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BACKGROUND: Maternal essential fatty acid status declines during pregnancy, and as a result, neonatal concentrations of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) may not be optimal. OBJECTIVE: Our objective was to improve maternal and neonatal fatty acid status by supplementing pregnant women with a combination of alpha-linolenic acid (ALA, 18:3n-3) and linoleic acid (LA, 18:2n-6), the ultimate dietary precursors of DHA and AA, respectively. DESIGN: From week 14 of gestation until delivery, pregnant women consumed daily 25 g margarine supplying either 2.8 g ALA + 9.0 g LA (n = 29) or 10.9 g LA (n = 29). Venous blood was collected for plasma phospholipid fatty acid analyses at weeks 14, 26, and 36 of pregnancy, at delivery, and at 32 wk postpartum. Umbilical cord blood and vascular tissue samples were collected to study neonatal fatty acid status also. Pregnancy outcome variables were assessed. RESULTS: ALA+LA supplementation did not prevent decreases in maternal DHA and AA concentrations during pregnancy and, compared with LA supplementation, did not increase maternal and neonatal DHA concentrations but significantly increased eicosapentaenoic acid (20:5n-3) and docosapentaenoic acid (22:5n-3) concentrations. In addition, ALA+LA supplementation lowered neonatal AA status. No significant differences in pregnancy outcome variables were found. CONCLUSIONS: Maternal ALA+LA supplementation did not promote neonatal DHA+AA status. The lower concentrations of Osbond acid (22:5n-6) in maternal plasma phospholipids and umbilical arterial wall phospholipids with ALA+LA supplementation than with LA supplementation suggest only that functional DHA status improves with ALA+LA supplementation. Copyright © 2004 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

With the shift to a greater focus on nutrition in Australian food production, the role of dietitians and nutritionists employed in this sector, and their educational preparation, deserve attention. This paper presents the findings of qualitative research aimed at describing the current work practices and educational needs of dietitians employed within the food industry. Open-ended questions were asked of twelve dietitians including those employed by Australia's major food companies. The outcomes of this research were that: (a) industry-based dietitians had a population perspective to nutrition practice and a keen sense of career development; (b) descriptions of work practices indicated a distinctive career structure for dietitians in this area, which can be supported with appropriate continuing education; and (c) entry level practitioners would benefit from industry placements in their qualifying program. The educational implications of this study are that with increasing industry experience, short courses in management and communications would be of benefit, followed by higher qualifications in management and research. The implications for the profession include a review of competency standards and requirements for accredited programs and more generally, the development of a broad framework for recognising specialist practice in a range of workplace contexts. [ABSTRACT FROM AUTHOR]

The development of inflammatory lung disorders in children may be related to maternal fatty acid intake during pregnancy. We therefore examined maternal fatty acid (FA) status during pregnancy and its associations with inflammatory markers and lung conditions in the child by analyzing data from the MEFAB cohort using multivariate canonical correlation analysis (CCA). In the MEFAB cohort, 39 different phospholipid FAs were measured in maternal plasma at 16, 22 and 32 weeks of pregnancy, and at day of birth. Child inflammatory markers and self-reported doctor diagnosis of inflammatory lung disorders were assessed at 7 years of age. Using CCA, we found that maternal FA levels during pregnancy were significantly associated with child inflammatory markers at 7 years of age and that Mead acid (20:3n-9) was the most important FA for this correlation. To further verify the importance of Mead acid, we examined the relation between maternal Mead acid levels at the day of birth with the development of inflammatory lung disorders in children at age 7. After stratification for the child's sex, maternal Mead acid levels at day of birth were significantly related with self-reported doctor diagnosis of asthma and lung infections in boys, and bronchitis and total number of lung disorders in girls. Future studies should investigate whether the importance of Mead acid in the relation between maternal FA status and inflammation and lung disorders in the child is due to its role as biomarker for essential fatty acid deficiency or due to its own biological function as pro-inflammatory mediator., 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Rouschop, Smolinska, Gielen, de Groot, Zeegers, Opperhuizen, van Schooten and Godschalk.)

Long-chain polyunsaturated fatty acids (LCPUFA) are important for brain development and functioning and with that, possibly school performance. Several cross-sectional studies have shown significant positive associations between fish consumption, an important source of LCPUFA and school grades in adolescents. The effect of LCPUFA supplementation on school grades in adolescents has not been investigated yet. The goal of the current study was to investigate (I) the associations between the Omega-3 Index (O3I) at baseline and after 12 months respectively and school grades and (II) the effect of one year krill oil supplementation (source of LCPUFA) on school grades in adolescents with a low O3I at baseline. A double-blind randomised placebo-controlled trial with repeated measurements was executed. Participants received either 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day for the first three months in Cohort 1 and the nine months thereafter 800 mg EPA + DHA per day, Cohort 2 started immediately with 800 mg EPA + DHA per day,or a placebo. The O3I was monitored with a finger prick at baseline, three, six and twelve months. Subject grades for English, Dutch and math were collected, a standardised mathematics test was executed at baseline and at 12 months. Data was analysed with (I) explorative linear regressions to investigate associations at baseline and follow-up and (II) mixed model analyses separately for each of the subject grades and the standardised mathematics test to investigate the effect of supplementation after 12 months. The krill oil group had a small significant increase in the mean O3I at all time points. However, very few participants achieved the intended target O3I range of 8-11%. At baseline a significant association between baseline O3I and English grade was show, additionally a trend for an association with Dutch grade was shown. After 12 months no significant associations were found. Additionally, there was no significant effect of krill oil supplementation on subject grades or standardised mathematics test score. In this study, no significant effect of krill oil supplementation on subject grades or standardised mathematics test performance was found. However, as many participants dropped out and/or were non-adherent, results should be interpreted with caution., Competing Interests: Declaration of Competing Interest CVS is the owner of Omegametrix, which is responsible for the blood analyses in this study. TB is a former employee of Aker Biomarine, who partly funded the study. ISMW, PAK, MPZ, and RHMG declare no conflicts of interest. The funders had no role in the collection, analyses, or interpretation of data, nor in the decision to publish the results., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: University students often exhibit high levels of sedentary behavior that is negatively associated with cognition and mood. On the other hand, light-intensity physical activity (LIPA) may improve cognitive performance and mood. Therefore, this study investigated the acute effect of LIPA breaks during prolonged sitting on attention, executive functioning, and mood., Methods: A randomized crossover design was used in this study. In total, 21 healthy adults (15 women, age = 24 ± 3 years, BMI = 23 ± 2 kg/m 2 ) completed three prolonged sitting conditions: (1) without a demanding cognitive task (SIT), (2) with a demanding cognitive task (COGN), and (3) with every 25 min sitting interrupted by a 5-minute walk (INTERRUPT). Attention, executive function (response inhibition, task shifting, and working memory updating), and mood were assessed before and after each condition., Results: Linear mixed models analyses showed that prolonged sitting frequently interrupted by LIPA (INTERRUPT) or with cognitively demanding activities (COGN) significantly improved task shifting compared to SIT. However, INTERRUPT did not significantly improve task shifting compared with COGN. No significant acute effects on attention, response inhibition, working memory updating, or mood were found., Conclusions: Frequent LIPA breaks or cognitively demanding activities have a selective, acute positive impact on one aspect of cognitive performance compared to idle sitting. No evidence was found that LIPA breaks have an acute improvement in attention, executive function, and mood compared to sitting with cognitive loading. To further investigate the effect of PA on cognitive performance, it is necessary to consider cognitive loading and control for the cognitive activity during sitting in the experimental design., (© 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Background: University students sit too much, which is detrimental to their physical and mental health. Academic schedules, including scheduled education time and self-study time, may influence their physical activity behaviors., Objectives: To investigate (1) the association between scheduled education time and students' physical activity levels during weekdays; (2) the association between self-study time and students' physical activity levels during the weekdays and weekends., Methods: 126 (68 Maastricht University (UM); 58 KU Leuven (KUL)) first-year undergraduate students in biomedical sciences (mean ± SD age: 19.3 ± 1.0, BMI: 22.0 ± 3.0, 17% men, 83% women) completed a demographics questionnaire and reported their academic activities with a 7-day logbook. Furthermore, their physical activity behavior was measured with the activPAL monitor for 7 days. Linear mixed models were used to examine the associations between university (UM versus KUL), academic activities (scheduled education time and self-study time), and students' activity levels., Results: During weekdays, each hour of scheduled education time per day was significantly associated with a 1.3 min decrease of moderate to vigorous physical activity (MVPA) per day. Scheduled education time was not significantly associated with the sedentary time, light-intensity physical activity (LPA), and active sedentary behavior ratio. Each hour of self-study per day was significantly associated with 8 min more of sedentary time per day, 6 min less LPA per day, and 1.3 min less MVPA per day. Self-study time was not significantly associated with active sedentary behavior ratio. During the weekend, each hour of self-study time per day was associated with an additional 17.8 min of sedentary time per day and a reduction of 15.2 min of LPA per day. Self-study time was not significantly associated with the time spent doing MVPA and active sedentary behavior ratio., Conclusions: It could be more effective to change students' physical activity behaviors during self-study than during scheduled education time. Therefore, offering a study environment that reduces sedentary behavior and promotes light-intensity physical activity, is crucial.

Background: Physical activity (PA) can increase mental and physical health in adults aged 50 years and older. However, it has been shown that PA guidelines are often not met within this population. Therefore, our research group developed 2 computer-tailored intervention programs in the last decade to stimulate PA: Active Plus and I Move. Although these programs were proven effective, positive effects diminished over time and attrition rates were relatively high. To respond to this, we will integrate 3 interactive mobile elements into the existing programs: activity tracker, ecological momentary intervention program, and virtual coach app., Objective: The goal of the research is to define systematic and evidence-based steps for extending our online computer-based PA intervention programs with 3 interactive mobile elements., Methods: Components often included in other (eHealth) design models were identified as key components and served as a base for the definition of systematic steps: exploration of context, involvement of the target population, prototype and intervention testing, and implementation. Based on these key components, 10 systematic steps were defined. The initial step is a literature search, with the results serving as a base for development of the low-fidelity prototypes in step 2. The pilot phase comprises the 3rd to 6th steps and includes semistructured interviews, pilot tests, and adaptations of the prototypes with intensive involvement of the target population of adults aged 50 years and older, where particular attention will be paid to lower educated persons. The 7th step is an effect evaluation in the form of a randomized controlled trial. During the 8th step, the most effective intervention programs will be selected and reinforced. These reinforced intervention programs will be used during the design of an implementation plan in the 9th step and the subsequent field study in the 10th step., Results: The project will be executed from December 2019 to December 2023. During this period, the systematic approach presented will be practically executed according to the methodological procedures described., Conclusions: Based on the 4 identified key components, we were able to design an evidence-based systematic design approach for separately adding 3 mobile elements to our existing online PA intervention programs. The 10 steps are presented as a useful approach to guide future eHealth design studies., International Registered Report Identifier (irrid): DERR1-10.2196/31677., (©Eline H G M Collombon, Catherine A W Bolman, Denise A Peels, Gert-Jan de Bruijn, Renate H M de Groot, Lilian Lechner. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 12.07.2022.)

Research suggests that sedentary behavior (SB) is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning (EF), which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up a large proportion of the adolescent population and who are known to sit more than other students of this age. In this study, we investigated the acute effects of reducing SB by short time standing on EF in vocational education and training (VET) students. In a randomized crossover study, 165 VET students were first taught for 15 min in seated position. After this, they performed while seated the Letter Memory Test for updating, and the Color Shape Test for shifting and inhibition. Students were randomly assigned to a sitting or standing condition. All students were taught again for 15 min and then took the same tests in the condition they were allocated to, respectively, standing or seated. After 1 week, the test procedure was repeated, in which students switched conditions. Mixed model analyses showed no significant effect of sitting or standing on updating, shifting, or inhibition. Also, no significant differences were found for the order of condition on updating, shifting, or inhibition. Our results suggest that 40 min of standing does not significantly influence EF among VET students., 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 © 2022 Luteijn, van der Wurff, Singh, Savelberg and de Groot.)

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total ( B = -.37, p = .01) and social loneliness ( B = -.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.

Supplementation of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) may enhance self-regulation (SR) and executive functioning (EF) in children of preschool age. The aim of the Omega Kid Study was to investigate the effect of n-3 LCPUFA supplementation on SR and EF in typically developing preschool-aged children. A double-blind placebo-controlled pilot trial was undertaken, the intervention was 12 weeks and consisted of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day compared to placebo. The HS-Omega-3 Index ® was assessed by capillary blood samples at baseline and post-intervention. Seventy-eight children were enrolled and randomised to either the n-3 LCPUFA treatment ( n = 39) or placebo ( n = 39) group. Post intervention, there was a significant three-fold increase in the HS-Omega-3 Index ® in the n-3 LCPUFA group ( p < 0.001). There were no improvements in SR or EF outcome variables for the n-3 LCPUFA group post intervention compared to the placebo group determined by linear mixed models. At baseline, there were significant modest positive Spearman correlations found between the HS-Omega-3 index ® and both behavioural self-regulation and cognitive self-regulation (r = 0.287, p = 0.015 and r = 0.242, p = 0.015 respectively). Although no treatment effects were found in typically developing children, further research is required to target children with sub-optimal self-regulation who may benefit most from n-3 LCPUFA supplementation.

Background: Regular physical activity (PA) is potentially beneficial for age-related cognitive decline. Although moderate-to-vigorous physical activity (MVPA) is mostly advised, older adults with chronic illnesses might benefit more from light physical activity (LPA), as they suffer from mobility problems, pain, and fatigue, limiting high-intensity PA. Therefore, the longitudinal association between change in LPA and MVPA and the change in cognitive functioning (CF) is investigated in older adults with chronic illnesses., Methods: In total 432 older adults (mean age 73.7 [±6.1] years; 46.8% female) with at least one chronic illness participated in this longitudinal observational study. Longitudinal associations between accelerometer-assessed change in PA (LPA and MVPA) and change in CF, measured with an objective validated neuropsychological test battery, were tested with multivariate linear regressions., Results: An increase in LPA between baseline and 6 months follow-up was significantly associated with improved short-term verbal memory and inhibition over the first 6 months. In addition, the change score in LPA over the first 6 months was predictive for the change score in short-term verbal memory over 12 months. Furthermore, an increase in MVPA between baseline and 6 months follow-up was significantly associated with a decrease in longer-term verbal memory scores over the same six-month period., Conclusions: For older adults with chronic illnesses who may experience difficulties in being sufficiently active, an increase in LPA is probably more achievable than an increase in MVPA. In addition, an increase in LPA enhances CF more than an increase in MVPA does., Trial Registration: Netherlands Trial Register NL6005 ; Date of Registration 21-03-2017., (© 2021. The Author(s).)

Background: Standing desks have been brought into the education environment to reduce sedentary behavior among students. The current study explored the effects of standing in tutorial group meetings on learning among undergraduate students., Methods: Ninety-six participants were randomly allocated to a Sit or Stand group, with 2 h tutorial group meetings scheduled, once or twice per week, for nine weeks. Learning was analyzed using exam grades, concept maps, and tutorial interactions., Results: Overall, the Sit and Stand groups did not differ from each other in terms of learning, measured through their exam, concept map, and the use of learning-oriented interactions., Conclusion: Standing in tutorial group meetings neither enhanced nor compromised learning. Considering the health risks associated with prolonged sedentary behavior, offering standing tutorial group meetings to undergraduate students is a recommended solution to break up prolonged sedentary behavior and encourage more physical activity, while maintaining the learning performance of students., (Copyright © 2021. Published by Elsevier GmbH.)

While executive functions (EFs) and self-regulated learning (SRL) strategy use have been found to be related in several populations, this relationship has not been studied in adult online distance education (ODE). This is surprising as self-regulation, and thus using such strategies, is very important here. In this setting, we studied the relation between basic executive functions (i.e., working memory and shifting, measured with cognitive tests) and reported SRL-strategy use (i.e., management of time and effort, complex and simple cognitive strategy use, contacts with others, and academic thinking) within a correlational design with 889 adult online distance students. In this study, we performed regression analyses and took age and processing speed into consideration, as processing speed and EFs decrease with age, whereas self-regulation is reported to increase with age. Cognitively measured working memory was not related to reported SRL-strategy use in adult ODE students. Thus, even though the SRL-components within the strategies seem to elicit working memory, reported SRL-strategy use is not related to the functioning of this basic EF (measured with cognitive tests). This means that if SRL-strategy use needs to be increased in adult ODE students, training of working memory might not be an effective manner for achieving that goal. Better shifting and processing speed were related to less reported SRL-strategy use, which might suggest that SRL-strategies might be used to compensate for lower shifting (in academic thinking) and lower processing speed (in simple cognitive strategy use and contacts with others). With increasing age, the number of contacts with peers or teachers decreases. This latter finding might be of relevance during the pandemic since contacts with others is importance during lockdown., 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 © 2021 Meijs, Gijselaers, Xu, Kirschner and De Groot.)

Vocational education and training (VET) educates students for a broad range of occupations, which may be associated with differences in habitual physical activity behavior (PAB). Research suggests that physical activity (PA) is positively and sedentary behavior (SB) is negatively associated with cognitive performance. Therefore, we aimed to compare habitual PAB in VET students from different educational tracks and investigate its association with cognitive performance in a cross-sectional study. Students wore an ActivPAL accelerometer continuously for seven days to measure PAB. Cognitive performance was assessed with objective tests for inhibition, shifting, and updating. Hairdresser and Sports students sat significantly less than Administrative and Nursing students. Hairdresser students stood significantly more than other tracks. Admin students stood significantly less than Sports / Nursing students. Sports students moved significantly more than Hairdresser and Nursing students. Time in bed was significantly lowest in Nursing students. No significant associations between any PAB and cognitive performance were found. In general, Admin students showed the unhealthiest habitual PAB. Higher PA or lower SB neither improve nor decrease cognitive performance. Thus, future health interventions focusing on exchanging SB for PA at schools can facilitate a healthier lifestyle of VET students, especially in Admin students, without interfering with cognitive performance.

This study explored the effects of using standing desks in tutorial meetings on the physical activity behavior (PAB) of undergraduate students. Standing desks have been introduced to minimize the detrimental health effects of prolonged sedentary behavior (SB). The effectiveness of using standing desks has not been explored among undergraduate students - a population showing high SB. Ninety-six undergraduate students were randomly assigned to a sitting or standing tutorial group that ran for nine weeks, and their PAB was monitored using the activPAL3™ triaxial activity monitor. To check for potential compensatory or other covarying behaviors, the students' PAB was monitored on tutorial and non-tutorial days. PAB monitoring was conducted in week 4-5, and a follow-up measurement was conducted in week 9 to examine longer-term effects. In week 4-5, the stand group (n = 41) showed less SB (β = -0.092, SE = 0.044, 95% CI: -0.179, -0.006) and more moderate-to-vigorous physical activity (β = 0.320, SE = 0.160, 95% CI: 0.004, 0.635) compared to the sit group (n = 36). On tutorial days, the stand group showed more light physical activity (LPA) than the sit group (p < .001, d = 1.04). In week 9, there was an exam on the last day of that week. Nonetheless, the stand group (n = 37) showed less SB (p < .001, d = 0.378) and more LPA (p = .008, d = 0.725), while breaking up prolonged SB more frequently (p = .007, d = 0.696) on the tutorial day compared to the sit group (n = 32). Overall, undergraduates attending standing tutorial meetings showed less SB and more LPA than those attending conventional, seated tutorial meetings. Standing tutorial meetings can contribute to a more active lifestyle for undergraduates., (Copyright © 2020. Published by Elsevier Inc.)

Background: Cognitive functioning (CF) is important for wellbeing and an independent life. However, older adults with chronic diseases are at a higher risk of poorer CF levels. Although, research suggests that physical activity (PA) could play an essential role in maintaining good CF, older adults with chronic diseases have low levels of PA. PA interventions to prevent cognitive decline for this specific group exist. Yet, until now these interventions focused on a single specific chronic disease. Active Plus is a proven effective computer-tailored PA stimulating intervention focused on increasing PA in daily life for the older adult population suffering from a broad range of chronic diseases. This study tests the cognitive effects of Active Plus in older adults with chronic diseases., Methods: In this RCT older adults with at least one chronic disease (≥65 years) were allocated to the intervention group (N = 260, mean age = 74.2) or waiting list control group (N = 325, mean age = 74.5). In total, intervention group participants received three times computer-tailored PA stimulating advice within four months (i.e., at baseline, after two months, and after three to four months). The online and print delivered advice were tailored to the specific needs and wishes of the participant and focused on incorporating PA in daily life. Baseline and follow-up measurements of the CF verbal memory (Verbal Learning Test), shifting (Trailmaking Test), inhibition (Stop-signal Task) and processing speed (Letter Digit Substitution Test) were assessed after six and 12 months. Intervention effects were analyzed with multilevel linear mixed-effects models adjusted for the clustered design and confounding variables., Results: The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Although both conditions improved on all verbal memory outcomes after 6 months, and all CF outcomes except inhibition after 12 months, no intervention effects were found, not even in subgroups (p > .05)., Conclusions: To our knowledge this is the first study to test the cognitive effects of a computer-tailored PA stimulating intervention in older adults suffering from a broad range of chronic diseases. The effects of the Active Plus intervention were not strong enough to improve CF or prevent cognitive decline. A blended approach, in which this computer-tailored intervention is combined with a face-to-face PA intervention and / or cognitive training, might be a good suggestion to increase the effects of Active Plus on PA and CF in older adults with chronic diseases., Trial Registration: Netherlands Trial Register NL6005; Date of Registration 03-21-2017; https://www.trialregister.nl/trial/6005.

While it has been shown that interrupting a person's sedentary behaviour has the potential to improve cognitive, physical and mental health, a large part of time that students spend in school is sedentary. As research has shown that approximately 80% of vocational education and training (VET) students have an unhealthy sedentary lifestyle, implementing "sit-to-stand" (StS) desks could interrupt sedentary behaviour and promote healthier behaviour. Therefore, the acceptability and feasibility of using such desks in the VET setting should be investigated. Using semi-structured focus group interviews analysed via deductive content analysis, the opinions of 33 students for the following topics were assessed: (1) usage of the standing option of the desks (2) reasons for standing in class (3) experienced effect of standing behind the desk, and (4) fostering future StS desks usage. Although VET students are aware of the potential benefits of using StS desks, they need to be actively stimulated and motivated by teachers to use them. In addition, time is needed to get into the habit of standing. Thus, for successful implementation of StS desks in the VET setting, all stakeholders (i.e., students, teachers, schoolboards) should be actively involved in stimulating the healthy behaviour of VET students.

Self-regulation, the regulation of behaviour in early childhood, impacts children's success at school and is a predictor of health, wealth, and criminal outcomes in adulthood. Self-regulation may be optimised by dietary supplementation of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). The aim of the "Omega Kid" study is to investigate the feasibility of a protocol to investigate whether n-3 LCPUFA supplementation enhances self-regulation in preschool-aged children. The protocol assessed involved a double-blind, randomised, placebo-controlled trial of 12 weeks duration, with an intervention of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day (0.3 g EPA and 1.3 g DHA) in a microencapsulated powder compared to placebo. Children (n = 78; 40 boys and 38 girls) aged 3-5 years old were recruited and randomly allocated to the treatment (n = 39) or placebo group (n = 39). The HS-Omega-3 Index ® served as a manipulation check on the delivery of either active (n-3 LCPUFAs) or placebo powders. Fifty-eight children (76%) completed the intervention (28-30 per group). Compliance to the study protocol was high, with 92% of children providing a finger-prick blood sample at baseline and high reported-adherence to the study intervention (88%). Results indicate that the protocol is feasible and may be employed in an adequately powered clinical trial to test the hypothesis that n-3 LCPUFA supplementation will improve the self-regulation of preschool-aged children.

With modern technological advances, distance education has become an increasingly important education delivery medium for, for example, the higher education provided by open universities. Among predictive factors of successful learning in distance education, the effects of non-cognitive skills are less explored. Grit, the dispositional tendency to sustain trait-level passion and long-term goals, has raised much research interest and gained importance for predicting academic achievement. The Grit Questionnaire, measuring Perseverance of Effort and Consistency of Interests, has been shown to be a reliable instrument in traditional university student populations. However, the measurement and predictive validity of this questionnaire is still unknown for adult distance education university students who differ from traditional students in various ways (e.g., having a wider range of student ages). Based on a sample of 2,027 students from a distance education university, this study assessed the psychometric properties of the two-factor structure grit measured by the Grit Questionnaire. The findings suggest that the short form of the Grit Questionnaire is a potentially useful assessment tool for measuring the grit construct for distance learning higher education and that the Consistency of Interests factor is especially relevant to consider the improvement of learning performance for distance education in terms of courses credit and exam attempts. The measurement precision of the Perseverance of Effort factor, however, should be improved in future research to provide higher measurement accuracy and broader item coverage., 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 © 2020 Xu, Meijs, Gijselaers, Neroni and de Groot.)

Introduction: Observational studies have shown a relationship between omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) and depression in adolescents. However, n-3 LCPUFA supplementation studies investigating the potential improvement in depressive feelings in adolescents from the general population are missing., Methods: A one-year double-blind, randomized, placebo controlled krill oil supplementation trial was conducted in two cohorts. Cohort I started with 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) or placebo, after three months this increased to 800 mg EPA and DHA per day, whilst cohort II started with this higher dose. Omega-3 Index (O3I) was monitored via finger-prick blood measurements. At baseline, six and 12 months participants completed the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Rosenberg Self Esteem questionnaire (RSE). Adjusted mixed models were run with treatment allocation/O3I as predictor of CES-D and RSE scores., Results: Both intention-to-treat and assessing the change in O3I analyses did not show significant effects on CES-D or RSE scores., Conclusion: There is no evidence for less depressive feelings, or higher self-esteem after one year of krill oil supplementation. However, due to a lack of adherence and drop-out issues, these results should be interpreted with caution., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation in the cardiovascular field is effective if a certain Omega-3 index (O3I) is achieved or the daily n-3 LCPUFA dose is high enough. Whether this applies to studies on cognition in children and adolescents is unclear. The aims of the current review were to investigate whether: (1) a certain O3I level and (2) a minimum daily n-3 LCPUFA dose are required to improve cognition in 4-25 year olds. Web of Science and PubMed were searched. Inclusion criteria: placebo controlled randomized controlled trial; participants 4-25 years; supplementation with docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA); assessing cognition; in English and ≥10 participants per treatment arm. Thirty-three studies were included, 21 in typically developing participants, 12 in those with a disorder. A positive effect on cognitive measures was more likely in studies with an increase in O3I to >6%. Half of the studies in typically developing children with daily supplementation dose ≥450 mg DHA + EPA showed improved cognition. For children with a disorder no cut-off value was found. In conclusion, daily supplementation of ≥450 mg DHA + EPA per day and an increase in the O3I to >6% makes it more likely to show efficacy on cognition in children and adolescents.

Objectives: Maternal pre-pregnancy weight is known to affect foetal development. However, it has not yet been clarified if gestational weight gain is associated with childhood behavioural development., Methods: We performed a pooled analysis of two prospective birth cohorts to investigate the association between gestational weight gain and childhood problem behaviours, and the effect modification of maternal pre-pregnancy BMI. In total, 378 mother-child pairs from the Maastricht Essential Fatty Acids Birth cohort (MEFAB) and 414 pairs from the Rhea Mother-Child cohort were followed up from early pregnancy to 6-7 years post-partum. At follow up, parents assessed their children's behaviour, measured as total problems, internalizing and externalizing behaviours, with the Child Behaviour Checklist. We computed cohort- and subject-specific gestational weight gain trajectories using mixed-effect linear regression models. Fractional polynomial regressions, stratified by maternal pre-pregnancy BMI status, were then used to examine the association between gestational weight gain and childhood problem behaviours., Results: In the pre-pregnancy overweight/obese group, greater gestational weight gain was associated with higher problem behaviours. On average, children of women with overweight/obesity who gained 0.5 kg/week scored 25 points higher (on a 0-100 scale) in total problems and internalizing behaviours, and about 18 points higher in externalizing behaviours than children whose mothers gained 0.2 kg/week. Inconsistent results were found in the pre-pregnancy normal weight group., Conclusions for Practice: Excessive gestational weight gain in women with pre-pregnancy overweight/obesity might increase problem behaviours in school-age children. Particular attention should be granted to avoid excessive weight gain in women with a pre-pregnancy overweight or obesity.

A statement on measuring blood omega-3 long chain polyunsaturated fatty acid levels was developed and edited based on input from ISSFAL members and accepted by vote of the ISSFAL Board of Directors. Summary of Statement: Omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) levels at baseline and post-intervention should be assessed and reported in future research to evaluate the efficacy of n-3 LCPUFA supplementation: b ecause; 1. there are numerous factors that affect n-3 LCPUFA levels in humans as described in the systematic literature review [1]; 2. assessing intake of n-3 LCPUFA from the diet and/or supplements is not sufficient to accurately determine n-3 LCPUFA levels in humans; 3. some studies do not provide sufficient doses of n-3 LCPUFA to produce a significant impact on bloodstream/organ content and there is substantial variability in the uptake of n-3 LPCUFA into tissues between individuals. In secondary analyses, clinical trials should consider the influence of fatty acid status (baseline, endpoint and change from baseline to endpoint) on the outcome variables., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Students starting at university tend to adopt unhealthy behaviors. With students expected to sit during classes, their academic schedule may be responsible for their activity patterns. The aim of the current study was to investigate the relationship between university students' academic schedule and day-to-day variations in sedentary behavior (SB) and physical activity (PA). The activity of 317 first-year undergraduate students (mean age 19.6 ± 1.4 years, 69.4% female, 30.0% male, and 0.6% other) was measured with the activPAL3™ triaxial monitor for seven consecutive days. Each class hour was found to be associated with 9.0 additional minutes of SB (95% CI [4.9, 13.1]), 54 additional seconds of moderate-to-vigorous PA (MVPA; 95% CI [12, 96]), and 12.2 min less time in bed (95% CI [-16.6, -7.8]). Active SB ratio (total duration of SB bouts < 30 min divided by total SB duration) decreased by 0.011 per hour of class scheduled for the students (95% CI [-0.016, -0.006]). Light PA (LPA) was not significantly associated with class duration. Students tend to cycle more on days with classes. Seated transportation was not significantly related to whether the students had classes or not. Overall, the academic schedule is associated with SB and PA in students.

eHealth interventions aimed at improving physical activity (PA) can reach large populations with few resources and demands on the population as opposed to centre-based interventions. Active Plus is a proven effective computer-tailored PA intervention for the older adult population focusing on PA in daily life. This manuscript describes the effects of the Active Plus intervention ( N = 260) on PA of older adults with chronic illnesses (OACI), compared to a waiting list control group ( N = 325). It was part of a larger randomized controlled trial (RCT) on the effects of the Active Plus intervention on cognitive functioning. OACI (≥65 years) with at least one chronic illness were allocated to one of the conditions. Intervention group participants received PA advice. Baseline and follow-up measurements were assessed after 6 and 12 months. Intervention effects on objectively measured light PA (LPA) and moderate-to-vigorous PA (MVPA) min/week were analysed with multilevel linear mixed-effects models adjusted for the clustered design. Intervention effects on self-reported MVPA min/week on common types of PA were analysed with two-part generalized linear mixed-effects models adjusted for the clustered design. The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Analyses showed no effects on objectively measured PA. Active Plus increased the likelihood to perform self-reported cycling and gardening at six months and participants who cycled increased their MVPA min/week of cycling. Twelve months after baseline the intervention increased the likelihood to perform self-reported walking and participants who cycled at 12 months increased their MVPA min/week of cycling. Subgroup analyses showed that more vulnerable participants (higher degree of impairment, age or body mass index) benefitted more from the intervention on especially the lower intensity PA outcomes. In conclusion, Active Plus only increased PA behaviour to a limited extent in OACI 6 and 12 months after baseline measurements. The Active Plus intervention may yet be not effective enough by itself in OACI. A blended approach, where this eHealth intervention and face-to-face contact are combined, is advised to improve the effects of Active Plus on PA in this target group.

The original version of this article unfortunately contained a mistake. Title was incorrect.

Background: Physical activity not only is beneficial to a person's health, but can also have a positive influence on cognitive functioning. However, elderly people with chronic illness(es) often do not meet the physical activity guidelines. Physical activity programs for the elderly exist, but these are often expensive and not easily accessible to the elderly with chronic illness(es). In addition, the beneficial effects of these physical activity programs on cognitive functioning have never been specifically tested in this target group. Hence, this randomized controlled trial aims to test whether Active Plus, a proven effective physical activity intervention, is able to improve the cognitive functioning of elderly people with chronic illness(es) or to slow down cognitive decline. In addition, it studies what kind of activity, intensity, duration and frequency of physical activity most strongly influence cognitive functioning., Methods: A randomized controlled trial is performed, comparing the Active Plus intervention group to a waiting list control group. In total 540 older adults (≥65 years) with at least one chronic illness that limits mobility are recruited from 7 municipalities. Comparable neighborhoods within a municipality are randomly allocated to the intervention or control group. Baseline and follow-up measurements after 6 and 12 months assess cognitive functioning and physical activity behavior, measured both objectively with an accelerometer and subjectively with a self-report questionnaire. Multilevel analyses are conducted to assess effects on cognitive functioning, including analyses on moderation effects for physical activity type, frequency, duration and intensity., Discussion: To our knowledge this is the first study to investigate effectiveness of a physical activity program on cognitive functioning in elderly people suffering from a broad range of chronic illnesses. If proven effective Active Plus would be a very cost effective intervention not only to increase physical activity, but also to improve cognitive functioning or slow down cognitive decline. Up till now clear evidence is lacking on the kind of physical activity, intensity, duration and frequency needed to achieve cognitive benefits. By measuring both with accelerometers and self-report questionnaires we hope to gain insight in these processes., Trial Registration: Nederlands Trial Register NL6005 ; Date of Registration 21-03-2017.

Purpose: Depression is common in adolescents and long-chain polyunsaturated fatty acids (LCPUFA) are suggested to be associated with depression. However, research in adolescents is limited. Furthermore, self-esteem has never been studied in relation to LCPUFA. The objective here was to determine associations of depression and self-esteem with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), Omega-3 Index (O3I), n-6 docosapentaenoic acid (n-6 DPA, also called Osbond acid, ObA), n-3 docosapentaenoic acid (DPA), and arachidonic acid (AA) concentrations in blood of adolescents attending lower general secondary education (LGSE)., Methods: Baseline cross-sectional data from a krill oil supplementation trial in adolescents attending LGSE with an O3I ≤ 5% were analysed using regression models built with the BayesFactor package in R. Fatty acids and O3I were determined in blood. Participants filled out the Centre for Epidemiologic Studies Depression (CES-D) scale and the Rosenberg Self-Esteem scale (RSE)., Results: Scores indicative of depression (CES-D ≥ 16) were found in 29.4% of the respondents. Of all fatty acids, we found extreme evidence [Bayes factor (BF) > 100] for a weak negative association between ObA and depression score [- 0.16; 95% credible interval (CI) - 0.28 to - 0.04; BF 10  = 245], and substantial evidence for a weak positive association between ObA and self-esteem score (0.09; 95% CI, - 0.03 to 0.20; BF 10  = 4). When all fatty acids were put in one model as predictors of CES-D or RSE, all of the 95% CI contained 0, i.e., no significant association., Conclusion: No evidence was found for associations of DHA, EPA and O3I with depression or self-esteem scores in LGSE adolescents with O3I ≤ 5%. The associations of higher ObA status with lower depression and higher self-esteem scores warrant more research.

Long-chain polyunsaturated fatty acids (LCPUFA) are important for brain development and function, maybe especially during adolescence. Observational studies have demonstrated an association between fish consumption (a source of LCPUFA) and cognition in adolescents, but intervention trials are lacking. The goal of the current study was to investigate the effect of one year of krill oil (a source of LCPUFA) supplementation on the cognitive performance of adolescents with a low Omega-3 Index (O3I ≤ 5%). A double-blind, randomized, and placebo-controlled supplementation trial with repeated measurements (baseline (T0), three months (T1), six months (T2), and 12 months (T3)) in adolescents (267 randomized) was executed. Participants were randomized to 400 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day in Cohort I or placebo and 800 mg EPA + DHA per day in Cohort II or placebo. O3I was monitored by a finger prick at all time points. At T0, T2, and T3, participants executed a neurocognitive test battery. Covariate corrected mixed models were run with either condition (krill or placebo) or O3I as predictors. Krill oil supplementation led to a small but significant increase in mean O3I, but few participants increased to the intended O3I range (8-11%). There was no significant effect of supplementation on the neurocognitive tests, nor a relationship between O3I and neurocognitive test scores. The increase in O3I was small in most participants, probably due to non-compliance. Possibly the increase in O3I was too small to demonstrate an effect. More research on the influence of LCPUFAs on cognition in adolescents is needed.

Background: The prenatal exposure to maternal n-6 and n-3 polyunsaturated fatty acids (PUFAs) might influence the development of social competence and internalizing and externalizing behaviours of the child, because of the numerous functions of PUFAs within the nervous system., Methods: To analyse the association of selected maternal PUFAs (i.e., AA, EPA, DHA, total n-6, total n-3, and the n-6:n-3 ratio) measured during gestation with childhood social competence and problem behaviours, we examined 311 mother-child pairs from the Maastricht Essential Fatty Acid Birth (MEFAB) cohort. For each woman, PUFA-specific changes in relative concentrations were calculated by identifying the best-fitting curve of PUFA concentration by linear splines of gestational age. The associations of changes in maternal PUFAs in early and late pregnancy with childhood social competence, total problems, internalizing and externalizing behaviours, measured with the Child Behaviour Checklist 4/18 at age 7, were investigated with linear regression analyses adjusted for maternal and children's socio-demographic characteristics., Results: In late gestation (i.e., from gestational week 30), an increase in AA was associated with higher social competence, while a decrease in total n-6 was associated with lower externalizing behaviours. No other significant associations were found., Discussion: In this prospective study, increasing maternal AA and decreasing total n-6 were associated with improved social competence and externalizing behaviours, respectively, in 7-year old children. Nonetheless, the clinical significance of the identified associations is modest and further investigations are warranted to clarify the relationship between maternal AA and total n-6 during pregnancy and childhood social and behavioural development., (Copyright © 2019. Published by Elsevier Ltd.)

Objective: To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations., Design: Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality., Data Sources: PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus., Eligibility Criteria for Selecting Studies: PA-intervention studies in children with at least one cognitive or academic performance assessment., Results: Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes. Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics., Conclusion: There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis., Prospero Registration Number: CRD42017082505., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Numerous health benefits are attributed to the n-3 long-chain PUFA (n-3 LCPUFA); EPA and DHA. A systematic literature review was conducted to investigate factors, other than diet, that are associated with the n-3 LCPUFA levels. The inclusion criteria were papers written in English, carried out in adult non-pregnant humans, n-3 LCPUFA measured in blood or tissue, data from cross-sectional studies, or baseline data from intervention studies. The search revealed 5076 unique articles of which seventy were included in the qualitative synthesis. Three main groups of factors potentially associated with n-3 LCPUFA levels were identified: (1) unmodifiable factors (sex, genetics, age), (2) modifiable factors (body size, physical activity, alcohol, smoking) and (3) bioavailability factors (chemically bound form of supplements, krill oil v. fish oil, and conversion of plant-derived α-linolenic acid (ALA) to n-3 LCPUFA). Results showed that factors positively associated with n-3 LCPUFA levels were age, female sex (women younger than 50 years), wine consumption and the TAG form. Factors negatively associated with n-3 LCPUFA levels were genetics, BMI (if erythrocyte EPA and DHA levels are &lt;5·6 %) and smoking. The evidence for girth, physical activity and krill oil v. fish oil associated with n-3 LCPUFA levels is inconclusive. There is also evidence that higher ALA consumption leads to increased levels of EPA but not DHA. In conclusion, sex, age, BMI, alcohol consumption, smoking and the form of n-3 LCPUFA are all factors that need to be taken into account in n-3 LCPUFA research.

Background/objectives: Polyunsaturated fatty acid (PUFA) status during pregnancy has been suggested to influence offspring obesity and cardiometabolic health. We assessed whether prenatal PUFA exposure is associated with rapid infant growth, childhood BMI, and cardiometabolic profile., Subjects/methods: In the Dutch MEFAB (n = 266) and Greek RHEA (n = 263) cohorts, we measured n-3 and n-6 PUFA concentrations in cord blood phospholipids, which reflect fetal exposure in late pregnancy. We defined rapid infant growth from birth to 6 months of age as an increase in weight z-score >0.67. We analyzed body mass index (BMI) as continuous and in categories of overweight/obesity at 4 and 6 years. We computed a cardiometabolic risk score at 6-7 years as the sum of waist circumference, non-high-density lipoprotein cholesterol and blood pressure z-scores. Associations of PUFAs with child health outcomes were assessed using generalized linear models for binary outcomes and linear regression models for continuous ones after adjusting for important covariates, and for the pooled estimates, a cohort indicator., Results: In pooled analyses, we found no association of PUFA levels with rapid infant growth, childhood BMI (β per SD increase in the total n-3:n-6 PUFA ratio = -0.04 SD; 99% CI: -0.15, 0.06; P = 0.65 at 4 years, and -0.05 SD; 99% CI: -0.18, 0.08; P = 0.78 at 6 years), and overweight/obesity. We also found no associations for clustered cardiometabolic risk and its individual components. The results were similar across cohorts., Conclusions: Our findings suggest that PUFA concentrations at birth are not associated with later obesity development and cardiometabolic risk in childhood.

Exercise is assumed to have positive effects on children's cognitive performance. However, given the inconclusive evidence for the long-term effects of exercise, it is difficult to advice schools on what specific exercise programs can improve children's cognitive performance. In particular, little is known about the effects of small exercise programs that may be feasible in daily school practice. Therefore, we assessed the effects of a 9-weeks program consisting of daily exercise breaks on children's cognitive performance, aerobic fitness and physical activity levels. We conducted a cluster-randomized controlled trial in 21 classes of eight Dutch primary schools. A total of 512 children aged 9-12 years participated. The exercise intervention had a duration of 9 weeks and consisted of a daily 10-min classroom-based exercise break of moderate to vigorous intensity. Before and after the intervention, we used four cognitive tasks (i.e., the Attention Network Test, Stroop test, d2 test of attention and Fluency task) to measure children's cognitive performance in domains of selective attention, inhibition and memory retrieval. In addition, we measured aerobic fitness with a Shuttle Run test and physical activity during school hours by accelerometers. We analyzed data using mixed models, adjusting for baseline scores, class and school. After 9 weeks, there were no intervention effects on children's cognitive performance or aerobic fitness. Children in the intervention group spent 2.9 min more of their school hours in moderate to vigorous physical activity as compared to the children in the control group. In conclusion, daily 10-min exercise breaks in the classroom did not improve, nor deteriorate cognitive performance in children. The exercise breaks had no effect on children's fitness, and resulted in 2.9 min more time spent in moderate to vigorous physical activity during school hours. Daily exercise breaks can be implemented in the classroom to promote children's physical activity during school time, without adverse effect on their cognitive performance.

This study evaluates boy-girl differences in 3D mental rotation in schoolchildren aged 7-12 years and the relation to arithmetic performance. A dedicated new task was developed: The Mental Rotation Task - Children (MRT-C). This task was applied to a large sample of 729 children. At the age of 7- to 9-years, a sex difference was found in the number of correct judgments made on the MRT-C. Boys performed better than girls. A closer look at the distribution of boys and girls in this age group showed that boys were overrepresented in the top performance quartile, whereas girls were overrepresented in the lowest performance quartile. A second finding was that higher mental rotation performance was significantly correlated to better mathematical achievement. This finding was done for boys, but not for girls. This correlation underscores the important role that spatial processing plays in mathematical achievement and has implications for school practice.

Schools are considered ideal venues to promote physical activity (PA) in children. However, a knowledge gap exists on how to adequately integrate PA into the school day and in particular, on the preferences of children regarding additional PA in school. Therefore, the aim of our qualitative study was to gain comprehensive insight into 10⁻13-year-old primary schoolchildren's perspectives on how to increase PA in the school setting. We conducted nine focus groups (32 girls and 20 boys) with children attending the final two grades of primary school in the Netherlands. We used inductive thematic analysis to analyze the data. The results showed that children were enthusiastic about additional PA in school. Children suggested various ways to increase PA, including more time for PA in the existing curriculum, e.g., physical education (PE), recess, and occasional activities, such as field trips or sports days; school playground adaptation; improving the content of PE; and implementing short PA breaks and physically active academic lessons. Children emphasized variation and being given a voice in their PA participation as a prerequisite to keep PA enjoyable and interesting in the long term. Finally, children mentioned the role of the teacher and making efforts to accommodate all children and their different preferences as important. Children have concrete ideas, acknowledging the challenges that accompany integrating additional PA in school. We therefore recommend actively involving children in efforts to increase school-based PA and to make "additional PA in school" a shared project of teachers and students., Competing Interests: The authors declare no conflict of interest.

Consumption of breakfast, fish, or caffeine are each separately often investigated in relation to learning performance in traditional education, but not in distance education (DE). The objective of this study was to investigate whether the relations between the consumption of breakfast, fish, and/or caffeine on the one hand and learning performance on the other are also found in DE students. This population is different from traditional students and characterized by a different profile in terms of age, personal and work responsibilities as well as other demographics. In an observational longitudinal study, the consumption of breakfast, fish, and caffeine of 1157 DE students (18-76 years old, mean 35.8 ± 11.1 years) was used to predict learning performance using multiple regression analysis. In an online digital survey, university students provided information about their consumption of these nutritional measures and on important covariates. Learning performance, measured as study progress (i.e., the number of successfully completed modules), was evaluated objectively after 14 months. Results showed that adding the consumption of breakfast, fish, and caffeine to the covariate model did not fit the data better, χ 2 (3, N = 1155) = 3.287, p = 0.35. This means that neither the consumption of breakfast nor fish nor caffeine predicted study progress in adults participating in DE. This study is important as it is the first to report on these relations in this specific age group and educational setting, which is increasingly important due to the increased preference for this type of education.

Participation in structured physical activity is assumed to have a positive effect on cognitive and academic performance. A single bout of moderate to vigorous exercise has been found to have a small acute positive effect on the cognitive performance of children and adolescents. However, the dose-response effects of exercise duration are largely unknown. Therefore, the current study examined the acute effects of moderate-to-vigorous exercise with a duration of either 10, 20, or 30 min on selective attention and working memory performance of young adolescents. One hundred and nineteen adolescents (11-14 years old) participated in a randomized, controlled crossover study. Adolescents were assigned to one of the three exercise durations, each paired with a sedentary control session of the same duration. Cognitive performance was measured before and immediately after the exercise and control condition. The Attention Network Test and n-back task were used to measure selective attention and working memory, respectively. There were no significant exercise effects on selective attention (i.e., alerting, orienting, or executive control) or working memory performance measured immediately after the exercise bouts. Furthermore, there were no differential effects of exercise duration. In sum, acute exercise bouts with a duration of 10, 20, or 30 min did not improve, but neither deteriorate cognitive performance of young adolescents compared to a sedentary control condition.

This large-scale cross-sectional study of schoolchildren aged 8-12 years ( N = 152) evaluates two factors which potentially determine individual differences in intentional learning: the child's sex and parental education. Intentional learning was assessed with a newly constructed Pictorial Verbal Learning Task (PVLT). This task presents line drawings of concrete objects as to-be-remembered information instead of written or auditory presented words. The PVLT has the advantage that performance is not confounded by individual differences in reading or hearing abilities. Results revealed clear sex differences in performance: Girls outperformed boys. Parental education also contributed to individual differences in performance since children of higher educated parents outperformed children of lower educated parents. The results therefore suggest that both sex and parental education could be potent contributors to individual differences in learning performance at school. The findings more specifically imply that children of less educated parents and boys need additional guidance and support in intentional learning when new information and procedures are presented for the first time.

There are major inter-individual differences in the school achievements of students aged 8-12. The determinants of these differences are not known. This paper investigates two possible factors: the self-regulation of the student and the educational levels obtained by their parents. The study first investigates whether children with high and low academic achievement differ in their self-regulation. It then evaluates whether there are differences in the self-regulation of children with high and moderate-to-low level of parental education (LPE). The focus was on the self-regulation of students as judged by their teacher. Teacher evaluations were assessed using an observer questionnaire: the Amsterdam Executive Functioning Inventory. Results showed that students with low school achievement had substantially lower teacher-perceived self-regulation than children with high school achievement. Furthermore, teacher-perceived self-regulation was lower for children with moderate-to-low LPE than for children with high LPE. The findings suggest that interventions on the domain of self-regulation skills should be developed and used, particularly in students at risk of poor school achievement.

Lower prenatal exposure to n-3 PUFA relative to n-6 PUFA has been hypothesised to influence allergy development, but evidence remains largely inconsistent. In the Dutch Maastricht Essential Fatty Acid Birth (MEFAB) (n 293) and Greek RHEA Mother-Child (n 213) cohorts, we investigated whether cord blood phospholipid PUFA concentrations are associated with symptoms of wheeze, asthma, rhinitis and eczema at the age of 6-7 years. Information on allergy-related phenotypes was collected using validated questionnaires. We estimated relative risks (RR) and 95 % CI for associations of PUFA with child outcomes using multivariable generalised linear regression models. In pooled analyses, higher concentration of the n-3 long-chain EPA and DHA and a higher total n-3:n-6 PUFA ratio were associated with lower risk of current wheeze (RR 0·61; 95 % CI 0·45, 0·82 per sd increase in EPA+DHA and 0·54; 95 % CI 0·39, 0·75 per unit increase in the n-3:n-6 ratio) and reduced asthma risk (RR 0·50; 95 % CI 0·31, 0·79 for EPA+DHA and 0·43; 95 % CI 0·26, 0·70 for the n-3:n-6 ratio). No associations were observed for other allergy-related phenotypes. The results were similar across cohorts. In conclusion, higher EPA and DHA concentrations and a higher n-3:n-6 fatty acid ratio at birth were associated with lower risk of child wheeze and asthma. Our findings suggest that dietary interventions resulting in a marked increase in the n-3:n-6 PUFA ratio, and mainly in n-3 long-chain PUFA intake in late gestation, may reduce the risk of asthma symptoms in mid-childhood.

Introduction: Concentrations of the fish fatty acids EPA and DHA are low among Dutch women of reproductive age. As the human brain incorporates high concentrations of these fatty acids in utero, particularly during third trimester of gestation, these low EPA and DHA concentrations may have adverse consequences for fetal brain development and functioning., Methods: Analyses were conducted using longitudinal observational data of 292 mother-child pairs participating in the MEFAB cohort. Maternal AA, DHA, and EPA were determined in plasma phospholipids - obtained in three trimesters - by gas-liquid chromatography. Cognitive function was assessed at 7 years of age, using the Kaufman Assessment Battery for Children, resulting in three main outcome parameters: sequential processing (short-term memory), simultaneous processing (problem-solving skills), and the mental processing composite score. Spline regression and linear regression analyses were used to analyse the data, while adjusting for potential relevant covariates., Results: Only 2% of the children performed more than one SD below the mental processing composite norm score. Children with lower test scores (<25%) were more likely to have a younger mother with a higher pre-gestational BMI, less likely to be breastfed, and more likely to be born with a lower birth weight, compared to children with higher test scores (≥25%). Fully-adjusted linear regression models did not show associations of maternal AA, DHA, or EPA status during any of the pregnancy trimesters with childhood sequential and simultaneous processing., Conclusion: Maternal fatty acid status during pregnancy was not associated with cognitive performance in Dutch children at age 7., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Prenatal exposure to polyunsaturated fatty acids (PUFAs) may influence childhood growth. However, available evidence mostly derived from short-term studies is inconsistent., Objective: To assess whether fetal PUFA exposure is associated with height and body mass index (BMI), a common measure of adiposity, from 6 months to 23 years of age., Methods: In the MEFAB cohort, we assessed cord blood phospholipid n-3 and n-6 PUFA levels, reflecting fetal exposure in late pregnancy. For 250 (45.2% females) participants, we collected a total of 1770 (n= 802 for females) repeated growth measurements from infancy to young adulthood. We examined sex-specific associations of PUFAs with height and BMI at different developmental ages (infant: 6 months; toddler: 2 years; pre-schooler: 4 years; school-aged child: 7 years; adolescent: 12 years; and young adult: 23 years) using fractional polynomial mixed models adjusted for important covariates., Results: Higher n-3 PUFA levels were associated with higher infant length in males (β= 0.44cm [95% CI: 0.07, 0.82] per SD increase), whereas, for females, higher n-6 PUFA concentrations were associated with lower length in infancy (β= -0.69cm [95% CI: -1.08, -0.30] per SD increase). A higher ratio of n-3 to n-6 PUFAs was associated with higher infant length in both sexes (β= 0.40cm [95% CI: 0.01, 0.78] and 0.42cm [95% CI: 0.05, 0.79] per unit increase for males and females, respectively). These associations were not detectable later in childhood and young adulthood. No associations with BMI were found at any time point examined., Conclusions: Our findings suggest a small sex-specific influence of PUFA status at birth on length in infancy, but this does not persist in later life up to young adulthood. PUFA status at birth does not seem to affect BMI from infancy till young adulthood., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools' focus on academic performance and a lack of involvement of school staff in program development. The potential cognitive and academic benefits of PA might increase chances of successful implementation. Therefore, the aim of this qualitative study was: (1) to explore the perceptions of teachers and principals with regard to implementation of additional PA aimed at improving cognitive and academic performance, and (2) to identify characteristics of PA programmes that according to them are feasible in daily school practice. Twenty-six face-to-face semi-structured interviews were conducted with primary school teachers (grades 5 and 6) and principals in The Netherlands, and analysed using inductive content analysis. Teachers and principals expressed their willingness to implement additional PA if it benefits learning. Time constraints appeared to be a major barrier, and strongly influenced participants' perceptions of feasible PA programmes. Teachers and principals emphasised that additional PA needs to be short, executed in the classroom, and provided in "ready-to-use" materials, i.e., that require no or little preparation time (e.g., a movie clip). Future research is needed to strengthen the evidence on the effects of PA for academic purposes, and should examine the forms of PA that are both effective as well as feasible in the school setting., Competing Interests: The authors declare no conflict of interest.

Introduction: The influence of n -3 long-chain polyunsaturated fatty acids ( n -3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However, what is unknown is how common these problems are in n -3 LCPUFA supplementation studies in children and adolescents. Therefore, this paper will review n -3 LCPUFA supplementation studies in children and adolescents with regard to recruitment, adherence and drop-out rates., Methods: The Web of Science, PubMed and Ovid databases were searched for papers reporting on RCT supplementing children and adolescents (2-18 years) with a form of n -3 LCPUFA (or placebo) for at least four weeks. As a proxy for abiding to CONSORT guidelines, we noted whether manuscripts provided a flow-chart and provided dates defining the period of recruitment and follow-up., Results: Ninety manuscripts (reporting on 75 studies) met the inclusion criteria. The majority of the studies did not abide by the CONSORT guidelines: 55% did not provide a flow-chart, while 70% did not provide dates. The majority of studies provided minimal details about the recruitment process. Only 25 of the 75 studies reported an adherence rate which was on average 85%. Sixty-five of the 75 studies included drop-out rates which were on average 17%., Conclusion: Less than half of the included studies abided by the CONSORT guidelines (45% included a flow chart, while 30% reported dates). Problems with recruitment and drop-out seem to be common in n -3 LCPUFA supplementation trials in children and adolescents. However, reporting about recruitment, adherence and dropout rates was very heterogeneous and minimal in the included studies. Some techniques to improve recruitment, adherence and dropout rates were identified from the literature, however these techniques may need to be tailored to n -3 LCPUFA supplementation studies in children and adolescents.

Background: The majority of studies investigating associations between physical activity and mental health in adolescents have been cross-sectional in design. Potential associations between physical activity and mental health may be better examined longitudinally as physical activity levels tend to decrease in adolescence. Few studies have investigated these associations longitudinally in adolescents and none by measuring physical activity objectively., Methods: A total of 158 Dutch adolescents (mean age 13.6 years, 38.6% boys, grades 7 and 9 at baseline) participated in this longitudinal study. Physical activity, depressive symptoms and self-esteem were measured at baseline and at the 1-year follow-up. Physical activity was objectively measured with an ActivPAL3™ accelerometer during one full week. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) and self-esteem was assessed with the Rosenberg Self-Esteem Scale (RSE). Results were analysed using structural equation modelling., Results: Physical activity levels decreased 15.3% over a 1-year period (p < .001), with significantly (p = .001) greater decreases during grade 7 (-20.7%) than during grade 9 (-5.0%). Overall, depressive symptoms decreased (-12.1%, p < .001) over a 1-year period, while self-esteem did not change significantly (+2.9%, p = .066). Higher levels of depressive symptoms at baseline predicted a greater decline in depressive symptoms (β = -.51, p < .001) and higher levels of self-esteem at baseline predicted a smaller increase in self-esteem (β = -.48, p < .001). The decline in physical activity did not appear to predict any change in depressive symptoms and self-esteem., Conclusion: The decline in physical activity over a 1-year period during adolescence is not associated with a change in mental health. Further studies in adolescents aiming to investigate whether a change in physical activity is associated with a change in mental health should control for baseline levels of mental health and academic year differences.