Children's executive functioning and health behaviors across pediatric life stages and ecological contexts

Nichole R Kelly¹, Derek Kosty², Yosef Bodovski³, Courtney K Blackwell⁴, Jody M Ganiban⁵, Jenae M Neiderhiser⁶, Dana Dabelea⁷, Diane Gilbert-Diamond^{8

9

10}, Judy L Aschner^{11

12}, Theresa M Bastain¹³, Carrie V Breton¹³, Nicole R Bush¹⁴, Catrina A Calub¹⁵, Carlos A Camargo¹⁶, Marie Camerota¹⁷, Lisa A Croen¹⁸, Amy J Elliott^{19

20}, Michelle Bosquet Enlow^{21

22}, Assiamira Ferrara¹⁸, Tina Hartert²³, Robert M Joseph²⁴, Margaret R Karagas²⁵, Rachel S Kelly²⁶, Kristen Lyall²⁷, Kelsey E Magee²⁸, Cindy T McEvoy²⁹, Francheska M Merced-Nieves³⁰, Thomas G O'Connor^{31

32

33}, Sara Santarossa³⁴, Susan L Schantz³⁵, Rebecca J Schmidt³⁶, Joseph B Stanford^{37

38}, Jennifer K Straughen³⁴, Annemarie Stroustrup^{39

40}, Nicole M Talge⁴¹, Rosalind J Wright³⁰, Qi Zhao⁴², Leslie D Leve⁴³; program collaborators for Environmental influences on Child Health Outcomes

Collaborators, Affiliations

Collaborators

program collaborators for Environmental influences on Child Health Outcomes:
P B Smith, K L Newby, L Adair, D Catellier, L Jacobson, D Cella, R Gershon, S L Teitelbaum, S Merhar, A Lampland, A Reynolds, M Hudak, G Pryhuber, P Moore, L Washburn, L Trasande, L Gatzke-Kopp, M Swingler, J M Mansbach, J M Spergel, M E Samuels-Kalow, M D Stevenson, C S Bauer, D Koinis Mitchell, S Deoni, V D'Sa, C S Duarte, C Monk, J Posner, G Canino, J Gern, E Zoratti, C Johnson, S Farzan, R Habre, I Hertz-Picciotto, A Hipwell, K Keenan, C Karr, F Tylavsky, A Mason, S Sathyanarayana, B Lester, B Carter, S Pastyrnak, C Neal, L Smith, J Helderman, L Leve, S T Weiss, A Litonjua, G O'Connor, R Zeiger, L Bacharier, R Tepper, H Volk, R Landa, S Ozonoff, R K Miller, H Simhan, C Buss, P Wadhwa, K Huff, M O'Shea, R Vaidya, R Obeid, C Rollins, K Bear, S Pastyrnak, M Lenski, R Singh, M Msall, J Frazier, S Gogcu, A Montgomery, K Kuban, L Douglass, H Jara, J M Kerver, C Barone, C Fussman, N Paneth, M Elliott, D Ruden, T Woodruff, C Porucznik, A Giardino, K Huddleston, R Nguyen, E Barrett, K Z LeWinn, S Swan

Affiliations

¹ Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA. nicholek@uoregon.edu.
² Prevention Science Institute, University of Oregon, Eugene, OR, USA.
³ Population Research Institute, Penn State University, University Park, PA, USA.
⁴ Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
⁵ Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.
⁶ Department of Psychology, Penn State University, University Park, PA, USA.
⁷ Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
⁸ Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
⁹ Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
¹⁰ Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
¹¹ Center for Discovery and Innovation, Hackensack Meridian Health, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
¹² Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
¹³ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁴ Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, Center for Health and Community, University of California, San Francisco, CA, USA.
¹⁵ Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.
¹⁶ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁷ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
¹⁸ Kaiser Permanente Division of Research, Oakland, CA, USA.
¹⁹ Avera Research Institute, Sioux Falls, SD, USA.
²⁰ Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
²¹ Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA.
²² Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
²³ Vanderbilt University Medical Center, Nashville, TN, USA.
²⁴ Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
²⁵ Department of Epidemiology, Geisel School of Medicine, Dartmouth, Hanover, NH, USA.
²⁶ Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
²⁷ AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
²⁸ University of Pittsburgh, Pittsburgh, PA, USA.
²⁹ Papé Pediatric Research Institute, Oregon Health and Science University, Portland, OR, USA.
³⁰ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
³¹ Department of Psychiatry, University of Rochester, Rochester, NY, USA.
³² Department of Neuroscience, University of Rochester, Rochester, NY, USA.
³³ Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
³⁴ Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA.
³⁵ Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
³⁶ Department of Public Health Sciences, MIND Institute, School of Medicine, University of California Davis, Sacramento, CA, USA.
³⁷ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA.
³⁸ Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
³⁹ Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Cohen Children's Medical Center, New Hyde Park, NY, USA.
⁴⁰ Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
⁴¹ Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
⁴² Department of Preventive Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA.
⁴³ Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA.

PMID: 39786706
PMCID: PMC12045159 (available on 2026-04-01)
DOI: 10.1007/s10865-024-00543-w

Children's executive functioning and health behaviors across pediatric life stages and ecological contexts

Nichole R Kelly et al. J Behav Med. 2025 Apr.

. 2025 Apr;48(2):230-250.

doi: 10.1007/s10865-024-00543-w. Epub 2025 Jan 9.

Authors

Collaborators

program collaborators for Environmental influences on Child Health Outcomes:
P B Smith, K L Newby, L Adair, D Catellier, L Jacobson, D Cella, R Gershon, S L Teitelbaum, S Merhar, A Lampland, A Reynolds, M Hudak, G Pryhuber, P Moore, L Washburn, L Trasande, L Gatzke-Kopp, M Swingler, J M Mansbach, J M Spergel, M E Samuels-Kalow, M D Stevenson, C S Bauer, D Koinis Mitchell, S Deoni, V D'Sa, C S Duarte, C Monk, J Posner, G Canino, J Gern, E Zoratti, C Johnson, S Farzan, R Habre, I Hertz-Picciotto, A Hipwell, K Keenan, C Karr, F Tylavsky, A Mason, S Sathyanarayana, B Lester, B Carter, S Pastyrnak, C Neal, L Smith, J Helderman, L Leve, S T Weiss, A Litonjua, G O'Connor, R Zeiger, L Bacharier, R Tepper, H Volk, R Landa, S Ozonoff, R K Miller, H Simhan, C Buss, P Wadhwa, K Huff, M O'Shea, R Vaidya, R Obeid, C Rollins, K Bear, S Pastyrnak, M Lenski, R Singh, M Msall, J Frazier, S Gogcu, A Montgomery, K Kuban, L Douglass, H Jara, J M Kerver, C Barone, C Fussman, N Paneth, M Elliott, D Ruden, T Woodruff, C Porucznik, A Giardino, K Huddleston, R Nguyen, E Barrett, K Z LeWinn, S Swan

Affiliations

¹ Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA. nicholek@uoregon.edu.
² Prevention Science Institute, University of Oregon, Eugene, OR, USA.
³ Population Research Institute, Penn State University, University Park, PA, USA.
⁴ Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
⁵ Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.
⁶ Department of Psychology, Penn State University, University Park, PA, USA.
⁷ Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
⁸ Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
⁹ Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
¹⁰ Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
¹¹ Center for Discovery and Innovation, Hackensack Meridian Health, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
¹² Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
¹³ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
¹⁴ Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, Center for Health and Community, University of California, San Francisco, CA, USA.
¹⁵ Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.
¹⁶ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹⁷ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
¹⁸ Kaiser Permanente Division of Research, Oakland, CA, USA.
¹⁹ Avera Research Institute, Sioux Falls, SD, USA.
²⁰ Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
²¹ Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA.
²² Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
²³ Vanderbilt University Medical Center, Nashville, TN, USA.
²⁴ Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
²⁵ Department of Epidemiology, Geisel School of Medicine, Dartmouth, Hanover, NH, USA.
²⁶ Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
²⁷ AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
²⁸ University of Pittsburgh, Pittsburgh, PA, USA.
²⁹ Papé Pediatric Research Institute, Oregon Health and Science University, Portland, OR, USA.
³⁰ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
³¹ Department of Psychiatry, University of Rochester, Rochester, NY, USA.
³² Department of Neuroscience, University of Rochester, Rochester, NY, USA.
³³ Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
³⁴ Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA.
³⁵ Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
³⁶ Department of Public Health Sciences, MIND Institute, School of Medicine, University of California Davis, Sacramento, CA, USA.
³⁷ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA.
³⁸ Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
³⁹ Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Cohen Children's Medical Center, New Hyde Park, NY, USA.
⁴⁰ Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
⁴¹ Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
⁴² Department of Preventive Medicine, The University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA.
⁴³ Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, USA.

PMID: 39786706
PMCID: PMC12045159 (available on 2026-04-01)
DOI: 10.1007/s10865-024-00543-w

Abstract

Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages. Pediatric participants (early childhood n = 2074, M_age = 6.4 ± 0.9 y; middle childhood n = 3230, M_age = 9.6 ± 1.2 y; adolescence n = 1416, M_age = 15.2 ± 1.7 y) were part of the Environmental influences on Child Health Outcomes (ECHO) Program. They completed neurocognitive tasks measuring cognitive flexibility, behavioral inhibition, and working memory. Parent- and/or child-report measures of dietary intake, physical activity, sleep duration and quality, income, and positive parenting were also collected. Neighborhood crime and greenspace were calculated from publicly available census-tract level indices. After adjusting for study site, child body mass index, and demographics, working memory was related in the hypothesized direction to several dietary behaviors within all pediatric life stages. Working memory and cognitive flexibility were positively related to physical activity in middle childhood and adolescence. In adolescence, behavioral inhibition was positively related to physical activity and inversely related to sugar-sweetened beverage and total caloric intake. Associations with sleep were all non-significant. All significant associations reflected small effect sizes. Income, positive parenting, greenspace, and crime did not significantly influence any of the EF-health behavior associations. Findings highlight the need to consider EF domains, specific health behaviors, and developmental stage in creating intervention strategies that target EF to improve health behaviors. The small effect sizes reinforce the need for multi-tiered interventions to maximize health.

Keywords: Child; Eating; Executive functioning; Physical activity; Sleep.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no competing interests to report. Ethics approval: The study protocol was approved by the single ECHO institutional review board, WCG IRB. Consent to participate: Written informed consent or parent's/guardian's permission was obtained along with child assent, as appropriate, for the ECHO Cohort Data and Biospecimen Collection Protocol participation and for participation in specific study sites. Consent for publication: Not applicable.

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Children's executive functioning and health behaviors across pediatric life stages and ecological contexts

Collaborators

Affiliations

Children's executive functioning and health behaviors across pediatric life stages and ecological contexts

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources