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Breakfast habits among European adolescents: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study
Karolinska institutet.ORCID iD: 0000-0001-9604-462X
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to study the associations of individual and socio-environmental factors with breakfast habits among adolescents on a European level.

 

Methods: The HELENA-study (Healthy Lifestyle in Europe by Nutrition in Adolescence) is a multi-centre cross-sectional, school-based study including 3528 adolescents (aged 12.5-17.49 years) from 10 European cities inEurope. Data was collected during the 2006-2007 academic year. Breakfast habits were assessed by a computerised, self-administered, 24-h recall and by questionnaires. The whole day dietary intake, measured with the computerised 24-h recall, was evaluated by comparing a self-administered and an interviewed 24-h recall. The socio-demographical factors used were sex, age, region inEurope (southern versus northern/central), mother and father’s education and occupation, family structure and family affluence. Body composition was measured with weight, height, waist circumference and skinfold thickness. Blood pressure, cardiorespiratory fitness, blood lipids, insulin and glucose were also measured.

 

Results: The evaluation between the self-administered and interview 24-h recall showed generally good agreement between the two methods. Few adolescents (4 %) had a ‘high-quality’ breakfast. Breakfast consumption on both recall days was reported among 77 % (24-h recall) and 55 % reported slightly disagreeing to strongly disagreeing with the statement ‘I often skip breakfast’. Younger adolescents, adolescents from the northern/central part of Europe and adolescents from families with high socio-demographical status were more likely to report consuming a ‘high-quality’ breakfast while breakfast consumption versus breakfast skipping were inappreciably associated with socio-demographical factors. Personal factors (‘hunger’, ‘taste of the food’ ‘concern for health’) and the socio-environmental factor (‘parents or guardian’) were the most important influences on the adolescents’ choice of food at breakfast. Regular ‘breakfast consumption’ was associated with higher cardiorespiratory fitness in both boys and girls, and with a healthier cardiovascular profile, especially in boys.

 

Conclusion: The public health implications of poor breakfast consumption habits are considerable. This work highlights the need to promote breakfast, especially a ‘high-quality’ breakfast, among adolescents, particularly older adolescents, adolescents from the southern part of Europe and adolescents from families with low socio-demographical status.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2011. , 59 p.
Keyword [en]
Breakfast; adolescents; socio-demographical factors; dietary assessment; 24-h recall; food groups; cardiovascular disease risk factors; Europe
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-13930ISBN: 978-91-7457-424-1 (print)OAI: oai:DiVA.org:mdh-13930DiVA: diva2:473233
Public defence
2011-09-16, Red seminarium room, Plan 6, NOVUM, Karolinska Institutet, Huddinge, 09:00 (English)
Opponent
Supervisors
Projects
HELENA
Available from: 2012-01-09 Created: 2012-01-05 Last updated: 2015-02-04Bibliographically approved
List of papers
1. Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe
Open this publication in new window or tab >>Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe
2008 (English)In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, no 32, 26-34 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To describe the development of a European computerized 24-h dietary recall method for adolescents, and to investigate the feasibility of self-administration (self report) by comparison with administration by a dietician (interview). Methods: Two hundred and thirty-six adolescents (mean age 14.6 years (s.d.¼1.7)) of eight European cities completed the 24-h recall (Young Adolescents Nutrition Assessment on Computer (YANA-C)) twice (once by self-report and once by interview). Results: A small but significant underestimate in energy (61 (s.e.¼31) kcal) and fat (4.2 (s.e.¼1.7) g) intake was found in the self-reports in comparison with the interviews; no significant differences were found for the intake of carbohydrates, proteins, fibre, calcium, iron and ascorbic acid. Spearman’s correlations were highly significant for all nutrients and energy ranging between 0.86 and 0.91. Agreement in categorizing the respondents as consumers and non-consumers for the 29 food groups was high (kappa statistics X0.73). Percentage omissions were on average 3.7%; percentage intrusions: 2.0%. Spearman’s correlations between both modes were high for all food groups, for the total sample (X0.76) as well as for the consumers only (X0.72). Analysing the consumer only, on an average 54% of the consumed amounts were exactly the same; nevertheless, only for one group ‘rice and pasta’ a significant difference in consumption was found. Conclusion: Adaptation, translation and standardization of YANA-C make it possible to assess the dietary intake of adolescents in a broad international context. In general, good agreement between the administration modes was found, the latter offering significant potential for large-scale surveys where the amount of resources to gather data is limited.

Place, publisher, year, edition, pages
Nature Publishing Group, 2008
Keyword
dietary assessment; computer; self-administration; 24-h recall; validation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-5216 (URN)10.1038/ijo.2008.180 (DOI)000260999400006 ()2-s2.0-56549091929 (Scopus ID)
Projects
Helena projektet
Available from: 2009-02-18 Created: 2009-02-12 Last updated: 2014-06-23Bibliographically approved
2. Breakfast Habits and their Association with Socio-demographic Factors among European Adolescents: The HELENA study.
Open this publication in new window or tab >>Breakfast Habits and their Association with Socio-demographic Factors among European Adolescents: The HELENA study.
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2012 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 15, no 10, 1879-1889 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To describe breakfast habits on food group level in European adolescents and to investigate the associations between these habits and socio-demographic factors.

Design: Cross-sectional study

Setting: Secondary schools from nine European cities participating in the HELENA (Healthy Lifestyle inEuropeby Nutrition in Adolescence) Study. Breakfast habits were assessed twice using a computer-based 24-h dietary recall. Adolescents who consumed breakfast on at least one recall day were classified as ‘breakfast consumers’ and adolescents who did not have anything for breakfast on either of the two recall days were considered ‘breakfast skippers’. A ‘breakfast quality-index’ to describe breakfast quality was created based on the consumption or non-consumption of: cereals/cereal products, dairy products and fruits/vegetables. The socio-demographic factors studied were sex, age, region of Europe, maternal and paternal education, family structure and family affluence.

Subjects: 2672 adolescents (12-17 years, 53 % girls).

Results: The majority of the adolescents reported a breakfast that scored poorly on the breakfast quality index. Older adolescents, adolescents from the southern part of Europe and adolescents from families with low socio-economic status were more likely to consume a low-quality breakfast.

Conclusion: This study highlights the need to promote the consumption of a high-quality breakfast among adolescents, particularly in older adolescents, adolescents from southern Europe and to adolescents from families with low socio-economic status, in order to improve public health.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-13910 (URN)10.1017/S1368980012000341 (DOI)000308718800013 ()2-s2.0-84866347768 (Scopus ID)
Available from: 2012-01-02 Created: 2012-01-02 Last updated: 2013-10-16Bibliographically approved
3. Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents: The HELENA Study
Open this publication in new window or tab >>Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents: The HELENA Study
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2011 (English)In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 56, no 3, 649-657 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate factors associated with breakfast habits and influences on food choices at breakfast, within the framework of the EU-funded HELENA Study in 3528 adolescents from ten cities across Europe. The statement “I often skip breakfast” and personal and socio-environmental factors hypothesized to be related to food choice at breakfast were dichotomized. Logistic regression was used to investigate the association between behavioral (skipping versus consume breakfast) and individual, personal and socio-environmental factors. Half of the adolescents (fewer girls) indicated being regular breakfast consumers. Mothers’ education and family structure were associated with breakfast consumption. Adolescents with peers who gave little or no encouragement, and boys whose parents gave encouragement, were more likely to be regular breakfast consumers. Personal factors influenced the girls more than the boys in their choice of food for breakfast and socio-environmental factors influenced younger adolescents more than older adolescents. In conclusion, a broad range of (behavioral, individual, personal and socio-environmental) factors influence breakfast habits and food choices at breakfast among European adolescents. Breakfast habits were inappreciably influenced by socio-demographical factors. These factors need to be considered in discussions surrounding the development of nutritional intervention programs intended for adolescents.

Keyword
socioeconomic factors; parents; siblings; sex; diet surveys; epidemiology; public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-10521 (URN)10.1016/j.appet.2011.02.019 (DOI)000291912700015 ()21376767 (PubMedID)2-s2.0-79952984962 (Scopus ID)
Projects
Helena-projektet
Available from: 2010-10-26 Created: 2010-10-26 Last updated: 2013-10-16Bibliographically approved
4. Breakfast consumption and CVD risk factors in European adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study
Open this publication in new window or tab >>Breakfast consumption and CVD risk factors in European adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study
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2013 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 7, 1296-1305 p.Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [en]

Objective To examine the association between breakfast consumption and CVD risk factors in European adolescents. Design Cross-sectional. Breakfast consumption was assessed by the statement 'I often skip breakfast' and categorized into 'consumer', 'occasional consumer' and 'skipper'. Blood pressure, weight, height, waist circumference, skinfold thickness, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), TAG, insulin and glucose were measured and BMI, TC:HDL-C, LDL-C:HDL-C and homeostasis model assessment-insulin resistance index (HOMA-IR) were calculated. Setting The European Union-funded HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Subjects European adolescents, aged 12·50- 17·49 years, from ten cities within the HELENA study (n 2929, n 925 with blood sample, 53 % females). Results In males, significant differences across breakfast consumption category ('consumer', 'occasional consumer' and 'skipper') were seen for age, BMI, skinfold thickness, waist circumference, cardiorespiratory fitness, systolic and diastolic blood pressures, TC:HDL-C, LDL-C:HDL-C, glucose, insulin, HOMA-IR and LDL-C; in females, for cardiorespiratory fitness, skinfold thickness, BMI, insulin and HOMA-IR. In overweight/obese males significant differences were also seen for TC and LDL-C, whereas no differences were observed in non-overweight males or in females regardless of weight status. Conclusions Our findings among European adolescents confirm previous data indicating that adolescents who regularly consume breakfast have lower body fat content. The results also show that regular breakfast consumption is associated with higher cardiorespiratory fitness in adolescents, and with a healthier cardiovascular profile, especially in males. Eating breakfast regularly may also negate somewhat the effect of excess adiposity on TC and LDL-C, especially in male adolescents.

Keyword
diet surveys; risk factors; physical fitness; body composition; blood; adolescent
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-10522 (URN)10.1017/S1368980012000973 (DOI)000319614800019 ()2-s2.0-84878462949 (Scopus ID)
Projects
Helena-projektet
Available from: 2012-05-04 Created: 2010-10-26 Last updated: 2016-03-10Bibliographically approved

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