© Freund Publishing House Ltd., London Journal of Pediatric Endocrinology & Metabolism, 23, xxx-xxx (2010)
VOLUME 23, NO. 8, 2010 1
Cognitive Profile, Parental Education and BMI in Children:
Reflections on Common Neuroendrocrinobiological Roots
Pasquale Parisi
1
, Alberto Verrotti
2
, Maria Chiara Paolino
1
, Silvia Miano
1
, Antonella Urbano
1
,
Mariangela Bernabucci
1
, and Maria Pia Villa
1
1
Child Neurology, Paediatric Sleep Centre and Pediatric Endocrinology Division, Chair of Paediatrics,
II Faculty of Medicine, “Sapienza University” c/o Sant’Andrea Hospital”, Via di Grottarossa,
1035-1039 – 00189 , Rome,
2
Paediatric Department, University of Chieti, Chieti, Italy
ABSTRACT
Overweight and obesity may be associated
with cognitive problems and both may share
“neuroendocrinobiological roots” in common
cerebral areas. We investigated intellectual
performances and a possible “specific cogni-
tive profile” in overweight/obese children. A
cross-sectional study was conducted on 898
school children (6 to 13 years) attending
primary schools. Wechsler Intelligence Scale
for Children-revised (WISC-R) revealed sig-
nificant differences in performance intelli-
gence quotient (PIQ) scores between body
mass index (BMI) subgroups (p<0.01). Regres-
sion analysis identified BMI as the only
variable significantly related to PIQ (p<0.05).
Gender (p<0.05) and parental educational
score (p<0.001) were significantly related to
verbal intelligence quotient (VIQ). Parental
educational score was the only factor signi-
ficantly related to total intelligence quotient
(TIQ) (p<0.05). Parental education seems to
play a major role in TIQ and VIQ; a lower
PIQ score is clearly related to a higher BMI. A
routine neurocognitive assessment in over-
weight/obese children is recommended.
Finally, we have added some reflections on
common neuroendocrinobiological roots.
KEY WORDS
overweight, obesity, cognitive profile, intellectual
performance, psychometric tests, body mass
index
Corresponding author:
Pasquale Parisi, MD, PhD
pasquale.parisi@uniroma1.it; parpas@iol.it
INTRODUCTION
Childhood obesity has increased so
dramatically over the past 20 years in Western
countries that the World Health Organization now
recognizes the “obesity epidemic” as one of the
top 10 global health problems
1
. Public concerns
are due not only to the association of obesity with
adverse physical problems, but also to a possible
correlation between obesity and cognitive im-
pairment. Preliminary evidence suggests that
obesity is an independent contributor to cognitive
functioning that is unrelated to medical co-
morbidities (e.g. cardiovascular, metabolic,
hepatic complications), at least in extremely
obese patients
2
.
There is growing evidence pointing to a
correlation between obesity and impaired
cognitive
functions in adults
3-5
. On the other hand, an
unsupported dieting has also been associated with
impaired cognitive function (vigilance and
planning functions)
6
. By contrast, few studies
have focused on this topic in children; moreover,
the results of the studies conducted on children
have been contrasting, probably owing to the
confounding effects
7-9
exerted mainly by
socioeconomic characteristics
10
.
The association between addiction and obesity
is not believed to be merely casual
11
. The same
underlying brain mechanisms might play a role in
both substance-dependent and obese subjects
12,13
,
whose poorer performance in mental flexibility
has been demonstrated
5,8,14
. Other “comorbid
conditions” in obese children, such as depres-
sion
15
and low self-esteem
16
, have also been
reported.
Some authors have suggested that leptin may
play a role. Indeed, leptin deficiency is believed
to affect both food intake and neurodevelopment,