https://www.mdu.se/

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.

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.

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.

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.

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)

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)

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.

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).

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.

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.

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.

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.

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.

To examine the association between food groups consumption and vitamin B-6, folate and B-12 intakes and biomarkers in adolescents. In total 2189 individuals participating in the cross-sectional Healthy Lifestyle in Europe by Nutrition in Adolescence study met the eligibility criteria for analysis of dietary intakes (46 % males) and 632 for biomarker analysis (47 % males). Food intakes were assessed by two non-consecutive 24-h recalls. Biomarkers were measured by chromatography and immunoassay. Food groups which best discriminated participants in the extreme tertiles of the distribution of vitamins were identified by discriminant analyses. Food groups with standardised canonical coefficients higher or equal to 0.3 were selected as valid discriminators of vitamins intake and biomarkers extreme tertiles. Linear mixed model elucidated the association between food groups and vitamins intakes and biomarkers. Vitamin B-6 intakes and biomarkers were best discriminated by meat (males and females), margarine and mixed origin lipids only in males and breakfast cereals (females). Breakfast cereals (males), and fruits, margarine and mixed origin lipids, vegetables excluding potatoes, breakfast cereals, and soups/bouillon (females) determined the most folate intakes and biomarkers. Considering vitamin B-12 intakes and biomarkers, meat, and white and butter milk (males and females), snacks (males), and dairy products (females) best discriminated individual in the extremes of the distribution. Fewer associations were obtained with mixed model for biomarkers than for vitamins intakes with food groups. Whereas B-vitamin intakes were associated with their food sources, biomarkers did with overall food consumption. Low-nutrient-density foods may compromise adolescents' vitamin status.

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.

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.

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.

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.

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.

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

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.