08 - Chapter 5

Chapter V
RESULTS AND DISCUSSION

CHAPTER – V
RESULTS AND DISCUSSION
Statistical results are the key factors to provide information whether the proposed
hypothesis of an empirical research has been accepted or rejected. Exhibiting the
statistical outcomes is followed by description and interpretation along with the
suitable conclusion at the end. Thus, this chapter highlights the findings of the present
empirical investigation..
The present research was carried out to assess executive functions in relation
to eating behavior of school students. The objectives of the study have been presented
in chapter III. For accomplishing the proposed objective of the study; in Phase I the
Eating Behaviour (subjective measure) and Executive functions (self-reported
measure) of 300 school students was assessed across three BMI groups i.e. normal,
under-weight and over-weight. In phase II after collecting and scoring of data,
respondents would be divided into 6 groups (3 (BMI) x 2 (eating behaviour
questionnaire) factorial design) and their executive functions would be assessed with
Delis Kaplan executive function system (D-KEFS). The data obtained in second phase
was statistically analyzed and obtained results have been presented and discussed as
per the objectives of mentioned in chapter IV. Therefore, this chapter presents the
analysis of the date in different sections .
Statistical analysis
To meet the objectives of the Phase I, the present study used a correlational
design to study the relationship between Eating Behaviour (subjective measure) and
Executive functions (self-reported measure) of school students across three BMI
groups i.e. normal, under-weight and over-weight. Further for phase II, two-way
ANOVA was used to identify the variations in executive functions as a function of
BMI and eating behavior. The data was analyzed using the SPSS software (Statistical
Package for Social Sciences). The results have been presented as per the objectives of
the study.
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The obtained results are presented in following three sections:
Section I: Descriptive statistics (Phase –I)
Section II: Correlational Analysis (Phase –I)
Section III : Two Way ANOVA (Phase – II)
SECTION – I
Descriptive Statistics
The mean and standard deviation were calculated which described the basic features
of the data collected in the Phase-I of present research. The BMI value of the 300
respondents are subjected to descriptive statistics (Mean and SD). Table 5.1 indicates
the descriptive statistics for BMI of 300 school students. The 300 respondents were
divided into groups based on their BMI. The mean and SD scores on BMI were
computed for each BMI group
Table 5.1
Mean and SD scores on BMI for 3 BMI groups
BMI N % age of Minimum Maximum Mean SD Range
groups respondents M±SD
Normal BMI 147 49 18.10 23.50 19.78 1.92 17.86 -21.7
Overweight 73 24.33 24.30 27.00 25.66 0.86 24.8 -26.52
Underweight 80 26.67 15.70 16.90 16.29 0.42 15.87-16.71
Total sample 300 100 15.90 27.00 21.92 3.70 18.22-25.62
As shown in Table 5.1 The minimum BMI obtained in normal BMI category
was 18.10 and maximum obtained BMI was 23.50 in the present study. The mean
score on norma BMI category was 19.78 (SD=1.92) with the mean range from 17.86
to 21.7. The minimum and maximum BMI obtained in overweight category were
24.30 and 27.00 respectively. The mean score on overweight category was 25.66
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(SD=0.86) with the mean range from 24.8 to 26.52. The minimum and maximum
BMI obtained in underweight category were 15.70 and 16.90 respectively. The mean
score on underweight category was 16.29 (SD=0.42) with the mean range from 15.87
to 16.71. The minimum BMI obtained in total BMI category was 15.90 and maximum
obtained BMI was 27.00 in the present study. The BMI mean value for total sample
was 21.92 (SD=3.70) with the mean range from 18.22 to 25.62.
Table 5.2
Descriptive Statistics for eight sub-sections of eating behaviour questionnaire
(N=300)
Eating behaviour N Minimum Maximum Mean SD Range
questionnaire M±SD
sections
Food habits 300 12.00 42.00 29.14 9.85 38.99-19.29
Physical activity
300 5.00 18.00 10.66 2.76 13.42-7.90
& lifestyle
Healthy- unhealthy
300 5.00 13.00 9.80 2.58 12.38-7.22
diet & food
Self- Efficacy 300 4.00 16.00 11.64 4.01 15.65-7.63
Barriers to change 300 3.00 9.00 6.87 1.77 8.64-5.10
Nutrition knowledge 300 1.00 14.00 5.15 3.08 8.23-2.07
Food safety
300 0.00 7.00 3.50 1.68 5.18-1.82
knowledge
Food safety &
behavior in hygiene 300 9.00 24.00 14.78 2.98 17.76-11.80
practices
As shown in Table 5.2 the minimum possible score on food habits section of
the eating behavior questionnaire could be 0 and maximum possible score could be
42. The minimum and maximum obtained score in the present study on this section
were 12.00 and 42.00 respectively. The mean score on food habits section was 29.14
(SD=9.85) with the mean range from 19.29 to 38.99. The minimum and maximum
possible score on physical activity & lifestyle section of the eating behavior
questionnaire could be 0 and 18 respectively. The minimum score obtained on
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physical activity & lifestyle section of the eating behavior questionnaire was 5 and
maximum obtained score was 18 in the present study. The mean score on physical
activity & lifestyle section was 10.66 (SD=2.76) with the mean range from 7.90 to
13.42 the minimum possible score on healthy, unhealthy diet and food section of the
eating behavior questionnaire could be 0 and maximum possible score could be 15 for
the same. The minimum and maximum obtained score in the present study on this
section were 5 and 13 respectively. The mean score on healthy, unhealthy diet and
food section was 9.80 (SD=2.58) with the range from 7.22 to 12.38. The maximum
and minimum possible score on self efficacy section of the eating behavior
questionnaire could be 16 and 0 respectively. The minimum score obtained on self
efficacy section of the eating behavior questionnaire was 4 and maximum obtained
score was 16 in the present study. The mean score on self efficacy was 11.64 (4.01)
with the mean range from 7.63 to 15.65 the maximum possible score on barriers to
change section of the eating behavior questionnaire could be 9 and minimum possible
score could be 0 for the same. The minimum and maximum obtained score in the
present study on this section were 3 and 9 respectively. The mean score on barriers to
change section 6.87 (SD=1.77) with the range from 5.10 to 8.64. The minimum and
maximum possible score on nutrition knowledge section of the eating behavior
questionnaire could be 0 and 11 respectively. The minimum score obtained on
nutrition knowledge section of the eating behavior questionnaire was 1 and maximum
obtained score was 14 in the present study. The mean score on nutrition knowledge
section was 5.15 (SD=3.08) with the range from 2.07 to 8.23. The minimum possible
score on food safety knowledge section of the eating behavior questionnaire could be
0 and maximum possible score could be 10 for the same. The minimum and
maximum obtained score in the present study on this section were 0 and 7
respectively. The mean score on food safety knowledge section was 3.50 (SD=1.68)
with the mean range from 1.82 to 5.18. On the last section of the eating behavior
questionnaire i.e. food safety & behavior in hygiene practices the minimum and
maximum possible score could be 0 and 24 respectively. The minimum score
obtained on food safety & behavior in hygiene practices section of the eating behavior
questionnaire was 9 and maximum obtained score was 24 in the present study. The
mean score on food safety & behavior in hygiene practices section was 14.78
(SD=2.98) with the mean range from 11.80 to 17.76.
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Table 5.3
Descriptive Statistics for five dimensions of executive functions
EFI N Minimum Maximum Mean S.D. Range
M±SD
Motivational Drive 300 8.00 20.00 14.27 3.21 11.06-17.48
Organisational ability 300 8.00 23.00 15.66 3.90 11.76-19.56
Strategic planning 300 14.00 34.00 23.59 6.11 17.48-29.70
Impulse control 300 5.00 24.00 14.50 4.75 9.75-19.25
Empathy 300 13.00 30.00 20.70 4.35 16.35-25.05
The descriptive statistics on five dimensions of Executive function index are

presented in Table 5.3 which is subjective measure of executive functions. The
minimum possible score on motivational drive section of the Executive function index
could be 4 and maximum possible score could be 20 for the same. The minimum and
maximum obtained score in the present study on this section were 8 and 20
respectively. The mean score on motivational drive section was 14.27 (SD=3.21) with
the mean range from 11.06 to 17.48. The minimum and maximum possible score on
organisational ability section of the Executive function index could be 5 and 25
respectively. The minimum score obtained on organisational ability section of the
Executive function index was 8 and maximum obtained score was 23 in the present
study. The mean score on organisational ability section was 15.66 (SD=3.90) with the
mean range from 11.76 to 19.56. The minimum possible score on strategic planning
section of the Executive function index could be 7 and maximum possible score
could be 35 for the same. The minimum and maximum obtained score in the present
study on this section were 14 and 34 respectively. The mean score on strategic
planning section was 23.59 (SD=6.11) with the mean range from 17.48 to 29.70.
The minimum and maximum possible score on Impulse control section of the
Executive function index could be 5 and 25 respectively. The minimum score
obtained on impulse control section of the Executive function index was 5 and
maximum obtained score was 24 in the present study. The mean score on Impulse
control section was 14.50 (SD=4.75) with the mean range from 9.75 to 19.25. The
minimum and maximum possible score on Empathy section of the Executive function
index could be 6 and 30 respectively. The minimum score obtained on empathy
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section of the Executive function index was 13 and maximum obtained score was 30
in the present study. The mean score on empathy section was 20.70 (SD=4.35) with
the range from 16.35 to 25.05. On the other hand this section is followed by
correlational analysis.
SECTION – II
Correlation Analysis
As mentioned earlier the major objectives of phase I were to study the relationship
between eating behaviour (subjective measure) and BMI (objective measure); and to
study the relationship of subjective and objective measures of eating behaviour with
executive functions. Thus, correlations were computed between two measures of
eating behaviour (BMI- objective measure and eating behaviour- subjective measure)
across three BMI groups. Further, correlation coefficients were computed between
measures of eating behaviour and executive functions in three BMI groups by
applying the Pearson product-moment method.
Eating Behaviour (subjective measure) and BMI (objective measure)
1. Eating behaviour (subjective measure) and BMI (objective measure) in

overweight school students
The coefficients of correlation in Table 5.4 show that food habits, a subscale of eating
behaviour questionnaire, was found to be negatively and significantly correlated with
BMI (r = -.674, p<.01). Thus, adolescents with healthy food habits who are more
regular in having healthy breakfast, ate fruits and vegetables every day and consumed
lesser amount of sweets and desserts have lower BMI i.e. they are more likely to fall
in the lower end of the overweight BMI category. These results were in line with
earlier studies (Faizi, Shah, Ahmad, Ansari, Amir & Khalique, 2018) who reported
that The dietary behavior was found to be poor in overweight and obese
adolescents. They found that overweight adolescents had adverse dietary practices
which include an irregularity in having timely breakfast, a low frequency of fruit and
vegetable intake, a predisposition toward higher consumption of junk food, and a high
frequency of soft drink intake. Similar resultshave also been reported by Leech
McNaughton and Timperio (2014) where they identified three basic factors
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contributing to the incidence of overweight and obesity are increased intake of high-
energy foods, foods poor in nutrients and rich in fats, sugar and salt, as well as
insufficient physical activity, which altogether lead to increased BMI. These eating
errors were more frequently seen among overweight and obese students rather than
normal weight ones.
Similar results were obtained with the physical activity & lifestyle subsection of
eating behaviour questionnaire, which was found to be negatively and significantly
correlated with BMI (r = -.465, p<.01) pointing out that overweight adolescents
having active physical activity & lifestyle posess lower BMI i.e. they fall in the lower
range of overweight BMI. From the results, it can be inferred that adolescents with a
sedentary lifestyle and having less physical activity were more likely to gain weight
and fall in a higher range of overweight BMI category. The third subscale, healthy,
unhealthy diet was also significantly and negatively correlated with BMI (r = -.620,
p<.01). Thus, overweight adolescents with a good knowledge of healthy and
unhealthy dietary habits and food are more likely to have lower BMI (BMI towards
normal BMI) as compared to those adolescents who have insufficient knowledge of
healthy and unhealthy dietary habits. The fourth subscale of eating behaviour
questionnaire i.e. self- efficacy was found to be significantly and negatively correlated
with BMI (r = -.657, p<.01) which reveals that overweight adolescents who have a
good self-efficacy are more likely to have lower BMI in the overweight category. The
next subscale of eating behaviour questionnaire i.e. barriers to change was found to be
significantly and negatively correlated with BMI (r = -.423, p<.01). A significant and
negative correlation between barriers to change and BMI indicates that adolescents
who have a lot of barriers in modifying one‘s eating habits to improve them were
more likely to be overweight. Another subscale of eating behaviour questionnaire i.e.
nutrition knowledge subscale was found to be negatively and significantly correlated
with BMI (r = -.175, p<.05). Food safety knowledge, a subscale of eating behaviour
questionnaire, was found to be non-significantly related to BMI (r = .096). Food
safety & hygiene subscale of eating behaviour questionnaire was negatively and
significantly correlated with BMI (r = -.211, p<.05).
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Table 5.4
Coefficients of correlation between two measures of eating behaviour (BMI- objective
measure and eating behaviour- subjective measure) in overweight BMI school
students
Eating behaviour BMI
Food habits -.674**
Physical activity & lifestyle -.465**
Healthy- unhealthy diet & food -.620**
Self- efficacy -.657**
Barriers to change -.423**
Nutrition knowledge -.175*
Food Safety knowledge .096
Food safety & behavior in hygiene practices -.211*
**p<0.01 *p<.05
Thus, it is clear from the results that overall there is an inverse relationship between
eating behaviour (subjective measure) and BMI (objective measure) in overweight
category. Thus, it can be said that school students who eat balanced diet and exercise
regularly, self efficient with good nutritional knowledge and have healthy eating
behaviour are less likely to be overweight.
2.Eating behaviour (subjective measure) and BMI (objective measure) in normal

weight school students
The coefficients of correlation in Table 5.5 show that food habits, a subscale of eating
behaviour questionnaire, was found to be negatively and significantly correlated with
BMI (r = -.546, p<.01), which implies that adolescents with more healthy food
choices like diet rich in protein, fiber and a lesser amount of sweets and desserts are
more likely to have normal BMI. Similar results were obtained with physical activity
& lifestyle subsection of eating behaviour questionnaire, which was found to be
negatively and significantly correlated with BMI (r = -.305, p<.01) which means that
adolescents having very active physical activity & lifestyle are less likely to fall in the
upper range of BMI. From the results, it can be inferred that adolescents with a
sedentary lifestyle and having less physical activity were more likely to gain weight
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and fall in a higher range of BMI category. Another significant and negative
correlation was found between healthy, unhealthy diet and BMI (r = -.432, p<.01).
Thus, adolescents with a good knowledge of healthy and unhealthy dietary habits and
food are more likely to have lower BMI as compared to those adolescents who have
insufficient knowledge of healthy and unhealthy dietary habits. Another subscale of
eating behaviour questionnaire i.e. self-efficacy was found to be significantly and
negatively correlated with BMI (r = -.475, p<.01) which reveals that self- efficient
adolescents are more likely to have lower BMI in normal BMI category. The next
subscale of eating behaviour questionnaire i.e. barriers to change was found to be
significantly and negatively correlated with BMI (r = -.447, p<.01). A significant and
negative correlation between barriers to change and BMI indicates that adolescents
who are facing barriers in modifying one‘s eating habits are more likely to be
overweight. Next subscale of eating behaviour questionnaire i.e. nutrition knowledge
subscale was found to be negatively and significantly correlated with BMI (r = -.248).
Food safety knowledge, a subscale of eating behaviour questionnaire, was found to be
non-significantly related to BMI (r =.040). Whereas, food safety & hygiene subscale
of eating behaviour questionnaire was negatively and significantly correlated with
BMI (r = -.257, p<.01).
Table 5.5
measure and eating behaviour- subjective measure) for normal BMI school students
Eating behavior BMI
Food habits -.546**
Physical activity & lifestyle -.305**
Healthy- unhealthy diet & food -.432**
Self- efficacy -.475**
Barriers to change -.447**
Nutrition knowledge -.248**
Food Safety knowledge .040
Food safety & behavior in hygiene practices -.257**
**p<0.01
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It is clear from the results that overall there is an inverse relationship between eating
behaviour (subjective measure) and BMI (objective measure) in normal BMI category.
Thus, it can be said that school students who eat balanced diet and exercise regularly
and have healthy eating behaviour are more likely to have normal BMI.
3 Eating Behaviour (subjective measure) and BMI (objective measure) in

underweight school students
The coefficients of correlation in Table 5.6 reveals that food habits, a subscale of
eating behaviour questionnaire, was found to be positively and significantly correlated
with BMI (r = .537, p<.01). This implies that adolescents who eat a more balanced
diet and consumed lesser amount of sweets and desserts are more likely to fall in the
higher range of underweight category. Similarly, a positive and significant correlation
was obtained between physical activity & lifestyle subsection of eating behaviour
questionnaire and BMI ( r= .468, p<.01), which implies that adolescents having active
lifestyle are likely to fall in the upper range of underweight category. From the results,
it can be inferred that adolescents with a sedentary lifestyle and having less physical
activity are less likely to gain normal healthy weight and fall in the lower range of
underweight BMI category. The third subscale, healthy-unhealthy diet was also
negatively and significantly correlated with BMI (r = .416, p<.01). Thus, adolescents
with good knowledge of healthy and unhealthy dietary habits and food are more likely
to consume healthy food and have higher BMI in this category as compared to those
adolescents who have insufficient knowledge of healthy and unhealthy dietary habits.
The fourth subscale of eating behaviour questionnaire i.e. self-efficacy was found to
be significantly and positively correlated with BMI (r = .507, p<.01) which reveals
that adolescents who have a good capacity for using advice aimed at improving one‘s
well-being are more likely to have higher BMI in the underweight category. The next
subscale of eating behaviour questionnaire i.e. barriers to change was found to be
significantly and positively correlated with BMI (r = .447, p<.01). A significant
positive correlation between barriers to change and BMI indicates that adolescents
face more barriers in modifying one‘s eating habits to improve them were more likely
to be underweight. Another subscale of eating behaviour questionnaire i.e. nutrition
knowledge subscale was found to be positively and significantly correlated with BMI
(r = .203, p<0.05) but a non-significant and negative correlation was obtained
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between Food Safety knowledge and BMI (r = -.143). Whereas, food safety &
hygiene subscale of eating behaviour questionnaire was positively and significantly
correlated with BMI (r = .218, p<0.05).
Table 5.6
measure and eating behaviour- subjective measure) in underweight school students
Eating behavior BMI
Food habits .537**
Physical activity & lifestyle .468**
Healthy- unhealthy diet & food .416**
Self- efficacy .507**
Barriers to change .447**
Nutrition knowledge .203*
Food Safety knowledge -.143
Food safety & behavior in hygiene practices .218*
**p<0.01, *p<0.05
Thus, it is clear from the results that overall there is a positive relationship between
eating behaviour (subjective measure) and BMI (objective measure) in underweight BMI
category. So, it can be said that school students who eat balanced diet and exercise
regularly and have healthy eating behaviour are more likely to have higher BMI in
underweight category i.e. they tend to have BMI closer to normal BMI category.
Results of the present study are consistent with previous findings i.e.
unhealthy eating behaviour & dietary habits are significantly associated with
increased BMI (Duffey, Gordon-Larson, Jacobs, Williams & Popkin, 2007; Niemeier,
Raynor, Llyod-Richardson, Rogers & Wing, 2006; Rosenheck, 2008; Taveras,
Berkey, Rifas-Shiman, Ludwig, Rockett & Field, 2005; Thompson, Ballew,
Resnicow, Must, Bandini, Cyr & Dietz, 2004)
On the basis of results of correlation analysis it is clear that the subjective and
objective measures of Eating behavior are associated with each other. Thus, it can be
inferred that healthy eating behavior is associated with normal BMI. Thus the 1st
hypothesis which states that there would be significant relationship between eating
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behaviour (subjective measure) and BMI (objective measure) across three BMI
groups of school students is proved and retained.
Executive function in relation to Eating Behaviour
1. Executive functions and Eating behaviour in overweight school students
Motivational drive and Eating behavior (subjective & objective measure) in

The coefficients of correlation between motivational drive, eating behaviour

(subjective measure) and BMI (objective measure) are shown in table 5.7. The table
reveals that motivational drive and food habits are positively correlated (r = .444,
p<0.01). Results reveal that adolescents with healthy food habits have a higher score
on motivational drive in the overweight category than adolescents having unhealthy
food habits. Healthy food habits include drinking milk or yoghurt in breakfast and
having at least two portions of fruits and vegetables every day. Further obtained
correlation coefficients showed that there was positive and significant association
between motivational drive and each section of eating behaviour i.e. for physical
activity & lifestyle ( r = .288, p<0.05), healthy unhealthy diet & food (r = .289,
p<0.05), self efficacy (r = .403 , p<0.01), barriers to change (r = .250, p<0.05), food
safety knowledge (r = .230, p<0.05), food safety & behaviour in hygiene (r = .316,
p<0.01). Motivational drive was positively but non-significantly correlated with
nutrition knowledge nutrition knowledge (r = .131). Whereas, BMI (objective
measure) (r = -.307, p<0.01) was negatively and significantly correlated with the
motivational drive which indicated that if the BMI will increase then the individual‘s
level of the motivational drive will decrease.
Organisational ability and Eating behavior (subjective & objective measure) in

Coefficients of correlation between Organisational ability, eating behaviour

(subjective measure) and BMI (objective measure) in adolescents, as shown in Table
5.7, clearly report significant and positive correlations with various sections of eating
behaviour and BMI. Results reveal that organisational ability and each section of
eating behaviour i.e. for food habits (r = .583, p<.01), physical activity & lifestyle (r
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= .388, p<.01), healthy unhealthy diet & food (r = .390, p<.01), self-efficacy (r =
.566, p<.01), barriers to change (r = .249, p<.05) are positively correlated which
depicts that if eating behaviour score in these sections would be increased then
individual‘s overall organisational abilities would be increased. Organisational ability
was positively but non-significantly correlated with nutrition knowledge (r = .162),
food safety knowledge (r = .212) and food safety & behaviour in hygiene (r = .215).
Whereas, BMI (objective measure) was negatively and significantly correlated with
the organisational ability (r = -.422, p<0.01) which depicts that if the BMI will
increase (i.e. obese category) then the individual‘s organisational skills will be poor.
Strategic planning and Eating behavior (subjective & objective measure) in

The third dimension of EFI, strategic planning, was found to be positively and
significantly correlated with food habits (r = .606, p<.01) physical activity & lifestyle
(r = .506, p<.01), healthy unhealthy diet & food (r = .561, p<.01), self-efficacy
(r = .629, p<.01), barriers to change (r = .286, p<.05), nutrition knowledge (r = .325,
p<.01), food safety & behaviour in hygiene (r = .264, p<.05). Strategic planning
ability was positively but non-significantly correlated with food safety knowledge
(r = .102). BMI (objective measure) was found to be negatively and significantly
correlated with strategic planning (r = -.451, p<0.01) which implies that adolescents
with good strategic planning ability will have lower BMI in the overweight category
i.e. BMI closer to Normal BMI category
Impulse Control and Eating Behaviour (subjective & objective measure) in

The fourth dimension of EFI assessed in the present study was impulse control, which
was found to be positively and significantly correlated with food habits (r =.514,
p<.01) physical activity & lifestyle (r =.378, p<.01), healthy unhealthy diet & food (r
=.362, p<.01), self-efficacy (r =.479, p<.01), barriers to change (r =.255, p<.05).
Impulse control was positively but non-significantly correlated with nutrition
knowledge (r =.126), food safety knowledge (r =.153) and food safety & behaviour in
hygiene (r =.132). Significant negative relationship of impulse control with BMI
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(objective measure) has also been obtained in results (r = -.278, p < 0.05) which
indicates that if BMI would increase then impulse control would be poor.
Empathy and Eating Behaviour (subjective & objective measure) in overweight

school students
The table 5.7 reveals that there is a positive and significant coefficient of correlation
between the last dimension of EFI i.e empathy and food habits (r = .426, p<.01)
physical activity & lifestyle (r = .273, p<.05), healthy unhealthy diet & food (r = .266,
p<.05), self-efficacy (r = .296, p<.05), barriers to change (r = .266, p<.05), nutrition
knowledge (r = .299, p<.05), food safety & behaviour in hygiene (r = .403, p<.01).
Results show that empathy was positively but non-significantly correlated with food
safety knowledge (r = .103). Similarly, BMI (objective measure) was found to be
negatively and non-significantly correlated with empathy (r = -.209)
Thus from the results in Table 5.7, it can be concluded that BMI (objective measure
of eating behavior) was negatively and significantly correlated with the four
dimensions of EFI i.e motivational drive, organizational ability strategic planning
ability and impulse control among overweight adolescents, which indicates that
increased BMI (i.e. BMI closer to overweight category) is associated with poor
motivational drive, organizational ability, strategic planning ability and impulse
control. Results of the present study are consistent with previous findings i.e.
overweight and obese adolescents perform poor on the test of planning ability
(Manasse, Juarascio, Forman, Berner, Butryn & Ruocco, 2014; Douchesne, Mattos,
Coutinho & Santos, 2010; Fitzpatrick, Gilbert & Serpell, 2013). The present findings
also indicate that overweight adolescents have poor inhibitory control are in line with
findings of earlier researches which indicate poor inhibitory control (inhibition) in
obese and overweight children and adolescents (Nederkoorn, Braet, Eijs, Tanghe &
Jansen, 2006; Pauli-pott, Albayrak, Hebebrand & pott, 2010; Verbeken, Braet, Claus,
Nederkoorn & Oosterlaan, 2009; Verdejo- Garcia, Perez- Exposito & Schmidt, 2010).
On the other hand, it was found that EFI was significantly and positively correlated
with self- reported eating behavior (dimensions) which means overweight individual‘s
having good eating behavior report better motivational drive, organisational ability,
strategic planning, impulse control and empathy.
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Table 5.7
Coefficients of correlation between measures of Eating Behaviour (eating behaviour & BMI) and Executive function in overweight school
students
EFI Food Physical Healthy- Self Barriers Nutrition Food Food BMI
habits activity unhealthy efficacy to knowledge safety safety &
& diet & change knowledge behaviour
lifestyle food in hygiene
Motivational Drive .444** .288* .289* .403** .250* .131 .230* .316** -.307**
Organisational .583** .388** .390** .566** .249* .162 .212 .215 -.422**
ability
Strategic planning .606** .506** .561** .629** .286* .325** .102 .264* -.451**
Impulse control .514** .378** .362** .479** .255* .126 .153 .132 -.278*
Empathy .426** .273* .266* .296* .266* .299* .103 .403** -.209
**p<0.01,*p<0.05
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2. . Executive functions and Eating behavior in Normal BMI school students
Motivational drive and Eating Behaviour (subjective & objective measure) in

normal BMI school students
The coefficients of correlation between motivational drive, eating behaviour

(subjective measure) and BMI (objective measure) are shown in table 5.8. The table
reveals that motivational drive and food habits are positively correlated (r =.339,
p<0.01). Results reveal that adolescents with healthy food habits scored high on
motivational drive in the normal BMI category than adolescents with unhealthy food
habits. Healthy food habits include drinking milk or yoghurt in breakfast and having
at least two portions of fruits and vegetables every day. Motivational Drive was not
found to be significantly correlated with physical activity & lifestyle (r = .025),
healthy unhealthy diet & food (r = .139), self-efficacy (r = .158). Further obtained
correlation coefficients showed that there was positive and significant correlation
between motivational drive and each section of eating behaviour i.e. for barriers to
change (r = .232, p<0.01), nutrition knowledge ( r =.243, p<0.01 ), food safety
knowledge (r = .358, p<0.01), food safety & behaviour in hygiene (r = .318, p<0.01).
These sub-sections of eating behaviour are positively and significantly correlated with
motivational drive whereas BMI (objective measure) (r = -.018) was negatively and
non- significantly correlated with the motivational drive.
Organisational ability and Eating Behaviour (subjective & objective measure) in

Table 5.8 shows that there is a significant correlation between eating behaviour
(subjective measure), BMI (objective measure) and organisational ability in
adolescents. The results reveal that organisational ability and each section of eating
behaviour i.e. for food habits (r = .374, p<.01), healthy unhealthy diet & food (r =
.283, p<.01), self-efficacy (r=.281, p<.01), barriers to change (r = .346, p<.01) and
nutrition knowledge (r = .446, p<.01) are positively and significantly correlated
which depicts that if eating behaviour score in these sections would be higher then
individual‘s overall organisational abilities would be better. Organisational ability
was positively but non-significantly correlated with physical activity & lifestyle (r =
.124), food safety knowledge (r = .096) and food safety & behaviour in hygiene (r =
87
.091). Whereas, BMI (objective measure) was (r = -.136) was negatively and non-
significantly correlated with organisational ability.
Strategic planning and Eating Behaviour (subjective & objective measure) in

The third dimension of EFI which was strategic planning was found to be positively
and significantly correlated with food habits (r =.448, p<.01) physical activity &
lifestyle (r = .236, p<.01), healthy unhealthy diet & food (r = .597, p<.01), self-
efficacy (r = .483, p<.01), barriers to change (r = .396, p<.01), nutrition knowledge (r
= .608, p<.01) food safety knowledge (r = .166, p<.05). Strategic planning ability was
positively but non-significantly correlated with, Food safety & behaviour in Hygiene
( r = .006). BMI (objective measure) was found to be negatively and significantly
correlated with strategic planning (r = -.194, p<0.05) which implies that adolescents
with good strategic planning ability will have lower BMI.
Impulse Control and Eating Behaviour (subjective & objective measure) in normal
BMI school students
was found to be positively and significantly correlated with food habits (r =.461,
p<.01) physical activity & lifestyle (r =.184, p<.05), healthy unhealthy diet & food (r
=.313, p<.01), self-efficacy (r = .311, p<.01), barriers to change (r=.261, p<.01),
nutrition knowledge (r = .201, p<.05) and food safety knowledge (r=.421 p<.01).
Impulse control was positively but non-significantly correlated with food safety &
behaviour in hygiene (r = .051). Whereas, significant negative relationship of impulse
control with BMI (objective measure) has also been obtained in results (r = -.234, p <
0.01) which indicates that if BMI would increase then impulse control would be poor.
Empathy and Eating Behaviour (subjective & objective measure) in normal BMI
school students
The table 5.8 shows that there is a positive and significant coefficient of correlation
between the last dimension of EFI i.e empathy and food habits (r =.339, p<.01)
healthy unhealthy diet & food (r = .225, p<.01), barriers to change (r = .408, p<.01),
nutrition knowledge (r = .647, p<.01), food safety & behaviour in hygiene (r = .290,
p<.01). Results show that Empathy was positively but non-significantly correlated
88
with physical activity & lifestyle (r = .143), self efficacy (r = .015) and food safety
knowledge (r = .148). Similarly, BMI (objective measure) was found to be negatively
and non-significantly correlated with empathy (r = -.135)
From overall perusal of table no. 5.8, it is observed that BMI was negatively
associated with all five dimensions of EFI (executive function index) whereas it was
significantly correlated with two dimensions i.e. strategic planning and impulse
control among normal BMI adolescents. The present findings suggest that as the BMI
deviates toward overweight category participants performed poor on planning ability
and impulse control. Goldschmidt, O'Brien, Lavender, Pearson, Grange and Hunter
(2018) also found similar results in which higher BMI characterize a unique pattern of
executive dysfunction in planning ability. Earlier researches also obsevered that
normal weight children and adolescents have better inhibitory control than obese and
overweight adolescents (Nederkoorn, Braet, Eijs, Tanghe & Jansen, 2006; Pauli-pott,
Albayrak, Hebebrand & pott, 2010; Verbeken, Braet, Claus, Nederkoorn &
Oosterlaan, 2009; Verdejo-Garcia, Perez-Exposito & Schmidt, 2010). Results in
present study shows that eating behavior (subjective measure) which includes healthy
diet rich in fruits, vegetables, grains, dairy and protein along with least barriers
affecting healthy food choices and good nutrition knowledge is associated with better
motivational drive, organizational ability, planning ability, impulse control and
empathy was observed in normal BMI category. Whereas physical activity, self-
efficacy and food safety knowledge subsection was associated with better strategic
planning, impulse control. Therefore, from the results, it can be said that all 5
dimensions of EFI are related positively with eating behavior (subjective measure)
and there is an inverse relationship with BMI among normal weight school students.
89
Table 5.8
Coefficients of correlation between measures of Eating Behaviour (eating behaviour & BMI) and Executive function in normal BMI school
students
EFI Food Physical Healthy- Self Barriers Nutrition Food safety Food BMI
habits activity unhealthy efficacy to knowledge knowledge safety &
& diet & food change behaviour
lifestyle in hygiene
Motivational Drive .339** .025 .139 .158 .232** .243** .358** .318** -.018
Organisational ability .374** .124 .283** .281** .346** .446** .096 .091 -.136
Strategic planning .448** .236** .597** .483** .396** .608** .166* .006 -.194*
Impulse control .461** .184* .313** .311** .261** .201* .421** .051 -.234**
Empathy .339** .143 .225** .015 .408** .647** .148 .290** -.135
**p<0.01, *p<0.05
90
3. Executive functions and Eating behavior in underweight school students
Motivational drive and Eating Behaviour (subjective & objective measure) in

The coefficient of correlations between motivational drive, eating behaviour

(subjective measure) and BMI (objective measure) is shown in table 5.9. The table
reveals that motivational drive and food habits are positively correlated (r = .417,
p<0.01). Results reveal that adolescents with healthy food habits are more inclined
towards higher BMI in the underweight category than adolescents with unhealthy
food habits. Healthy food habits include drinking milk or yoghurt in breakfast and
having at least two portions of fruits and vegetables every day. Further obtained
correlation values showed that there was positive and significant correlation between
motivational drive and each section of eating behaviour i.e. for physical activity &
lifestyle (r = .513, p<0.01), healthy unhealthy diet & food (r = .456, p<0.01), self
efficacy (r = .509, p<0.01), barriers to change (r = .405, p<0.05), nutrition knowledge
(r = .240, p<0.05), food safety knowledge (r = .263, p<0.05) while, non significant
and positive correlation was found with food safety & behaviour in hygiene (r = .163).
Similarly, BMI (r = .237, p<0.05) was also positively and significantly correlated
with the motivational drive which indicated that if the BMI will increase i.e. BMI
closer to normal BMI category the individual‘s level of the motivational drive will
increase.
Organisational ability and Eating Behaviour (subjective & objective measure) in

Coefficients of correlation between organisational ability, eating behaviour

(subjective measure) and BMI (objective measure) in adolescents, as shown in Table
5.9, clearly report significant correlations with various sections of eating behaviour
and BMI. Results reveal that organisational ability and each section of eating
behaviour i.e. for food habits (r = .579, p<.01), physical activity & lifestyle (r = .660,
p<.01), healthy unhealthy diet & food (r = .455, p<.01), self-efficacy (r = .583,
p<.01), barriers to change (r = .457, p<.01), food safety knowledge (r = .389, p<.01)
and food safety & behaviour in hygiene (r = .440, p<0.01) are positively correlated
91
which depicts that if eating behaviour score in these sections would be increased then
individual‘s overall organisational abilities would be increased. organisational ability
was positively but non-significantly correlated with nutrition knowledge (r = .119).
Whereas, BMI (objective measure) was negatively and significantly correlated with
Organisational ability (r = .259, p<0.05) which depicts that if the BMI will increase
the individual‘s organisational skills will also increase in the underweight category
i.e. they tend to have BMI closer to normal BMI category.
Strategic planning and Eating Behaviour (subjective & objective measure) in

The third dimension of EFI which was Strategic planning was found to be positively
and significantly correlated with food habits (r =.479, p<.01) physical activity &
lifestyle (r = .533, p<.01), healthy unhealthy diet & food (r = .457, p<.01), self-
efficacy (r = .556, p<.01), barriers to change (r = .387, p<.01), nutrition knowledge (r
= .228, p<.05), food safety knowledge ( r = .256, p<.05) and Food safety & behaviour
in Hygiene (r = .303, p<.01). Strategic planning ability was positively and
significantly correlated with BMI (objective measure) (r = .231, p<0.05) which
implies that adolescents with good strategic planning ability will have higher BMI in
the underweight category i.e. they tend to have BMI closer to normal BMI category.
Impulse Control and Eating Behaviour (subjective & objective measure) in

was found to be positively and significantly correlated with food habits (r = .290,
p<.01) physical activity & lifestyle (r = .477, p<.01), healthy unhealthy diet & food (r
= .285, p<.05), self-efficacy (r = .302, p<.01) and barriers to change (r = .357, p<.05).
Impulse control was positively but non-significantly correlated with nutrition
knowledge (r = .128), food safety knowledge (r = .144) and food safety & behaviour
in hygiene (r = .125). Similarly, a positive and non-significant relationship of impulse
control with BMI (objective measure) has also been obtained in results (r = .164)
92
Empathy and Eating Behaviour (subjective & objective measure) in underweight
school students
The table 5.9 reveals that there is a positive and significant coefficient of correlation
between the last dimension of EFI i.e empathy and physical activity & lifestyle (r =
.238, p<.05), nutrition knowledge (r = .266, p<.05), food safety knowledge (r = .275,
p<.05 ) food safety & behaviour in hygiene (r = .237, p<.05). Results show that
empathy was positively but non-significantly correlated with food habits (r = .077)
healthy unhealthy diet & food (r = .034), self-efficacy (r = .040) barriers to change (r
= .083). Similarly, BMI (objective measure) was also found to be positively and non-
significantly correlated with empathy (r = .127).
Thus, results show that BMI was positively and significantly correlated with
motivational drive, organizational ability and strategic planning ability which
indicates that if the BMI increases i.e. BMI closer to normal BMI category the
individual‘s level of the motivational drive, organizational ability and strategic
planning ability improves. Results in present study shows that eating behavior
(subjective measure) which includes healthy diet rich in fruits, vegetables, grains,
dairy and protein along with active lifestyle, good nutrition knowledge is associated
with better motivational drive, planning ability, impulse control and organizational
ability was observed in underweight category. Wyckoff & Forman (2016) also found
that poor planning ability is associated with a poor diet (a few fruits and vegetables
and high saturated fat intake). The present findings also get support from a research
conducted by Kesari, Handa and Prasad (2010) which aimed to explore the effect of
undernutrition on cognitive development among children. The study reported deficits
on most of the cognitive abilities including executive functions among under-
nourished children
93
Table 5.9
Coefficients of correlation between measures of Eating Behaviour (eating behaviour & BMI) and Executive function in underweight school
students
EFI Food Physical Healthy- Self Barriers Nutrition Food safety Food safety BMI
habits activity unhealthy efficacy to change knowledge knowledge &
& diet & food behaviour
lifestyle in hygiene
Motivational Drive .417** .513** .456** .509** .405** .240* .263* .163 .237*
Organisational .579** .660** .455** .583** .457** .119 .389** .440** .259*
ability
Strategic planning .479** .533** .457** .556** .387** .228* .256* .303** .231*
Impulse control .290** .477** .285* .302** .357** .128 .144 .125 .164
Empathy .077 .238* .034 .040 .083 .266* .275* .237* .127
**p<0.01, *p<0.05
94
As it is clear from the results of correlation analysis that eating behavior
(subjective measure and objective measure- BMI) are significantly associated with
executive functions among overweight, normal and underweight school students/
adolescents. Thus, the 2nd hypothesis which states that there would be significant
relationship between eating behavior (subjective measure and objective measure of
eating behaviour) and executive functions across 3 BMI groups of school students is
proved and retained.
Phase – II:
In second phase Executive functions (D-KEFS) of 6 groups based on two

measures of eating behavior would be assessed. To accomplish the desired objectives,
a multi-group design was used for which 3 x 2 factorial design was used in present
research. The present section deals with group wise descriptive statistical analysis
followed by two-way ANOVA with post-hoc (LSD) test on the basis of variables.
Cognitive Flexibility
In the present study cognitive flexibility was assessed through cognitive

switching conditions of these three tests i.e. Verbal Fluency Test, Design Fluency
Test and Trail making Test of D-KEFS.
Category Switching (D-KEFS Verbal Fluency)
The results in Table 5.10 (a) shows the obtained values for mean and SD for 6 groups
based on BMI and eating behaviour on category switching task of verbal fluency
subtest. On this task normal BMI adolescents with healthy eating behaviour scored a
mean value of 14.47 (SD=2.98), whereas healthy BMI group with unhealthy eating
behaviour scored a mean value of 9.65 (SD = 3.66). On the other hand, overweight
adolescents with healthy eating behaviour obtained a mean score of 11.59 (SD=5.08)
and mean value obtained by overweight adolescents with unhealthy eating behaviour
is 8.00 (SD = 1.32). Further, underweight adolescents with healthy eating behaviour
secured mean score of 9.88 (SD = 3.74) and underweight adolescents with unhealthy
eating behaviour secured a mean value of 7.29 (SD = 1.57). Overall, mean value for
healthy eating behaviour adolescents is 11.98 (SD = 4.38) and for unhealthy eating
95
behaviour adolescent mean value is 8.31 (SD = 2.57) on category switching task. The
same has been exhibited in following Figure 5.10 (a)
Table 5.10 (a)

Mean and SD values of category switching (D-KEFS verbal fluency) of 6 groups
1.Eating behaviour→ Healthy eating Unhealthy Total (BMI)
group eating group
2. BMI
Mean SD Mean SD Mean SD
↓
Normal BMI 14.47 2.98 9.65 3.66 12.06 4.09
Overweight BMI 11.59 5.08 8.00 1.32 9.79 4.08
Underweight BMI 9.88 3.74 7.29 1.57 8.59 3.11
Total (Eating behaviour) 11.98 4.38 8.31 2.57 10.15 4.02
Figure 5.10 (a)
Mean Score on Category Switching (D-KEFS Verbal Fluency) of 6 Groups
In order to determine whether the 6 groups differed significantly on category

switching two-way ANOVA was applied, results of which have been depicted in
Table 5.10 (b).
96
Table 5.10 (b)
Summary table of two-way ANOVA on Category Switching (D-KEFS verbal fluency)

across 6 groups
Sources SS df MS F
BMI 211.11 2 105.55 9.56*
Eating behaviour 342.83 1 342.83 31.06*
BMI× Eating behaviour 21.31 2 10.65 .96
Error 1059.52 96 11.03
*p≤.05
Table 5.10 (c)
Significance of mean differences based on Post hoc (LSD) test on Category Switching
(D-KEFS verbal fluency) of three BMI groups
BMI Groups Normal Overweight Underweight

(M=12.06) (M=9.79) (M=8.59)
Normal - 2.26* 3.47*
(M=12.06)
Overweight - - 1.20
(M= 9.79)
Underweight - - -
(M= 8.59)
*p<.05
Two-way ANOVA shows significant main effect of BMI (F = 9.56; p≤.05) on

category switching task of verbal fluency subtest among 3 BMI groups i.e. normal
BMI, overweight and underweight. As F value for BMI (three groups) was found to
be significant, a post hoc analysis (LSD) was applied. The results of post hoc analysis,
97
as shown in table 5.10 (c) highlights that normal BMI participant (M = 12.06),
significantly differ from overweight (M = 9.79) and underweight (M=8.59) students.
On the other hand, no difference has been obtained between overweight and
underweight on category switching task. Similarly, significant main effect of eating
behaviour has been found (F = 31.06; p<.05) between healthy eating participants and
unhealthy eating participants on category switching task. Mean values for healthy
eating behaviour group is (M = 11.98), which is significantly higher than mean value
of unhealthy eating group (M = 8.31). This means that adolescents with healthy food
habits, good nutritional knowledge, active lifestyle, better food safety knowledge,
hygienic food and less barriers in modifying their eating habits scored better score on
category switching task. Interaction effect of BMI and eating behaviour was not found
to be significant. Thus, from the results it can be inferred that BMI and eating
behaviour independently influences performance on category switching task.
Switching (D-KEFS Design Fluency)
Table 5.11 (a) depicts the mean and SD scores on switching task of design fluency
test for 6 groups. On this ability normal BMI adolescents with healthy eating
behaviour scored a mean value of 8.47 (SD = 1.55), whereas healthy BMI group with
unhealthy eating behaviour scored a mean value of 6.18 (SD = 1.78). On the other
hand, overweight adolescents with healthy eating behaviour obtained a mean score of
6.18 (SD = 1.78) and mean value obtained by overweight adolescents with unhealthy
eating behaviour is 5.18 (SD = 2.10). Further underweight adolescents with healthy
eating behaviour secured mean score of 5.88 (SD = 3.58) and underweight
adolescents with unhealthy eating behaviour secured a mean value of 5.11 (SD =
4.09). Overall, mean value for healthy eating behaviour adolescents is 6.84 (SD =
2.69) and for unhealthy eating behaviour adolescent mean value is 5.59 (SD = 3.69)
on switching task. The same has been depicted through graphical representation in the
following manner in Figure 5.11 (a).
98
Table 5.11 (a)
Mean and SD values of switching (D-KEFS design fluency) of 6 groups
1. Eating behaviour→ Healthy eating Unhealthy Total (BMI)
group eating group
2. BMI
↓
Normal BMI 8.47 1.55 6.47 4.50 7.47 3.47
Overweight BMI 6.18 1.78 5.18 2.10 5.68 1.98
Underweight BMI 5.88 3.58 5.11 4.09 5.50 3.81
Figure 5.11 (a)
Mean Values of switching (D-KEFS design fluency) of 6 Groups
In order to determine whether the 6 groups differed significantly on switching task

two-way ANOVA was applied, results of which have been depicted in Table 5.11 (b).
99
Table 5.11 (b)
Summary table of two-way ANOVA on switching (D-KEFS design fluency) across 6
groups
Sources SS df MS F
BMI 80.84 2 40.42 4.05*
Error 956.94 96 9.97
*p≤.05
Table 5.11 (c)

Significance of mean differences based on Post hoc (LSD) test on switching (D-KEFS
design fluency) of three BMI groups
(M=5.50)
(M=7.47) (M=5.68)
Normal (M=7.47) - 1.79* 1.97*
Overweight (M=5.68) - - 0.18
Underweight (M=5.50) - - -
*p<.05
Two way ANOVA shows significant main effect of BMI (F = 4.05; p≤.05)
among 3 BMI groups i.e. normal BMI, overweight and underweight on switching task
of design fluency subtest. Meaning thereby, three BMI groups differ with regard to
their switching task score. As F value for BMI (three groups) was found to be
significant, a post hoc analysis (LSD) was applied. The results of post hoc analysis, as
shown in table 5.11 (c) highlights that normal BMI participant (M = 7.47),
significantly differ from overweight (M = 5.68) and underweight (M = 5.50) students.
100
underweight on switching task of design fluency subtest. Similarly, significant main
effect of eating behaviour has been found (F = 4.02; p<.05) between healthy eating
participants and unhealthy eating participants on switching task of design fluency
subtest. Mean values for healthy eating behaviour group is (M = 6.84), which is more
than mean value of unhealthy eating group (M = 5.59). This means that adolescents
with healthy food habits, good nutritional knowledge, active lifestyle, better food
safety knowledge, hygienic food and less barriers in modifying their eating habits
scored better on switching task. Interaction effect of BMI and eating behaviour was
not found to be significant. Thus, from the results it can be inferred that BMI and
eating behaviour independently influences performance on switching task.
Number – Letter Switching (D-KEFS Trail Making Test)
The results in Table 5.12 (a) depict the obtained values for mean and SD for 6 groups
based on BMI and EB on number-letter switching task of trail making subtest. On this
task, normal BMI adolescents with healthy eating behaviour scored a mean value of
7.94 (SD = 1.85), whereas healthy BMI group with unhealthy eating behaviour scored
a mean value of 5.47 (SD = 2.42). On the other hand, overweight adolescents with
healthy eating behaviour obtained a mean score of 6.47 (SD = 2.23) and mean value
obtained by overweight adolescents with unhealthy eating behaviour is 3.82 (SD =
1.74). Further underweight adolescents with healthy eating behaviour secured mean
score of 5.39 (SD = 1.87) and underweight adolescents with unhealthy eating
behaviour secured a mean value of 3.70 (SD = 1.86). Overall, mean value for healthy
eating behaviour adolescents is 6.59 (SD = 2.23) and for unhealthy eating behaviour,
adolescent mean value is 4.33 (SD = 2.15) on number-letter switching task of trail
making subtest. The same has been exhibited in following Figure 5.12 (a).
101
Table 5.12 (a)
Mean and SD values of Number – letter switching (D-KEFS Trail Making Test) of 6
groups
group eating group
2. BMI
↓
Normal BMI 7.94 1.85 5.47 2.42 6.70 2.47
Overweight BMI 6.47 2.23 3.82 1.74 5.15 2.39
Underweight BMI 5.39 1.87 3.70 1.86 4.53 2.02
Figure 5.12 (a)
Mean Values of Number – Letter Switching (D-KEFS Trail Making Test) of 6

Groups
102
In order to determine whether the 6 groups differed significantly on number-letter
switching task (Trail making test) two-way ANOVA was applied, results of which
have been depicted in Table 5.12 (b).
Table 5.12 (b)

Summary table of two-way ANOVA on Number – letter switching (D-KEFS Trail
Making Test) across 6 groups
Sources SS df MS F
BMI 85.54 2 42.77 10.54*
Error 389.29 96 4.05
*p≤.05
Table 5.12 (c)

Significance of mean differences based on Post hoc (LSD) test on Number – letter
switching (D-KEFS Trail Making Test) of three BMI groups
(M=6.70) (M=5.15) (M=4.53)
Normal - 1.56* 2.18*
(M=6.70)
Overweight - - 0.26
(M=5.15)
Underweight - - -
(M=4.53)
*p<.05
103
Two-way ANOVA shows significant main effect of BMI (F = 10.54; p≤.05)
among 3 BMI groups i.e. normal BMI, overweight and underweight on number-letter
switching task of trail making subtest. As F value for BMI (three groups) was found
to be significant, a post hoc analysis (LSD) was applied. The results of post hoc
analysis, as shown in table 5.12 (c) highlights that normal BMI participant (M =
6.70), significantly differ from overweight (M = 5.15) and underweight (M = 4.53)
students. On the other hand, no difference has been obtained between overweight and
underweight on number-letter switching task of trail making subtest. Similarly,
significant main effect of eating behaviour has been found (F = 31.97; p<.05) between
healthy eating participants and unhealthy eating participants on number-letter
switching task. Mean values for healthy eating behaviour group is (M = 6.59), which
is much higher than the mean value of unhealthy eating group (M = 4.33). This means
that adolescents with healthy food habits, good nutritional knowledge, active lifestyle,
better food safety knowledge, hygienic food and less barriers in modifying their
eating habits scored better on number-letter switching task. Interaction effect of BMI
and eating behaviour was not found to be significant. Thus, from the results it can be
inferred that BMI and eating behaviour independently influences performance on
number-letter switching task.
Cognitive flexibility, ability to shift openly from one circumstance to other

and to think flexibly to react appropriately to the situation, in the present study was
assessed by category switching task of verbal fluency subtest, switching task of
design fluency subtest and number-letter switching task of trail making subtest. In the
present study only main effects of BMI and eating behavior was observed on all the
three measures of cognitive flexibility. Normal BMI adolescents significantly differ
from overweight and underweight students on performance on cognitive flexibility
task. Similarly healthy eating adolescents performed significantly better on cognitive
flexibility task than adolescents with unhealthy eating behaviour. The findings of this
study are in line with the observations of Fagundo, Torre, Murcia, Granero & Aranda
(2012) which pointed out that anorexic subjects and obese subjects exhibit difficulties
in cognitive flexibility. Another research on adolescents also reported that obese
students compared to students with normal BMI showed significant impairement in
cognitive flexibility along with other cognitive like attention, retention, intelligence
104
(Meo, Altuwayam, Alfallaj, Alduraibi, Alhamoudi, Alghamdi & Akram, 2019).
Lokken, Boeka, Austin, Gunstad and Harmon (2009) also reported that obese
adolescents showed impairement in cognitive flexibility compared to normative data.
Douchesne, Mattos, Coutinho and Santos (2010) concluded that obese individual with
binge eating disorder exhibited impairments in cognitive flexibility. Research
conducted on obese individuals to assess their cognitive flexibility through
performance on trail- making Test- B (TMT-B) also pointed out that obesity is
associated with impaired performance on TMT-B task (Gunstad, Paul, Cohen, Tate,
Spitznagel & Gordon, 2007; Verdejo-Garcia, Perez- Exposito, & Schmidt, 2010; Yau,
Kang, Javier & Convit, 2014). Faster TMT-B performance is associated with grey
mater volume (Laubach, Lammers, Zacharias, Feinkohl, Pischon, Borchers, Slooter
Kühn, Spies & Winterer, 2018). And there are researches which point out that
decreased grey matter volume is associated with obesity (Bobb, Schwartz, Davatzikos
& Caffo, 2014; Gunstad, Paul, Cohen, Tate, Spitznagel & Grieve, 2008; Taki,
Kinomura, Sato, Inoue, Goto & Okada, 2008; Yokum & Stice, 2012). Therfore,
obesity and unhealthy eating may directly result in impaired cognitive flexibility or it
may be due to decreased grey matter volume that is associated with obesity.
Results of the present finding also reveals that adolescents having healthy
eating behaviour had better cognitive flexibility. On the other hand, adolescents
having an unhealthy eating behaviour, who prefer food rich in fat and carbohydrates
(such as having fast- food everytime on the lunch break in school) sedentary lifestyle,
poor nutritional knowledge, unhygienic food and more barriers in modifying their
eating habits, exhibit poor flexibility. Similar findings were reported by Khan, Raine
and Drollette (2015) who observed that greater amount of fat consumption was
associated with the longer reaction time on cognitive flexibility tasks. A study
conducted by Shemilt, Harvey and Shepstone (2004) found that time taken to
complete trail making test Part A was significantly shorter in the intervention group
where healthy diet was given to participants. Nkhoma et al. (2013) noticed fewer
errors on the set shift task in students who had school breakfast compared to students
who did not have school breakfast.
Thus, the hypothesis 3 (a) which states that ―There would be significant main
effect of BMI (objective measure) on cognitive flexibility among school student‖ and
105
3(b) which states ―There would be significant main effect of eating behavior
(subjective measure) on cognitive flexibility among school students‖ are proved and
retained. Whereas, hypothesis 3(c) which states ―There would be significant
interaction effect of BMI (objective measure) and eating behavior (subjective
measure) on cognitive flexibility among school students‖ is not proved and hence
rejected.
Problem -Solving ability
Problem solving ability was assessed through free sorting condition of D-KEFS
sorting test.
Free Sorting (D-KEFS Sorting Test)
The obtained values for mean and SD for 6 groups based on BMI and EB on free
sorting task of sorting subtest are shown in Table 5.13 (a). On this task normal BMI
adolescents with healthy eating behaviour scored a mean value of 12.35 (SD=2.29),
whereas healthy BMI group with unhealthy eating behaviour scored a mean value of
8.82 (SD = 2.63). On the other hand, overweight adolescents with healthy eating
behaviour obtained a mean score of 11.70 (SD = 1.83) and mean value obtained by
overweight adolescents with unhealthy eating behaviour is 7.41 (SD = 1.66). Further
Underweight adolescents with healthy eating behaviour secured mean score of 11.23
(SD = 1.25) and underweight adolescents with unhealthy eating behaviour secured a
mean value of 6.88 (SD = 1.27). Overall, mean value for healthy eating behaviour
adolescents is 11.76 (SD = 1.86) and for unhealthy eating behaviour adolescent mean
value is 7.70 (SD = 2.07) on free sorting task. The same has been depicted through
graphical representation in Figure 5.13 (a).
106
Table 5.13 (a)
Mean and SD values on free sorting (D-KEFS sorting test) of 6 groups

group eating group
2. BMI
↓
Normal BMI 12.35 2.29 8.82 2.63 10.59 3.20
Overweight BMI 11.70 1.83 7.41 1.66 9.56 2.78
Underweight BMI 11.23 1.25 6.88 1.27 9.06 2.53
Figure 5.13 (a)
Mean Values on free Sorting (D-KEFS sorting test) of 6 Groups
In order to determine whether the 6 groups differed significantly on free Sorting task
107
Table 5.13 (b)
Summary table of two-way ANOVA on free sorting (D-KEFS sorting test) across 6
groups
Sources SS Df MS F
BMI 41.35 2 20.67 5.79*
Error 342.82 96 3.57
*p≤.05
Table 5.13 (c)

Significance of mean differences based on Post hoc (LSD) test on free sorting (D-
KEFS sorting test) of three BMI groups
(M=10.59) (M=9.56) (M=9.06)
Normal - 1.03* 1.53*
(M=10.59)
Overweight - - 0.50
(M=9.56)
Underweight - - -
(M=9.06)
*p<.05

among 3 BMI groups i.e. normal BMI, overweight and underweight on free sorting
task of sorting subtest. As F value for BMI (three groups) was found to be significant,
a post hoc analysis (LSD) was applied. The results of post hoc analysis, as shown in
table 5.13 (c) highlights that normal BMI participant (M = 10.59), significantly differ
from overweight (M = 9.56) and underweight (M = 9.06) students. On the other hand,
108
no difference has been found between overweight and underweight BMI groups on
free sorting task scores. Similarly, significant main effect of eating behaviour has
been found (F = 117.63; p<.05) between healthy eating participants and unhealthy
eating participants on free sorting task. Mean values for healthy eating behaviour
group is (M = 11.76), which is much higher than mean value of unhealthy eating
group (M = 7.70). This means that adolescents with healthy food habits, good
nutritional knowledge, active lifestyle, better food safety knowledge, hygienic food
and less barriers in modifying their eating habits scored better on free sorting task.
Interaction effect of BMI and eating behaviour was not found to be significant. Thus,
from the results it can be inferred that BMI and eating behaviour independently
influence performance on free sorting task.
The problem-solving is considered as a mental process which involves many

activities in terms of analyzing, discovering and solving problems. The chief goal of
this process is to find the best solution resolving the issue by overcoming all the
obstacles. In the present study Problem-solving ability was assessed through free
sorting task of sorting test (D-KEFS). Results of the present research work report
significant main effects of BMI and eating behaviour on measure of problem-solving
ability i.e. sorting test. Normal BMI school students significantly performed better on
problem-solving task as compared to overweight and underweight students. This
corresponds well with the previous findings that overweight performed poor on
problem-solving tasks compared to normal weight control. Overweight characterize a
unique pattern of executive dysfunction (Volkow, Wang, Telang, Fowler, Goldstein,
Alia- Klein, 2008). Qavam, Anison, Fathi and Pourabbasi (2015) reported that there is
significant difference between the executive functions such as planning – organizing
and problem solving in obese/ overweight in comparison to normal weight
adolescents. Previous research also emphasized that overweight individuals face many
difficulties in problem solving and decision-making in comparison to the individual
having normal BMI. (Boeka & Lokken 2008; Fergenbaum, Bruce, Lou, Hanley,
Greenwood & Young 2009; Fitzpatrick, Gilbert & Serpell, 2013; Gunstad, Paul,
Cohen, Tate, Spitznagel & Gordon, 2007).
Similarly, significant main effect of eating behaviour has been observed on

problem solving ability. Outcome of the present results are in line with the earlier
109
studies and confirmed that adolescents having healthy eating behaviour posses better
problem solving ability as compared to adolescents having unhealthy eating
behaviour. The study performed by Junger, Marianne, Kampen and Margit (2010)
shows that adolescents, who involve in regular physical activities and have healthier
dietary habits scored better in the problem solving task. Another study in support of
the present findings revealed that poorer decision making & problem solving ability is
associated with sugar- sweetened beverage consumption (Ames, Kisbustakarya &
Reynolds, 2014). Karabulut and Ulucan (2011) reported that those students who do
not participate in sports have a more avoidant approach to problem solving in contrast
to those that participate in sports. Therefore, physical activity & sports have positive
effects on problem- solving approaches. Diet, exercise and other aspects of our daily
interaction with the environment have the potential to alter our brain health and
mental function. There are particular nutrients which influence cognition by acting on
molecular systems or cellular processes that are vital for maintaining cognitive
function like problem solving ability (Gómez-Pinilla, 2008). This raises the exciting
possibility that dietary manipulations are a viable strategy for enhancing cognitive
abilities (problem-solving) and protecting the brain from damage, promoting repair
and counteracting the effects of aging. Thus, emerging research indicates that the
effects of diet on the brain are integrated with the actions of other lifestyle modalities,
such as exercise and sleep.
Thus, the hypothesis 4 (a) which states that there would be significant main effect of
BMI (objective measure) on problem solving ability among school student and 4 (b)
hypothesis which states that there would be significant main effect of eating behavior
(subjective measure) on problem solving ability among school students are proved
and retained. Whereas, hypothesis 4 (c) which states that there would be significant
interaction effect of BMI (objective measure) and eating behavior (subjective
measure) on problem solving ability among school students is not proved and hence
rejected.
110
Inhibition
Inhibitory control was assessed through inhibition condition of D-KEFS color-word

interference test.
Inhibition (D-KEFS Color-Word Interference Test)
The obtained values for mean and SD for 6 groups based on BMI and eating
behavior on inhibition task are indicated in Table 5.14 (a), in which normal BMI
adolescents with healthy eating behaviour scored a mean value of 8.18 (SD = 3.15),
Underweight adolescents with healthy eating behaviour secured mean score of 6.41
value is 4.82 (SD = 3.02) on inhibition. The same has been exhibited in following
Figure 5.14 (a).
Table 5.14 (a)
Mean and SD values on Inhibition (D-KEFS color-word interference test) of 6 groups
1. Eating behaviour → Healthy eating Unhealthy Total (BMI)

group (n=17) eating group (n=34)
2. BMI (n=17)
↓ Mean SD Mean SD Mean SD
Normal BMI (n=34) 8.18 3.15 5.76 2.11 6.97 2.91
Overweight BMI (n=34) 5.59 2.67 5.23 1.75 5.41 2.23
Underweight BMI (n=34) 6.41 2.18 3.47 3.68 4.94 3.33
Total (Eating behaviour) (n=102) 6.72 2.68 4.82 3.02 5.77 2.96
111
Figure 5.14 (a)
Mean Values on Inhibition (D-KEFS color-word interference test)
In order to determine whether the 6 groups differed significantly on inhibition two-

way ANOVA was applied, results of which have been depicted in Table 5.14 (b).
Table 5.14 (b)

Summary table of two-way ANOVA on inhibition (D-KEFS Color-Word Interference
Test) across 6 groups.
Sources SS df MS F
BMI 76.72 2 38.36 5.38*
BMI× Eating behaviour 53.20 2 26.60 3.73*
Error 685.06 96 7.14
p≤.05
112
Table 5.14 (c)
Significance of mean differences based on Post hoc (LSD) test on inhibition task (D-
KEFS Color-Word Interference) of three age groups
(M=6.97) (M=5.41) (M=4.94)
Normal - 1.56* 2.03*
(M=6.97)
Overweight - - .47
(M=5.41)
Underweight - - -
(M=4.94)
*P≤.05

among 3 BMI groups i.e. normal BMI, overweight and underweight on inhibition task
of Color-Word Interference test. As F value for BMI (three groups) was found to be
shown in table 5.14 (c), highlights that normal BMI participant (M = 6.97),
underweight BMI groups on inhibition task. Similarly, significant main effect of
eating behaviour has been found (F = 9.93; p<.05) between healthy eating participants
and unhealthy eating participants on inhibition. Mean values for healthy eating
behaviour group is (M = 6.72), which is significantly higher than mean value of
unhealthy eating group (M = 4.82). This means that adolescents with healthy food
hygienic food and less barriers in modifying their eating habits scored better on
inhibition task. Along with significant main effect of BMI and eating behaviour, a
significant interaction effect (F = 3.73; p≤.05) has been found between the two factors
i.e. BMI (3 levels) and eating behaviour (2 levels).
113
Table 5.14 (d)
Significance of mean differences based on post hoc (LSD) test for interaction on
Inhibition task
BMI× Eating N+HE N+UE OW+HE OW+UE UW+HE UW+UE
behaviour (M=8.18) (M=5.76) (M=5.59) (M=5.23) (M=6.41) (M=3.47)
N+HE - 2.42* 2.59* 2.95* 1.77 4.71*
(M=8.18)
N+UE - - .17 .53 .65 2.29*
(M=5.76)
OW+HE - - - .36 .82 2.12*
(M=5.59)
OW+UE - - - - 1.18 1.76
(M=5.23)
UW+HE - - - - - 2.94*
(M=6.41)
UW+UE - - - - - -
(M=3.47)
*P≤.05
Figure 5.14 (b)
Interaction Effect of BMI and Eating Behaviour on Inhibition task
114
The results of post hoc analysis (LSD) for the interaction effect, as shown in Table
5.14 (d) and Figure 5.14 (b), reveals that normal BMI students having healthy eating
(Mean = 8.18) significantly differs from all other 4 groups across BMI and eating
behaviour except underweight participants having healthy eating behaviour. Normal
BMI students with healthy eating behaviour (Mean = 8.18) have scored highest score
and differ on inhibition from all participants across BMI and eating behaviour groups
except underweight students with healthy eating habits. Further, findings of the post-
hoc (LSD) confirms that underweight students with unhealthy eating habits (Mean =
3.47) have scored lowest on inhibition and hence significantly differ on inhibition
from all participants across BMI and eating behaviour groups except overweight
students with unhealthy eating behaviour.
Inhibitory control is the ability to focus on relevant stimuli in the presence of

irrelevant stimuli by actively controlling attention, such as ignoring irrelevant stimuli
or distractor or controlling a habitual response. People having difficulty with
inhibitory control get distracted easily, are impulsive, and they are driven by impluse.
Individuals who have good inhibitory control are better at everyday adjustment and
skills and are more persistent and they are less impulsive. In the present study
inhibitory control was assessed through inhibition task of Color-Word Interference
Test subtest (D-KEFS). The main and interaction effects of BMI and eating behavior
were observed on the measure of inhibition. The results of the present study highlight
that normal BMI adolescents with healthy eating behaviour scored high on inhibition
as compared to overweight and underweight students having unhealthy eating
behavior. These results are in line with other studies and suggest that overweight
adolescents have poor inhibitory control than healthy (normal) weight adolescents
(Nederkoom, Braet, Ejis, Tanghe & Jansen, 2006; Verbeken, Braet, Claus,
Nederkoorn & Ooserlann, 2009; Verdejo- Garcia, Perez- Exposito & Schmidt, 2010;
Wills, Issasi, Mendoza & Ainette, 2007). Similar results were also reported by Pauli-
pott, Albayrak Hebebrand and Pott (2010) that overweight and obese adolescents
have poor inhibition. Significant effect of eating behaviour has been observed on
inhibition tasks where adolescents having healthy eating performed better on tasks of
inhibition control, which means adolescents who ate healthy diet that includes fruits,
vegetables, grains, diary and protein in their daily meals along with active lifestyle
115
and face less barriers to any change that may lead to healthy food choices, have better
control on their impulses to do any inappropriate behaviour. Outcomes of the present
results are in line with the findings of previous researches and suggest that unhealthy
eating pattern is related to more impulsive behaviour (Guerrieri, Nederkoorn &
Jansen, 2008; Guerrieri, Nederkoorn, Jansen, Schrooten & Martijn, 2009; Guerrieri,
Nederkoorn, Stankiewicz, Alberts, Geschwind & Martijn, 2007; Nederkoorn, Houben,
Hofmann, Roefs & Jansen, 2010; Limbers & Yung, 2015 Qinghua et al. 2014). A few
studies have also found that fatty food, sugar-sweetened beverages, sweet, and salty
consumption of snack is associated with poor inhibitory control (Riggs, Spruitz, Metz,
Sakuma, Chau & Pentz 2010; Ames, kisbusakarya & Reynolds 2014). Gailliot and
Baumeister (2007) found that blood glucose is one of important part of the energy
source for acts of self- control. Self- control that requires inhibitiory control depletes
large amount of glucose. So poor inhibition/ inhibitory control is more likely when
glucose is low.
The significant interaction effect reveals that normal BMI students having
healthy eating significantly differs from all other 4 groups across BMI and eating
behaviour except underweight participants having healthy eating behaviour. Whereas
underweight students with unhealthy eating habits perform poorest on tasks of
inhibition.
Thus, the 5th (a) hypothesis which states ―There would be significant main
effect of BMI (objective measure) on inhibition among school student‖, 5th (b)
hypothesis which states ―There would be significant main effect of eating behavior
(subjective measure) on inhibition among school students‖ and 5th (c) which states
―There would be significant interaction effect of BMI (objective measure) and Eating
behavior (subjective measure) on inhibition among school students‖ are also proved
and retained.
116
Planning ability
Planning ability was assessed through total achievement score on D-KEFS Tower test.
Total Achievement Score (D-KEFS Tower Test)
As reflected in the Table 5.15 (a) the obtained values for mean and SD for 6 groups
based on BMI and eating behaviour on total achievement score of Tower Test. On this
subtest normal BMI adolescents with healthy eating behaviour scored a mean value of
14.06 (SD = 2.81), whereas healthy BMI group with unhealthy eating behaviour
scored a mean value of 9.59 (SD = 2.15). On the other hand, overweight adolescents
with healthy eating behaviour obtained a mean score of 10.29 (SD = 3.01) and mean
value obtained by overweight adolescents with unhealthy eating behaviour is 9.11
(SD = 2.47). Further underweight adolescents with healthy eating behaviour secured
mean score of 10.76 (SD = 3.52) and underweight adolescents with unhealthy eating
eating behaviour adolescents is 11.70 (SD = 3.50) and for unhealthy eating behaviour
adolescent mean value is 8.90 (SD = 2.38) on tower test. The same has been depicted
through graphical representation in the following manner in Figure 5.15 (a).
Table 5.15 (a)

Mean and SD values on total achievement score (D-KEFS Tower test) of 6 groups
group eating group
2. BMI
↓
Normal BMI 14.06 2.81 9.59 2.15 11.82 3.35
Overweight BMI 10.29 3.01 9.11 2.47 9.70 2.78
Underweight BMI 10.76 3.52 8.00 2.35 9.38 3.27
117
Figure 5.15 (a)
Mean Values on total achievement score (D-KEFS Tower test) of 6 Groups
In order to determine whether the 6 groups differed significantly on total

achievement score two-way ANOVA was applied, results of which have been
depicted in Table 5.15 (b).
Table 5.15 (b)

Summary table of two-way ANOVA on total achievement score (D-KEFS Tower test)
across 6 groups
Sources SS df MS F
BMI 119.54 2 59.77 7.84*
Error 731.41 96 7.61
*p≤.05
118
Table 5.15 (c)
Significance of mean differences based on Post hoc (LSD) test on Total achievement
score (D-KEFS Tower test) of three BMI groups
(M=11.82) (M=9.70) (M=9.38)
Normal - 2.12* 2.44*
(M=11.82)
Overweight - - 0.32
(M=9.70)
Underweight - - -
(M=9.38)
*p<.05
Two-way ANOVA shows significant main effect of BMI (F = 7.84; p≤.05) among 3
BMI groups i.e. normal BMI, overweight and underweight on total achievement score
of tower test. As F value for BMI (three groups) was found to be significant, a post
hoc analysis (LSD) was applied. The results of post hoc analysis, as shown in table
5.15 (c) highlights that normal BMI participant (M = 11.82) significantly differ from
overweight (M = 9.70) and underweight (M = 9.38) students. No significant
difference has been found between overweight and underweight students on total
achievement score of tower test. Similarly, significant main effect of eating behaviour
has been found (F = 26.31; p≤.05) between healthy eating participants and unhealthy
eating participants on total achievement score. Mean values for healthy eating
hygienic food and less barriers in modifying their eating habits scored better on total
achievement score of tower test. Along with significant main effect of BMI and eating
behaviour, a significant interaction effect (F = 3.02; p≤.05) has been found between
the two factors i.e. BMI (3 level) and eating behaviour (2 level).
119
Table 5.15 (d)
Significance of mean differences based on Post hoc (LSD) test on total achievement
score (D-KEFS Tower test) across 6 groups
BMI× N+HE N+UE OW+HE OW+UE UW+HE UW+UE
Eating (M=14.06) (M=9.59) (M=10.29) (M=9.11) (M=10.76) (M=8.00)
behaviour
N+HE - 4.47* 3.76* 4.94* 3.29* 6.06*
(M=14.06)
N+UE - - 0.70 0.70 1.17 1.59
(M=9.59)
OW+HE - - - 1.18 0.47 2.29*
(M=10.29)
OW+UE - - - - 1.65 1.11
(M=9.11)
UW+HE - - - - - 2.76*
(M=10.76)
UW+UE - - - - - -
(M=8.00)
*p≤.05
Figure 5.15 (b)
Interaction Effect of BMI and Eating Behaviour on Total achievement score (D-KEFS
Tower test)
120
The results of post hoc analysis (LSD) for the interaction effect, as shown in
Table 5.15 (d) and Figure 5.15 (b), reveals that normal BMI students having healthy
eating (Mean = 14.06) significantly differ from all other groups. This indicates that
students who practice healthy eating behaviour with normal BMI scored maximum on
tower test. Additionally, students having healthy eating behaviour of overweight
group (M = 10.29) and underweight group (M = 10.76) significantly differ from
underweight students with unhealthy eating behaviour (M = 8.00). This indicates the
significant effect of BMI and eating behaviour on tower test. Other participants of
various BMI groups and eating behaviour groups do not significantly differ to each
other.
In present research planning ability was assessed with the help of tower test
(Total achievement score). Planning ability is a fundamental cognitive skill that forms
part of our executive functions. It is the thinking skill that helps an individual develop
strategies to accomplish goals. It also helps them to think over about their future and
mentally predict the right path to carry out a target. In this study the main and
interaction effect of BMI and eating behavior was observed on the measure of
planning ability i.e. tower test. The result of the present findings point out that as the
BMI deviates toward unhealthy weight category participants performed poor on
planning ability. Moreover results revealed that overweight participants with both
healthy and unhealthy eating behaviour performed poor than normal BMI group
having healthy eating habits on tower test. Goldschmidt and Hunter (2018) also found
similar results in which overweight with or without loss of control on eating
performed poor on planning task. Results of the current investigation are consistent
with previous studies pointing out that adolescents with excess weight perform poor
on tests of planning ability (Douchesne, Mattos, Coutinho & Santos, 2010;
Fergenbaum, Bruce, Lou, Hanley, Greenwood & Young, 2009; Fitzpatrick, Gilbert &
Serpell, 2013; Manasse, Juarascio, Forman, Berner, Butryn & Ruocco, 2014).
Further the results also indicate main significant effect of eating behaviour on
planning ability. The results highlight that healthy eating behaviour group performed
better on tower test. Outcome of the present findings are in line with the earlier
findings and highlight that adolescents school students having healthy eating
behaviour scored higher on planning ability compared to adolescents having
121
unhealthy eating behaviour. This indicates their thinking ability and the ability to
manage tasks by taking the assistance of available resources in order to attain the
certain goals is better. Previous researches have also emphasized that healthier eating
habits are related to better planning ability (Fagundo, Torre, Murcia, Granero and
aranda, 2012; Houban, 2011; Limbers, Egan & Cohen, 2017, Nyaradi, foster &
Hickling, 2014; Wykoff, Evans, Manasse, Butryn & Forman, 2017). It was found that
poor executive functioning is associated with lesser intake of healthy foods in healthy
weight samples and higher intake of unhealthy food (Hall, 2012; Jasinka et. al., 2012;
Hall, Vincent & Lowe, 2014). A few studies have also found that healthy diet rich in
fruits, vegetables, grains, diary and protein is associated with better planning ability
(Houban, 2011; Nyaradi, Foster & Hickling, 2014; Sheppard & Cheatham, 2013),
which support the present findings.
The significant interaction effect reveals that normal BMI students having
healthy eating significantly differ from all other groups. This indicates that students
who practice healthy eating behaviour with normal BMI scored maximum on tower
test. Additionally, overweight and underweight students having healthy eating
behaviour significantly differ from underweight students with unhealthy eating
behaviour. This indicates the significant interaction effect of BMI and eating
behaviour on tower test.
Thus, the 6th (a) hypothesis which states ―There would be significant main
effect of BMI (objective measure) on planning ability among school student‖, 6th (b)
hypothesis that states ―There would be significant main effect of eating behavior
(subjective measure) on planning ability among school students and 6th (c) which
states ―There would be significant interaction effect of BMI (objective measure) and
eating behavior (subjective measure) on planning ability among school students‖ are
proved and retained.
122
Fluency ability
Fluency ability was assessed through letter fluency and category fluency conditions of
D-KEFS verbal fluency test, filled dots and empty dots conditions of D-KEFS Design
Fluency Test.
Letter Fluency (D-KEFS Verbal Fluency Test)
Table 5.16 (a) shows the obtained values for mean and SD for 6 groups based on BMI
and EB on letter fluency task of verbal fluency subtest. On this ability normal BMI
underweight adolescents with healthy eating behaviour secured mean score of 5.59
value is 4.39 (SD = 3.05) on letter fluency task. The same has been depicted in
following Figure 5.16 (a).
Table 5.16 (a)
Mean and SD values on letter fluency (D-KEFS verbal fluency test) of 6 groups

group eating group
2. BMI
↓
Normal BMI 9.53 1.37 5.94 3.68 7.73 3.29
Overweight BMI 7.35 3.90 2.76 1.44 5.06 3.72
Underweight BMI 5.59 2.74 4.47 2.85 5.03 2.81
123
Figure 5.16 (a)
Mean Values on letter fluency (D-KEFS verbal fluency test) of 6 Groups
In order to determine whether the 6 groups differed significantly on letter fluency task
Table 5.16 (b)

Summary table of two-way ANOVA on letter fluency (D-KEFS verbal fluency test)
across 6 groups
Sources SS df MS F
BMI 164.17 2 82.08 10.14*
Error 776.47 96 8.08
*p≤.05
124
Table 5.16 (c)
Significance of mean differences based on Post hoc (LSD) test on letter fluency (D-
KEFS verbal fluency test) of three BMI groups
(M=7.73) (M=5.06) (M=5.03)
Normal - 2.67* 2.70*
(M=7.73)
Overweight - - 0.03
(M=5.06)
Underweight - - -
(M=5.03)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on letter fluency task. As F
value for BMI (three groups) was found to be significant, a post hoc analysis (LSD)
was applied. The results of post hoc analysis, as shown in table 5.16 (c) highlights that
normal BMI participant (M = 7.73), significantly differ from overweight (M = 5.06)
and underweight (M = 5.03) students. On the other hand, no difference has been
obtained between overweight and underweight on letter fluency. Similarly, significant
main effect of eating behaviour has been found (F = 30.25; p≤.05) between healthy
eating participants and unhealthy eating participants on letter fluency task. Mean
values for healthy eating behaviour group is (M = 7.49), which is significantly higher
scored better on letter fluency task. Along with significant main effect of BMI and
eating behaviour, a significant interaction effect (F = 3.35; p≤.05) has been found
between the two factors i.e. BMI (3 level) and eating behaviour (2 level).
125
Table 5.16 (d)
Significance of mean differences based on Post hoc (LSD) test on letter fluency (D-
KEFS verbal fluency test) across 6 groups
N+HE - 3.59* 2.18* 6.76* 3.94* 5.06*
(M=9.53)
N+UE - - 1.41 3.18* 0.35 1.47
(M=5.94)
OW+HE - - - 4.59* 1.76 2.88*
(M=7.35)
OW+UE - - - - 2.82* 1.70
(M=2.76)
UW+HE - - - - - 1.12
(M=5.59)
UW+UE - - - - - -
(M=4.47)
*p≤.05
Figure 5.16 (b)
Interaction Effect of BMI and Eating Behaviour on letter fluency (D-KEFS verbal
fluency test)
126
The results of post hoc analysis (LSD) for the interaction effect, as shown in
Table 5.16 (d) and Figure 5.15 (b), reveals that Normal BMI students having healthy
eating (Mean = 9.53) significantly differs from all other groups across BMI and eating
behaviour. This also indicates that students who practice healthy eating behaviour and
maintain normal BMI scored maximum on letter fluency test. Further, findings of the
post hoc (LSD) confirms that overweight BMI students with unhealthy eating
behaviour (Mean = 2.76) have scored lowest score and significantly differs on letter
fluency from all other groups across BMI and eating behaviour group except
underweight students with unhealthy eating behaviour. Overweight healthy eating
group (M = 7.35) significantly differs from underweight participants having unhealthy
eating behaviour (M = 4.47). Other participants of various BMI groups and eating
behaviour groups do not significantly differ to each other
Category Fluency (D-KEFS Verbal Fluency Test)
Table 5.17 (a) shows the obtained values for mean and SD for 6 groups based on
BMI and eating behaviour on category fluency task of verbal fluency test. On this task
normal BMI adolescents with healthy eating behaviour scored a mean value of 8.65
(SD = 1.22), whereas healthy BMI group with unhealthy eating behaviour scored a
mean value of 7.35 (SD = 3.33). On the other hand, overweight adolescents with
2.69). Further, underweight adolescents with healthy eating behaviour secured mean
adolescent mean value is 4.98 (SD = 3.09) on category fluency task. The same has
been depicted in following Figure 5.17 (a).
127
Table 5.17 (a)
Mean and SD values on Category Fluency (D-KEFS verbal fluency test) of 6 groups

group eating group
2. BMI
↓
Normal BMI 8.65 1.22 7.35 3.33 8.00 2.56
Overweight BMI 7.82 2.40 3.59 1.58 5.70 2.94
Underweight BMI 6.29 2.75 4.00 2.69 5.15 2.92
Figure 5.17 (a)
Mean Values on Category Fluency (D-KEFS verbal fluency test) of 6 Groups
In order to determine whether the 6 groups differed significantly on category fluency

128
Table 5.17 (b)
Summary table of two-way ANOVA on Category Fluency (D-KEFS verbal fluency
test) across 6 groups
Sources SS df MS F
BMI 155.43 2 77.71 13.04*
Error 571.88 96 5.95
*p≤.05
Table 5.17 (c)

Significance of mean differences based on Post hoc (LSD) test on category fluency
(D-KEFS verbal fluency test) of three BMI groups
(M=8.00) (M=5.70) (M=5.15)
Normal - 2.29* 2.85*
(M=8.00)
Overweight - - 0.55
(M=5.70)
Underweight - - -
(M=5.15)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on category fluency task
of verbal fluency subtest. As F value for BMI (three groups) was found to be
129
shown in table 5.17 (c) highlights that normal BMI participant (M = 8.00),
underweight on category fluency. Similarly, significant main effect of eating
behaviour has been found (F = 29.11; p≤.05) between healthy eating participants and
unhealthy eating participants on category fluency task. Mean values for healthy eating
behaviour group is (M = 7.59), which is much higher than mean value of unhealthy
eating group (M = 4.98). This means that adolescents with healthy food habits, good
nutritional knowledge, active lifestyle, better food safety knowledge, hygienic food
and less barriers in modifying their eating habits scored better on category fluency.
Along with significant BMI and eating behaviour differences, a significant interaction
effect (F = 3.19; p≤.05) has been found between the two factors i.e. BMI (3 level) and
eating behaviour (2 level).
Table 5.17 (d)

Significance of mean differences based on Post hoc (LSD) test on Category Fluency
(D-KEFS verbal fluency test) across 6 groups
N+HE - 1.29 0.82 5.06* 2.35* 4.65*
(M=8.65)
N+UE - - 0.47 3.76* 1.06 3.35*
(M=7.35)
OW+HE - - - 4.23* 1.53 3.82*
(M=7.82)
OW+UE - - - - 2.70* 0.41
(M=3.59)
UW+HE - - - - - 2.29*
(M=6.29)
UW+UE - - - - - -
(M=4.00)
*p≤.05
130
Figure 5.17 (b)
Interaction Effect of BMI and Eating Behaviour on Category Fluency Task (D-KEFS
verbal fluency test)
The results of post hoc analysis (LSD) for the interaction effect, as shown in Table
5.17 (d) and Figure 5.17 (b), reveals that normal BMI students having healthy eating
(Mean = 8.65) significantly differs from all other groups across BMI and Eating
behaviour except normal BMI participants having unhealthy eating behaviour and
overweight participants having healthy eating behaviour. This also indicates that
students who practice healthy eating behaviour and maintain normal BMI scored
maximum on category fluency task. Further, findings of the post hoc (LSD) confirms
that overweight BMI students with unhealthy eating behaviour (Mean = 3.59) have
scored lowest score and significantly differs on category fluency from all other groups
across BMI and Eating behaviour group except underweight students with unhealthy
eating behaviour. Similarly, underweight students with unhealthy eating habits (Mean
= 4.00) have scored low on category fluency task and hence significantly differ on
category fluency from all participants across BMI and Eating behaviour groups except
overweight students with unhealthy eating behaviour Other participants of various
BMI groups and eating behaviour groups do not significantly differ to each other.
131
Filled Dots (D-KEFS Design Fluency)
Table 5.18 (a) shows the mean and SD values for 6 groups based on BMI and eating
behaviour on filled dot task of design Fluency subtest. On this test normal BMI
overweight adolescents with unhealthy eating behaviour is 2.06 (SD=1.85). Further,
underweight adolescents with healthy eating behaviour secured mean score of 5.12
value is 4.33 (SD = 3.62) on filled dot task of design fluency. The same has been
depicted through graphical representation in the following manner in Figure. 5.18 (a)
Table 5.18 (a)
Mean and SD values on Filled dots (D-KEFS Design fluency) of 6 groups

group eating group
2. BMI
↓
Normal BMI 8.12 1.90 6.29 4.31 7.20 3.41
Overweight BMI 7.76 3.38 2.06 1.85 1.91 3.95
Underweight BMI 5.12 3.62 4.65 3.06 4.88 3.31
132
Figure 5.18 (a)
Mean Values on Filled dots (D-KEFS Design fluency) of 6 Groups
In order to determine whether the 6 groups differed significantly on filled dot task of
design fluency two-way ANOVA was applied, results of which have been depicted in
Table 5.18 (b).
Table 5.18 (b)
Summary table of two-way ANOVA on Filled dots (D-KEFS Design fluency) across 6
groups
Sources SS df MS F
BMI 120.84 2 60.42 6.08*
Error 952.94 96 9.93
*p≤.05
133
Table 5.18 (c)
Significance of mean differences based on Post hoc (LSD) test on Filled dots (D-
KEFS Design fluency) of three BMI groups
(M=7.20) (M=1.91) (M=4.88)
Normal - 2.29* 2.32*
(M=7.20)
Overweight - - 0.03
(M=1.91)
Underweight - - -
(M=4.88)
*p<.05
Two- way ANOVA shows significant main effect of BMI (F = 6.08; p≤.05) among 3
BMI groups i.e. normal BMI, overweight and underweight on filled dot condition of
design fluency subtest. As F value for BMI (three groups) was found to be significant,
no difference has been obtained between overweight and underweight on design
fluency condition 1 (Filled dots). Similarly, significant main effect of eating
behaviour has been found (F = 18.26; p≤.05) between healthy eating participants and
unhealthy eating participants on filled dot condition of design fluency subtest. Mean
values for healthy eating behaviour group is (M = 7.00), which is significantly higher
scored better on filled dots condition in design fluency test. Along with significant
BMI and eating behaviour differences, a significant interaction effect (F = 6.32;
p≤.05) has been found between the two factors i.e. BMI (3 level) and eating behaviour
(2 level).
134
Table 5.18 (d)
Significance of mean differences based on Post hoc (LSD) test on filled dots (D-KEFS
Design fluency) across 6 groups
N+HE - 1.82 0.35 6.06* 3.00* 3.47*
(M=8.12)
N+UE - - 1.47 4.23* 1.17 1.65
(M=6.29)
OW+HE - - - 5.70* 2.65* 3.11*
(M=7.76)
OW+UE - - - - 3.06* 2.59*
(M=2.06)
UW+HE - - - - - 0.47
(M=5.12)
UW+UE - - - - - -
(M=4.65)
*p≤.05
Figure 5.18 (b)
Interaction Effect of BMI and Eating Behaviour on filled dots (D-KEFS Design fluency)
135
The results of post hoc analysis (LSD) for the interaction effect as shown in Table
5.18 (d) and Figure 5.18 (b), reveals that Normal BMI students having healthy eating
(Mean = 8.12) significantly differs from all other groups across BMI and Eating
behaviour except normal BMI participants having unhealthy eating behaviour and
overweight participants having healthy eating behaviour. This also indicates that
students who practice healthy eating behaviour and maintain normal BMI scored
maximum on design fluency test (condition1). Further, findings of the post hoc (LSD)
confirms that overweight BMI students with unhealthy eating behaviour (Mean =
2.06) have scored lowest score and significantly differs on design fluency from all
other groups across BMI and eating behaviour group. Similarly, overweight students
with healthy eating habits (Mean = 7.76) significantly differ on filled dot design
fluency subtest from all participants across BMI and eating behaviour groups except
normal BMI participants having healthy and unhealthy eating behaviour. Other
participants of various BMI groups and eating behaviour groups do not significantly
differ to each other.
Empty Dots (D-KEFS Design Fluency)
As it can be seen from Table 5.19 (a) that it shows the obtained values for mean and
SD for 6 groups based on BMI and eating behaviour on Empty dot (condition 2) of
design fluency subtest. On this ability normal BMI adolescents with healthy eating
behaviour scored a mean value of 8.29 (SD = 1.83), whereas healthy BMI group with
unhealthy eating behaviour scored a mean value of 6.06 (SD = 4.33). On the other
hand, overweight adolescents with healthy eating behaviour obtained a mean score of
7.94 (SD = 3.07) and mean value obtained by overweight adolescents with unhealthy
eating behaviour is 2.53 (SD = 2.03). Further underweight adolescents with healthy
eating behaviour secured mean score of 5.94 (SD = 3.68) and underweight
on empty dot (condition 2) of design fluency. The same has been depicted in
following Figure 5.19 (a)
136
Table 5.19 (a)
Mean and SD values on empty dots (D-KEFS Design fluency) of 6 groups

group eating group
2. BMI
↓
Normal BMI 8.29 1.83 6.06 4.33 7.18 3.47
Overweight BMI 7.94 3.07 2.53 2.03 5.23 3.76
Underweight BMI 5.94 3.68 4.88 2.91 5.41 3.31
Figure 5.19 (a)
Mean Values on empty dots (D-KEFS Design fluency) of 6 Groups
In order to determine whether the 6 groups differed significantly on design fluency

137
Table 5.19 (b)
Summary table of two-way ANOVA on empty dots (D-KEFS Design fluency) across 6
groups
Sources SS df MS F
BMI 78.35 2 39.17 4.06*
Error 924.35 96 9.62
*p≤.05
Table 5.19 (c)

Significance of mean differences based on Post hoc (LSD) test on empty dots (D-
KEFS Design fluency) of three BMI groups
(M=7.18) (M=5.23) (M=5.41)
Normal - 1.94* 1.76
(M=7.18)
Overweight - - 0.18
(M=5.23)
Underweight - - -
(M=5.41)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on empty dot condition of
design fluency subtest. As F value for BMI (three groups) was found to be significant,
138
no difference has been obtained between overweight and underweight on empty dot
(condition 2) of design fluency. Similarly, significant main effect of eating behaviour
has been found (F = 22.30; p≤.05) between healthy eating participants and unhealthy
eating participants on empty dot condition of design fluency subtest. Mean values for
healthy eating behaviour group is (M = 7.39), which is much higher than mean value
of unhealthy eating group (M = 4.49). This means that adolescents with healthy food
hygienic food and less barriers in modifying their eating habits scored better on empty
dot (condition 2) of design fluency test. Along with significant BMI and eating
behaviour differences, a significant interaction effect (F = 4.47; p≤.05) has been found
between the two factors i.e. BMI (3 level) and eating behaviour (2 level).
Table 5.19 (d)

Significance of mean differences based on Post hoc (LSD) test on empty dots (D-
KEFS Design fluency) across 6 groups
N+HE - 2.23* 0.35 5.76* 2.35* 3.41*
(M=8.29)
N+UE - - 1.88 3.53* 0.11 1.17
(M=6.06)
OW+HE - - - 5.41* 2.00 3.05*
(M=7.94)
OW+UE - - - - 3.41* 2.35*
(M=2.53)
UW+HE - - - - - 1.05
(M=5.94)
UW+UE - - - - - -
(M=4.88)
*p≤.05
139
Figure 5.19 (b)
Interaction Effect of BMI and Eating Behaviour on empty dots (D-KEFS Design fluency)
The results of post hoc (LSD) for the interaction effect, as shown in Table 5.19 (d)
and Figure 5.19 (b), reveals that normal BMI students having healthy eating (Mean =
8.29) significantly differs from all other groups across BMI and eating behaviour
except overweight participants having healthy eating behaviour. This also indicates
that students who practice healthy eating behaviour and maintain normal BMI scored
maximum on design fluency test (condition 2). Further, findings of the post hoc
(LSD) confirms that overweight BMI students with unhealthy eating behaviour (Mean
= 2.53) have scored lowest score and significantly differs on design fluency from all
other groups across BMI and eating behaviour group. Similarly, overweight students
with healthy eating habits (Mean = 7.94) significantly differ on design fluency
(condition 2) from underweight students with unhealthy eating behaviour (Mean =
4.88). Other participants of various BMI groups and eating behaviour groups do not
significantly differ to each other.
Fluency ability was assessed with the help of letter fluency condition and
category fluency condition of verbal fluency subtest; and filled dots condition and
empty dots condition of design fluency subtest. Findings of the present study
highlight significant main and interaction effects of BMI and eating behaviour on
fluency ability. Normal BMI adolescents significantly differs from overweight and
underweight students on performance on fluency tasks. The findings of this study are
140
consistent with other investigations which reported that overweight/obese
participants showed significantly poor fluency (Benito-Leon, Mitchell, Hernandez-
Gallego & Bermego- Pareja, 2013; Gonzals, Tarumi, Miles, Tanaka, Shah and Haley,
2010; Maayan, Hoogendoorn, Sweat & Convit, 2011). Results of the present study
also indicate that adolescents having healthy eating behaviour had better fluency
ability.these findings are supported by earlier studies that highlight the role of
breakfast in improved performance on tasks of verbal fluency (Chandler, Walker &
Connolly, 1995; Grantham-McGregor, Chang & Walker, 1998; Micha, Roger and
Nelson, 2011)
Moreover, significant interaction effect of BMI and eating behaviour was

observed on measure of fluency ability. The results confirm that healthy eating
participants with normal BMI and healthy eating behaviour performe better on tasks
of fluency. On the contrary, overweight BMI students with unhealthy eating
behaviour scored lowest on fluency from all other groups across BMI and eating
behaviour group.
Thus, the 7th (a), (b) and (c) hypothesis which states that there would be
significant main effect of BMI (objective measure), eating behavior (subjective
measure) and interaction effect of BMI and eating behavior on fluency ability among
school students are proved and hence retained.
Linguistic ability
Linguistic ability was assessed through word context test, color naming and
word reading condition of Color word interference test. Word Context Test and two
sub-tests of Color-Word Interference Test i.e. Colour naming condition and Word
reading condition.
Word context test
Table 5.20 (a) shows the obtained values for mean and SD for 6 groups based on BMI
and EB on word context test. On this ability normal BMI adolescents with healthy
eating behaviour scored a mean value of 8.53 (SD = 2.72), whereas healthy BMI
group with unhealthy eating behaviour scored a mean value of 5.82 (SD = 3.43). On
the other hand, overweight adolescents with healthy eating behaviour obtained a mean
141
score of 6.29 (SD = 3.12) and mean value obtained by overweight adolescents with
unhealthy eating behaviour is 5.53 (SD = 3.36). Further underweight adolescents with
healthy eating behaviour secured mean score of 6.76 (SD = 2.66) and underweight
on word context. The same has been depicted in following Figure 5.20 (a)
Table 5.20 (a)

Mean and SD values of word context test of 6 groups
group eating group
2. BMI
↓
Normal BMI 8.53 2.72 5.82 3.43 7.18 3.34
Overweight BMI 6.29 3.12 5.53 3.36 5.91 3.21
Underweight BMI 6.76 2.66 2.00 1.50 4.38 3.22
Figure 5.20 (a)
Mean Values of Word Context Test of 6 Groups
142
In order to determine whether the 6 groups differed significantly on inhibition two-
way ANOVA was applied, results of which have been depicted in Table 5.20 (b).
Table 5.20 (b)

Summary table of two-way ANOVA on word context test across 6 groups
Sources SS df MS F
BMI 133.11 2 66.55 8.07*
Error 791.52 96 8.24
*p≤.05
Table 5.20 (c)

Significance of mean differences based on Post hoc (LSD) test on word Context of
three BMI groups
(M=7.18) (M=5.91) (M=4.38)
Normal - 1.26 2.79*
(M=7.18)
Overweight - - 1.53*
(M=5.91)
Underweight - - -
(M=4.38)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on word context. As F
143
underweight participant (M = 4.38), significantly differ from normal BMI (M = 7.18)
and overweight (M = 5.91) students. No significant difference has been found
between overweight students and normal BMI students. Similarly, significant main
effect of eating behaviour has been found (F = 23.30; p≤.05) between healthy eating
participants and unhealthy eating participants on word context test. Mean values for
healthy eating behaviour group is (M = 7.19), which is significantly higher than mean
value of unhealthy eating group (M = 4.45). This means that adolescents with healthy
food habits, good nutritional knowledge, active lifestyle, better food safety
knowledge, hygienic food and less barriers in modifying their eating habits scored
better word context (linguistic skill). Along with significant BMI and eating
behaviour differences, a significant interaction effect (F = 4.12; p≤.05) has been found
between the two factors i.e. BMI (3 level) and eating behaviour (2 level). The same
has been exhibited through the graphical representation in Figure 5.20 (b).
Table 5.20 (d)

Significance of mean differences based on Post hoc (LSD) test on Word context test
across 6 groups
N+HE - 2.70* 2.24* 3.00* 1.77 6.53*
(M=8.53)
N+UE - - 0.47 0.29 0.94 3.82*
(M=5.82)
OW+HE - - - 0.76 0.47 4.29*
(M=6.29)
OW+UE - - - - 1.23 3.53*
(M=5.53)
UW+HE - - - - - 4.76*
(M=6.76)
UW+UE - - - - - -
(M=2.00)
*p≤.05
144
Figure 5.20 (b)
Interaction Effect of BMI and Eating Behaviour on Word Context Test
and Figure 5.20 (b), reveals that normal BMI students having healthy eating (Mean =
8.53) significantly differs from all other groups across BMI and eating behaviour
except underweight participants with healthy eating behaviour. This also indicates
that students who practice healthy eating behaviour and maintain normal BMI scored
maximum on word context test. Further, findings of the post hoc (LSD) confirms that
underweight BMI students with unhealthy eating behaviour (Mean = 2.00) have
scored lowest score and significantly differs on word context test differs from all
other groups across BMI and eating behaviour. Other participants of various BMI
groups and eating behaviour groups do not significantly differ to each other.
Color Naming (D-KEFS Color Word Interference Test)
Table 5.21 (a) shows the mean and SD values for 6 groups based on BMI and
EB on color naming (condition 1) of Color Word Interference test. On this task
145
adolescent mean value is 4.76 (SD = 3.51) on color naming (condition 1) of Color
Word Interference test. The same has been depicted in following Figure 5.21 (a)
Table 5.21 (a)

Mean and SD values on color naming (D-KEFS Color Word Interference Test) of 6
groups
group eating group
2. BMI
↓
Normal BMI 8.82 2.57 6.11 3.56 7.47 3.35
Overweight BMI 6.58 3.02 5.88 3.62 6.23 3.30
Underweight BMI 7.05 2.72 2.29 1.75 4.67 3.30
Figures 5.21 (a)

Mean Values of Color Naming (D-KEFS Color Word Interference Test) of 6 Groups
146
In order to determine whether the 6 groups differed significantly on color naming
Table 5.21 (b)

Summary table of two-way ANOVA on color naming (D-KEFS Color Word
Interference Test) across 6 groups
Sources SS df MS F
BMI 133.31 2 66.65 7.66*
Error 834.58 96 8.69
**p<.05
Table 5.21 (c)

Significance of mean differences based on Post hoc (LSD) test on color naming (D-
KEFS Color Word Interference Test) of three BMI groups
(M=7.47) (M=6.23) (M=4.67)
Normal - 1.23 2.79*
(M=7.47)
(M=6.23)
Underweight - - -
(M=4.67)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on color naming. As F
that underweight participant (M = 4.67), significantly differ from normal BMI (M =
147
7.47) and overweight (M = 6.23) students. No significant difference has been found
effect of eating behaviour has been found (F = 21.78; p<.05) between healthy eating
participants and unhealthy eating participants on color naming task. Mean values for
healthy eating behaviour group is (M = 7.49), which is significantly higher than mean
value of unhealthy eating group (M = 4.76). This basically implies that adolescents
safety knowledge, hygienic food and fewer barriers in modifying their eating habits
scored better on color naming task. Additionally, a significant interaction effect (F =
4.02; p≤.05) has also been found between the two factors i.e. BMI (3 levels) and
eating behaviour (2 levels). The same has been exhibited through the graphical
representation in Figure 5.21 (b).
Table 5.21 (d)
Significance of mean differences based on Post hoc (LSD) test on Color Naming (D-
KEFS Color Word Interference Test) across 6 groups

N+HE - 2.70* 2.23* 2.94* 1.76 6.52*
(M=8.82)
N+UE - - -.47 .23 -.94 3.82*
(M=6.11)
OW+HE - - - .70 -.47 4.29*
(M=6.58)
OW+UE - - - - -1.17 3.58*
(M=5.88)
UW+HE - - - - - 4.76*
(M=7.05)
UW+UE - - - - - -
(M=2.29)
*p<.05
148
Figures 5.21 (b)
Interaction Effect of BMI and Eating Behaviour on Color Naming (D-KEFS Color
Word Interference Test)
and Figure 5.21 (b), reveals that underweight students having unhealthy eating (Mean
= 2.29) differ on color naming task from all participants across BMI and eating
behaviour groups. Similarly, normal BMI with Healthy eating group (Mean = 8.82)
differ on color naming task from all participants across BMI and eating behaviour
groups except underweight students with healthy eating behaviour. Other participants
of various BMI group and eating behaviour groups do not significantly differ from
each other.
Word Reading (D-KEFS Color Word Interference Test)
Table 5.22 (a) shows the mean and SD values for 6 groups based on BMI and eating
behaviour on word reading task of Color Word Interference subtest. On this task
149
adolescent mean value is 5.23 (SD = 3.23) on word reading task. The same has been
depicted in following Figure 5.22 (a).
Table 5.22 (a)

Mean and SD values on word reading (D-KEFS Color Word Interference Test) of 6
groups
group eating group
2. BMI
↓
Normal BMI 9.11 2.39 6.58 3.06 7.85 2.99
Overweight BMI 7.35 2.34 6.35 3.16 6.85 2.78
Underweight BMI 7.23 2.75 2.76 1.88 5.00 3.24
Figure 5.22 (a)
Mean Values of Word Reading (D-KEFS Color Word Interference Test) of 6 Groups
150
Now the data were subjected to two-way ANOVA, results of which have been
revealed in Table 5.22 (b).
Table 5.22 (b)

Summary table of two-way ANOVA on word reading (D-KEFS Color Word
Interference Test) across 6 groups
Sources SS df MS F
BMI 142.49 2 71.24 10.24*
Error 667.76 96 6.95
*p≤.05
Table 5.22 (c)

Significance of mean differences based on Post hoc (LSD) test on word Reading (D-
KEFS Color Word Interference Test) of three BMI groups
(M=7.85) (M=6.85) (M=5.00)
Normal - 1.00 2.85*
(M=7.85)
(M=6.85)
Underweight - - -
(M=5.00)
*p<.05
BMI groups i.e. normal BMI, overweight and underweight on word reading task. As F
151
underweight participant (M = 5.00), significantly differ from normal BMI (M = 7.85)
and overweight (M = 6.85) students. No significant difference has been found
effect of eating behaviour has been found (F = 26.06; p≤.05) between healthy eating
participants and unhealthy eating participants on word reading task. Mean value for
healthy eating behaviour group is (M = 7.90), which is significantly higher than the
mean value of unhealthy eating group (M = 5.23). This means that adolescents with
healthy food habits, good nutritional knowledge, active lifestyle, better food safety
knowledge, hygienic food and fewer barriers in modifying their eating habits had
better score on reading task. Along with significant BMI and eating behaviour
differences, a significant interaction effect (F = 3.69; p≤.05) has been found between
the two factors i.e. BMI (3 levels) and eating behaviour (2 levels). The same has been
exhibited through the graphical representation in Figure 5.22 (b).
Table 5.22 (d)
Significance of mean differences based on Post hoc (LSD) test on Word Reading
(D-KEFS Color Word Interference Test) across 6 groups

N+HE - 2.52* 1.76 2.76* 1.88* 6.35*
(M=9.11)
N+UE - - -.76 .23 -.64 3.82*
(M=6.58)
OW+HE - - - 1.00 .11 4.58*
(M=7.35)
OW+UE - - - - -.88 3.58*
(M=6.35)
UW+HE - - - - - 4.47*
(M=7.23)
UW+UE - - - - - -
(M=2.76)
*p≤.05
152
Figure 5.22 (b)
Interaction Effect of BMI and Eating Behaviour on Word Reading task(D-KEFS

Color Word Interference Test)
The result of post hoc (LSD) for the interaction effect, as shown in Table 5.22 (d) and
Figure 5.22 (b), reveals that underweight students having unhealthy eating (Mean =
2.76) differ on word reading from all participants across BMI and Eating behaviour
groups. Similarly, normal BMI with Healthy eating group (Mean = 9.11) differs on
word reading from all participants across BMI and eating behaviour groups except
overweight students with healthy eating behaviour. Other participants of various BMI
group and eating behaviour groups do not significantly differ from each other.
Linguistic ability was assessed by Word Context Test and two sub-tests of
Color-Word Interference Test i.e. Colour naming condition and Word reading
condition. In the present study, significant main and interaction effects of BMI and
eating behaviour were observed on all three measures of linguistic ability.
Underweight adolescents significantly perform poor on linguistic ability tasks
compared to normal BMI and overweight school students. These findings are
supported by observations of previous studies pointing out that moderate or even mild
degree of thinness can delay the child‘s development including language (Pearce,
Scalzi, Lynch, Smithers, 2016; Nyaradi, Li, Hickling, Foster & Oddy, 2013; Sandjaja
153
et al. 2013). The present study could not find difference in performance between
normal BMI students and overweight school students. Whereas, earlier investigations
had found that overweight and obese individuals perform poor on linguistic and
reading ability (Braet and Crombez, 2003; Davis & Cooper, 2011; Holcke, 2008).
Significant effect of eating behaviour has been found on linguistic ability, indicating
that adolescents having healthy eating behaviour perform better on linguistic ability
tasks. The present findings are supported by earlier studies that highlight the positive
effect of breakfast on language skills and grammatical reasoning tasks (Meyers,
Sampson & Weitzman, 1989; Wesnes, Pincock & Richardson, 2003; Wyon,
Abrahamson & Jartelius, 1997). Research also indicates that school based breakfast
program intervention had significant effect on reading (Wahlstrom & Begalle, 1999;
Meyers, Sampson & Weitzman, 1989). Pollitt, Cueto and Jacoby (1996) reported
positive effect of breakfast on vocabulary. The significant intereaction effect indicates
that normal BMI school students with healthy eating perform best on tasks of
language and linguistic abilities. Whereas, underweight BMI students with unhealthy
eating behaviour have scored lowest.
Thus, hypothesis 8th (a), (b) and (c) which states that there would be
significant main and intereaction effects of BMI (objective measure) and eating
behavior (subjective measure) on linguistic ability among school students are proved
and hence retained
Psychomotor ability
Psychomotor ability was assessed through motor speed condition of trail making test
Motor Speed (D-KEFS Trail Making Test)
Table 5.23 (a) presents the mean and SD values across three BMI groups (normal
BMI, overweight and underweight) for healthy and unhealthy eating behaviour
participants on motor speed task of the trail making subtest. On this ability normal
BMI adolescents with healthy eating behaviour scored a mean value of 7.70 (SD =
1.89), whereas, participants having unhealthy eating behaviour of same BMI group
scored a mean value of 5.70 (SD = 2.36). On the other hand, overweight adolescents
with healthy eating behaviour obtained a mean score of 4.88 (SD = 2.37) and mean
value obtained by overweight adolescents with unhealthy eating behaviour is 3.94
154
(SD = 1.75). Further underweight adolescents with healthy eating behaviour secured
mean score of 6.29 (SD = 3.12) and underweight adolescents with unhealthy eating
adolescent mean value is 5.07 (SD = 2.65) on motor speed task. The same has been
exhibited through the graphical representation in Figure 5.23 (a).
Table 5.23 (a)

Mean and SD values on Motor speed (D-KEFS Trail making test) of 6 groups
group eating group
2. BMI
↓
Normal BMI 7.70 1.89 5.70 2.36 6.70 2.34
Overweight BMI 4.88 2.37 3.94 1.75 4.41 2.10
Underweight BMI 6.29 3.12 5.53 3.36 5.91 3.21
Figure 5.23 (a)
Mean Values on Motor speed (D-KEFS Trail making test) task of 6 Groups
155
In order to determine whether the 6 groups differed significantly on motor speed task
Table 5.23 (b)

Summary table of two-way ANOVA on Motor speed (D-KEFS Trail making test)
across 6 groups
Sources SS df MS F
BMI 92.29 2 46.15 7.13*
Error 621.53 96 6.47
*p≤.05
Table 5.23 (c)

Significance of mean differences based on Post hoc (LSD) test on Motor speed (D-
KEFS Trail making test) of three BMI groups
(M=6.70) (M=4.41) (M=5.91)
Normal - 2.29* 0.79
(M=6.70)
(M=4.41)
Underweight - - -
(M=5.91)
*p<.05
Two-way ANOVA shows significant main effect of BMI among 3 BMI

groups i.e. Normal BMI, overweight and underweight on motor speed task. The
obtained F- value (F = 7.13; p≤.05) shows that participants across three BMI groups
156
differ with regard to score on motor speed task. As F value for BMI (three groups)
was found to be significant, a post hoc analysis (LSD) was applied. The results of post
hoc analysis, as shown in table 5.23 (c) highlights that overweight participants (M =
4.41), significantly differ from normal BMI (M = 6.70) and underweight (M = 5.91)
students. On the other hand, no difference has been obtained between normal BMI
and underweight students on motor speed task. Similarly, significant main effect of
eating behaviour has been found (F = 6.01; p≤.05) between healthy eating participants
and unhealthy eating participants on motor speed task. Mean values for healthy eating
hygienic food and less barriers in modifying their eating habits scored better on motor
speed task. Interaction effect of BMI and eating behaviour was not found to be
significant. Thus, from the results it can be inferred that BMI and eating behaviour
independently influences performance on motor speed task.
Psychomotor ability was assessed through motor speed task/ condition of Trail
making subtest. The result of the present findings point out the significant main effect
of BMI and eating behaviour on motor ability. The results indicate that overweight
category participants performed poor on psychomotor ability compared to normal and
underweight school students. The results also revealed that school students exhibiting
healthy eating behaviour performed better than unhealthy eating behaviour group
eating on trail making- motor speed test.
A few earlier studies have also reported an association between the overweight status
and poorer psychomotor performances (Cournot et. al. 2006; Etou et. al., 1989). Cliff,
Okely, Morgan, Jones, Steele, & Baur (2004) found that overweight and obese
children exihibit poor motor skills, which supports the present study. Wright,
Waldstein, Kuczmarski, Pohlig, Gerassimakis, Gaynor and Zonderman (2017)
conducted a study in which participants were asked to recall all the foods and
beverages consumed during the previous 24 hrs by trained interviewers on two
occasions: during phase 1 (in-home interview) and phase 2 (mobile research vehicle
visit). Results showed that when diet quality was higher, performance in the domains
of attention and cognitive flexibility, visuospatial ability and motor speed was better
157
among participants. In addition, higher diet quality was associated with better
performance on psychomotor task.
Thus, the 9th (a) hypothesis which states ―There would be significant main effect of
BMI (objective measure) on psychomotor ability among school students‖ and 9th (b)
which states ―There would be significant main effect of eating behavior (subjective
measure) on psychomotor ability among school students‖ are proved and retained.
Whereas, hypothesis 9th (c) which states ―There would be significant interactional
effect of BMI (objective measure) and eating behaviour (subjective measure) on
psychomotor ability among school students was not supported by the results.
Implications of the Present Research
 The findings of the present study highlight that healthy eating is associated
with normal BMI.
 The present study emphasize that healthy eating with normal BMI was
associated with better executivefunctions.
 The present research highlights the significant effect of eating behavior on
executive functions (cognitive flexibility, problem solving ability, inhibition,
planning ability, fluency ability, linguistic ability, psychomotor ability)
 The current findings also call attention to the significant effect of BMI on
executive functions (cognitive flexibility, problem solving ability, inhibition,
planning ability, fluency ability, linguistic ability, psychomotor ability)
 The present findings indicate significant interaction effect of eating behavior
and BMI on cognitive inhibition, planning ability, fluency ability and
linguistic ability, indicating that school students with healthy eating behavior
and normal BMI perform better on task requiring cognitive inhibition,
planning ability, fluency ability and linguistic ability.
 Unhealthy eating habits and deviations in body mass index (overweight and
underweight) result in poor executive functions; therefore, poor executive
functions should be considered as one of the complications associated with
overweight and underweight; and also with unhealthy eating behavior.
158
 The findings of the present study provide direction for school counselors and
psychologists to focus on improving eating behavior and maintaining
healthy/normal BMI for better executive functions.
Limitations of the Present Research
In the present study, every effort was made to make the investigation comprehensive
and exclusive. However, the study has certain limitations
 Efforts were made to cover maximum abilities of executive functions, but due
to the vast domain of executive functions some abilities remained unacessed in
the present investigation.
 A single assessment of Eating behavior, BMI and executive functioning was

made. Longitudinal assessments could have provided more reliable results.
 BMI is comprised of both fat and fat free tissues therefore; an additional index
of adiposity such as waist to hip ratios or skinfold thickness test could have
been used.
 Eating behavior, BMI and executive functions are influenced by demographic

factors such as age, gender, ethnic background, socioeconomic status etc.
These variables were not considered in the present study.
Suggestions for Further Research
 The representative sample taken in the study was small which restricts
generalization of results. Thus, the findings of the study can be replicated with
large representative sample.
 Similar study can be planned to assess executive functions of adolescents with

eating disorders, which would help to understand their dietary patterns in the
context of executive functioning.
 Longitudinal assessment of the executive functions over a period of time along

with some interventions for weight management (transitory /stable) can throw
light on the nature of executive dysfunction associated with obesity and
159
improvements in executive function with reducing BMI and healthy eating
behavior due to weight management interventions.
 Based on the present findings, intervention modules can be developed to

improve the eating behavior of school students which would lead to better
executive functionings.
 Psycho-educational programs can be developed to educate school students

about healthy eating behavior and to maintain a normal BMI.
160

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Chapter V

RESULTS AND DISCUSSION

RESULTS AND DISCUSSION

Section I: Descriptive statistics (Phase –I)

Section II: Correlational Analysis (Phase –I)

Section III : Two Way ANOVA (Phase – II)

groups respondents M±SD

Normal BMI 147 49 18.10 23.50 19.78 1.92 17.86 -21.7

Overweight 73 24.33 24.30 27.00 25.66 0.86 24.8 -26.52

Underweight 80 26.67 15.70 16.90 16.29 0.42 15.87-16.71

Total sample 300 100 15.90 27.00 21.92 3.70 18.22-25.62

The descriptive statistics on five dimensions of Executive function index are

Eating Behaviour (subjective measure) and BMI (objective measure)

1. Eating behaviour (subjective measure) and BMI (objective measure) in

2.Eating behaviour (subjective measure) and BMI (objective measure) in normal

3 Eating Behaviour (subjective measure) and BMI (objective measure) in

Executive function in relation to Eating Behaviour

1. Executive functions and Eating behaviour in overweight school students

Motivational drive and Eating behavior (subjective & objective measure) in

The coefficients of correlation between motivational drive, eating behaviour

Organisational ability and Eating behavior (subjective & objective measure) in

Coefficients of correlation between Organisational ability, eating behaviour

Strategic planning and Eating behavior (subjective & objective measure) in

Impulse Control and Eating Behaviour (subjective & objective measure) in

Empathy and Eating Behaviour (subjective & objective measure) in overweight

Motivational drive and Eating Behaviour (subjective & objective measure) in

The coefficients of correlation between motivational drive, eating behaviour

Organisational ability and Eating Behaviour (subjective & objective measure) in

Strategic planning and Eating Behaviour (subjective & objective measure) in

Motivational drive and Eating Behaviour (subjective & objective measure) in

The coefficient of correlations between motivational drive, eating behaviour

Organisational ability and Eating Behaviour (subjective & objective measure) in

Coefficients of correlation between organisational ability, eating behaviour

Strategic planning and Eating Behaviour (subjective & objective measure) in

Impulse Control and Eating Behaviour (subjective & objective measure) in

In second phase Executive functions (D-KEFS) of 6 groups based on two

In the present study cognitive flexibility was assessed through cognitive

Category Switching (D-KEFS Verbal Fluency)

Table 5.10 (a)

Normal BMI 14.47 2.98 9.65 3.66 12.06 4.09

Overweight BMI 11.59 5.08 8.00 1.32 9.79 4.08

Underweight BMI 9.88 3.74 7.29 1.57 8.59 3.11

Total (Eating behaviour) 11.98 4.38 8.31 2.57 10.15 4.02

Figure 5.10 (a)

Mean Score on Category Switching (D-KEFS Verbal Fluency) of 6 Groups

In order to determine whether the 6 groups differed significantly on category

Summary table of two-way ANOVA on Category Switching (D-KEFS verbal fluency)

BMI 211.11 2 105.55 9.56*

Eating behaviour 342.83 1 342.83 31.06*

BMI× Eating behaviour 21.31 2 10.65 .96

Error 1059.52 96 11.03

Table 5.10 (c)

BMI Groups Normal Overweight Underweight

Normal - 2.26* 3.47*

Two-way ANOVA shows significant main effect of BMI (F = 9.56; p≤.05) on

Switching (D-KEFS Design Fluency)

Normal BMI 8.47 1.55 6.47 4.50 7.47 3.47

Overweight BMI 6.18 1.78 5.18 2.10 5.68 1.98

Underweight BMI 5.88 3.58 5.11 4.09 5.50 3.81

Total (Eating behaviour) 6.84 2.69 5.59 3.69 6.21 3.28

Figure 5.11 (a)

Mean Values of switching (D-KEFS design fluency) of 6 Groups

In order to determine whether the 6 groups differed significantly on switching task