title: Obesity, fitness, and brain integrity in adolescence.
abstract: OBJECTIVE
  We set out to ascertain the relationship between insulin resistance, fitness, and brain structure and function in adolescents.
  
  
  METHODS
  We studied 79 obese and 51 non-obese participants who were recruited from the community, all without type 2 diabetes mellitus. All participants received medical, endocrine, neuropsychological, and MRI evaluations as well as a 6-minute walk test that was used to estimate fitness (maximal oxygen consumption).
  
  
  RESULTS
  Obese adolescents had significantly thinner orbitofrontal cortices and performed significantly worse on Visual Working Memory tasks and the Digit Vigilance task. Insulin sensitivity and maximal oxygen consumption (VO2 max) were both highly correlated with central obesity and orbitofrontal cortical thickness, although insulin sensitivity was the stronger predictor for orbitofrontal cortical thickness. We also found that VO2 max was the only significant physiological variable related to visual working memory.
  
  
  CONCLUSIONS
  This is the first study to report positive associations between insulin resistance, VO2 max, and frontal lobe brain integrity in adolescents. Given the importance of brain health for learning and school performance, we conclude that schools should also emphasize physical fitness in order to maintain structural and functional brain integrity and facilitate academic achievement.
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
authors.forename: Naima
authors.initials: N
authors.lastname: Ross
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
authors.forename: Po Lai
authors.initials: PL
authors.lastname: Yau
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY, USA; Departments of Medicine and Radiology, New York University School of Medicine, New York, NY, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA. Electronic address: antonio.convit@med.nyu.edu.
authors.forename: Antonio
authors.initials: A
authors.lastname: Convit
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology*; D063766:Pediatric Obesity / Q000473:pathology / Q000503:physiopathology*; D010809:Physical Fitness / Q000502:physiology*; D017397:Prefrontal Cortex / Q000473:pathology*; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: Adolescence; Fitness; Obesity; Orbitofrontal cortex; VO(2) max
references.citation: PLoS One. 2013;8(4):e60393
references.pmid: 23593210
references.citation: Brain Res. 2013 May 28;1512:22-36
references.pmid: 23548596
references.citation: Neuroimage. 2013 Nov 15;82:510-6
references.pmid: 23769914
references.citation: World J Pediatr. 2013 Nov;9(4):307-11
references.pmid: 24235064
references.citation: JAMA Pediatr. 2014 Jun;168(6):561-6
references.pmid: 24710576
references.citation: Neurobiol Aging. 2014 Sep;35 Suppl 2:S20-8
references.pmid: 24952993
references.citation: Obesity (Silver Spring). 2014 Aug;22(8):1865-71
references.pmid: 24891029
references.citation: Br J Sports Med. 2014 Oct;48(20):1508-12
references.pmid: 23410883
references.citation: J Clin Endocrinol Metab. 2000 Jul;85(7):2402-10
references.pmid: 10902785
references.citation: J Clin Epidemiol. 2008 Jul;61(7):646-53
references.pmid: 18359190
references.citation: Pak J Biol Sci. 2007 Jun 15;10(12):1963-9
references.pmid: 19093433
references.citation: Hum Brain Mapp. 2010 Mar;31(3):353-64
references.pmid: 19662657
references.citation: Acta Cir Bras. 2010 Apr;25(2):194-200
references.pmid: 20305888
references.citation: Psychosom Med. 2010 Apr;72(3):239-52
references.pmid: 20223924
references.citation: J Pediatr. 2010 Dec;157(6):917-922.e1-5
references.pmid: 20673915
references.citation: Proc Natl Acad Sci U S A. 2011 Feb 15;108(7):3017-22
references.pmid: 21282661
references.citation: Prev Med. 2011 Jun;52 Suppl 1:S29-35
references.pmid: 21291906
references.citation: Obesity (Silver Spring). 2011 Jul;19(7):1382-7
references.pmid: 21350433
references.citation: MMWR Morb Mortal Wkly Rep. 2011 Dec 16;60(49):1673-8
references.pmid: 22169977
references.citation: Diabetes Metab Res Rev. 2012 Jan;28(1):76-83
references.pmid: 21695767
references.citation: Obes Rev. 2012 Mar;13(3):275-86
references.pmid: 22106927
references.citation: Brain Behav Immun. 2012 Jul;26(5):811-9
references.pmid: 22172477
references.citation: Psychiatry Res. 2012 Apr 30;202(1):77-9
references.pmid: 22595506
references.citation: Pediatrics. 2012 Oct;130(4):e856-64
references.pmid: 22945407
references.citation: Eur Heart J. 2000 Apr;21(7):540-9
references.pmid: 10775009
references.citation: Child Obes. 2014 Jun;10(3):251-9
references.pmid: 24783961
references.citation: IEEE Trans Med Imaging. 2001 Jan;20(1):70-80
references.pmid: 11293693
references.citation: Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
references.pmid: 12091180
references.citation: Am J Clin Nutr. 2002 Sep;76(3):653-8
references.pmid: 12198014
references.citation: Psychol Sci. 2003 Mar;14(2):125-30
references.pmid: 12661673
references.citation: Ann Epidemiol. 2003 Nov;13(10):683-91
references.pmid: 14599732
references.citation: JAMA. 2003 Dec 17;290(23):3092-100
references.pmid: 14679272
references.citation: Neuroimage. 2004;23 Suppl 1:S69-84
references.pmid: 15501102
references.citation: Am J Clin Nutr. 1999 Mar;69(3):373-80
references.pmid: 10075319
references.citation: J Clin Endocrinol Metab. 2005 Jun;90(6):3262-7
references.pmid: 15784710
references.citation: Med Sci Sports Exerc. 2005 Nov;37(11):1967-74
references.pmid: 16286868
references.citation: Eur J Cardiovasc Prev Rehabil. 2007 Aug;14(4):526-31
references.pmid: 17667643
references.citation: Obesity (Silver Spring). 2007 Aug;15(8):2135-44
references.pmid: 17712133