Impact of energy-dense food intake on cognitive functions in schoolchildren: moderating role of cardiometabolic health parameters and emotional well-being (PACH study)

Cognitive skills play fundamental role in learning, problem-solving, and adapting to new information and everyday situations, enabling children to effectively process and retain knowledge. This study investigated relations between dietary habits, cardiometabolic health parameters, emotional well-being and cognitive performance in schoolchildren. Prospective longitudinal study involved 106 pupils (aged 8 – 10 years; 53.5% boys) over three consecutive years. Dietary habits and emotional well-being were assessed by food frequency survey and revised children's anxiety and depression scale (RCADS-25). Cognitive functions were determined by Vienna test system – determination test (DT), visual pursuit test (VPT), reaction test (RT) and computerised cognitive function tests. For determination of cardiorespiratory (CRF) level pupils performed Kasch Pulse Recovery test. Latent growth curve model was used to test whether changes in cognitive functions over time are linear. Linear mixed model (LMM) analysis was used to identify influencing factors. Principal component analysis (PCA) was used to reduce food group dimensionality by creating principal components (PC), PCs were included in LMM. PCA identified 2 PCs, PC1 and PC2 represented energy-dense foods and nutrient dense foods, respectively. Increase of PC1 score was associated with decreased correct responses in DT (mean estimate -5.11 s) and decrease in VPT score (mean estimate -1.60). Increase in systolic blood pressure (BP) was associated with increase in RT reaction time (mean estimate 1.41 ms). RCADS-25 score, waist circumference (WC), CRF and low-density lipoprotein (LDL) showed to have a moderating effect on relation between cognitive performance and intake of energy-dense foods; emotional well-being on number of DT correct responses (mean—1SD -8.70); WC – on executive function test results (mean -1SD -0.88) and CRF on VPT score (mean -1SD -2.89), as well as between systolic BP and RT reaction time (mean -1SD 2.78 ms). LDL was a moderator between glucose levels and DT median reaction time (mean + 1SD 0.05 s). More frequent consumption of energy-dense foods, higher systolic BP and WC were associated with poorer cognitive performance. RCADS-25 score, WC, CRF, LDL were identified as moderators. LDL as moderator highlighted negative impact of increased glucose levels in combination with increased LDL on cognitive performance.