European adolescents' level of perceived stress is inversely related to their diet quality: the Healthy Lifestyle in Europe by Nutrition in Adolescence study

As stress is hypothesised to influence dietary behaviour, the relationship between perceived stress and diet quality in European adolescents was investigated. Within the Healthy Lifestyle in Europe by Nutrition in Adolescence study, adolescents (n 704, aged 12-17 years) from schools in five European cities (Ghent, Stockholm, Zaragoza, Athens and Vienna) completed a 2 d 24 h dietary recall assessment and an Adolescent Stress Questionnaire. Measurements and information were taken on height, weight, pubertal stage, parental education level, the level of moderate-to-vigorous physical activity (MVPA) and sleep duration. The Diet Quality Index for Adolescents (DQI-A) was calculated from the dietary data, which comprised three components reflecting dietary diversity, quality and equilibrium. Hierarchical linear models were performed to investigate the relationship between the adolescents' level of perceived stress and the DQI-A and its components, adjusting for relevant covariates (age, BMI z-score, pubertal stage and parental education). These models were additionally adjusted for MVPA or sleep duration. In both boys and girls, perceived stress was a significant independent negative predictor for their overall DQI-A. This inverse relationship was observed for all dietary components, except for dietary diversity in boys, and it was unaltered when additionally adjusted for MVPA or sleep duration. The observed inverse relationship between stress and diet quality within these European adolescents supports the hypothesis that stress influences dietary behaviour, thus emphasising the need for preventive stress-coping strategies for adolescents

Nutritional knowledge in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study.

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).status: publishe

Correlates of ideal cardiovascular health in European adolescents: The HELENA study

The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents. METHODS AND RESULTS: The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01). CONCLUSION: Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status