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oai:recercat.cat:11351/136042025-10-24T08:28:39Zcom_2072_451660com_2072_378040col_2072_451662

2025-10-24T08:28:39Z urn:hdl:11351/13604 Cortisol, Anxiety, and TNFα Mediate the Relationship Between BMI and Executive Functions caldú, xavier SENDER PALACIOS, MARIA JOSÉ Sánchez Garre, Consuelo Salas, Paloma Garolera, Maite Prunell, Anna JURADO, MARIA ANGELES Hidrocortisona Ansietat Índex de massa corporal Funció executiva (Neuropsicologia) CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones::Hydroxycorticosteroids::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones::Hydroxycorticosteroids::17-Hydroxycorticosteroids::Hydrocortisone PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Emotions::Anxiety PUBLIC HEALTH::Nutrition, Public Health::Nutritional Status::Nutrition Assessment::Anthropometry::Body Mass Index PSYCHIATRY AND PSYCHOLOGY::Psychological Phenomena::Mental Processes::Executive Function COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal::hidroxicorticosteroides::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal::hidroxicorticosteroides::17-hidroxicorticosteroides::hidrocortisona PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::emociones::ansiedad ATENCIÓN DE SALUD::ambiente y salud pública::salud pública::medidas epidemiológicas::biometría::antropometría::índice de masa corporal PSIQUIATRÍA Y PSICOLOGÍA::fenómenos psicológicos::procesos mentales::función ejecutiva Cortisol; Anxiety; Executive functions Cortisol; Ansietat; Funcions executives Cortisol; Ansiedad; Funciones ejecutivas Overweight and obesity are associated with poorer executive functions (EF). The underlying mechanisms contributing to this relationship are not yet conclusive, but cortisol, anxiety, and inflammation are likely among the contributing factors. Our objective was to evaluate whether fibrinogen, tumour necrosis factor alpha (TNFα), cortisol, and anxiety significantly mediate the association between body mass index (BMI) z-score and EF (i.e., working memory, inhibition, cognitive flexibility, and a latent EF component) in both adolescents and adults. In this cross-sectional study, 268 participants aged 11-49 years with BMI values ranging from normal-weight to obesity were medically and neuropsychologically evaluated. Moderated multiple mediation analyses with mediators in parallel were conducted (X: BMI z-score; M: cortisol, anxiety, TNFα, and fibrinogen; Y: executive functions; Moderator: adolescent and adult groups). Our results suggested that TNFα mediated the association between BMI z-score and working memory only in adolescents (indirect effect = 0.09, 95% CI [0.03, 0.19]), whereas in adults, cortisol (indirect effect = -0.06, 95% CI [-0.13, -0.01]) and anxiety (indirect effect = 0.02, 95% CI [0.0001, 0.07]) mediated this association. Additionally, in adults, anxiety also mediated the relationship between BMI z-score and the latent EF component (indirect effect = 0.03, 95% CI [0.004, 0.08]). In the full sample, TNFα significantly mediated the relationship between BMI z-score and inhibition (indirect effect = -0.03, 95% CI [-0.06, -0.002]). In conclusion, our study suggests that inflammation, cortisol, and anxiety are biologically and psychologically plausible mechanisms through which BMI may influence cognitive performance. Large-scale longitudinal studies are needed to confirm these findings and to determine whether the observed associations are age-dependent. This study was supported by a grant (PRE2019-087430) recieved by APC, funded by MICIU/AEI/10.13039/501100011033 and by ‘ESF Investing in your future’. MAJ received grants (PSI2017- 86536-C2-1-R, PSI2013-48045-C2-1-P, and PSI2008-05803-C02-01) and MG received grants (PSI2017-86536-C2-2-R, PSI2013- 48045-C2-2-P, and PSI2008-05803-C02-02), funded by MICIU/AEI/10.13039/501100011033 and the European Regional Development Fund (ERDF). MAJ, MG, XC, and APC have additionally received funding from the Departament d’Innovació, Universitats i Empresa, Generalitat de Catalunya (2021SGR0801). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. 2025-10-24T08:28:39Z 2025-10-24T08:28:39Z 2025-09-03T11:27:01Z 2025-09-03T11:27:01Z 2025-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13604 Stress & Health;41(4) https://www.doi.org/10.1002/smi.70077 Attribution-NonCommercial 4.0 International https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Wiley Scientia