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  • 1.
    Bel, Sarah
    et al.
    Ghent University, Belgium.
    Michels, Nathalie
    Ghent University, Belgium.
    De Vriendt, Tineke
    Research Foundation – Flanders, Belgium.
    Patterson, Emma
    Karolinska Institutet, Sweden.
    Cuenca-García, Magdalena
    Granada University, Spain.
    Diethelm, Katharina
    Rheinische Friedrich-Wilhelms-University Bonn, Germany.
    Gutin, Bernard
    University of North Carolina, US.
    Grammatikaki, Evangelia
    Harokopio University, Athens, Greece.
    Manios, Yannis
    Harokopio University, Athens, Greece.
    Leclercq, Catherine
    National Research Institute for Food and Nutrition (INRAN), Italy.
    Ortega, Francisco B
    Karolinska Institutet, Sweden.
    Moreno, Luis A
    University of Zaragoza, Spain.
    Gottrand, Frederic
    Université Lille 2, France.
    Gonzalez-Gross, Marcela
    Technical University of Madrid, Spain.
    Widhalm, Kurt
    Medical University of Vienna, Austria.
    Kafatos, Anthony
    University of Crete, Greece.
    Garaulet, Marta
    University of Murcia, Spain.
    Molnar, Denes
    University of Pécs, Hungary.
    Kaufman, Jean-Marc
    Ghent University Hospital, Belgium.
    Gilbert, Chantal C
    Campden BRI, Gloucestershire, UK .
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Sjöström, Michael
    Karolinska Institutet, Sweden.
    Marcos, Ascensión
    Spanish Council for Scientific Research (CSIC), Spain.
    De Henauw, Stefaan
    Ghent University, Belgium.
    Huybrechts, Inge
    International Agency for Research on Cancer (IARC), Lyon, France.
    Association between self-reported sleep duration and dietary quality in European adolescents.2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 110, no 5, p. 949-959Article in journal (Refereed)
    Abstract [en]

    Evidence has grown supporting the role for short sleep duration as an independent risk factor for weight gain and obesity. The purpose of the present study was to examine the relationship between sleep duration and dietary quality in European adolescents. The sample consisted of 1522 adolescents (aged 12·5-17·5 years) participating in the European multi-centre cross-sectional 'Healthy Lifestyle in Europe by Nutrition in Adolescence' study. Sleep duration was estimated by a self-reported questionnaire. Dietary intake was assessed by two 24 h recalls. The Diet Quality Index for Adolescents with Meal index (DQI-AM) was used to calculate overall dietary quality, considering the components dietary equilibrium, dietary diversity, dietary quality and a meal index. An average sleep duration of ≥ 9 h was classified as optimal, between 8 and 9 h as borderline insufficient and < 8 h as insufficient. Sleep duration and the DQI-AM score were positively associated (β = 0·027, r 0·130, P< 0·001). Adolescents with insufficient (62·05 (sd 14·18)) and borderline insufficient sleep (64·25 (sd 12·87)) scored lower on the DQI-AM than adolescents with an optimal sleep duration (64·57 (sd 12·39)) (P< 0·001; P= 0·018). The present study demonstrated in European adolescents that short sleep duration was associated with a lower dietary quality. This supports the hypothesis that the health consequences of insufficient sleep may be mediated by the relationship of insufficient sleep to poor dietary quality.

  • 2.
    Cuenca-Garcia, Magdalena
    et al.
    School of Medicine, University of Granada, Spain.
    Ruiz, Jonatan
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Ortega, Francisco B
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Labayen, Idoia
    Department of Nutrition and Food Science, University of the Basque Country, Vitoria, Spain.
    González Gross, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Spain.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Spain.
    Gómez-Martínez, Sonia
    Instituto del Frío, Spanish National Research Council, Spain.
    Ciarapica, Donatella
    Nationell research institute for Food and Nutrition, Rome, Italy.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wästlund, Acki
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille, France.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University, Athens, Greece.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna, Austria.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Castillo, Manuel J
    School of Medicine, University of Granada, Spain.
    Association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness in European adolescents: the HELENA (Healthy Lifestylein Europe by Nutrition in Adolescence) Study2014In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, no 10, p. 2226-2236Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness.

    Design: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a 'Food Choices and Preferences' questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire. 

    Setting: Ten European cities. Subjects: Adolescents (n 2148; aged 12.5-17.5 years). 

    Results: Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P <= 0.005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR = 0.33; 95% CI 0.18, 0.59 and OR = 0.56; 95 % CI 0.32, 0.98, respectively). Results persisted across methods. 

    Conclusions: Skipping breakfast does not seem to be related to physical activity, sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings.

  • 3.
    Duffey, Kiyah
    et al.
    Department of Nutrition and the Carolina Population Center University of North Carolina at Chapel Hill, Chapel Hill, NC.
    Huybrechts, Inge
    Department of Public Health, Ghent University.
    Mouratidou, T
    GENUD (“Growth, Exercise, Nutrition and Development”) Research Group, EU. Ciencias de la Salud, Universidad de Zaragoza, Spain.
    Libuda, L
    Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Germany.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    DeVriendt, Tinike
    Ghent University, Department of Public Health, Ghent, Belgium.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna.
    Dallongeville, Jean
    Institut Pasteur de Lille, France.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    González Gross, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Popkin, Barry
    Department of Nutrition and the Carolina Population Center University of North Carolina at Chapel Hill, Chapel Hill, NC.
    Beverage consumption among European adolescents in the HELENA study2012In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 66, no 2, p. 244-252Article in journal (Refereed)
    Abstract [en]

    Background/Objectives: Our objective was to describe the fluid and energy consumption of beverages in a large sample of European adolescents.

    Subjects/Methods: We used data from 2741 European adolescents residing in 8 countries participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). We averaged two 24-h recalls, collected using the HELENA-dietary assessment tool. By gender and age subgroup (12.5–14.9 years and 15–17.5 years), we examined per capita and per consumer fluid (milliliters (ml)) and energy (kilojoules (kJ)) intake from beverages and percentage consuming 10 different beverage groups.

    Results: Mean beverage consumption was 1611 ml/day in boys and 1316 ml/day in girls. Energy intake from beverages was about 1966 kJ/day and 1289 kJ/day in European boys and girls, respectively, with sugar-sweetened beverages (SSBs) (carbonated and non-carbonated beverages, including soft drinks, fruit drinks and powders/concentrates) contributing to daily energy intake more than other groups of beverages. Boys and older adolescents consumed the most amount of per capita total energy from beverages. Among all age and gender subgroups, SSBs, sweetened milk (including chocolate milk and flavored yogurt drinks all with added sugar), low-fat milk and fruit juice provided the highest amount of per capita energy. Water was consumed by the largest percentage of adolescents followed by SSBs, fruit juice and sweetened milk. Among consumers, water provided the greatest fluid intake and sweetened milk accounted for the largest amount of energy intake followed by SSBs. Patterns of energy intake from each beverage varied between countries.

    Conclusions: European adolescents consume an average of 1455 ml/day of beverages, with the largest proportion of consumers and the largest fluid amount coming from water. Beverages provide 1609 kJ/day, of which 30.4%, 20.7% and 18.1% comes from SSBs, sweetened milk and fruit juice, respectively.

  • 4.
    Hallström, Lena
    Karolinska institutet.
    Breakfast habits among European adolescents: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study2011Doctoral 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.

  • 5.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Mesana, Maribel
    Universidad de Zaragoza, Spain.
    Kacsándi, Anna
    University of Budapest, Hungary.
    Vereecken, Carine
    Ghent University, Belgium.
    Validation of a computerized 24h-recall in European Adolescents from the HELENA study2009Conference paper (Refereed)
    Abstract [en]

    Introduction: The HELENA study (Healthy Lifestyle in Europe by Nutrition in Adolescents) has been performed in ten cities around Europe. The study has been using a computerized 24h-recall program called Young adolescents' nutrition assessment on computer” (YANA-C). The program has been developed, used and validated in Belgium. In the HELENA study all countries translated and culturally adapted the YANA-C software. The validity of the results might depend on the translation and compliance to the test protocol of the YANA-C. Therefore it is important to validate YANA-C in other countries.

    Aim: To validate the computerized 24h-recall, YANA-C, against estimated dietary records, in adolescents (13 and 16 years of age) in three additional countries (Sweden, Hungary and Spain) belonging to the HELENA study, and to compare it with the outcome from the Belgium validation study.

    Method: More than three hundred adolescents completed YANA-C on two non-consecutive days. One to five days later, the adolescents completed an estimated dietary record on two non-consecutive comparable days as those for which YANA-C was completed. Wilcoxon signed rank test is used to compare the intakes of food groups and nutrients (energy, carbohydrates, protein, fat, fiber, calcium, vitamin C, iron) between both methods.

    Results: The results from Belgium showed a significant lower intake in energy (p<0.001), carbohydrate (p<0.01), protein (p<0.05), fat (p<0.01), fiber (p<0.001), vitamin C (p<0.05) and iron (p<0.05) in the dietary record compared to YANA-C. The Belgium results had a higher energy and nutrient intake (except calcium) from YANA-C comparing to the dietary record. Preliminary results from the Hungarian sample (n=99) show a significant lower intake of carbohydrates (p<0.001), protein (p<0.001) and a higher intake of fat (<0.05), fiber (<0.05), calcium (<0.01) in the dietary records compared to the YANA-C. There was no significant difference in energy, vitamin C and iron.

    Conclusion: The Belgium and Hungarian samples showed different results of the validation studies. This shows the importance to validate the results from countries using YANA-C database. Analyses on a food group level might help to explain these differences.

    HELENA study takes place with the financial support of the European Community (FP6-2003-Food-2-A, FOOD-2003-T2.4, Contract FOOD-CT-2005-007034)

  • 6.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Mesana, Maribella
    Escuela Universitaria de Ciencias de la Salud. Universidad de Zaragoza. Zaragoza.
    Kacsándi, Anna
    Semmelweis University of Budapest, Department of Health Sciences and Sport Medicine, Hungary.
    Prats, Miguel
    Karolinska Institutet, Dept Biosciences and Nutrition, Stockholm.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Relative validity of a computerized 24h-recall used to assess dietary intake in adolescents from the HELENA study2009Conference paper (Refereed)
    Abstract [en]

    Introduction: The HELENA study (Healthy Lifestyle in Europe by Nutrition in Adolescents) has been performed in ten cities around Europe. The study has used a computerized 24h-recall program called Young adolescents' nutrition assessment on computer” (YANA-C). The first YANA-C version has been developed, used and validated in Belgium. In the HELENA study all countries translated and culturally adapted the international YANA-C software according to a standard protocol. The validity of the results might depend on the translation and compliance to the protocol.

    Aim: To investigate the relative validity of the computerized 24h-recall, YANA-C, against estimated dietary records, in adolescents (13 and 16 years of age) in three (additional) countries (Sweden, Hungary and Spain) belonging to the HELENA study.

    Method: More than three hundred adolescents completed YANA-C on two non-consecutive days. One to five days later, the adolescents completed an estimated dietary record on two non-consecutive comparable days as those for which YANA-C was completed. Wilcoxon signed rank test is used to compare the intakes of food groups and nutrients (energy, carbohydrates, protein, fat, fiber, calcium, vitamin C, iron) between both methods.

    Results: Preliminary results from the Hungarian sample (n=99) show a significant lower intake of carbohydrates (p<0.001), protein (p<0.001) and a higher intake of fat (<0.05), fiber (<0.05), calcium (<0.01) in the dietary records compared to the YANA-Cs. There was no significant difference in energy, vitamin C and iron.

    Discussion/Conclusion: The results differ from what previously has been found in the Flemish validation study. This indicates the importance to validate the instrument in the different countries using YANA-C. Analyses on a food group level might help to explain differences between methods and between countries.

    HELENA study takes place with the financial support of the European Community (FP6-2003-Food-2-A, FOOD- 2003-T2.4, Contract FOOD-CT-2005-007034)

  • 7.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Ruiz, Jonatan
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Labayen, Idoia
    Department of Nutrition and Food Science, University of the Basque Country, Vitoria, Spain.
    Paterson, Emma
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent, Belgium.
    Christina Breidenassel, Christina
    fInstitut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille, France.
    Huybrechts, Inge
    Department of Public Health, Ghent University, Belgium.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens, Greece.
    Mistura, Lorenza
    National Research Institute on Food and Nutrition, Italy.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna, Austria.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Spain.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Breakfast consumption and CVD risk factors in European adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 7, p. 1296-1305Article in journal (Other (popular science, discussion, etc.))
    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.

  • 8.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Sichert-Hellert, Wolfgang
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Beghin, Laurent
    Université Lille, France.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    GRAMMATIKAKI, Eva
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Mesana, Maribella
    Escuela Universitaria de Ciencias de la Salud. Universidad de Zaragoza. Zaragoza.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Dietrich, Sabina
    Devision of Clinical Nutrition and Prevention, Medical University of Vienna, Vienna, Austria.
    PICCINELLI, Raffaela
    National Research Institute for Food and Nutrition, Rome, Italy.
    Plada, Maria
    Preventive Medicine & Nutrition Unit, University of Crete, Heraklion, Crete, Greece.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Nutritional knowledge in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 12, p. 2083-2091Article in journal (Refereed)
    Abstract [en]

    Objective: To build up sufficient knowledge of a ‘healthy diet’. Here, we report on the assessment of nutritional knowledge using a uniform method in a large sample of adolescents across Europe.

    Design: A cross-sectional study.

    Setting: The European multicentre HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study conducted in 2006–2007 in ten cities in Austria, Belgium, France, Germany, Greece (one inland and one island city), Hungary, Italy, Spain and Sweden.

    Subjects: A total of 3546 adolescents (aged 12,5–17,5 years) completed a validated nutritional knowledge test (NKT). Socio-economic variables and anthropometric data were considered as potential confounders.

    Results: NKT scores increased with age and girls had higher scores compared with boys (62% v.59 %;P<0,0001). Scores were approximately 10% lower in ‘immigrant’ adolescents or in adolescents with ‘immigrant’ mothers. Misconceptions with respect to the sugar content in food or in beverages were found. Overall, there was no correlation between BMI values and NKT scores. After categorization according to BMI, scores increased significantly with BMI group only in boys. These differences disappeared after controlling for socio-economic status (SES). Smoking status and educational level of the mother influenced the NKT scores significantly in boys, as well as the educational levels of both parents in girls.

    Conclusions: Nutritional knowledge was modest in our sample. Interventions should be focused on the lower SES segments of the population. They should be initiated at a younger age and should be combined with environmental prevention (e.g. healthy meals in school canteens).

  • 9.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Vereecken, Carine
    Department of Public Health, Ghent University, Belgium.
    Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe2008In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, no 32, p. 26-34Article in journal (Refereed)
    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.

  • 10.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent.
    Labayen, Idoia
    Department of Nutrition and Food Science, University of the Basque Country, Vitoria, Spain.
    Ruiz, Jonatan
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute.
    Le Donne, Cinzia
    National Research Institute on Food and Nutrition, Italy.
    Cuenca, Magdalena
    School of Medicine, University of Granada.
    Gilbert, Chantal
    Campden BRI, Gloucestershire, UK.
    Gómez-Martínezi, Sonia
    Instituto del Frío, Spanish National Research Council.
    GRAMMATIKAKI, Eva
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Huybrechts, Inge
    Department of Public Health, Ghent University.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Paterson, Emma
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna.
    DeVriendt, Tinike
    Ghent University, Department of Public Health, Ghent, Belgium.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Breakfast Habits and their Association with Socio-demographic Factors among European Adolescents: The HELENA study.2012In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 15, no 10, p. 1879-1889Article in journal (Refereed)
    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.

  • 11.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent.
    Ruiz, Jonatan
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute.
    Patterson, Emma
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute.
    Gilbert, Chantal
    Campden BRI, Gloucestershire, UK.
    Catasta, Giovina
    National Institute for Food and Nutrition Research, Italy.
    Diaz, Ligia-Esperanza
    Instituto del Frío, Spanish National Research Council.
    Gómez-Martínez, Sonia
    Instituto del Frío, Spanish National Research Council.
    González Gross, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille.
    Hegyi, Adrienn
    Campden BRI Magyarország, Budapest.
    Lehoux, Claire
    Meurice Research and Development asbl, Brussels.
    Mouratidou, Theodora
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna.
    Åström, Annika
    The Swedish Institute for Food and Biotechnology, Göteborg.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents: The HELENA Study2011In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 56, no 3, p. 649-657Article in journal (Refereed)
    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.

  • 12.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent.
    Ruiz, Jonatan
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    ASSOCIATIONS BETWEEN FAMILIAR FACTORS AND BREAKFAST CONSUMPTION AMONG EUROPEAN ADOLESCENTS: THE HELENA-STUDY2009In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 55, no 1, p. 627-627Article in journal (Other academic)
    Abstract [en]

    Rationale & Objectives

    To identify factors influencing breakfast habits in European adolescents.

     

    Materials & Methods

    The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) is a school based study. In 2006-2007, 3546 adolescents, 12,5-17,49 years of age, in ten European cities responded to questions about breakfast habits and determinants about eating behavior. Logistic regression and descriptive percentage are used for the analyses.

     

    Results & Findings

    66% of boys and 58% of girls regularly consume breakfast. Boys whose parents support them to eat healthy are more likely to consume breakfast (OR, 0.61; 95% CI, 0.43-0.85). Girls whose peers eat healthy are more likely to consume breakfast (OR, 0.68; 95% CI, 0.51-0.91). Hunger (59%), taste (57%), health (48%) and parents (45%) are the most important factors influencing adolescents’ food choices at breakfast.

     

    Conclusions

    Parents’ and peers’ influences should be considered in the development and testing of intervention strategies.

  • 13.
    Hallström, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Vereecken, Carine
    Ghent University, Belgium.
    Ruiz, Jonatan
    Karolinska Institutet, Sweden.
    Sjöström, Michael
    Karolinska Institutet, Sweden.
    Familiar factors and breakfast consumption among European adolescents: The HELENA-study2009In: Familiar factors and breakfast consumption among European adolescents: The HELENA-study, Bangkok: Kager Medical and Scientific Publishers , 2009, p. 627-627Conference paper (Refereed)
    Abstract [en]

    Objectives: To identify familiar factors influencing breakfast consumption and choices at breakfast in European adolescents participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study.

    Methods: The HELENA is a multicentre school-based study. A total of 3546 adolescents aged12.5-17.49 years responded to questions about breakfast habits and determinants about eating behavior during the academic year 2006-2007.

    Results: 66% of boys and 58% of girls indicated to regularly consume breakfast. Boys whose parents support them to eat healthy are more likely to consume breakfast (OR, 0.61; 95% CI, 0.43-0.85). Girls whose peers eat healthy are more likely to consume breakfast (OR, 0.68; 95% CI, 0.51-0.91). Hunger (59%), taste (57%), health (48%) and parents (45%) are the most important factors influencing adolescents’ food choices at breakfast.

    Conclusion: Parents’ and peers’ influences should be considered in the development and testing of intervention strategies.

  • 14. Iglesia, I.
    et al.
    Mouratidou, T.
    Gonzalez-Gross, M.
    Huybrechts, I.
    Breidenassel, C.
    Diaz, L.
    Palacios, G.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    de Henauw, S.
    Gottrand, F.
    Kafatos, A.
    Widhalm, K.
    Manios, Y.
    Molnar, D.
    Stehle, P.
    Moreno, L.
    B-VITAMIN INTAKES AND RELATED BIOMARKER STATUS AND ASSOCIATION TO FOOD CONSUMPTION IN EUROPEAN ADOLESCENTS PARTICIPATING IN THE HELENA STUDY.2013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, p. 417-418Article in journal (Other academic)
  • 15.
    Iglesia, Iris
    et al.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, IA2, IIS Aragon, C Pedro Cerbuna 12,SAI Bldg Serv Apoyo Invest, E-50009 Zaragoza, Spain.;Red Salud Maternoinfantil & Desarrollo SAMID, Madrid, Spain..
    Mouratidou, Theodora
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, IA2, IIS Aragon, C Pedro Cerbuna 12,SAI Bldg Serv Apoyo Invest, E-50009 Zaragoza, Spain..
    Gonzalez-Gross, Marcela
    Univ Politecn Madrid, Dept Hlth & Human Performance, ImFINE Res Grp, Madrid, Spain..
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, Ghent, Belgium.;IARC, 150 Cours Albert Thomas, F-69372 Lyon 08, France..
    Breidenassel, Christina
    Univ Bonn, Dept Nutr & Food Sci, D-53115 Bonn, Germany..
    Santabarbara, Javier
    Univ Zaragoza, Dept Prevent Med & Publ Hlth, Zaragoza, Spain..
    Diaz, Ligia-Esperanza
    CSIC, Immunonutr Res Grp, Dept Metab & Nutr, Inst Food Sci Technol & Nutr ICTAN, Madrid, Spain..
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, Dept Biosci & Nutr, Unit Prevent Nutr, Huddinge, Sweden..
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, Ghent, Belgium..
    Gottrand, Frederic
    Univ Lille 2, Fac Med, INSERM, U995, Lille, France..
    Kafatos, Anthony
    Univ Crete, Sch Med, Iraklion 71033, Greece..
    Widhalm, Kurt
    Med Univ Vienna, Div Clin Nutr & Prevent, Dept Pediat, Vienna, Austria..
    Manios, Yannis
    Harokopio Univ, Sch Hlth Sci & Educ, Dept Nutr & Dietet, Athens, Greece..
    Molnar, Denes
    Univ Pecs, Dept Paediat, Pecs, Hungary..
    Stehle, Peter
    Univ Bonn, Dept Nutr & Food Sci, D-53115 Bonn, Germany..
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, IA2, IIS Aragon, C Pedro Cerbuna 12,SAI Bldg Serv Apoyo Invest, E-50009 Zaragoza, Spain.;Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr, Madrid, Spain..
    Foods contributing to vitamin B-6, folate, and vitamin B-12 intakes and biomarkers status in European adolescents: The HELENA study (vol 56, pg 1767, 2017)2017In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 56, no 4, p. 1783-1783Article in journal (Refereed)
  • 16.
    Maes, Lea
    et al.
    Department of Public Health, University Hospital,Gent.
    Cook, Tina
    Harokopio University Athen.
    Ottovaere, C
    Department of Public Health, University Hospital, Ghent.
    Matthys, Christopher
    Department of Public Health, University Hospital, Ghent.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Papadaki, A
    Athen.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Dietrich, Sabina
    Devision of Clinical Nutrition and Prevention, Medical University of Vienna, Vienna, Austria.
    Hallström, Lena
    Karolinska institutet.
    Haerens, L
    Gent.
    De Bourdeaudhuij, Ilse
    Department of Public Health, University Hospital, Ghent.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent.
    Pilot evaluation of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Food-O-Meter, a computer-tailored nutrition advice for adolescents: a study in six European cities2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 7, p. 1292-1302Article in journal (Refereed)
    Abstract [en]

    Objective: investigating the feasibility and impact of the Food-O-Meter, an internet based computer-tailored nutrition intervention in adolescents.

    Design: participants in the intervention condition received the computer-tailored advice at baseline and at one month. Participants in the control condition received a generic standard advice. Effects were evaluated at one month (n=621) and at three months (n=558) using multi-level modelling.

    Setting: secondary schools in 6 European cities.

    Subjects: adolescents (12-17 year old) out of the 6 centres of the HELENA study, Vienna (Austria), Ghent (Belgium), Heraklion (Crete), Dortmund (Germany), Athens (Greece) and Stockholm (Sweden), were randomised into intervention and control schools.

    Results: after 1 month students receiving the standardised advice reported an increase in their fat intake while in the intervention condition, fat intake was stable (F=4.82, P<0;05). After 3 months,  there was in the total group  a trend for an intervention effect of the tailored advice on fat intake (F=2.80, p<0.10). In the overweight group there was a clear positive effect (F=5.76, p<0.05).

    For sugared soft drinks consumption both the standardised, and the tailored advice, resulted after 3 months in a decrease in the consumption of soft drinks, but the effect was slightly greater for the standardised advice (F=4.52, p<0.05). No effects were found for other foods and nutrients.

    Conclusions: this pilot study showed that in most study centres the implementation of a web based tailored intervention was feasible and well appreciated by the adolescents. The results were modest but clear for percent energy from fat, specifically in the overweight group.

  • 17.
    Michels, Nathalie
    et al.
    Ghent University, Belgium.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    Breidenassel, Christina
    Institut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany.
    Censi, L
    Agricultural Research Council, Food and Nutrition Research Centre (CRA-NUT), Rome, Italy .
    Cuenca-Garcia, Magdalena
    School of Medicine, University of Granada, Spain.
    González Gross, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Spain.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille, France.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institutet, Sweden.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    Plada, Maria
    Preventive Medicine & Nutrition Unit, University of Crete, Heraklion, Crete, Greece.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens, Greece.
    Marcos, A
    Institute of food science and Technology and Nutrition, Spain.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Claessens, Mandy
    University of Ghent, Belgium.
    European adolescent ready-to-eat-cereal (RTEC) consumers have a healthier intake and body composition compared with non-RTEC consumers2015In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 54, no 4, p. 653-664, article id 805Article in journal (Refereed)
    Abstract [en]

    Purpose 

    This study aims to analyse the association of European adolescents' ready-to-eat-cereal (RTEC) consumption frequency with their dietary intake by applying the concept of diet quality index and nutritional status.

    METHODS:

    From the multi-centre European HELENA study, relevant data were available in 1,215 adolescents (12.5-17.5 years). RTEC consumption was identified from a food frequency questionnaire. A diet quality index, daily nutrient intakes and daily milk/yoghurt and fruit intake were calculated from two 24-h dietary recalls. BMI, waist and hip circumference and body fat were measured for body composition. Cross-sectional regression analyses were adjusted for sex, age, socio-economic status, city and breakfast skipping. Differences in sub-regions within Europe were explored.

    RESULTS:

    RTEC consumers showed a more favourable daily micronutrient intake (vitamin B2, B5, B7, D, calcium, phosphorus and potassium), a better diet quality index, more frequent fruit (57 vs. 51 %) and milk/yoghurt consumption (81.2 vs. 56 %) and less breakfast skipping (25.1 vs. 36.7 %). No differences in energy and macronutrient intake were observed. Daily RTEC consumers were 57 % less likely to be overweight than RTEC non-consumers but did not differ in glucose and lipid status (N = 387).

    CONCLUSION:

    This is the first comprehensive pan-European survey elucidating socio-demographic determinants of European adolescents' RTEC consumption and indicating better dietary habits in RTEC consumers. The improved dietary profile was reflected in a more beneficial body composition. Our results have also shown the advantage of using an all-integrating diet quality index by capturing the diet complexity.

  • 18.
    Michels, Nathalie
    et al.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent B, Belgium..
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent B, Belgium.;Hogesch Gent, Dept Hlth Sci, Ghent, Belgium..
    Breidenassel, Christina
    Univ Bonn, Inst Ernahrungs & Lebensmittelwissensch Humanerna, Bonn, Germany..
    Censi, Laura
    Agr Res Council, Food & Nutr Res Ctr CRA NUT, Rome, Italy..
    Cuenca-Garcia, Magdalena
    Univ Granada, Sch Med, Dept Med Physiol, Granada, Spain..
    Gonzalez-Gross, Marcela
    Univ Politecn Madrid, Fac Phys Act & Sport Sci INEF, Dept Hlth & Human Performance, ImFine Res Grp, Madrid, Spain..
    Gottrand, Frederic
    Univ Lille 2, INSERM, U995, Lille, France..
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kafatos, Anthony
    Univ Crete, Sch Med, Prevent Med & Nutr Clin, Dept Social Med, Iraklion, Crete, Greece..
    Kersting, Mathilde
    Univ Bonn, Res Inst Child Nutr, Bonn, Germany..
    Manios, Yannis
    Harokopio Univ, Dept Nutr & Dietet, Athens 17671, Greece..
    Marcos, Ascension
    Spanish Natl Res Council, Inst Food Sci & Technol & Nutr, Madrid, Spain..
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary..
    Moreno, Luis A.
    Univ Zaragoza, Sch Hlth Sci, Res Grp, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza 50009, Spain..
    Plada, Maria
    Univ Crete, Sch Med, Prevent Med & Nutr Clin, Dept Social Med, Iraklion, Crete, Greece..
    Sjostrom, Michael
    Karolinska Inst, Dept Biosci & Nutr, Stockholm, Sweden..
    Reye, Beatrice
    Cereal Partners Worldwide SA, Lausanne, Switzerland..
    Thielecke, Frank
    Cereal Partners Worldwide SA, Lausanne, Switzerland.;Nestle Res Ctr, CH-1000 Lausanne, Switzerland..
    Valtuena, Jara
    Univ Politecn Madrid, Fac Phys Act & Sport Sci INEF, Dept Hlth & Human Performance, ImFine Res Grp, Madrid, Spain..
    Widhalm, Kurt
    Private Med Univ Salzburg, Dept Pediat, Salzburg, Austria.;Med Univ Vienna, Dept Pediat, Div Clin Nutr Obes & Lipoprot Disorders, Vienna, Austria..
    Claessens, Mandy
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent B, Belgium..
    European adolescent ready-to-eat-cereal (RTEC) consumers have a healthier dietary intake and body composition compared with non-RTEC consumers (vol 54, pg 653, 2015)2015In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 54, no 4, p. 665-666Article in journal (Refereed)
  • 19.
    Müller, K.
    et al.
    Research Institute of Child Nutrition (FKE), Dortmund.
    Libuda, L.
    Research Institute of Child Nutrition (FKE), Dortmund.
    Diethelm, K.
    Research Institute of Child Nutrition (FKE), Dortmund.
    Huybrechts, I.
    Ghent University.
    Moreno, L. A.
    Escuela Universitaria de Ciencias de la Salud Universidad de Zaragoza.
    Manios, Y.
    Harokopio University, Athens.
    Mistura, L.
    National Research Institute on Food and Nutrition, Rome.
    Dallongeville, J.
    Univ Lille Nord de France.
    Kafatos, A.
    University of Crete.
    González-Gross, M.
    Universidad Politécnica de Madrid.
    Cuenca-García, M.
    University of Granada, Spain .
    Sjöström, Michael
    Mälardalen University, School of Health, Care and Social Welfare.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Widhalm, K.
    Academic Institute for Clinical Nutrition, Vienna.
    Kersting, M.
    Research Institute of Child Nutrition (FKE), Dortmund.
    Lunch at school, at home or elsewhere: Where do adolescents usually get it and what do they eat? Results of the HELENA study2013In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 71, p. 332-339Article in journal (Refereed)
    Abstract [en]

    Considering the lack of uniformity regarding school meals in Europe, information on adolescents' school lunch patterns is of public health importance. Thus, the aim of this analysis was to describe and evaluate lunchtime energy and food intake of European adolescents at different lunch locations. Data on nutritional and health-related parameters were derived from the HEalthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). A sub-sample of 891 adolescents (47% male) with plausible data on total and lunchtime energy intake (2. ×. 24. h recall) as well as usual lunch location was considered. Food intake was compared to lunch of the Optimized Mixed Diet (OMD) for children and adolescents. Although energy intake was nearly in line with the recommendations, food intake was suboptimal compared to the OMD regardless of usual lunch location. Adolescents had more potatoes and less sweets at school, and more drinks (water, coffee and tea) and vegetables at home when each compared with the other locations. Food intake of adolescents getting their lunch elsewhere was characterized by the smallest amounts of potatoes and the highest amounts of sweets. Although lunch patterns may differ among countries, schools in Europe do not seem to reveal all their potential to offer access to a healthy lunch for adolescents yet.

  • 20.
    Santaliestra-Pasias, A. M.
    et al.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain..
    Mouratidou, T.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain..
    Huybrechts, I.
    Univ Ghent, B-9000 Ghent, Belgium. Int Agcy Res Canc, Dietary Exposure Assessment Grp DEX, F-69372 Lyon, France..
    Beghin, L.
    Univ Lille 2, Lille, France.;INSERM, F-59045 Lille, France..
    Cuenca-Garcia, M.
    Univ Granada, Granada, Spain..
    Castillo, M. J.
    Univ Granada, Granada, Spain..
    Galfo, M.
    Natl Res Inst Food & Nutr INRAN, Rome, Italy..
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, Huddinge, Sweden..
    Kafatos, A.
    Univ Crete, Iraklion, Greece..
    Manios, Y.
    Marcos, A.
    Molnar, D.
    Plada, M.
    Univ Crete, Iraklion, Greece..
    Pedrero-Chamizo, R.
    Widhalm, K.
    De Bourdeaudhuij, I.
    Univ Ghent, B-9000 Ghent, Belgium. Int Agcy Res Canc, Dietary Exposure Assessment Grp DEX, F-69372 Lyon, France..
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain..
    STUDY TIME IS ASSOCIATED WITH DIETARY PATTERNS IN EUROPEAN ADOLESCENTS PARTICIPATING IN THE HELENA STUDY2013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, p. 233-233Article in journal (Other academic)
  • 21.
    Santaliestra-Pası´as, AM
    et al.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Mouratidou, T
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Huybrechts, Inge
    Department of Public Health, Ghent University.
    Beghin, Laurent
    Université Lille, France.
    Cuenca-Garcia, Magdalena
    School of Medicine, University of Granada, Spain.
    Castillo, MJ
    Department of Medical Physiology, Faculty of Medicine, University of Granada, Granada, Spain.
    Galfo, M
    National Research Institute for Food and Nutrition (INRAN), Rome, Italy.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Marcos, A
    munonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frı´o, Institute of Food Science and Technology an Nutrition.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Plada, Maria
    Preventive Medicine & Nutrition Unit, University of Crete, Heraklion, Crete, Greece.
    Pedrero-Chamizo, R
    ImFINE Research Group Department of Health and Human Performance, Universidad Polite´cnica de Madrid, Madrid, Spain.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna.
    De Bourdeaudhuij, Ilse
    Department of Public Health, University Hospital, Ghent.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Increased sedentary behaviour is associated with unhealthy dietary patterns in European adolescents participating in the HELENA study2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 3, p. 300-308Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: To assess dietary patterns (DPs) in European adolescents and to examine their relationship with

    several indicators of sedentary behaviour.

    SUBJECTS/METHODS: A multinational cross-sectional study was carried out in 2202 adolescents (45.4% boys) aged 12.5–17.5 years. A self-reported questionnaire with information on sedentary behaviours, separately for weekdays and weekend days, and two non-consecutive 24 h-recalls were used. Principal component analysis was used to obtain DPs, and linear regression examined the association between DPs scores and sedentary behaviour.

    RESULTS: Four DPs for boys (‘plant based’, ‘snacking’, ‘breakfast’ and ‘health conscious’) and five DPs for girls (‘confectionary and snacking’, ‘plant based’, ‘breakfast’, ‘animal protein’ and ‘health conscious’) were obtained. Boys who spent 44 h/day watching television (TV) had lower adherence to the ‘plant based’, ‘breakfast’ and ‘health conscious’ DPs, and higher adherence to the ‘snacking’ DP. Higher computer use and internet use for recreational reason were associated with higher adherence to the ‘snacking’ DP. In girls, TV viewing and using internet for recreational reasons for 44 h/day was associated with higher adherence to the ‘confectionary and snacking’ and lower adherence with ‘health conscious’ DP. Also, studying between 2 and 4 h during weekend days was associated with lower adherence to the ‘snacking’ and with higher adherence to the ‘plant based’ and ‘breakfast’ DPs.

    CONCLUSION: Adolescents’ DPs are related with the time spent in several sedentary behaviours. Such findings may help to generate interventions focusing on decreasing unhealthy dietary habits and specific sedentary behaviours.

  • 22.
    Vandevijvere, S.
    et al.
    Scientific Institute of Public Health, Department of Public Health and Surveillance, Brussels, Belgium.
    Michels, N.
    Ghent University, Department of Public Health, Gent, Belgium.
    Verstraete, S.
    Ghent University, Department of Public Health, Gent, Belgium.
    Ferrari, M.
    INRAN-National Research Institute for Food and Nutrition, Rome, Italy.
    Leclercq, C.
    INRAN-National Research Institute for Food and Nutrition, Rome, Italy.
    Cuenca-García, M.
    Department of Medical Physiology, Faculty of Medicine, Granada, Spain.
    Grammatikaki, E.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Gottrand, F.
    Inserm U995, Université de Lille2, Hôpital J de Flandre CHRU de Lille, France.
    Santamaría, J. V.
    Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Madrid, Spain.
    Kersting, M.
    Research Institute of Child Nutrition, Dortmund, Germany.
    Gonzalez-Gross, M.
    Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Madrid, Spain.
    Moreno, L.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences (EUCS), University of Zaragoza, Zaragoza, Spain.
    Mouratidou, T.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences (EUCS), University of Zaragoza, Zaragoza, Spain.
    Stevens, K.
    Ghent University, Department of Public Health, Gent, Belgium.
    Meirhaeghe, A.
    INSERM U744, Institut Pasteur de Lille, Lille, France.
    Dallongeville, J.
    INSERM U744, Institut Pasteur de Lille, Lille, France.
    Sjöström, M.
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.
    Hallstrom, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.
    Kafatos, A.
    Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.
    Widhalm, K.
    Medical University Wien, Clinical Endocrinology, Metabolism and Nutrition, Vienna, Austria.
    Molnar, D.
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    De Henauw, S.
    Ghent University, Department of Public Health, Gent, Belgium.
    Huybrechts, I.
    Ghent University, Department of Public Health, Gent, Belgium.
    Intake and dietary sources of haem and non-haem iron among European adolescents and their association with iron status and different lifestyle and socio-economic factors2013In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 67, no 7, p. 765-772Article in journal (Refereed)
    Abstract [en]

    Background/Objectives:Adolescents are at risk of iron deficiency because of their high iron requirements. The aims of this study were: (1) to assess iron intake, its determinants and its most important food sources and; (2) to evaluate the relation of iron intake and status in European adolescents. Subjects/Methods:Two non-consecutive 24-h recalls were completed by a computerised tool. The socio-demographic and socio-economic data were collected by a self-reported questionnaire. Weight and height were measured. A distinction was made between haem and non-haem iron.Results:The total iron intake was significantly higher among boys (13.8 mg/day; n=1077) than girls (11.0 mg/day; n=1253). About 97.3% of the boys and 87.8% of the girls met the estimated average requirement, and 72.4% of the boys and 13.7% of the girls met the recommendation for bio-available iron intake. The ratio of haem/non-haem iron intake was lower for girls than boys. Meat (19.2; 76%) and bread and rolls (12.6;3.9%) contributed most to total and haem iron intake. Bread and rolls (13.8%) and meat (10.8%) contributed most to non-haem iron intake. Age, sex and body mass index were associated with iron intake. Only red blood cell concentration was significantly negatively associated with total, haem and non-haem iron intake.Conclusion:Girls had lower iron intakes and ratio of haem/non-haem iron intake than boys. The main total iron and haem iron source was meat, while the main non-haem iron source was bread and rolls. Adolescent girls may be a group at risk for iron deficiency. Consequently, special attention and strategies are needed in order to improve iron intakes during adolescence.

  • 23.
    Vandevijvere, Stefanie
    et al.
    Scientific Institute of Public Health, J. Wytsmanstraat 14, 1050 Brussels.
    Geelen, A
    University of Wageningen, Department of Nutrition, Wageningen, The Netherlands.
    González Grossj, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid.
    Van't Veer, P
    University of Wageningen, Department of Nutrition, Wageningen, The Netherlands.
    Dallongeville, Jean
    Institut Pasteur de Lille, France.
    Mouratidou, T
    GENUD (“Growth, Exercise, Nutrition and Development”) Research Group, EU. Ciencias de la Salud, Universidad de Zaragoza, Spain.
    Deekers, A
    RIVM (Dutch National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, the Netherlands.
    Börnhorst, C
    Bremen Institute for Prevention Research and Social Medicine, Division of Biometry and Data Management, Bremen, Germany.
    Breidenassel, Christina
    fInstitut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn.
    Crispim, S
    Dietary Exposure Assessment Group, International Agency for Research on Cancer (IARC), Lyon, France..
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Cuenca-Garcia, Magdalena
    School of Medicine, University of Granada.
    Vyncke, K
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185 – 2 Blok A, B-9000 Ghent, Belgium.
    Beghin, Laurent
    Université Lille, France.
    GRAMMATIKAKI, Eva
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    Ocké, M
    GENUD (Growth, Exercise, Nutrition and Development) Research Group. School of Health Sciences (EUCS). University of Zaragoza. C/ Domingo Miral s/n, 50009 Zaragoza, Spain.
    DeVriendt, Tinike
    Ghent University, Department of Public Health, Ghent, Belgium.
    Catasta, Giovina
    National Institute for Food and Nutrition Research, Italy.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Wärnberg, Julia
    Karolinska Institute, Unit of Preventive Medicine, Sweden.
    Esperanza, L
    Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Madrid. Spain.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    Gilbert, Chantal
    Campden BRI, Gloucestershire, UK.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    Huybrechts, Inge
    Department of Public Health, Ghent University.
    Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the HELENA study2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no 4, p. 736-747Article in journal (Refereed)
    Abstract [en]

    Accurate food and nutrient intake assessment is essential for investigating diet-disease relationships. In the present study, food and nutrient intake assessment among European adolescents using 24 h recalls (mean of two recalls) and a FFQ (separately and the combination of both) were evaluated using concentration biomarkers. Biomarkers included were vitamin C, β-carotene, DHA+EPA, vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasma folate). For the evaluation of the food intake assessment 390 adolescents were included, while 697 were included for the nutrient intake assessment evaluation. Spearman rank and Pearson correlations, and validity coefficients, which are correlations between intake estimated and habitual true intake, were calculated. Correlations were higher between frequency of food consumption (from the FFQ) and concentration biomarkers than between mean food intake (from the recalls) and concentration biomarkers, especially for DHA+EPA (r 0·35 v. r 0·27). Most correlations were higher among girls than boys. For boys, the highest validity coefficients were found for frequency of fruit consumption (0·88) and for DHA+EPA biomarker (0·71). In girls, the highest validity coefficients were found for fruit consumption frequency (0·76), vegetable consumption frequency (0·74), mean fruit intake (0·90) and DHA+EPA biomarker (0·69). After exclusion of underreporters, correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24 h recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake

  • 24.
    Vyncke, K
    et al.
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185 – 2 Blok A, B-9000 Ghent, Belgium.
    Fernandez Cruz, Estefania
    Research Foundation Flanders, Brussels,.
    Fajó-Pascual, Marta
    Facultad Ciencias Salud y Deporte, University of Zaragoza.
    Cuenca-Garcia, Magdalena
    School of Medicine, University of Granada.
    De Keyser, Willem
    Department of Public Health, Ghent University,.
    González Gross, Marcela
    Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid.
    Moreno, Luis
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Beghin, Laurent
    Université Lille, France.
    Breidenassel, Christina
    fInstitut für Ernährungs- und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn.
    Kersting, Mathilde
    Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Dortmund, Germany.
    Albers, Ulrike
    Department of Health and Human Performance, Madrid.
    Diethelm, Katharina
    Research Institute of Child Nutrition Dortmund.
    Mouratidou, Theodora
    Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza.
    Grammatikaki, Eva
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    DeVriendt, Tinike
    Ghent University, Department of Public Health, Ghent, Belgium.
    Marcos, Ascensión
    Department of Metabolism and Nutrition, Institute of Food Science and Technology, Madrid.
    Bammann, Karin
    Institute for Public Health and Nursing Care Research, University of Bremen.
    Börnhorst, Claudia
    BIPS Institute for Epidemiology and Prevention Research, Bremen.
    Leclercq, Caterine
    National Research Institute on Food and Nutrition, Rome.
    Manios, Yannis
    Department: Nutrition & Dietetics; Harokopio University Athens.
    Dallongeville, Jean
    Institut Pasteur de Lille, France.
    Vereecken, Carine
    Department of Public Health, University Hospital, Ghent.
    Maes, Lea
    Department of Public Health, University Hospital,Gent.
    Gwozdz, Wencke
    Department of Intercultural Communication and Management, Copenhagen Business School.
    Van Winckel, Myriam
    Department of Pediatrics and Medical Genetics, Ghent University Hospital, Ghent.
    Gottrand, Frédéric
    Faculté de Médecine, Université de Lille.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Karolinska Institute.
    Diaz, Ligia-Esperanza
    Instituto del Frío, Spanish National Research Council.
    Geelen, Anouk
    Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
    Hallström, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Widhalm, Kurt
    Department of Pediatrics, Medical University of Vienna.
    Kafatos, Anthony
    Preventive Medicine and Nutrition Clinic, Department of Social Medicine, School of Medicine, University of Crete, Greece.
    Molnar, Dénes
    University of Pecs, Pecs, Hungary.
    De Henauw, Stefaan
    Ghent University, Ghent, Belgium.
    Huybrechts, Inge
    Department of Public Health, Ghent University.
    Validation of the Diet Quality Index for Adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no 11, p. 2067-2078Article in journal (Refereed)
    Abstract [en]

    Food-based dietary guidelines (FBDG) aim to address the nutritional requirements at population level in order to prevent diseases and promote a healthy lifestyle. Diet quality indices can be used to assess the compliance with these FBDG. The present study aimed to investigate whether the newly developed Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to FBDG, and whether adherence to these FBDG effectively leads to better nutrient intakes and nutritional biomarkers in adolescents. Participants included 1804 European adolescents who were recruited in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Dietary intake was assessed by two, non-consecutive 24 h recalls. A DQI-A score, considering the components' dietary quality, diversity and equilibrium, was calculated. Associations between the DQI-A and food and nutrient intakes and blood concentration biomarkers were investigated using multilevel regression analysis corrected for centre, age and sex. DQI-A scores were associated with food intake in the expected direction: positive associations with nutrient-dense food items, such as fruits and vegetables, and inverse associations with energy-dense and low-nutritious foods. On the nutrient level, the DQI-A was positively related to the intake of water, fibre and most minerals and vitamins. No association was found between the DQI-A and total fat intake. Furthermore, a positive association was observed with 25-hydroxyvitamin D, holo-transcobalamin and n-3 fatty acid serum levels. The present study has shown good validity of the DQI-A by confirming the expected associations with food and nutrient intakes and some biomarkers in blood.

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