or not consistent for the rest of outcomes studied. Our findings suggest that having a more favorable genetic profile makes children with overweight/obesity more responsive to exercise, particularly for cognitive flexibility. NEW & NOTEWORTHY Interindividual differences have been reported in brain health-related outcomes in response to exercise interventions in adults, which could be partially explained by genetic background differences. However, the role of genetic polymorphisms on brain health-related outcomes in response to exercise interventions remains unexplored in pediatric population. The current study in children with overweight/obesity showed that a genetic score composed of six brain health-related polymorphisms ( BDNF , CREB1 , NTRK2 , COMT , and APOE ) regulated the exercise-induced response on several brain health outcomes, yet mainly and more consistently on cognitive flexibility.

Alzheimer's disease is currently the leading cause of dementia and one of the most expensive, lethal and severe diseases worldwide. Age-related decline in executive function is widespread and plays a key role in subsequent dementia risk. Physical exercise has been proposed as one of the leading non-pharmaceutical approaches to improve executive function and ameliorate cognitive decline. This single-site, two-arm, single-blinded, randomized controlled trial (RCT) will include 90 cognitively normal older adults, aged 65-80 years old. Participants will be randomized to a 24-week resistance exercise program (3 sessions/week, 60 min/session, n = 45), or a wait-list control group ( n = 45) which will be asked to maintain their usual lifestyle. All study outcomes will be assessed at baseline and at 24-weeks after the exercise program, with a subset of selected outcomes assessed at 12-weeks. The primary outcome will be indicated by the change in an executive function composite score assessed with a comprehensive neuropsychological battery and the National Institutes of Health Toolbox Cognition Battery. Secondary outcomes will include changes in brain structure and function and amyloid deposition, other cognitive outcomes, and changes in molecular biomarkers assessed in blood, saliva, and fecal samples, physical function, muscular strength, body composition, mental health, and psychosocial parameters. We expect that the resistance exercise program will have positive effects on executive function and related brain structure and function, and will help to understand the molecular, structural, functional, and psychosocial mechanisms involved., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Solis-Urra, Molina-Hidalgo, García-Rivero, Costa-Rodriguez, Mora-Gonzalez, Fernandez-Gamez, Olvera-Rojas, Coca-Pulido, Toval, Bellón, Sclafani, Martín-Fuentes, Triviño-Ibañez, de Teresa, Huang, Grove, Hillman, Kramer, Catena, Ortega, Gómez-Río, Erickson and Esteban-Cornejo.)

Background: Walking cadence (steps/min) has emerged as a valid proxy of physical activity intensity, with consensus across numerous laboratory-based treadmill studies that ≥100 steps/min approximates absolutely defined moderate intensity (≥3 metabolic equivalents; METs). We recently reported that this cadence threshold had a classification accuracy of 73.3% for identifying moderate intensity during preferred pace overground walking in young adults. The purpose of this study was to evaluate and compare the performance of a cadence threshold of ≥100 steps/min for correctly classifying moderate intensity during overground walking in middle- and older-aged adults., Methods: Participants (N = 174, 48.3% female, 41-85 years of age) completed laboratory-based cross-sectional study involving an indoor 5-min overground walking trial at their preferred pace. Steps were manually counted and converted to cadence (total steps/5 min). Intensity was measured using indirect calorimetry and expressed as METs. Classification accuracy (sensitivity, specificity, accuracy) of a cadence threshold of ≥100 steps/min to identify individuals walking at ≥3 METs was calculated., Results: The ≥100 steps/min threshold demonstrated accuracy of 74.7% for classifying moderate intensity. When comparing middle- vs. older-aged adults, similar accuracy (73.4% vs. 75.8%, respectively) and specificity (33.3% vs. 34.5%) were observed. Sensitivity was high, but was lower for middle- vs. older-aged adults (85.2% vs. 93.9%, respectively)., Conclusion: A cadence threshold of ≥100 steps/min accurately identified moderate-intensity overground walking. Furthermore, accuracy was similar when comparing middle- and older-aged adults. These findings extend our previous analysis in younger adults and confirm the appropriateness of applying this cadence threshold across the adult lifespan., (© 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

ABSTRACT Neurotrophic factors and cardiorespiratory fitness are both considered important in developmental trajectories but their link to brain health remains poorly understood. The aims of the study were to examine whether levels of plasma-derived neurotrophic factors were associated with brain health indicators in children with overweight or obesity; and to test whether these associations were moderated by cardiorespiratory fitness. 100 children (41% girls) were included in this analysis. Plasma levels of brain-derived neurotrophic factor, insulin-like growth factor-1, vascular endothelial growth factor A, and epidermal growth factor were determined by XMap technology. Academic performance and executive function were assessed using validated neuropsychological tests. Hippocampal volume was measured using magnetic resonance imaging. Cardiorespiratory fitness was assessed using the 20-m Shuttle Run Test. Insulin-like growth factor-1 was positively associated with cognitive flexibility. Stratified analyses by fitness categories (i.e. unfit vs. fit) showed that brain-derived neurotrophic factor was positively associated with right posterior hippocampal volume in fit children, and epidermal growth factor was negatively associated with right hippocampal, and right anterior hippocampal volumes in their unfit peers, with a moderating role of cardiorespiratory fitness in these associations. However, all these significant associations disappeared after correction for multiple comparisons. The association between neurotrophic factors and brain health indicators in children with overweight/obesity was neither strong nor consistent. These results could help enhance our understanding of determinants of brain health in children with overweight/obesity. Highlights This study provides novel findings on the associations between neurotrophic factors and a wide range of brain health indicators in children.This study additionally explored the role of cardiorespiratory fitness in these associations.The association between neurotrophic factors and brain health in children with overweight/obesity was neither strong nor consistent.Cardiorespiratory fitness moderated the associations of brain-derived neurotrophic factor and epidermal growth factor with right hippocampal volume.

Objective: We investigated the association of anthropometric neonatal data (birth length and birth weight) and breastfeeding practices (exclusive and any breastfeeding) with hippocampal functional connectivity and its academic implication in children with overweight/obesity., Methods: Ninety six children with overweight/obesity aged 8-11 years (10.01 ± 1.14), from the ActiveBrains project were included in this cross-sectional study. Anthropometric neonatal data were collected from birth records, whereas breastfeeding practices were reported by parents. A 3.0 Tesla Siemens Magnetom Tim Trio system was used to acquire T1-weighted and resting-state functional magnetic resonance images. Academic performance was assessed by the Woodcock-Muñoz standardized test. Hippocampal seed-based methods with post-hoc regression analyses were performed. Analyses were considered significant when surpassing Family-Wise Error corrections., Results: Birth weight showed a positive association with the connectivity between the hippocampus and the pre- and postcentral gyri, and the cerebellum. In addition, breastfeeding was negatively associated with the connectivity between the hippocampus and the primary motor cortex and the angular gyrus. Any breastfeeding, in turn, showed a positive association with the connectivity between the hippocampus and the middle temporal gyrus. None of the connectivity outcomes related to early life factors was coupled with better academic abilities (all p > 0.05)., Conclusions: Our findings suggest that birth weight at birth and breastfeeding are associated with hippocampal connectivity in children with overweight/obesity. Despite this, how the results relate to academic performance remains a matter of speculation. Our findings suggest that clinicians should recognize the importance early life factors for potentially avoiding consequences on offspring's brain development., (© 2022 World Obesity Federation.)

Background: There is a need to promote initiatives toward reaching more active and healthier lifestyles. Gamification has emerged among teachers as a powerful teaching strategy that favors students' motivation and behavioral change by applying game elements in nongame contexts. Purpose: To examine the effects of a 14-week gamification-based teaching program, including the use of a game-based mobile app on body composition in college students. Materials and Methods: One hundred twelve college students (21.22 ± 2.55 years) were assigned to a gamification-based group or a control group. College students from the intervention group participated in a gamification program under the narrative of "STAR WARS" and had a mobile app with a countdown timer. They had to meet physical activity recommendations to gain lifetime (i.e., sum time to the countdown). A portable eight-polar bioelectrical impedance analysis was used to obtain body composition outcomes; height (cm) was measured with a stadiometer; and waist circumference (cm) was measured using a metric tape. Body mass index (BMI), muscle mass index, fat mass index, and body fat percentage were computed. Results: Participants from the gamification program reported a significantly lower BMI, waist circumference, fat mass index and body fat percentage after the intervention, in comparison with the control group, indicated by an effect size ranging from -0.23 to -0.11 (all P  ≤ 0.043). Conclusion: Gamification and the use of interactive mobile app are powerful teaching strategies in higher education to motivate students toward healthier lifestyles that lead to body composition benefits.

Background: Standardized validation indices (i.e., accuracy, bias, and precision) provide a comprehensive comparison of step counting wearable technologies., Purpose: To expand a previously published child/youth catalog of validity indices to include adults (21-40, 41-60 and 61-85 years of age) assessed across a range of treadmill speeds (slow [0.8-3.2 km/h], normal [4.0-6.4 km/h], fast [7.2-8.0 km/h]) and device wear locations (ankle, thigh, waist, and wrist)., Methods: Two hundred fifty-eight adults (52.5 ± 18.7 years, 49.6% female) participated in this laboratory-based study and performed a series of 5-min treadmill bouts while wearing multiple devices; 21 devices in total were evaluated over the course of this multi-year cross-sectional study (2015-2019). The criterion measure was directly observed steps. Computed validity indices included accuracy (mean absolute percentage error, MAPE), bias (mean percentage error, MPE), and precision (correlation coefficient, r; standard deviation, SD; coefficient of variation, CoV)., Results: Over the range of normal speeds, 15 devices (Actical, waist-worn ActiGraph GT9X, activPAL, Apple Watch Series 1, Fitbit Ionic, Fitbit One, Fitbit Zip, Garmin vivoactive 3, Garmin vivofit 3, waist-worn GENEActiv, NL-1000, PiezoRx, Samsung Gear Fit2, Samsung Gear Fit2 Pro, and StepWatch) performed at < 5% MAPE. The wrist-worn ActiGraph GT9X displayed the worst accuracy across normal speeds (MAPE = 52%). On average, accuracy was compromised across slow walking speeds for all wearable technologies (MAPE = 40%) while all performed best across normal speeds (MAPE = 7%). When analyzing the data by wear locations, the ankle and thigh demonstrated the best accuracy (both MAPE = 1%), followed by the waist (3%) and the wrist (15%) across normal speeds. There were significant effects of speed, wear location, and age group on accuracy and bias (both p < 0.001) and precision (p ≤ 0.045)., Conclusions: Standardized validation indices cataloged by speed, wear location, and age group across the adult lifespan facilitate selecting, evaluating, or comparing performance of step counting wearable technologies. Speed, wear location, and age displayed a significant effect on accuracy, bias, and precision. Overall, reduced performance was associated with very slow walking speeds (0.8 to 3.2 km/h). Ankle- and thigh-located devices logged the highest accuracy, while those located at the wrist reported the worst accuracy., Trial Registration: Clinicaltrials.gov NCT02650258. Registered 24 December 2015., (© 2022. The Author(s).)

Importance: Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences., Objectives: To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise., Design, Setting, and Participants: All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses., Interventions: All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting., Main Outcomes and Measures: Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging., Results: The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, -0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, -0.17 [95% CI, -0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, -0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, -0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls., Conclusions and Relevance: In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified., Trial Registration: ClinicalTrials.gov Identifier: NCT02295072.

Background: Heuristic (i.e., evidence-based, rounded) cadences of ≥100 and ≥ 130 steps/min have consistently corresponded with absolutely-defined moderate (3 metabolic equivalents [METs]) and vigorous (6 METs) physical activity intensity, respectively, in adults 21-60 years of age. There is no consensus regarding similar thresholds in older adults., Purpose: To provide heuristic cadence thresholds for 3, 4, 5, and 6 METs in 61-85-year-old adults., Methods: Ninety-eight community-dwelling ambulatory and ostensibly healthy older adults (age = 72.6 ± 6.9 years; 49% women) walked on a treadmill for a series of 5-min bouts (beginning at 0.5 mph with 0.5 mph increments) in this laboratory-based cross-sectional study until: 1) transitioning to running, 2) reaching ≥75% of their age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed and hand-tallied. Intensity (oxygen uptake [VO 2 ] mL/kg/min) was assessed with indirect calorimetry and converted to METs (1 MET = 3.5 mL/kg/min). Cadence thresholds were identified via segmented mixed effects model regression and using Receiver Operating Characteristic (ROC) curves. Final heuristic cadence thresholds represented an analytical compromise based on classification accuracy (sensitivity, specificity, positive and negative predictive value, and overall accuracy)., Results: Cadences of 103.1 (95% Prediction Interval: 70.0-114.2), 116.4 (105.3-127.4), 129.6 (118.6-140.7), and 142.9 steps/min (131.8-148.4) were identified for 3, 4, 5, and 6 METs, respectively, based on the segmented regression. Comparable values based on ROC analysis were 100.3 (95% Confidence Intervals: 95.7-103.1), 111.5 (106.1-112.9), 116.0 (112.4-120.2), and 128.6 steps/min (128.3-136.4). Heuristic cadence thresholds of 100, 110, and 120 were associated with 3, 4, and 5 METs. Data to inform a threshold for ≥6 METs was limited, as only 6/98 (6.0%) participants achieved this intensity., Conclusions: Consistent with previous data collected from 21-40 and 41-60-year-old adults, heuristic cadence thresholds of 100, 110, and 120 steps/min were associated with 3, 4, and 5 METs, respectively, in 61-85-year-old adults. Most older adults tested did not achieve the intensity of ≥6 METs; therefore, our data do not support establishing thresholds corresponding with this intensity level., Trial Registration: Clinicaltrials.gov NCT02650258 . Registered 24 December 2015., (© 2021. The Author(s).)

Background: Wearable technologies play an important role in measuring physical activity (PA) and promoting health. Standardized validation indices (i.e., accuracy, bias, and precision) compare performance of step counting wearable technologies in young people., Purpose: To produce a catalog of validity indices for step counting wearable technologies assessed during different treadmill speeds (slow [0.8-3.2 km/h], normal [4.0-6.4 km/h], fast [7.2-8.0 km/h]), wear locations (waist, wrist/arm, thigh, and ankle), and age groups (children, 6-12 years; adolescents, 13-17 years; young adults, 18-20 years)., Methods: One hundred seventeen individuals (13.1 ± 4.2 years, 50.4% female) participated in this cross-sectional study and completed 5-min treadmill bouts (0.8 km/h to 8.0 km/h) while wearing eight devices (Waist: Actical, ActiGraph GT3X+, NL-1000, SW-200; Wrist: ActiGraph GT3X+; Arm: SenseWear; Thigh: activPAL; Ankle: StepWatch). Directly observed steps served as the criterion measure. Accuracy (mean absolute percentage error, MAPE), bias (mean percentage error, MPE), and precision (correlation coefficient, r; standard deviation, SD; coefficient of variation, CoV) were computed., Results: Five of the eight tested wearable technologies (i.e., Actical, waist-worn ActiGraph GT3X+, activPAL, StepWatch, and SW-200) performed at < 5% MAPE over the range of normal speeds. More generally, waist (MAPE = 4%), thigh (4%) and ankle (5%) locations displayed higher accuracy than the wrist location (23%) at normal speeds. On average, all wearable technologies displayed the lowest accuracy across slow speeds (MAPE = 50.1 ± 35.5%), and the highest accuracy across normal speeds (MAPE = 15.9 ± 21.7%). Speed and wear location had a significant effect on accuracy and bias (P < 0.001), but not on precision (P > 0.05). Age did not have any effect (P > 0.05)., Conclusions: Standardized validation indices focused on accuracy, bias, and precision were cataloged by speed, wear location, and age group to serve as important reference points when selecting and/or evaluating device performance in young people moving forward. Reduced performance can be expected at very slow walking speeds (0.8 to 3.2 km/h) for all devices. Ankle-worn and thigh-worn devices demonstrated the highest accuracy. Speed and wear location had a significant effect on accuracy and bias, but not precision., Trial Registration: Clinicaltrials.gov NCT01989104 . Registered November 14, 2013., (© 2021. The Author(s).)

The present study aims (i) to examine the association of physical fitness components (i.e., cardiorespiratory fitness, speed-agility, and muscular fitness) with brain current source density during working memory; and (ii) to examine whether fitness-related current density was associated to working memory performance and academic achievement. Eighty-five children with overweight/obesity aged 8-11 years participated in this cross-sectional study. Physical fitness components were assessed using the ALPHA test battery. Electroencephalography recordings were performed during a Delayed Non-Match-to-Sample task that assessed working memory. Brain source analysis was carried out using sLORETA to estimate regional current source density differences between high and low (H-L) working memory loads. Academic achievement was measured by the Spanish version of the Woodcock-Johnson III test battery. The main results showed that higher cardiorespiratory fitness was associated with higher H-L current density differences in frontal, limbic, and occipital regions during encoding and maintenance task's phases (β≥0.412, p ≤ 0.019). A limbic area was further related to better working memory performance (β=0.267, p = 0.005). During retrieval, higher cardiorespiratory fitness was also associated with higher current density in temporal regions (β=0.265, p = 0.013), whereas lower muscular fitness was associated with higher current density in frontal regions (β=-0.261, p = 0.016). Our results suggest that cardiorespiratory fitness, but not speed-agility nor muscular fitness, is positively associated with brain current source density during working memory processes in children with overweight/obesity. Fitness-related current density differences in limbic regions were associated with better working memory., (© 2020 John Wiley & Sons Ltd.)

This study aimed to analyze the associations of activity-rest pattern indicators with academic achievement, executive function, and intelligence and to explore whether these associations are mediated by the total gray matter volume among children with overweight/obesity. Ninety-five children (10 ± 1 year, 37 girls) with overweight/obesity (based on the World Obesity Federation body mass index cutoff points) were included in this cross-sectional study. Hip- and wrist-worn ActiGraph GT3X + accelerometers were used to assess the activity-rest pattern. Interdaily stability (IS), intradaily variability (IV), the mean value of the lowest 5 hours (L5), and the mean value of the maximum 10 hours (M10) of activity and their respective timing (TL5, TM10) were used as indicators of the activity-rest pattern throughout the day. Chronotype and social jetlag were used as indicators of circadian preference. Academic achievement, executive function, and intelligence were assessed with standardized tests. Gray matter volume was acquired by magnetic resonance imaging (MRI). IS was positively associated with executive function (β = 0.244, P = .014). IV was negatively associated with mathematics and academic applications (β: -0.211 to -0.238, P's ≤ .026). Later TM10 in the day was related to lower writing, academic skills, and intelligence (β: -0.229 to -0.271, P's ≤ .025). None of the associations found were mediated by gray matter volume. A non-fragmented and stable activity-rest pattern and earlier physical activity in the day were associated with better academic achievement, executive function, and intelligence in children with overweight/obesity. Further studies are required to corroborate or contrast our findings., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Heuristic cadence (steps/min) thresholds of ≥100 and ≥ 130 steps/min correspond with absolutely-defined moderate (3 metabolic equivalents [METs]; 1 MET = 3.5 mL O 2 ·kg - 1 ·min - 1 ) and vigorous (6 METs) intensity, respectively. Scarce evidence informs cadence thresholds for relatively-defined moderate (≥ 64% heart rate maximum [HR max  = 220-age], ≥ 40%HR reserve [HRR = HR max -HR resting , and ≥ 12 Rating of Perceived Exertion [RPE]); or vigorous intensity (≥ 77%HR max , ≥ 60%HRR, and ≥ 14 RPE)., Purpose: To identify heuristic cadence thresholds corresponding with relatively-defined moderate and vigorous intensity in 21-60-year-olds., Methods: In this cross-sectional study, 157 adults (40.4 ± 11.5 years; 50.6% men) completed up to twelve 5-min treadmill bouts, beginning at 0.5 mph and increasing by 0.5 mph. Steps were directly observed, HR was measured with chest-worn monitors, and RPE was queried in the final minute of each bout. Segmented mixed model regression and Receiver Operating Characteristic (ROC) curve analyses identified optimal cadence thresholds, stratified by age (21-30, 31-40, 41-50, and 51-60 years). Reconciliation of the two analytical models, including trade-offs between sensitivity, specificity, positive and negative predictive values, and overall accuracy, yielded final heuristic cadences., Results: Across all moderate intensity indicators, the segmented regression models estimated optimal cadence thresholds ranging from 123.8-127.5 (ages 21-30), 121.3-126.0 (ages 31-40), 117.7-122.7 (ages 41-50), and 113.3-116.1 steps/min (ages 51-60). Corresponding values for vigorous intensity were 140.3-144.1, 140.2-142.6, 139.3-143.6, and 131.6-132.8 steps/min, respectively. ROC analysis estimated chronologically-arranged age groups' cadence thresholds ranging from 114.5-118, 113.5-114.5, 104.6-112.9, and 103.6-106.0 across all moderate intensity indicators, and 127.5, 121.5, 117.2-123.2, and 113.0 steps/min, respectively, for vigorous intensity., Conclusions: Heuristic cadence thresholds corresponding to relatively-defined moderate intensity for the chronologically-arranged age groups were ≥ 120, 120, 115, and 105 steps/min, regardless of the intensity indicator (i.e., % HR max , %HRR, or RPE). Corresponding heuristic values for vigorous intensity indicators were ≥ 135, 130, 125, and 120 steps/min. These cadences are useful for predicting/programming intensity aligned with age-associated differences in physiological response to, and perceived experiences of, moderate and/or vigorous intensity., Trial Registration: Clinicaltrials.gov NCT02650258 . Registered 24 December 2015.

Background: Children with overweight/obesity have poorer sleep and smaller gray matter volume (GMV) than normal-weight children. No studies have investigated the associations of objectively-assessed sleep and GMV in children with overweight/obesity, or their implications for academic and cognitive outcomes., Objectives: To explore the associations of sleep behaviors with GMV in the whole brain and particularly the hippocampus as a region of interest independent of sedentary time (SED) and physical activity; and to assess whether GMV in the associated regions was related to academic achievement, executive function and intelligence quotient (IQ)., Methods: Ninety-six children with overweight/obesity (10 ± 1 year) were included. Sleep behaviors were assessed with accelerometers. GMV was acquired by magnetic resonance imaging. Academic achievement, executive function and IQ were assessed with separate tests. Analyses were adjusted for sex, peak height velocity and parent education as well as SED and physical activity., Results: Earlier wake time, less time in bed, wakening after sleep onset (WASO) and WASO occurrences were associated with higher GMV in eight cortical brain regions (k:56-448, P's < .001). Longer total sleep time, higher sleep efficiency and less WASO time were associated with higher GMV in the right hippocampus (β:0.187-0.220, P's < .05). The inferior temporal, fusiform, supramarginal, and postcentral gyri, the superior parietal cortex, precuneus and hippocampus associated with academic achievement and/or IQ. Associations remained after adjustments for SED and physical activity., Conclusions: Sleep behaviors are associated with GMV in multiple cortical regions including the right hippocampus in children with overweight/obesity, which in turn, were associated with academic achievement and IQ., (© 2020 World Obesity Federation.)

Background: In younger adults (i.e., those < 40 years of age) a walking cadence of 100 steps/min is a consistently supported threshold indicative of absolutely-defined moderate intensity ambulation (i.e., ≥ 3 metabolic equivalents; METs). Less is known about the cadence-intensity relationship in adults of middle-age., Purpose: To establish heuristic (i.e., evidence-based, practical, rounded) cadence thresholds for absolutely-defined moderate (3 METs) and vigorous (6 METs) intensity in adults 41 to 60 years of age., Methods: In this cross-sectional study, 80 healthy adults of middle-age (10 men and 10 women representing each 5-year age-group between 41 to 60 years; body mass index = 26.0 ± 4.0 kg/m 2 ) walked on a treadmill for 5-min bouts beginning at 0.5 mph and increasing in 0.5 mph increments. Performance termination criteria included: 1) transitioning to running, 2) reaching 75% of age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed (i.e., hand tallied). Intensity (i.e., oxygen uptake [VO 2 ] mL/kg/min) was assessed with an indirect calorimeter and converted to METs (1 MET = 3.5 mL/kg/min). A combination of segmented regression and Receiver Operating Characteristic (ROC) modeling approaches was used to identify optimal cadence thresholds. Final heuristic thresholds were determined based on an evaluation of classification accuracy (sensitivity, specificity, positive and negative predictive value, overall accuracy)., Results: The regression model identified 101.7 (95% Predictive Interval [PI]: 54.9-110.6) and 132.1 (95% PI: 122.0-142.2) steps/min as optimal cadence thresholds for 3 METs and 6 METs, respectively. Corresponding values based on ROC models were 98.5 (95% Confidence Intervals [CI]: 97.1-104.9) and 117.3 (95% CI: 113.1-126.1) steps/min. Considering both modeling approaches, the selected heuristic thresholds for moderate and vigorous intensity were 100 and 130 steps/min, respectively., Conclusions: Consistent with our previous report in 21 to 40-year-old adults, cadence thresholds of 100 and 130 steps/min emerged as heuristic values associated with 3 and 6 METs, respectively, in 41 to 60-year-old adults. These values were selected based on their utility for public health messaging and on the trade-offs in classification accuracy parameters from both statistical methods. Findings will need to be confirmed in older adults and in free-living settings.

Molina-Garcia, P, Mora-Gonzalez, J, Migueles, JH, Rodriguez-Ayllon, M, Esteban-Cornejo, I, Cadenas-Sanchez, C, Plaza-Florido, A, Gil-Cosano, JJ, Pelaez-Perez, MA, Garcia-Delgado, G, Vanrenterghem, J, and Ortega, FB. Effects of exercise on body posture, functional movement, and physical fitness in children with overweight/obesity. J Strength Cond Res 34(8): 2146-2155, 2020-This study aims to analyze whether a 13-week exercise program based on "movement quality" and "multi-games" can lead to simultaneous benefits to body posture, fundamental movements, and physical fitness of children with overweight/obesity. A total of 64 children (10.9 ± 1.3 years, 25.9 ± 3.8 kg·m, 38 girls and 26 boys) with overweight/obesity were assigned either to a 13-week exercise-based intervention group (IG) (n = 33) or to a control group (CG) (n = 31). Subjects underwent assessments of basic anthropometry (body mass and height), body posture (2-dimensional photogrammetry), fundamental movements (Functional Movement Screen), and physical fitness (1 repetition maximum [1RM] arm and leg press, and ALPHA test battery). After the exercise program, the IG reduced lower limb angle (high effect size: -0.82 SDs; p = 0.001) and plumb-tragus distance (low effect: -0.43 SDs; p = 0.002) in the sagittal plane and increased lower limb angle in the frontal plane (high effect: 0.82 SDs; p = 0.003) compared with the CG. The IG improved their performance in deep squat (p = 0.004), active straight leg raise (p < 0.001), 1RM arm (low effect: 0.46 SDs; p = 0.002), handgrip strength (medium effect: 0.53 SDs; p < 0.001), and standing long jump (medium effect: 0.59 SDs; p = 0.003), all compared with the CG. In conclusion, children with overweight/obesity who participated in our 13-week exercise program developed a better alignment of the head and lower limb, improved their performance in fundamental movements, and experienced global muscular strength gains compared with the peers who continued with their usual lives. Among other potential implications, these improvements could contribute to the prevention of musculoskeletal disorders associated with childhood obesity and could increase adherence by positioning these children in a better physical status to keep practicing exercise.

Background: Childhood obesity is known to negatively impact body posture with severe consequences for the musculoskeletal system. Physical performance could play a positive role in the body posture conformation of these children, but there is little evidence to date., Research Question: Is physical performance (i.e., physical fitness and functional movement) associated with a better body posture in children with overweight/obesity (OW/OB)? If so, is physical performance more determinant than their obesity degree in the body posture conformation?, Method: A total of 62 children with OW/OB (10.86 ± 1.25 years, 58 % girls) were included. BMI, physical fitness components (one-repetition-maximum (1RM) arms and leg press, and ALPHA test battery), functional movement quality (Functional Movement Screen™) and body posture (two-dimensional photogrammetry) were evaluated., Results: Physical fitness components and functional movement were overall associated with a more aligned posture of the head, lumbar and thoracic spines and lower limb. BMI was associated with head protraction, thoracic hyperkyphosis, lumbar hyperlordosis and lower limb valgus. BMI was the best predictor of head and lumbar spine posture, cardiorespiratory fitness of lower limb posture in frontal plane, speed-agility of lower limb posture in the sagittal plane and functional movement of thoracic spine., Significance: Our findings reveal that physical fitness and functional movement are associated with a better global body posture in children with OW/OB, and that in some musculoskeletal structures are even better predictors than their obesity degree., (Copyright © 2020. Published by Elsevier B.V.)