Dietary and lifestyle quality indices with/without physical activity and markers of insulin resistance in European adolescents: the HELENA study

Resistencia a la insulina en adolescente

Development of a Genetic Risk Score to predict the risk of overweight and obesity in European adolescents from the HELENA study

Obesity is the result of interactions between genes and environmental factors. Since monogenic etiology is only known in some obesity-related genes, a genetic risk score (GRS) could be useful to determine the genetic predisposition to obesity. Therefore, the aim of our study was to build a GRS able to predict genetic predisposition to overweight and obesity in European adolescents. A total of 1069 adolescents (51.3% female), aged 11–19 years participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were genotyped. The sample was divided in non-overweight (non-OW) and overweight/obesity (OW/OB). From 611 single nucleotide polymorphisms (SNP) available, a first screening of 104 SNPs univariately associated with obesity (p < 0.20) was established selecting 21 significant SNPs (p < 0.05) in the multivariate model. Unweighted GRS (uGRS) was calculated by summing the number of risk alleles and weighted GRS (wGRS) by multiplying the risk alleles to each estimated coefficient. The area under curve (AUC) was calculated in uGRS (0.723) and wGRS (0.734) using tenfold internal cross-validation. Both uGRS and wGRS were significantly associated with body mass index (BMI) (p < .001). Both GRSs could potentially be considered as useful genetic tools to evaluate individual’s predisposition to overweight/obesity in European adolescents.European Commission FOOD-CT-2005-007034HELENA projectSpanish Ministry of Economy and Competitiveness RYC-2010-05957 RYC2011-09011Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)Iberus Talent Pre-doctoral fellowships under the European Union 801586Instituto de Salud Carlos III CB15/0004

Correlates of dietary energy misreporting among European adolescents : the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two selfadministered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12.5-17.5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires.Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33.3% of the adolescents were UR and 15.6% were OV when considering mean EI. Overweight (OR 3.25; 95% CI 2.01, 5.27) and obese (OR 4.31; 95% CI 1.92, 9.65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1.67; 95% CI 1.01, 2.76). Being content with their own figures (OR 0.61; 95% CI 0.41, 0.89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2.14; 95% CI 1.53, 2.99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0.55; 95% CI 0.33, 0.92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet-disease associations

North-south gradients in plasma concentrations of B-vitamins and other components of one-carbon metabolism in Western Europe: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study.

Different lifestyle patterns across Europe may influence plasma concentrations of B-vitamins and one-carbon metabolites and their relation to chronic disease. Comparison of published data on one-carbon metabolites in Western European regions is difficult due to differences in sampling procedures and analytical methods between studies. The present study aimed, to compare plasma concentrations of one-carbon metabolites in Western European regions with one laboratory performing all biochemical analyses. We performed the present study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort among 5446 presumptively healthy individuals. Quantile regression was used to compare sex-specific median concentrations between Northern (Denmark and Sweden), Central (France, Germany, The Netherlands and United Kingdom) and Southern (Greece, Spain and Italy) European regions. The lowest folate concentrations were observed in Northern Europe (men, 10·4 nmol/l; women, 10·7 nmol/l) and highest concentrations in Central Europe. Cobalamin concentrations were slightly higher in Northern Europe (men, 330 pmol/l; women, 352 pmol/l) compared with Central and Southern Europe, but did not show a clear north-south gradient. Vitamin B₂ concentrations were highest in Northern Europe (men, 22·2 nmol/l; women, 26·0 nmol/l) and decreased towards Southern Europe (P trend< 0·001). Vitamin B(6) concentrations were highest in Central Europe in men (77·3 nmol/l) and highest in the North among women (70·4 nmol/l), with decreasing concentrations towards Southern Europe in women (P trend< 0·001). In men, concentrations of serine, glycine and sarcosine increased from the north to south. In women, sarcosine increased from Northern to Southern Europe. These findings may provide relevant information for the study of regional differences of chronic disease incidence in association with lifestyle

Dietary and lifestyle quality indices with/without physical activity and markers of insulin resistance in European adolescents: the HELENA study

Abstract Emerging data indicate that higher levels of insulin resistance (IR) are common among children and adolescents and are related to cardiometabolic risk; therefore, IR requires consideration early in life. In addition, there is a lack of conclusive evidence regarding the role of dietary nutrients on IR. The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) was conducted in European adolescents aged 12·5 -17·5 years. A total of 637 participants with valid homeostasis model assessment (HOMA) index data and who completed at least a 2 d 24 h dietary recall were included in the study (60 % of the total HELENA-CSS sample). There were two dietary indices calculated, with the only difference between them being the inclusion or not of physical activity (PA). Markers of IR such as HOMA and the quantitative insulin sensitivity check index (QUICKI) were calculated. Pubertal status, BMI and cardiorespiratory fitness (CRF) were measured as potential confounders. The dietary index including PA was inversely associated with HOMA and directly with the QUICKI in females, but not in males, after adjusting for pubertal status, centre, BMI and CRF. In conclusion, the present study indicates that considering PA as part of the dietary index is of relevance as the resulted index is inversely related to IR independently of potential confounders including CRF. Overall, these findings suggest that intervention studies aimed at preventing IR in young people should focus on increasing the quality of the diet and also on including an optimal PA level in healthy adolescents

Relationship between self-reported dietary intake and physical activity levels among adolescents: The HELENA study

Background Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. Therefore it is important to investigate associations between dietary and physical activity behavior, the two most important lifestyle behaviors influencing our energy balance and body composition. The objective of the present study is to describe the relationship between energy, nutrient and food intake and the physical activity level among a large group of European adolescents. Methods The study comprised a total of 2176 adolescents (46.2% male) from ten European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Dietary intake and physical activity were assessed using validated 24-h dietary recalls and self-reported questionnaires respectively. Analyses of covariance (ANCOVA) were used to compare the energy and nutrient intake and the food consumption between groups of adolescents with different physical activity levels (1st to 3rd tertile). Results In both sexes no differences were found in energy intake between the levels of physical activity. The most active males showed a higher intake of polysaccharides, protein, water and vitamin C and a lower intake of saccharides compared to less active males. Females with the highest physical activity level consumed more polysaccharides compared to their least active peers. Male and female adolescents with the highest physical activity levels, consumed more fruit and milk products and less cheese compared to the least active adolescents. The most active males showed higher intakes of vegetables and meat, fish, eggs, meat substitutes and vegetarian products compared to the least active ones. The least active males reported the highest consumption of grain products and potatoes. Within the female group, significantly lower intakes of bread and cereal products and spreads were found for those reporting to spend most time in moderate to vigorous physical activity. The consumption of foods from the remaining food groups, did not differ between the physical activity levels in both sexes. Conclusion It can be concluded that dietary habits diverge between adolescents with different self-reported physical activity levels. For some food groups a difference in intake could be found, which were reflected in differences in some nutrient intakes. It can also be concluded that physically active adolescents are not always inclined to eat healthier diets than their less active peers.The HELENA study took place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT: 2005-007034). This work was also partially supported by the European Union, in the framework of the Public Health Programme (ALPHA project, Ref: 2006120), the Swedish Council for Working Life and Social Research (FAS), the Spanish Ministry of Education (EX-2007-1124, and EX-2008-0641), and the Spanish Ministry of Health, Maternal, Child Health and Development Network (number RD08/0072) (JPRL, LAM)

Reliability and validity of a healthy diet determinants questionnaire for adolescents

OBJECTIVE: To describe the development of a short questionnaire including a wide range of personal, social and environmental constructs in relation to a healthy diet in an adolescent population. DESIGN: The questionnaire was developed based on the literature, past experiences and feedback from a small pilot study (n 10). Test and retest (2 weeks later) of the questionnaire was done to investigate test-retest reliability. Data of four non-consecutive 24 h recalls were collected to investigate the predictive validity with food (fruit, vegetables, milk, snacks, soft drinks), nutrient (fibre, ascorbic acid, Ca, percentage energy from fat) and energy intakes. SETTING: At home, in the presence of a student. SUBJECTS: Convenience sample of fifty-five Belgian-Flemish adolescents approached by university students for course credits. RESULTS: Test-retest correlations of the constructs ranged between 0.51 and 0.78. Eleven of the eighteen final constructs were significantly associated with one or more of the five selected food items, all in the expected direction. Most significant associations with the food items were found for taste, perceived peers' behaviour and availability of soft drinks at home. Fresh fruit and soft drinks were correlated with most constructs (seven) followed by snacks (five). Concerning energy and the selected nutrient variables, the findings were less clear. CONCLUSIONS: The results are promising: the test-retest stability was moderate to good; most of the psychosocial constructs were significantly associated with one or more of the selected dietary variables. Future work in a larger sample of European adolescents is warranted.status: publishe

Reliability and validity of a healthy diet determinants questionnaire for adolescents

Objective To describe the development of a short questionnaire including a wide range of personal, social and environmental constructs in relation to a healthy diet in an adolescent population. Design The questionnaire was developed based on the literature, past experiences and feedback from a small pilot study (n 10). Test and retest (2 weeks later) of the questionnaire was done to investigate test–retest reliability. Data of four non-consecutive 24 h recalls were collected to investigate the predictive validity with food (fruit, vegetables, milk, snacks, soft drinks), nutrient (fibre, ascorbic acid, Ca, percentage energy from fat) and energy intakes. Setting At home, in the presence of a student. Subjects Convenience sample of fifty-five Belgian-Flemish adolescents approached by university students for course credits. Results Test–retest correlations of the constructs ranged between 0·51 and 0·78. Eleven of the eighteen final constructs were significantly associated with one or more of the five selected food items, all in the expected direction. Most significant associations with the food items were found for taste, perceived peers’ behaviour and availability of soft drinks at home. Fresh fruit and soft drinks were correlated with most constructs (seven) followed by snacks (five). Concerning energy and the selected nutrient variables, the findings were less clear. Conclusions The results are promising: the test–retest stability was moderate to good; most of the psychosocial constructs were significantly associated with one or more of the selected dietary variables. Future work in a larger sample of European adolescents is warranted

Psychosocial determinants and perceived environmental barriers as mediators of the effectiveness of a web-based tailored intervention promoting physical activity in adolescents: the HELENA Activ-O-Meter

Background: The aim was to examine if psychosocial determinants (attitudes, self-efficacy, social support from a sports partner) and perceived environmental barriers (PEB) of physical activity (PA) mediated the effect of a 3-month Internet-based intervention on PA in European adolescents. Methods: A sample of 536 adolescents (51% boys) aged 12-17 years were randomly assigned to intervention or control condition. Questionnaires were used to assess different PA behaviors, psychosocial determinants and PEB at baseline and at 3-month follow-up. Mediating effects were assessed with the bootstrapping method. Results: PEB regarding neighborhood safety mediated the effect of the intervention on all PA indices. PEB regarding sports facilities availability at neighborhood and PEB regarding sport-related facilities availability at school mediated the effect of the intervention on moderate to vigorous PA (MVPA) and moderate PA (in leisure time and at school, respectively). Social support from a sports partner suppressed the effect of the intervention on vigorous PA and MVPA. No other factor had a mediation effect. Conclusions: All PEB measures appear to mediate PA behaviors of different intensities and in different contexts. Interventions promoting PA in adolescents should also focus on improving the targeted PEB as mediators of engagement in PA to bring the desired effects in actual behaviors