The relationship between extracurricular physical activities, mental health, cognitive ability, and academic performance: A longitudinal association study of children and adolescents with obesity in China

The relationship between extracurricular physical activities, mental health, cognitive ability, and academic performance: A longitudinal association study of children and adolescents with obesity in China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The relationship between extracurricular physical activities, mental health, cognitive ability, and academic performance: A longitudinal association study of children and adolescents with obesity in China Bao Gen zhang, Xiao Fang Qian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8135438/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Apr, 2026 Read the published version in Scientific Reports → Version 1 posted 19 You are reading this latest preprint version Abstract Purpose: Exploring the effects of extracurricular sports activities on the academic performance of adolescents with obesity and their psychological and cognitive mechanisms. Patients and Methods: The study included 221 adolescents with a BMI ≥ 24, with a mean age at baseline period of 14.67±1.33 years and a follow-up period of 15.44±1.29 years. Through two waves of surveys separated by a year, extracurricular sports activity time, mental health, cognitive ability, and academic performance were measured, and the chain-mediating effect was tested using a structural equation model. Results : (1) Baseline extracurricular sports activities can significantly positively predict academic performance after one year; (2) Mental health did not have a significant mediating effect between extracurricular sports activities and academic performance, but cognitive ability has a significant mediating effect between extracurricular sports activities and academic performance. (3) The chain mediating effect was significant, and there was an action path of "extracurricular sports activities→ mental health→ cognitive ability→ academic performance." Conclusion: Implementing a physical activity intervention grounded in psychological support and focused on cognitive development in adolescents with obesity may be more effective at improving their academic performance. Educational practitioners should consider psychological experiences and cognitive challenges when designing physical activity programs to achieve the comprehensive educational benefits of "physical and mental co-construction.” Health sciences/Health care Biological sciences/Psychology Social science/Psychology extracurricular sports activities academic performance mental health cognitive ability Obesity Introduction Multidimensional Developmental Dilemmas in Children and Adolescents with Obesity Obesity in children and adolescents has been one of the most serious public health challenges worldwide since the beginning of the 21st century. According to data from the World Health Organization, the obesity rate among children and adolescents worldwide has been increasing for many years, reaching epidemic levels in many countries 1 . In China, with the rapid development of its economy, the significant improvement in people's living standards, and significant lifestyle changes, the obesity rate among children and adolescents has shown a significant upward trend, making it the country with the highest number of people with obesity 2 . Obesity in children and adolescents directly endangers physical health by increasing the risk of diseases such as cardiovascular disease, diabetes, and bone problems. Also, it has a profound impact on key areas such as mental health, social cognition, and academic performance 3 . Studies have shown that children with obesity and adolescents are more likely to suffer from depression and anxiety than their normal weight peers, because they are more likely to suffer from social stigma, peer bullying, and discrimination. These factors result in a significantly higher incidence of negative emotional states such as damaged self-esteem, social avoidance, anxiety, and depression 3, 4 . This psychological stress creates immediate distress and can form a vicious cycle, further leading to unhealthy coping behaviors, such as emotional eating and reduced physical exercise 5 . A growing body of research suggests that obesity can negatively affect academic cognitive abilities, such as working memory, cognitive flexibility, and inhibitory control, in children and adolescents 6 . Neuroimaging studies also suggest that children with obesity have weakened brain activity during cognitive control tasks, indicating reduced neural efficiency and academic-related cognitive processing 7 . Negative mental health and cognitive deficits inevitably restrict academic performance. The results of a series of cross-sectional surveys also showed that children with obesity and adolescents tend to perform less academically than their normal-weight peers, which may be the result of a combination of factors, including lower attendance, decreased learning engagement, low classroom participation, and potential cognitive disparities 8, 9 . However, few studies have systematically examined how extracurricular physical activity influences the academic performance of adolescents with obesity, accounting for the combined effects of mental health and cognitive ability, leaving an important gap in understanding the mechanisms linking physical and academic development in this group. To address this complex health and developmental dilemma, it is crucial to develop effective intervention strategies. Extracurricular sports activities are widely recognized as the central means of preventing and managing obesity, and their benefits have been well documented. Extracurricular physical activities improve mental health problems such as depression, social interaction, and self-confidence in children and adolescents with obesity, and improve their cognitive function and academic performance 10 . However, how extracurricular sports activities improve the academic performance of children and adolescents with obesity, especially how to ultimately improve academic performance through the dual pathways of mental health and cognition, the mechanisms of which are yet to be established, is an intrinsic mechanism specific to the people with obesity group. This has become a core problem that needs to be urgently addressed in the field of health education. Literature review Impact of extracurricular sports activities on mental health and cognitive function in children and adolescents Physical activity can be divided into two types: structured and unstructured. Structured physical activity usually refers to activities planned with clear objectives, such as physical education classes. Extracurricular sports activities, on the other hand, refer to sports activities outside the school physical education curriculum, in which students voluntarily participate in organized or spontaneous forms of physical activity, have the characteristics of independent selectivity, are interest-oriented, and are relatively relaxed environments that are more likely to stimulate the enthusiasm and persistence of children and adolescents to participate 11 . Many empirical studies have shown that extracurricular physical activity can improve body composition and weight control in children and adolescents 12 , increase bone density 13 , and enhance basal metabolic rate 14 and cardiopulmonary function 15 . The value of adolescents' participation in extracurricular sports activities goes far beyond these physiological aspects. Recent research has shown that extracurricular sports activities have a profound positive impact on mental health and cognitive function in children and adolescents. In terms of mental health, relevant studies have consistently shown that systematic and regular participation in extracurricular sports activities can significantly reduce the level of poor mental health in children and adolescents, such as by significantly reducing anxiety and depressive symptoms 16 and improving subjective well-being and life satisfaction 17 . The mechanism by which extracurricular sports activities promote mental health in children and adolescents involves multiple levels of complex pathways, both biological and sociopsychological. At the biological level, a review of 37 related studies suggested that regular extracurricular physical activity can improve the symptoms of depression and anxiety through neuroendocrine and inflammatory inhibition and brain structure optimization 18 . Extracurricular physical activity can also increase brain-derived neurotrophic factor levels, which are directly associated with increases in hippocampal volume and reduce the risk of depression in children and adolescents 19 . At the psychosocial level, participation in extracurricular sports activities provides a platform for children and adolescents to compete and confront one another through teamwork and communication. In this process, children and adolescents have the opportunity to receive peer support, build positive friendships, develop social skills, and gain successful experiences and recognition, which directly and significantly enhance their self-efficacy 20 , physical self-esteem, and overall self-esteem 21 . In terms of cognitive function, extracurricular sports activities play a particularly important role in shaping the brain structure and function. Neuroimaging evidence suggests that regular participation in extracurricular sports activities in children and adolescents can enhance gray matter volume and thickness in the prefrontal cortex and optimize neural network connectivity efficiency 22 . In addition, extracurricular physical activities have been shown to significantly improve cognitive flexibility 23 , working memory, and the ability to suppress impulses and control extraneous interference in children and adolescents 24 . These higher-order cognitive abilities are the cornerstones of classroom learning, problem solving, and academic achievement. The impact of mental health and cognitive ability on the academic performance of children and adolescents Academic performance is a core indicator of children's and adolescents' development, and its merits and demerits are shaped by a large and complex ecosystem. Traditional research emphasizes the decisive roles of intelligence, learning motivation, teaching quality, and family socioeconomic status. However, contemporary psychosocial models clearly demonstrate the significant contributions of mental health and cognitive function to academic achievement. In recent years, many high-impact empirical studies have examined the mechanisms by which these two core factors affect academic performance. Mental health status, especially depression and anxiety in mood disorders, is a significant predictor of academic performance decline 25, 26 . In the context of anxiety, children and adolescents have an increased probability of abnormal amygdala-prefrontal functional connections, resulting in a temporary decrease in working memory capacity and an increase in the error rate of problem-solving 27 . Depressive symptoms significantly affect academic performance by significantly eroding intrinsic learning motivation and goal-oriented behavior, reducing the frequency of deep learning strategies, and significantly affecting academic performance 28 . Empirical studies have also shown that anxiety symptoms, especially social anxiety, can seriously interfere with classroom questioning, group cooperation, and teacher-student interactions, hindering knowledge acquisition and application 29 . As a core element of children's and adolescents' learning, cognitive ability has a systematic, multilevel impact on academic performance, and its components, such as working memory, executive function, and metacognition, are highly related to performance in specific subjects. Neuroimaging studies have shown that working memory capacity positively correlates with problem-solving and reading comprehension 30, 31 . As a higher-order cognitive regulation system, cognitive ability includes three components — inhibitory control, cognitive flexibility, and working memory update —that have a broad impact on academic performance. Studies have shown that the effect of cognitive ability on the academic performance of children and adolescents increases with age 32 . Cognitive ability usually supports learning through cognitive flexibility by promoting the transformation of problem-solving strategies, inhibitory control, and goal maintenance 33, 34 Recent studies have shown that metacognitive training can improve academic performance in children and adolescents. Its mechanisms include promoting deep integration of concepts, optimizing the selection of learning strategies, and enhancing the monitoring of learning processes 35 . The connection between mental health and cognitive ability in extracurricular sports activities, academic performance, and the exploration of integration models Although there are extensive theoretical associations and preliminary empirical support for extracurricular physical activity, mental health, cognitive ability, and academic performance, the integration of these four core variables into a clear mechanism of action model, specifically for children and adolescents with obesity, is still in its infancy, and there are significant gaps: First, most of the literature focuses on a single path, discussing the direct impact of extracurricular sports activities on mental health or cognitive ability, or the direct impact of mental health and cognitive ability on academics. However, the ultimate effect of extracurricular physical activities on improving the academic performance of children and adolescents is not achieved through a single path of cognitive ability or mental health, but rather through two parallel paths that are independent of each other and may interact. For example, extracurricular sports activities can enhance children's and adolescents' self-esteem and improve their emotional state, which may further enhance their learning motivation and classroom participation 18, 36 . At the same time, extracurricular sports activities can directly improve the cognitive function of children and adolescents. Improved executive function directly enhances the efficiency of information processing and the ability to apply learning strategies, both of which contribute to improved academic performance 37 . The lack of paths will lead to an underestimation of the effect size of extracurricular physical exercise on academic performance or a deviation in the understanding of the mechanism, resulting in incomplete and systematic intervention planning, and the final intervention effect will be poor. Second, the specific mechanisms underlying obesity are questionable. Most existing association studies on extracurricular physical activity, mental health, cognitive performance, and academic performance are based on normal-weight groups or undifferentiated weight statuses. Children and adolescents with obesity may face unique physiological limitations such as low physical fitness and exercise discomfort at the physiological level 38, 39 ; psychological disorders such as sports shame and low self-efficacy; social obstacles such as peer ridicule and stigma at the social level 40 ; and special conditions such as baseline disadvantages in cognitive function 41 , resulting in significantly different exercise patterns, experiences, and effects. Existing studies have pointed out that if extracurricular sports activities effectively release the cognitive resources of children and adolescents with obesity, it is necessary to prioritize reducing their heavy psychological burden in terms of depression and anxiety 42 . Other studies have shown that improving obesity-related physiological disorders may be a unique biological premise of physical activity that promotes mental health and cognitive performance 43 . These potential group-specific pathways of action must be verified in individuals with obesity. Third, in terms of research methodology, most existing studies rely on cross-sectional surveys, making it difficult to establish causal associations among variables and their dynamic trajectories over time. Psychological state, cognitive ability, and academic performance of children and adolescents with obesity exhibit significant developmental and temporal characteristics. The intervention effect of extracurricular sports activities on cognitive function and academic achievement in this group usually accumulates over a period before gradually appearing. However, previous studies have generally lacked longitudinal designs, making it difficult to systematically explain how extracurricular sports activities have a sustained, lagged impact on academic performance by improving mediating variables such as mental health and cognitive function over time. Revealing such time lags and cumulative effects is of great theoretical value for clarifying internal mechanisms and identifying key intervention windows. Therefore, this study proposes adopting a longitudinal tracking design to systematically explore the dynamic associations among extracurricular physical activity, mental health, cognitive ability, and academic performance in children and adolescents with obesity, and their evolution over time. H1: Extracurricular sports activities in T1 significantly positively predict academic performance in T2. H2: Mental health at T2 mediates the relationship between extracurricular physical activity at T1 and academic performance at T2 H3: T2 cognitive abilities play a mediating role between extracurricular physical activity at T1 and academic performance at T2. H4: Mental health in T2 and cognitive performance in T2 play chain-mediating roles between extracurricular physical activity in T1 and academic performance in T2. By analyzing the multi-dimensional benefits and potential mechanisms generated by this group in the process of participating in extracurricular sports activities, this study aimed to provide an empirical basis for the construction of a structured and precise multi-dimensional intervention program to help block the adverse developmental chain related to obesity and promote the overall improvement of this group in terms of physical health, psychological state, cognitive ability, and academic achievement. Methods Data sources Data for this study were obtained from the China Education Tracking Survey. CEPS from baseline (including a total of 19,487 subjects) and follow-up data after one year (9,449 subjects were successfully followed). The above data has been disclosed to the academic community (available at the website: http://ceps.ruc.edu.cn/English/Home.htm). This research was performed following the principles of the Declaration of Helsinki. The study protocol received review and approval from the Ethics Committee of Chinese University, and all parents/guardians provided written informed consent agreement for participation.To construct an effective tracking sample, extreme data that do not conform to common sense are excluded; second, the data of the two surveys are matched and screened according to the following criteria: complete records of mental health, cognitive ability, and academic performance during the T1 and T2 periods; body mass index (BMI) not less than 24. After screening, the final sample size included 221 participants, of whom 135 were boys and 86 were girls. The mean age at the first survey (T1) was 13.87±1.14 years, and the mean age at the second survey (T2) was 14.92±1.28 years. Variable measurement Extracurricular sports activities In this study, the amount of extracurricular physical activity on weekends was used as an independent variable, calculated as follows: students self-reported the average daily extracurricular physical activity time on weekends, then multiplied it by two to obtain the total amount of extracurricular physical activity on weekends. Mental health Students’ mental health status was evaluated using the Mental Health Short Version Scale of the Center for Epidemiological Research. The scale requires students to independently review their emotional experiences in the past seven days, covering the 10 dimensions of anxiety, depression, unhappiness, sadness, and meaninglessness in life. Example questions included, "How often have you been depressed in the past seven days?" The options were scored on a five-point Likert scale (1= never , 2= rarely , 3= sometimes , 4= often , and 5= always ). The scale has 10 items, with a total score ranging from 5 to 50 points; higher scores indicate worse mental health. In this study, the internal consistency reliability of the scale was good, with Cronbach's α coefficient of 0.913 and 0.905 at T1 and T2, respectively, and the half-folded reliability of 0.877 and 0.849, respectively. Cognitive ability In this study, the CEPS cognitive ability test score was introduced as an independent variable, with a total score of 30 points. The test covers a variety of reasoning question types, including language analogy, numerical laws, and spatial graphics. It aims to systematically measure subjects' basic cognitive functions, such as logical thinking, pattern recognition, and problem-solving. The test results included parameter calibration and score standardization using the item response theory (IRT) model to provide comparable ability estimates and effectively reduce endogenous bias caused by cognitive ability differences. Academic performance The CEPS data included the average scores of the three core subjects: Chinese, mathematics, and English. In this study, the average grades of the three were summed and divided by three to obtain an average academic performance score. Subject scores have a key impact on the selection process of junior high school students. Data analysis After extracting the heading data from the database, extreme values and invalid responses were removed, and the missing samples were identified and screened to complete matching valid samples that met the research conditions. Subsequently, the variable codes were uniformly revised, and the cleaned data were imported into SPSS 25 to perform univariate descriptive statistics and correlation analyses among multiple variables. In addition, to further investigate the structural relationships among variables, ProcessV4.0 was used to conduct statistical modeling and analysis of chain mediation. Common method bias test Data on variables such as extracurricular physical activities, mental health, cognitive ability, and academic performance in this study were collected via students' self-reports at 1-year intervals. Due to the continued use of similar measurements across time periods, there may be a potential risk of common methodological biases. To test this, all items in both measurements were included in Harman’s one-factor test. The results showed that the variance explained by the first common factor was 23.69%, which was lower than the discriminant threshold of 40%, indicating that there was no serious common-method bias in this study. Results Describe statistics and correlation analysis Descriptive statistics and correlation analysis results for T1 physical activity, T2 mental health, T2 cognitive ability at T2, and academic performance are shown in Table 1. The results of the correlation analysis showed a significant correlation among the four representations, indicating that extracurricular physical activities were associated with mental health, cognitive ability, and academic performance over time and across synchronization for 1 year. There was a lagging correlation between the variables, consistent with the basic assumptions of the longitudinal design. Table 1. Descriptive statistics and correlation coefficient matrix of each variable M SD T1 Extracurricular Physical Activities T2 mental health T2 cognitive abilities T2 academic performance T1 extracurricular sports activities 34.25 32.38 1 T2 mental health 19.74 5.99 0.165 * 1 T2 cognitive abilities 21.56 5.45 0.306 ** 0.319 ** 1 T2 academic performance 64.44 22.06 0.315 ** 0.166 * 0.439 * 1 Note. M = mean; SD = standard deviation; T1 = Time 1; T2 = Time 2. ** indicates significance at the 0.01 level (two-tailed), and * indicates significance at the 0.05 level (two-tailed). Vertical correlation between variables In this study, the longitudinal chain mediation model was tested by using the process procedure for SPSS Version 4.0. The specific results are shown in Table 2 Table 2. The path coefficient of mediation benefit of T that affects y among students with obesity (n=221) Effect Item Effect HERSELF LLCI ULCI Direct effect X→Y 0.1299 0.0428 0.0456 0.2143 Indirect effect X-M1-Y 0.0016 0.0069 -0.0128 0.0158 T-M2-Y 0.0655 0.0258 0.0225 0.1237 X-M1-M2-Y 0.0117 0.0075 0.0003 0.0293 Total indirect effect 0.0788 0.0256 0.0351 0.1341 Total effect 0.2088 0.0438 0.1224 0.2951 Note. X = independent variable; Y = dependent variable; M1 = mediator 1 (mental health); M2 = mediator 2 (cognitive abilities); SE = standard error (originally labeled as HERSELF due to a typographical error); LLCI = lower limit of the 95% confidence interval; ULCI = upper limit of the 95% confidence interval. The correlation between variables was investigated using the path coefficients of the structural model (Table 2). The effect of extracurricular physical activity T1 on academic performance T2 was statistically significant (β = 0.1299; 95% CI [0.0456, 0.2143, excluding 0]). There was no significant or statistically significant effect of extracurricular sports activities on academic performance through the mediating effect of mental health (β=0.0016, 95% CI was -0.0128, 0.0158, including 0). The pathway of extracurricular sports activities affecting academic performance through cognitive ability was significant and statistically significant (β=0.0016, 95% CI = 0.0003, 0.0293, including 0). Discussion This study systematically explored the impact and mechanisms of extracurricular sports activities on academic performance through multiple mediating pathways—mental health and cognitive function — using a year-long, longitudinal follow-up survey. The following is a comprehensive discussion of the findings of this study in combination with the existing literature and theory. The continuous predictive effect of extracurricular sports activities on academic performance This study validated H1, i.e., that baseline (T1) extracurricular physical activity can significantly positively predict academic performance one year later (T2). This shows that, in adolescents with obesity, participation in extracurricular sports activities had a crowding effect on learning time and promoted medium- and long-term academic performance. From a mechanistic perspective, physical activity may affect academic achievement through multisystem synergy. At the physiological level, extracurricular physical activity helps improve cardiovascular function. It promotes the secretion of neuroactive substances, such as brain-derived neurotrophic factors, thereby optimizing brain function and cognitive flexibility 44 . At the psychosocial level, extracurricular sports activities provide an important platform for emotional regulation and social interaction, helping relieve stress and enhance a sense of belonging, thereby creating a more conducive emotional environment for learning 45 . This finding was consistent with international empirical studies on the strong association between physical activity and academic performance 46, 47 . This study further advanced previous research by focusing on the Chinese adolescents with obesity population and providing new evidence of the temporal and predictive association between extracurricular physical activity and academic performance through longitudinal data modeling. It also controlled for baseline academic performance, thereby enhancing the robustness of causal inference. Despite multiple disadvantages such as health risks, psychological adaptation challenges, and weak cognitive foundations in adolescents with obesity, this study found that extracurricular sports activities exhibit significant academic promotion functions. Additionally, the sample of this study was from the educational and cultural backgrounds of East Asia, which has a heavy schoolwork burden and attaches great importance to academic performance. In this context, the positive effects of extracurricular physical activities on academic performance were not attenuated by test-taking pressure. Still, they may be stronger, acting through mechanisms such as emotional regulation and cognitive enhancement. This finding has important reference value for educational policymaking, especially in promoting physical activity in cultural settings that emphasize academic performance. Mediating role of mental health The longitudinal mediation analysis found that T2 mental health had no significant effect on T1 extracurricular physical activities or T2 academic performance. Therefore, H2 was not validated. This finding suggested that extracurricular physical activity did not improve the academic performance of adolescents with obesity by improving mental health. This result differed from findings in studies based on the general population. It may suggest the presence of alternative, more direct pathways or stronger mediating variables that are specific to children and adolescents with obesity. Previous studies have shown that children and adolescents with obesity often experience psychosocial stressors such as weight stigma and peer exclusion 48, 49 . When the activity environment is supportive and inclusive, physical activity can offer these adolescents valuable experiences of social success, a sense of team belonging, and positive peer interactions that directly counter daily experiences of stigma and may lead to significant improvements in mental health 50 . Conversely, suppose the activity environment is filled with ridicule, competitive exclusion, or social rejection. In that case, physical activity itself may become a new stressor that weakens, negates, or even reverses its theoretically positive effects on mental health 51 . As Hawker's research on adolescent psychological stressors clearly points out, issues such as peer exclusion and bullying in social relationships are often more central stressors than the academics themselves 52 . Moreover, the mental health scale used in this study may not have captured the dimensions most relevant to academics, and the tracking time may be insufficient to observe the transformation of psychological benefits into academic outcomes. This finding reminds us that future studies should incorporate cognitive neural indicators and social relationship variables to reveal the internal mechanisms more clearly. Educators and parents should focus on building an inclusive, supportive, and process-oriented sports environment while attaching importance to physical activities to promote academic performance, emphasizing participation experience, cooperative interaction, and emotional development, rather than simply focusing on competition and sports performance, to give full play to the promotion function of physical activities in educational situations. Mediation of cognitive function Using a longitudinal mediation model, this study confirmed that T2 cognitive ability mediated the relationship between T1 extracurricular physical activity and T2 academic performance. This finding suggested that extracurricular sports activities directly affected academic performance and, indirectly, improved academic performance among adolescents with obesity by promoting the development of core cognitive functions. This result echoed the study of neural mechanisms underlying exercise-promoting brain plasticity and provided empirical support for the role of physical activity in cognitive and academic improvement. From a neural mechanism’s perspective, the theory of brain plasticity provides a strong explanation for this mediating pathway: regular physical activity can upregulate the expression of brain-derived neurotrophic factors and promote hippocampal neurogenesis and synaptic plasticity in the prefrontal cortex, thereby enhancing the neural basis of learning and memory 53-55 . However, cognitive load theory also supports this mechanism: physical activity helps improve core cognitive abilities, such as working memory and inhibitory control, enabling students to allocate cognitive resources more effectively, suppress extraneous interference, and optimize information processing efficiency, thereby reducing cognitive load and improving the effect of deep learning when completing academic tasks 56 . An important contribution of this study is that, even though obesity was associated with chronic inflammation 18 and impaired cognitive function 41 ,the positive effect of physical activity on cognitive function was still observed, indicating that it retained significant neuroprotective potential in adolescents with obesity. Therefore, extracurricular physical activity should be redefined as an effective cognitive intervention, rather than just a means of physical facilitation. Based on the above findings, we suggest that educational and curriculum makers should attach great importance to the fundamental role of physical activity in cognitive development and ensure students with obesity have opportunities and time to participate in physical activity. Particularly in an educational environment with increasing academic pressure, it is necessary to avoid reducing physical activity time due to a one-sided emphasis on academic training, and it should be regarded as an important way to improve cognitive readiness and support overall academic development. The chain mediating role of psychology and cognition This study confirmed the chain mediation hypothesis and identified a pathway of action with temporal and mechanistic continuity: T1 extracurricular physical activities, T2 mental health, T2 cognitive function, and T2 academic performance. The results showed that in adolescents with obesity, improvements in psychological state and cognitive function are not independent of each other but constitute a continuous mechanism of multi-stage sequential action. This finding supports the developmental view of mind-body synergy and suggests that emotion regulation efficacy has a prospective impact on higher-order cognitive processes. From the perspective of theoretical mechanisms, the extension-construction theory provides a partial explanation for this chain effect: physical activity can stimulate positive emotional experiences such as pleasure and accomplishment 20, 21 , expand individual cognitive and behavioral resources 22 , and accumulate long-term psychological capital such as psychological resilience and social support to provide the necessary preparation for subsequent cognitive activities 57 . However, the cognitive resource theory proposes a complementary explanation: emotional problems such as anxiety and depression may occupy and consume limited cognitive resources, thereby weakening individuals' ability to process information in learning tasks 27, 29 . In contrast, physical activity promotes academic performance by improving emotional state, releasing cognitive resources overwhelmed by emotional load, and reallocating them to higher cognitive processes, such as executive function and working memory 23 . Although similar pathway hypotheses have been proposed in existing theories, this study is the first to empirically verify this chain-mediation mechanism among adolescents with obesity, representing a significant theoretical innovation Unlike previous studies that examined only single pathways or cross-sectional associations, this research highlights the leading role of mental health in promoting cognitive function, demonstrating that mental health is not merely correlated with cognitive changes but serves as a crucial prerequisite for cognitive improvement. This finding is particularly applicable to adolescents with obesity, suggesting that the alleviation of psychological impairment may constitute a key condition for the effective release of their cognitive potential. At a practical level, this study's results emphasized that comprehensive intervention strategies must reflect phases and hierarchies. Physical activity design that focuses solely on cognitive challenges, such as performance-oriented, high-intensity training, and ignores psychological experiences, may undermine the effectiveness of interventions due to negative experiences such as frustration and body shame. On the contrary, effective programs should prioritize improving participants' mental health through supportive, inclusive activity designs and gradually integrate tasks with high cognitive demands to achieve synergistic gains in psychological, cognitive, and academic benefits. The ultimate goal is to build a developmental activity environment that combines psychological empowerment and cognitive development, and to achieve deep integration of physical and mental health with academic development. Research deficiencies and future prospects Although this study explored the mechanisms by which extracurricular sports activities affect academic performance through multiple psychological and cognitive pathways, using a longitudinal design, it still faces certain limitations that warrant further investigation. First, factors such as learning motivation, family socioeconomic background, and sex may have mixed effects on the relationship between extracurricular sports activities and academic performance. Future research may introduce more layers of variables or adopt more rigorous causal inference methods to estimate the net effect of extracurricular physical activities on academic performance more accurately. Second, the measurement of extracurricular sports activities relied mainly on students' self-assessment questionnaires, which may be subject to social expectation bias and recall error. In the future, objective devices such as accelerometers and heart rate monitors can be combined to achieve a multimodal evaluation of activity intensity, frequency, and type, enabling more accurate analysis of the correlation between different exercise loads and academic performance. Third, although this study verified the mediating role of mental health and cognitive performance, the measurement of these variables should be further refined. For example, mental health can be divided into dimensions, such as emotional symptoms, self-esteem, and social anxiety, and neurophysiological indicators can be used to reveal the mediating mechanisms more deeply. Finally, this study focused on mechanism verification, and no specific intervention plan was proposed. In the future, based on the results of this study, a structured physical activity program integrating cognitive training and psychological support should be developed, and its comprehensive benefits on academic performance and physical and mental health should be tested through randomized controlled trials. Overall, the findings highlight the importance of integrating physical activity, psychological support, and cognitive development in educational programs for adolescents with obesity, offering a comprehensive pathway toward improving both academic performance and well-being. Declarations Disclosure The authors report no financial sources or conflicts of interest regarding this work Funding This research was supported by Guangdong Provincial Sports Bureau Science and Technology Innovation Project (GDSS2024N106) and Guangdong Province Characteristic and Innovative Project for Regular Higher Education Institutions(2025wtscx061and2025wtscx103). Author Contribution Authors’ ContributionsZhang. BG (Conceptualization [lead], Writing—original draft [equal], Writing—review & editing [lead]), Qian. XF (Visualization [lead], Writing—review & editing [supporting]). Data Availability “The datasets analyzed in this study are available in the China Education Panel Survey (CEPS) repository at [http://ceps.ruc.edu.cn](http:/ceps.ruc.edu.cn) . Due to confidentiality protections regarding participant information, the raw data are not publicly accessible but can be requested through the CEPS official website upon reasonable justification.” References Heerman WJ, Kenney E, Block JP, Fiechtner L, McMahon E, Kruse L, Sharifi M, Edmondson EK, Virudachalam S. A Narrative Review of Public Health Interventions for Childhood Obesity. Curr Obes Rep . 2024; 13:87-97. DOI: 10.1007/s13679-023-00550-z. Zhang BG, Qian XF. Path of Physical Exercise's Impact on Deviant Behavior Among Chinese Adolescents. Psychol Res Behav Manag . 2024; 17:1561-1571. 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Curr Obes Rep . 2020; 9:402-411. DOI: 10.1007/s13679-020-00408-8. Hawker DSJ, Boulton MJ. Twenty Years' Research on Peer Victimization and Psychosocial Maladjustment: A Meta-analytic Review of Cross-sectional Studies. J Child Psychol Psychiatry . 2000; 41:441-455. DOI: 10.1111/1469-7610.00629. Rico-Gonzalez M, Gonzalez-Devesa D, Gomez-Carmona CD, Moreno-Villanueva A. Exercise as Modulator of Brain-Derived Neurotrophic Factor in Adolescents: A Systematic Review of Randomized Controlled Trials. Sports (Basel) . 2025;13. DOI: 10.3390/sports13080253. O Brien BJ, Evans S, Worn RL, Lavender AP, Bell LR, Cover T. High intensity interval training and its impact on brain-derived neurotrophic factor: a potential mechanism to reduce early onset dementia. Med Hypotheses . 2025; 202:111725. DOI: 10.1016/j.mehy.2025.111725. Jeon YK, Ha CH. The effect of exercise intensity on brain derived neurotrophic factor and memory in adolescents. Environ Health Prev Med . 2017; 22:27. 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According to data from the World Health Organization, the obesity rate among children and adolescents worldwide has been increasing for many years, reaching epidemic levels in many countries\u003csup\u003e1\u003c/sup\u003e. In China, with the rapid development of its economy, the significant improvement in people\u0026apos;s living standards, and significant lifestyle changes, the obesity rate among children and adolescents has shown a significant upward trend, making it the country with the highest number of people with obesity\u003csup\u003e2\u003c/sup\u003e. Obesity in children and adolescents directly endangers physical health by increasing the risk of diseases such as cardiovascular disease, diabetes, and bone problems. Also, it has a profound impact on key areas such as mental health, social cognition, and academic performance\u003csup\u003e3\u003c/sup\u003e. Studies have shown that children with obesity and adolescents are more likely to suffer from depression and anxiety than their normal weight peers, because they are more likely to suffer from social stigma, peer bullying, and discrimination. These factors result in a significantly higher incidence of negative emotional states such as damaged self-esteem, social avoidance, anxiety, and depression\u003csup\u003e3, 4\u003c/sup\u003e. This psychological stress creates immediate distress and can form a vicious cycle, further leading to unhealthy coping behaviors, such as emotional eating and reduced physical exercise\u003csup\u003e5\u003c/sup\u003e. A growing body of research suggests that obesity can negatively affect academic cognitive abilities, such as working memory, cognitive flexibility, and inhibitory control, in children and adolescents\u003csup\u003e6\u003c/sup\u003e. Neuroimaging studies also suggest that children with obesity have weakened brain activity during cognitive control tasks, indicating reduced neural efficiency and academic-related cognitive processing\u003csup\u003e7\u003c/sup\u003e. Negative mental health and cognitive deficits inevitably restrict academic performance. The results of a series of cross-sectional surveys also showed that children with obesity and adolescents tend to perform less academically than their normal-weight peers, which may be the result of a combination of factors, including lower attendance, decreased learning engagement, low classroom participation, and potential cognitive disparities\u003csup\u003e8, 9\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eHowever, few studies have systematically examined how extracurricular physical activity influences the academic performance of adolescents with obesity, accounting for the combined effects of mental health and cognitive ability, leaving an important gap in understanding the mechanisms linking physical and academic development in this group. To address this complex health and developmental dilemma, it is crucial to develop effective intervention strategies. Extracurricular sports activities are widely recognized as the central means of preventing and managing obesity, and their benefits have been well documented. Extracurricular physical activities improve mental health problems such as depression, social interaction, and self-confidence in children and adolescents with obesity, and improve their cognitive function and academic performance\u003csup\u003e10\u003c/sup\u003e. However, how extracurricular sports activities improve the academic performance of children and adolescents with obesity, especially how to ultimately improve academic performance through the dual pathways of mental health and cognition, the mechanisms of which are yet to be established, is an intrinsic mechanism specific to the people with obesity group. This has become a core problem that needs to be urgently addressed in the field of health education.\u003c/p\u003e"},{"header":"Literature review","content":"\u003cp\u003e\u003cstrong\u003eImpact of\u0026nbsp;extracurricular sports activities on mental health and cognitive function in children and adolescents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePhysical activity can be divided into two types: structured and unstructured. Structured physical activity usually refers to activities planned with clear objectives, such as physical education classes. Extracurricular sports activities, on the other hand, refer to sports activities outside the school physical education curriculum, in which students voluntarily participate in organized or spontaneous forms of physical activity, have the characteristics of independent selectivity, are interest-oriented, and are relatively relaxed environments that are more likely to stimulate the enthusiasm and persistence of children and adolescents to participate\u003csup\u003e11\u003c/sup\u003e. Many empirical studies have shown that extracurricular physical activity can improve body composition and weight control in children and adolescents\u003csup\u003e12\u003c/sup\u003e, increase bone density\u003csup\u003e13\u003c/sup\u003e, and enhance basal metabolic rate\u003csup\u003e14\u003c/sup\u003e and cardiopulmonary function\u003csup\u003e15\u003c/sup\u003e. The value of adolescents\u0026apos; participation in extracurricular sports activities goes far beyond these physiological aspects. Recent research has shown that extracurricular sports activities have a profound positive impact on mental health and cognitive function in children and adolescents.\u003c/p\u003e\n\u003cp\u003eIn terms of mental health, relevant studies have consistently shown that systematic and regular participation in extracurricular sports activities can significantly reduce the level of poor mental health in children and adolescents, such as by significantly reducing anxiety and depressive symptoms\u003csup\u003e16\u003c/sup\u003e and improving subjective well-being and life satisfaction\u003csup\u003e17\u003c/sup\u003e. The mechanism by which extracurricular sports activities promote mental health in children and adolescents involves multiple levels of complex pathways, both biological and sociopsychological. At the biological level, a review of\u0026nbsp;37\u0026nbsp;related studies suggested that regular extracurricular physical activity can improve the symptoms of depression and anxiety through neuroendocrine and inflammatory inhibition and\u0026nbsp;brain structure\u0026nbsp;optimization\u003csup\u003e18\u003c/sup\u003e. Extracurricular physical activity can also increase brain-derived neurotrophic factor levels, which are directly associated with increases in hippocampal volume and reduce the risk of depression in children and adolescents\u003csup\u003e19\u003c/sup\u003e. At the psychosocial level, participation in extracurricular sports activities provides a platform for children and adolescents to compete and confront one another through teamwork and communication. In this process, children and adolescents have the opportunity to receive peer support, build positive friendships, develop social skills, and gain successful experiences and recognition, which directly and significantly enhance their self-efficacy\u003csup\u003e20\u003c/sup\u003e, physical self-esteem, and overall self-esteem\u003csup\u003e21\u003c/sup\u003e. In terms of cognitive function, extracurricular sports activities play a particularly important role in shaping the brain structure and function. Neuroimaging evidence suggests that regular participation in extracurricular sports activities in children and adolescents can enhance gray matter volume and thickness in the prefrontal cortex and optimize neural network connectivity\u0026nbsp;efficiency\u003csup\u003e22\u003c/sup\u003e. In addition, extracurricular physical activities have been shown to significantly improve cognitive flexibility\u003csup\u003e23\u003c/sup\u003e, working memory, and the ability to suppress impulses and control extraneous interference\u0026nbsp;in children and adolescents\u003csup\u003e24\u003c/sup\u003e. These higher-order cognitive abilities are the cornerstones of classroom learning, problem solving, and academic achievement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe impact of\u0026nbsp;mental health and cognitive ability on the academic performance of children and adolescents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAcademic performance is a core indicator of children\u0026apos;s and adolescents\u0026apos; development, and its merits and demerits are shaped by a large and complex ecosystem. Traditional research emphasizes the decisive roles of intelligence, learning motivation, teaching quality, and family socioeconomic status. However, contemporary psychosocial models clearly demonstrate the significant contributions of mental health and cognitive function to academic achievement. In recent years, many high-impact empirical studies have examined the mechanisms by which these two core factors affect academic performance. Mental health status, especially depression and anxiety in mood disorders, is a significant predictor of academic performance decline\u003csup\u003e25, 26\u003c/sup\u003e. In the context of anxiety, children and adolescents have an increased probability of abnormal amygdala-prefrontal functional connections, resulting in a temporary decrease in working memory capacity and an increase in the error rate of problem-solving\u003csup\u003e27\u003c/sup\u003e. Depressive symptoms significantly affect academic performance by significantly eroding intrinsic learning motivation and goal-oriented behavior, reducing the frequency of deep learning strategies, and significantly affecting academic performance\u003csup\u003e28\u003c/sup\u003e. Empirical studies have also shown that anxiety symptoms, especially social anxiety, can seriously interfere with classroom questioning, group cooperation, and teacher-student interactions, hindering knowledge acquisition and application\u003csup\u003e29\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eAs a core element of children\u0026apos;s and adolescents\u0026apos; learning, cognitive ability has a systematic, multilevel impact on academic performance, and its components, such as working memory, executive function, and metacognition, are highly related to performance in specific subjects. Neuroimaging studies have shown that working memory capacity positively correlates with problem-solving and reading comprehension\u003csup\u003e30, 31\u003c/sup\u003e. As a higher-order cognitive regulation system, cognitive ability includes three components \u0026mdash; inhibitory control, cognitive flexibility, and working memory update \u0026mdash;that have a broad impact on academic performance. Studies have shown that the effect of cognitive ability on the academic performance of children and adolescents increases with age\u003csup\u003e32\u003c/sup\u003e. Cognitive ability usually supports learning through cognitive flexibility by promoting the transformation of problem-solving strategies, inhibitory control, and goal maintenance\u003csup\u003e33, 34\u003c/sup\u003eRecent studies have shown that metacognitive training can improve academic performance in children and adolescents. Its mechanisms include promoting deep integration of concepts, optimizing the selection of learning strategies, and enhancing the monitoring of learning processes\u003csup\u003e35\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe\u0026nbsp;connection between mental health and cognitive ability in extracurricular sports activities, academic performance, and the exploration\u0026nbsp;of integration models\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlthough there are extensive theoretical associations and preliminary empirical support for extracurricular physical activity, mental health, cognitive ability, and academic performance, the integration of these four core variables into a clear mechanism of action model, specifically for children and adolescents with obesity, is still in its infancy, and there are significant gaps:\u003c/p\u003e\n\u003cp\u003eFirst, most of the literature focuses on a single path, discussing the direct impact of extracurricular sports activities on mental health or cognitive ability, or the direct impact of mental health and cognitive ability on academics. However, the ultimate effect of extracurricular physical activities on improving the academic performance of children and adolescents is not achieved through a single path of cognitive ability or mental health, but rather through two parallel paths that are independent of each other and may interact. For example, extracurricular sports activities can enhance children\u0026apos;s and adolescents\u0026apos; self-esteem and improve their emotional state, which may further enhance their learning motivation and classroom participation\u003csup\u003e18, 36\u003c/sup\u003e. At the same time, extracurricular sports activities can directly improve the cognitive function of children and adolescents. Improved executive function directly enhances the efficiency of information processing and the ability to apply learning strategies, both of which contribute to improved academic performance\u003csup\u003e37\u003c/sup\u003e. The lack of paths will lead to an underestimation of the effect size of extracurricular physical exercise on academic performance or a deviation in the understanding of the mechanism, resulting in incomplete and systematic intervention planning, and the final intervention effect will be poor.\u003c/p\u003e\n\u003cp\u003eSecond, the specific mechanisms underlying obesity are questionable. Most existing association studies on extracurricular physical activity, mental health, cognitive performance, and academic performance are based on normal-weight groups or undifferentiated weight statuses. Children and adolescents with obesity may face unique physiological limitations such as low\u0026nbsp;physical fitness\u0026nbsp;and exercise discomfort at the physiological level\u003csup\u003e38, 39\u003c/sup\u003e; psychological disorders such as sports shame and low self-efficacy; social obstacles such as peer ridicule and stigma at the social level\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003e40\u003c/sup\u003e; and special conditions such as baseline disadvantages in cognitive function\u003csup\u003e41\u003c/sup\u003e, resulting in significantly different exercise patterns, experiences, and effects. Existing studies have pointed out that if extracurricular sports activities effectively release the cognitive resources of children and adolescents with obesity, it is necessary to prioritize reducing their heavy psychological burden in terms of depression and anxiety\u003csup\u003e42\u003c/sup\u003e. Other studies have shown that improving obesity-related physiological disorders may be a unique biological premise of physical activity that promotes mental health and cognitive performance\u003csup\u003e43\u003c/sup\u003e. These potential group-specific pathways of action must be verified in individuals with obesity.\u003c/p\u003e\n\u003cp\u003eThird, in terms of research methodology, most existing studies rely on cross-sectional surveys, making it difficult to establish causal associations among variables and their dynamic trajectories over time. Psychological state, cognitive ability, and academic performance of children and adolescents with obesity exhibit significant developmental and temporal characteristics. The intervention effect of extracurricular sports activities on cognitive function and academic achievement in this group usually accumulates over a period before gradually appearing. However, previous studies have generally lacked longitudinal designs, making it difficult to systematically explain how extracurricular sports activities have a sustained, lagged impact on academic performance by improving mediating variables such as mental health and cognitive function over time. Revealing such time lags and cumulative effects is of great theoretical value for clarifying internal mechanisms and identifying key intervention windows.\u003c/p\u003e\n\u003cp\u003eTherefore, this study proposes adopting a longitudinal tracking design to systematically explore the dynamic associations among extracurricular physical activity, mental health, cognitive ability, and academic performance in children and adolescents with obesity, and their evolution\u0026nbsp;over time.\u003c/p\u003e\n\u003cp\u003eH1: Extracurricular sports activities in\u0026nbsp;T1\u0026nbsp;significantly positively predict academic performance\u0026nbsp;in\u0026nbsp;T2.\u003c/p\u003e\n\u003cp\u003eH2: Mental health at T2 mediates the relationship between extracurricular physical activity at T1\u0026nbsp;and academic performance at T2\u003c/p\u003e\n\u003cp\u003eH3:\u0026nbsp;T2\u0026nbsp;cognitive abilities play a mediating role\u0026nbsp;between extracurricular physical activity at T1\u0026nbsp;and academic performance at T2.\u003c/p\u003e\n\u003cp\u003eH4: Mental health in\u0026nbsp;T2\u0026nbsp;and cognitive performance in\u0026nbsp;T2\u0026nbsp;play chain-mediating roles between extracurricular physical activity in\u0026nbsp;T1\u0026nbsp;and academic performance in\u0026nbsp;T2.\u003c/p\u003e\n\u003cp\u003eBy analyzing the multi-dimensional benefits and potential mechanisms generated by this group in the process of participating in extracurricular sports activities, this study aimed to provide an empirical basis for the construction of a structured and precise multi-dimensional intervention program to help block the adverse developmental chain related to obesity and promote the overall improvement of this group in terms of physical health, psychological state, cognitive ability, and academic achievement.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eData sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData for this study were obtained from the China Education Tracking Survey. CEPS from baseline (including a total of 19,487 subjects) and follow-up data after one year (9,449 subjects were successfully followed). The above data has been disclosed to the academic community (available at the website: http://ceps.ruc.edu.cn/English/Home.htm). This research was performed following the principles of the Declaration of Helsinki. The study protocol received review and approval from the Ethics Committee of Chinese University, and all parents/guardians provided written informed consent agreement for participation.To construct an effective tracking sample, extreme data that do not conform to common sense are excluded; second, the data of the two surveys are matched and screened according to the following criteria: complete records of mental health, cognitive ability, and academic performance during the T1 and T2 periods; body mass index (BMI) not less than 24. After screening, the final sample size included 221 participants, of whom 135 were boys and 86 were girls. The mean age at the first survey (T1) was 13.87\u0026plusmn;1.14 years, and the mean age at the second survey (T2) was 14.92\u0026plusmn;1.28 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVariable measurement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExtracurricular sports activities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the amount of extracurricular physical activity on weekends was used as an independent variable, calculated as follows: students self-reported the average daily extracurricular physical activity time on weekends, then multiplied it by two to obtain the total amount of extracurricular physical activity on weekends.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMental health\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudents\u0026rsquo; mental health status was evaluated using the Mental Health Short Version Scale of the Center for Epidemiological Research. The scale requires students to independently review their emotional experiences in the past seven days, covering the 10\u0026nbsp;dimensions of anxiety, depression, unhappiness, sadness, and meaninglessness in life. Example questions included, \u0026quot;How often have you been depressed in the past seven days?\u0026quot;\u0026nbsp;The\u0026nbsp;options were scored on a five-point Likert scale (1=\u003cem\u003enever\u003c/em\u003e,\u0026nbsp;2=\u003cem\u003erarely\u003c/em\u003e,\u0026nbsp;3=\u003cem\u003esometimes\u003c/em\u003e,\u0026nbsp;4=\u003cem\u003eoften\u003c/em\u003e, and 5=\u003cem\u003ealways\u003c/em\u003e). The scale has\u0026nbsp;10\u0026nbsp;items, with a total score ranging from 5\u0026nbsp;to\u0026nbsp;50\u0026nbsp;points; higher scores indicate worse mental health. In this study, the internal consistency reliability of the scale was good, with\u0026nbsp;Cronbach\u0026apos;s \u0026alpha;\u0026nbsp;coefficient of\u0026nbsp;0.913\u0026nbsp;and\u0026nbsp;0.905\u0026nbsp;at\u0026nbsp;T1\u0026nbsp;and\u0026nbsp;T2, respectively, and the half-folded reliability of\u0026nbsp;0.877\u0026nbsp;and\u0026nbsp;0.849, respectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCognitive ability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the CEPS cognitive ability test score was introduced as an independent variable, with a total score of\u0026nbsp;30\u0026nbsp;points. The test covers a variety of reasoning question types, including language analogy, numerical laws, and spatial graphics. It aims to systematically measure subjects\u0026apos; basic cognitive functions, such as logical thinking, pattern recognition, and problem-solving. The test results included parameter calibration and score standardization using the item response theory (IRT) model to provide comparable ability estimates and effectively reduce endogenous bias caused by cognitive ability differences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcademic performance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe CEPS data included the average scores of the three core subjects: Chinese, mathematics, and English. In this study, the average grades of the three were summed and divided by three to obtain an average academic performance score. Subject scores have a key impact on the selection process of junior high school students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter extracting the heading data from the database, extreme values and invalid responses were removed, and the missing samples were identified and screened to complete matching valid samples that met the research conditions. Subsequently, the variable codes were uniformly revised, and the cleaned data were imported into\u0026nbsp;SPSS 25\u0026nbsp;to perform univariate descriptive statistics and correlation analyses among multiple variables. In addition, to further investigate the structural relationships among variables,\u0026nbsp;ProcessV4.0 was used to conduct statistical modeling and analysis of chain mediation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCommon method bias test\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData on variables such as extracurricular physical activities, mental health, cognitive ability, and academic performance in this study were collected via students\u0026apos; self-reports at 1-year intervals. Due to the continued use of similar measurements across time periods, there may be a potential risk of common methodological biases. To test this, all items in both measurements were included in Harman\u0026rsquo;s one-factor test. The results showed that the variance explained by the first common factor was 23.69%, which was lower than the discriminant threshold of 40%, indicating that there was no serious common-method bias in this study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eDescribe statistics and correlation analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics and correlation analysis results for T1 physical activity,\u0026nbsp;T2\u0026nbsp;mental health,\u0026nbsp;T2\u0026nbsp;cognitive ability at T2, and academic performance are shown in Table\u0026nbsp;1. The results of the correlation analysis showed a significant correlation\u0026nbsp;among\u0026nbsp;the four\u0026nbsp;representations, indicating that extracurricular physical activities were associated with mental health, cognitive ability, and academic performance over time and across synchronization for 1 year. There was a lagging correlation between the variables, consistent with the basic assumptions of the longitudinal design.\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;1.\u0026nbsp;Descriptive statistics and correlation coefficient matrix\u0026nbsp;of each variable\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003eM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003eT1\u0026nbsp;Extracurricular Physical Activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;mental health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;cognitive abilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;academic performance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003eT1\u0026nbsp;extracurricular sports activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e34.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e32.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;mental health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e19.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e5.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003e0.165\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;cognitive abilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e21.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e5.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003e0.306\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e0.319\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003eT2\u0026nbsp;academic performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e64.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.16327%;\"\u003e\n \u003cp\u003e22.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.4082%;\"\u003e\n \u003cp\u003e0.315\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e0.166\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e0.439\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.2857%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u0026nbsp;\u003c/em\u003eM = mean; SD = standard deviation; T1 = Time 1; T2 = Time 2. ** indicates significance at the\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e0.01 level (two-tailed), and * indicates significance at the 0.05 level (two-tailed).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVertical correlation between variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the longitudinal chain mediation model was tested by using the process procedure for SPSS Version 4.0. The specific results are shown in Table 2\u003c/p\u003e\n\u003cp\u003eTable 2. The path coefficient of mediation benefit of T that affects y among students with obesity (n=221)\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003eEffect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003eEffect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003eHERSELF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003eLLCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003eULCI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003eDirect effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eX\u0026rarr;Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.1299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0428\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e0.0456\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.2143\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003eIndirect effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eX-M1-Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e-0.0128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0158\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eT-M2-Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e0.0225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.1237\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eX-M1-M2-Y\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e0.0003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0293\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003eTotal indirect effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0788\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e0.0351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.1341\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 23.9583%;\"\u003e\n \u003cp\u003eTotal effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 32.2917%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.2088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.0438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5%;\"\u003e\n \u003cp\u003e0.1224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.4167%;\"\u003e\n \u003cp\u003e0.2951\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003eNote.\u0026nbsp;\u003c/em\u003eX = independent variable; Y = dependent variable; M1 = mediator 1 (mental health); M2 = mediator 2 (cognitive abilities); SE = standard error (originally labeled as HERSELF due to a typographical error); LLCI = lower limit of the 95% confidence interval; ULCI = upper limit of the 95% confidence interval.\u003c/p\u003e\n\u003cp\u003eThe correlation between variables was investigated using the path coefficients of the structural model (Table 2). The effect of extracurricular physical activity T1 on academic performance T2 was statistically significant (\u0026beta; = 0.1299; 95% CI [0.0456, 0.2143, excluding 0]). There was no significant or statistically significant effect of extracurricular sports activities on academic performance through the mediating effect of mental health (\u0026beta;=0.0016, 95% CI was -0.0128, 0.0158, including 0). The pathway of extracurricular sports activities affecting academic performance through cognitive ability was significant and statistically significant (\u0026beta;=0.0016, 95% CI = 0.0003, 0.0293, including 0).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study systematically explored the impact and mechanisms of extracurricular sports activities on academic performance through multiple mediating pathways\u0026mdash;mental health and cognitive function \u0026mdash; using a year-long, longitudinal follow-up survey. The following is a comprehensive discussion of the findings of this study in combination with the existing literature and theory.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe\u003c/strong\u003e \u003cstrong\u003econtinuous predictive effect\u0026nbsp;of extracurricular sports activities on academic performance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study validated H1, i.e., that baseline (T1) extracurricular physical activity can significantly positively predict academic performance one year later (T2). This shows that, in adolescents with obesity, participation in extracurricular sports activities had a crowding effect on learning time and promoted medium- and long-term academic performance. From a mechanistic perspective, physical activity may affect academic achievement through multisystem synergy. At the physiological level, extracurricular physical activity helps improve cardiovascular function. It promotes the secretion of neuroactive substances, such as brain-derived neurotrophic factors, thereby optimizing brain function and cognitive flexibility\u003csup\u003e44\u003c/sup\u003e. At the psychosocial level, extracurricular sports activities provide an important platform for emotional regulation and social interaction, helping relieve stress and enhance a sense of belonging, thereby creating a more conducive emotional environment for learning\u003csup\u003e45\u003c/sup\u003e. This finding was consistent with international empirical studies on the strong association between physical activity and academic performance\u003csup\u003e46, 47\u003c/sup\u003e. This study further advanced previous research by focusing on the Chinese adolescents with obesity population and providing new evidence of the temporal and predictive association between extracurricular physical activity and academic performance through longitudinal data modeling. It also controlled for baseline academic performance, thereby enhancing the robustness of causal inference.\u003c/p\u003e\n\u003cp\u003eDespite multiple disadvantages such as health risks, psychological adaptation challenges, and weak cognitive foundations in adolescents with obesity, this study found that extracurricular sports activities exhibit significant academic promotion functions. Additionally, the sample of this study was from the educational and cultural backgrounds of East Asia, which has a heavy schoolwork burden and attaches great importance to academic performance. In this context, the positive effects of extracurricular physical activities on academic performance were not attenuated by test-taking pressure. Still, they may be stronger, acting through mechanisms such as emotional regulation and cognitive enhancement. This finding has important reference value for educational policymaking, especially in promoting physical activity in cultural settings that emphasize academic performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMediating role\u0026nbsp;of mental health\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe longitudinal mediation analysis found that\u0026nbsp;T2\u0026nbsp;mental health had no significant effect on\u0026nbsp;T1\u0026nbsp;extracurricular physical activities or\u0026nbsp;T2\u0026nbsp;academic performance.\u0026nbsp;Therefore, H2 was not validated. This finding suggested that extracurricular physical activity did not improve the academic performance of adolescents with obesity by improving mental health. This result differed from findings in studies based on the general population. It may suggest the presence of alternative, more direct pathways or stronger mediating variables that are specific to children and adolescents with obesity. Previous studies have shown that children and adolescents with obesity often experience psychosocial stressors such as weight\u0026nbsp;stigma\u0026nbsp;and peer exclusion\u003csup\u003e48, 49\u003c/sup\u003e. When the activity environment is supportive and inclusive, physical activity can offer these adolescents valuable experiences of social success, a sense of team belonging, and positive peer interactions that directly counter daily experiences of stigma and may lead to significant improvements in mental health\u003csup\u003e50\u003c/sup\u003e. Conversely, suppose the activity environment is filled with ridicule, competitive exclusion, or social rejection. In that case, physical activity itself may become a new stressor that weakens, negates, or even reverses its theoretically positive effects on mental health\u003csup\u003e51\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAs\u0026nbsp;Hawker\u0026apos;s\u0026nbsp;research on adolescent psychological stressors clearly points out, issues such as peer exclusion and bullying in social relationships are often more central stressors than the academics themselves\u003csup\u003e52\u003c/sup\u003e. Moreover, the mental health scale used in this study may not have captured the dimensions most relevant to academics, and the tracking time may be insufficient to observe the transformation of psychological benefits into academic outcomes. This finding reminds us that future studies should incorporate cognitive neural indicators and social relationship variables to reveal the internal mechanisms more clearly. Educators and parents should focus on building an inclusive, supportive, and process-oriented sports environment while attaching importance to physical activities to promote academic performance, emphasizing participation experience, cooperative interaction, and emotional development, rather than simply focusing on competition and sports performance, to give full play to the promotion function of physical activities in educational situations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMediation of\u0026nbsp;cognitive function\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUsing a longitudinal mediation model, this study confirmed that\u0026nbsp;T2\u0026nbsp;cognitive ability mediated the relationship between T1 extracurricular physical activity and T2 academic performance. This finding suggested that extracurricular sports activities directly affected academic performance and, indirectly, improved academic performance among adolescents with obesity by promoting the development of core cognitive functions. This result echoed the study of neural mechanisms underlying exercise-promoting brain plasticity and provided empirical support for the role of physical activity in cognitive and academic improvement.\u003c/p\u003e\n\u003cp\u003eFrom a neural mechanism\u0026rsquo;s perspective, the theory of brain plasticity provides a strong explanation for this mediating pathway: regular physical activity can upregulate the expression of brain-derived neurotrophic factors and promote hippocampal neurogenesis and synaptic plasticity in the prefrontal cortex, thereby enhancing the neural basis of learning and memory\u003csup\u003e53-55\u003c/sup\u003e. However, cognitive load theory\u0026nbsp;also supports\u0026nbsp;this mechanism: physical activity helps improve core cognitive abilities, such as working memory and inhibitory control, enabling students to allocate cognitive resources more effectively, suppress extraneous interference, and optimize information processing efficiency, thereby reducing cognitive load and improving the effect of deep learning when completing academic tasks\u003csup\u003e56\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eAn important contribution of this study is that, even though obesity was associated with chronic inflammation\u003csup\u003e18\u003c/sup\u003e and impaired cognitive function\u003csup\u003e41\u003c/sup\u003e,the positive effect of physical activity on cognitive function was still observed, indicating that it retained significant neuroprotective potential in adolescents with obesity. Therefore, extracurricular physical activity should be redefined as an effective cognitive intervention, rather than just a means of physical facilitation. Based on the above findings, we suggest that educational and curriculum makers should attach great importance to the fundamental role of physical activity in cognitive development and ensure students with obesity have opportunities and time to participate in physical activity. Particularly in an educational environment with increasing academic pressure, it is necessary to avoid reducing physical activity time due to a one-sided emphasis on academic training, and it should be regarded as an important way to improve cognitive readiness and support overall academic development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe chain mediating role\u0026nbsp;of psychology and cognition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study confirmed the chain mediation hypothesis and identified a pathway of action with temporal and mechanistic continuity:\u0026nbsp;T1\u0026nbsp;extracurricular physical activities, T2\u0026nbsp;mental health, T2\u0026nbsp;cognitive function, and T2\u0026nbsp;academic performance. The results showed that in adolescents with obesity, improvements in psychological state and cognitive function are not independent of each other but constitute a continuous mechanism of multi-stage sequential action. This finding supports the developmental view of mind-body synergy and suggests that emotion regulation efficacy has a prospective impact on higher-order cognitive processes.\u003c/p\u003e\n\u003cp\u003eFrom the perspective of theoretical mechanisms, the\u0026nbsp;extension-construction\u0026nbsp;theory provides a partial explanation for this chain effect: physical activity can stimulate positive emotional experiences such as pleasure and accomplishment\u003csup\u003e20, 21\u003c/sup\u003e, expand individual cognitive and behavioral resources\u003csup\u003e22\u003c/sup\u003e, and accumulate long-term psychological capital such as\u0026nbsp;psychological resilience and social support\u003csup\u003e\u0026nbsp;\u003c/sup\u003eto provide the necessary preparation for subsequent cognitive activities\u003csup\u003e57\u003c/sup\u003e. However, the cognitive resource theory proposes a complementary explanation: emotional problems such as anxiety and depression may occupy and consume limited cognitive resources, thereby weakening individuals\u0026apos; ability to process information in learning tasks\u003csup\u003e27, 29\u003c/sup\u003e. In contrast, physical activity promotes academic performance by improving emotional state, releasing cognitive resources overwhelmed by emotional load, and reallocating them to higher cognitive processes, such as executive function and working memory\u003csup\u003e23\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eAlthough similar pathway hypotheses have been proposed in existing theories, this study is the first to empirically verify this chain-mediation mechanism among adolescents with obesity, representing a significant theoretical innovation\u0026nbsp;Unlike previous studies that examined only single pathways or cross-sectional associations, this research highlights the leading role of mental health in promoting cognitive function, demonstrating that mental health is not merely correlated with cognitive changes but serves as a crucial prerequisite for cognitive improvement. This finding is particularly applicable to adolescents with obesity, suggesting that the alleviation of psychological impairment may constitute a key condition for the effective release of their cognitive potential.\u003c/p\u003e\n\u003cp\u003eAt a practical level, this study\u0026apos;s results emphasized that comprehensive intervention strategies must reflect\u0026nbsp;phases and hierarchies. Physical activity design that focuses solely on cognitive challenges, such as performance-oriented, high-intensity training, and ignores psychological experiences, may undermine the effectiveness of interventions due to negative experiences such as frustration and body shame. On the contrary, effective programs should prioritize improving participants\u0026apos; mental health through supportive, inclusive activity designs and gradually integrate tasks with high cognitive demands to achieve synergistic gains in psychological, cognitive, and academic\u0026nbsp;benefits. The ultimate goal is to build a developmental activity environment that combines psychological empowerment and cognitive development, and to achieve deep integration of physical and mental health with academic development.\u003c/p\u003e\n\u003cp\u003eResearch deficiencies and future prospects\u003c/p\u003e\n\u003cp\u003eAlthough this study explored the mechanisms by which extracurricular sports activities affect academic performance through multiple psychological and cognitive pathways, using a longitudinal design, it still faces certain limitations that warrant further investigation. First, factors such as learning motivation, family socioeconomic background, and sex may have mixed effects on the relationship between extracurricular sports activities and academic performance. Future research may introduce more layers of variables or adopt more rigorous causal inference methods to estimate the net effect of extracurricular physical activities on academic performance more accurately. Second, the measurement of extracurricular sports activities relied mainly on students\u0026apos; self-assessment questionnaires, which may be subject to social expectation bias and recall error. In the future, objective devices such as accelerometers and heart rate monitors can be combined to achieve a multimodal evaluation of activity intensity, frequency, and type, enabling more accurate analysis of the correlation between different exercise loads and academic performance. Third, although this study verified the mediating role of mental health and cognitive performance, the measurement of these variables should be further refined. For example, mental health can be divided into dimensions, such as emotional symptoms, self-esteem, and social anxiety, and neurophysiological indicators can be used to reveal the mediating mechanisms more deeply. Finally, this study focused on mechanism verification, and no specific intervention plan was proposed. In the future, based on the results of this study, a structured physical activity program integrating cognitive training and psychological support should be developed, and its comprehensive benefits on academic performance and physical and mental health should be tested through randomized controlled trials. Overall, the findings highlight the importance of integrating physical activity, psychological support, and cognitive development in educational programs for adolescents with obesity, offering a comprehensive pathway toward improving both academic performance and well-being.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eDisclosure\u003c/h2\u003e\n\u003cp\u003eThe authors report no financial sources or conflicts of interest regarding this work\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis research was supported by Guangdong Provincial Sports Bureau Science and Technology Innovation Project (GDSS2024N106) and Guangdong Province Characteristic and Innovative Project for Regular Higher Education Institutions(2025wtscx061and2025wtscx103).\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eAuthors\u0026rsquo; ContributionsZhang. BG (Conceptualization [lead], Writing\u0026mdash;original draft [equal], Writing\u0026mdash;review \u0026amp; editing [lead]), Qian. XF (Visualization [lead], Writing\u0026mdash;review \u0026amp; editing [supporting]).\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003e\u0026ldquo;The datasets analyzed in this study are available in the China Education Panel Survey (CEPS) repository at [http://ceps.ruc.edu.cn](http:/ceps.ruc.edu.cn) . Due to confidentiality protections regarding participant information, the raw data are not publicly accessible but can be requested through the CEPS official website upon reasonable justification.\u0026rdquo;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHeerman WJ, Kenney E, Block JP, Fiechtner L, McMahon E, Kruse L, Sharifi M, Edmondson EK, Virudachalam S. A Narrative Review of Public Health Interventions for Childhood Obesity. \u003cem\u003eCurr Obes Rep\u003c/em\u003e. 2024; 13:87-97. 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DOI: 10.1016/j.socscimed.2006.03.012.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"extracurricular sports activities, academic performance, mental health, cognitive ability, Obesity","lastPublishedDoi":"10.21203/rs.3.rs-8135438/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8135438/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose: \u003c/strong\u003eExploring the effects of extracurricular sports activities on the academic performance of adolescents with obesity and their psychological and cognitive mechanisms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatients and Methods:\u003c/strong\u003e The study included 221 adolescents with a BMI ≥ 24, with a mean age at baseline period of 14.67±1.33 years and a follow-up period of 15.44±1.29 years. Through two waves of surveys separated by a year, extracurricular sports activity time, mental health, cognitive ability, and academic performance were measured, and the chain-mediating effect was tested using a structural equation model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: (1) Baseline extracurricular sports activities can significantly positively predict academic performance after one year; (2) Mental health did not have a significant mediating effect between extracurricular sports activities and academic performance, but cognitive ability has a significant mediating effect between extracurricular sports activities and academic performance. (3) The chain mediating effect was significant, and there was an action path of \"extracurricular sports activities→ mental health→ cognitive ability→ academic performance.\"\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Implementing a physical activity intervention grounded in psychological support and focused on cognitive development in adolescents with obesity may be more effective at improving their academic performance. Educational practitioners should consider psychological experiences and cognitive challenges when designing physical activity programs to achieve the comprehensive educational benefits of \"physical and mental co-construction.”\u003c/p\u003e","manuscriptTitle":"The relationship between extracurricular physical activities, mental health, cognitive ability, and academic performance: A longitudinal association study of children and adolescents with obesity in China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-04 13:27:28","doi":"10.21203/rs.3.rs-8135438/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-16T06:03:29+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-14T01:40:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"288587828637085073048192465684354474866","date":"2026-01-07T10:52:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-07T09:38:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"143892548114532858326739923013338283900","date":"2026-01-07T00:48:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-06T14:10:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263552275323813194667634427986274321188","date":"2026-01-06T11:01:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"243324123595381205214233158714669930731","date":"2026-01-06T02:16:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"220779450609150400181838532060103714980","date":"2026-01-03T09:48:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263081508576743861805331515980053669686","date":"2026-01-03T02:07:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"52987449022907391700857262497075102691","date":"2026-01-02T03:12:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-01T15:01:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"67310714164783423620959420793007328855","date":"2026-01-01T02:07:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"217595719919955508989779040806670887296","date":"2025-12-10T01:13:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-02T09:17:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-02T09:07:22+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-01T12:55:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-28T12:31:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-11-28T12:24:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b85d0073-fd6a-4a03-ab08-a0d19298c93c","owner":[],"postedDate":"December 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":58992877,"name":"Health sciences/Health care"},{"id":58992878,"name":"Biological sciences/Psychology"},{"id":58992879,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2026-04-13T16:10:53+00:00","versionOfRecord":{"articleIdentity":"rs-8135438","link":"https://doi.org/10.1038/s41598-026-47332-w","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2026-04-12 15:58:21","publishedOnDateReadable":"April 12th, 2026"},"versionCreatedAt":"2025-12-04 13:27:28","video":"","vorDoi":"10.1038/s41598-026-47332-w","vorDoiUrl":"https://doi.org/10.1038/s41598-026-47332-w","workflowStages":[]},"version":"v1","identity":"rs-8135438","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8135438","identity":"rs-8135438","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}