Psychosocial stress and inflammation driving tryptophan breakdown in children and adolescents : a cross-sectional analysis of two cohorts

Background: Tryptophan breakdown is an important mechanism in several diseases e.g. inflammation and stress induced inflammation have been associated with the development of depression via enhanced tryptophan breakdown. Depression is a major public health problem which commonly starts during adolescence, thus identifying underlying mechanisms during early life is crucial in prevention. The aim of this work was to verify whether independent and interacting associations of psychosocial stress and inflammation on tryptophan breakdown already exist in children and adolescents as a vulnerable age group. Methods: Two cross-sectional population-based samples of children/adolescents (8-18 y) were available: 315 from the European HELENA study and 164 from the Belgian ChiBS study. In fasting serum samples, tryptophan, kynurenine, kynurenic acid, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, soluble vascular adhesion molecule 1 (sVCAM1) and soluble intercellular adhesion molecule 1 (sICAM1) were measured. Psychological stress was measured by stress reports (subjective) and cortisol (objective - awakening salivary cortisol or hair cortisol). Linear regressions with stress or inflammation as predictor were adjusted for age, sex, body mass index, puberty, socio-economic status and country. Results: In both cohorts, inflammation as measured by higher levels of CRP, sVCAM1 and sICAM1 was associated with kynurenine/tryptophan ratio and thus enhanced tryptophan breakdown (beta: 0.145-0.429). Psychological stress was only associated with tryptophan breakdown in the presence of higher inflammatory levels (TNF-alpha in both populations). Conclusions: Inflammatory levels were replicable key in enhancing tryptophan breakdown along the kynurenine pathway, even at young age and in a non-clinical sample. The stress-inflammation interaction indicated that only the stress exposures inducing higher inflammatory levels (or in an already existing inflammatory status) were associated with more tryptophan breakdown. This data further contributes to our understanding of pathways to disease development, and may help identifying those more likely to develop stress or inflammation-related illnesses

Association between PTPN1 polymorphisms and obesity-related phenotypes in European adolescents: influence of physical activity

Background: To study the associations of Protein Tyrosine Phosphatase-N1 (PTPN1) polymorphisms with obesity-related phenotypes in European adolescents, and the influence of physical activity on these relationships. Methods: Five polymorphisms of PTPN1 were genotyped in 1057 European adolescents (12–18 years old). We measured several phenotypes related to obesity, such as adiposity markers, and biochemical and clinical parameters. Physical activity was objectively measured by accelerometry. Results: The T, A, T, T and G alleles of the rs6067472, rs10485614, rs2143511, rs6020608 and rs968701 polymorphisms, respectively, were associated with lower levels of obesity-related phenotypes (i.e., body mass index, body fat percentage, hip circumference, fat mass index, systolic blood pressure and leptin) in European adolescents. In addition, the TATTG haplotype was associated with lower body fat percentage and fat mass index compared to the AACCA haplotype. Finally, when physical activity levels were considered, alleles of the rs6067472, rs2143511, rs6020608 and rs968701 polymorphisms were only associated with lower adiposity in active adolescents. Conclusions: PTPN1 polymorphisms were associated with adiposity in European adolescents. Specifically, alleles of these polymorphisms were associated with lower adiposity only in physically active adolescents. Therefore, meeting the recommendations of daily physical activity may reduce obesity risk by modulating the genetic predisposition to obesity. Impact: - Using gene-phenotype and gene*environment analyses, we detected associations between polymorphisms of the Protein Tyrosine Phosphatase-N1 (PTPN1) gene and obesity-related phenotypes, suggesting a mechanism that can be modulated by physical activity. - This study shows that genetic variability of PTPN1 is associated with adiposity, while physical activity seems to modulate the genetic predisposition. - This brings insights about the mechanisms by which physical activity positively influences obesity

Association of physical activity with muscular strength and fat free mass in adolescents; The HELENA Study

Objective: To analyze the association of objectively assessed physical activity (PA) with muscular strength and fat free mass in adolescents, and to determine whether meeting the current PA recommendations is associated with higher levels of muscular strength and fat free mass. Subjects/Methods: The present cross-sectional study comprised 363 Spanish adolescents (180 females) aged 12.5-17.5 years. PA was assessed by accelerometry and expressed as average PA (counts/min), and min/day of inactive, light, moderate, vigorous and moderate to vigorous PA (MVPA). MVPA was dichotomized into <60 min/day and ≥60. Upper body muscular strength was measured with the handgrip strength test, and lower body muscular strength was measured with the standing broad jump, squat jump, counter movement jump and Abalakov tests. Fat free mass was measured by DXA. Results: We observed positive associations between vigorous PA and all the lower body muscular strength tests except for the counter movement jump in males. PA was not associated with fat free mass in both males and females. Male adolescents engaged in at least 60 min/day MVPA performed better in the standing broad jump test. Conclusions: The findings of the present study suggest that only vigorous PA is associated with muscular strength, particularly lower-body muscular strength in male adolescents

Skipping breakfast is associated with adiposity markers especially when sleep time is adequate in adolescents

Adolescence is a critical stage of development and has an important influence on energy balancerelated behaviours (EBRBs). When adolescents are associated with obesity it can lead to increased cardiometabolic risk. Here we assess if EBRBs adopted by adolescents included in a subsample are associated with markers of total and abdominal adiposity in a multicentre European study, Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA-CSS) and a Brazilian study, Brazilian Cardiovascular Adolescent Health (BRACAH study), and whether sleep duration influence the association between skipping breakfast, physical activity and sedentary behaviours, with total and abdominal obesity (AO). Multilevel linear regression models using fixed and random intercepts were used to analyse the association between markers of obesity and EBRBs. Skipping breakfast was the prevalent behaviour in association with obesity among European and Brazilian boys besides European girls, even after stratification by sleep time. Moreover, European boys who slept properly and skipped breakfast had an increased waist circumference (WC), while body mass index (BMI) increased in Brazilian boys. Among Brazilian boys less sleep was protective for total obesity (β = −0.93 kg/m2; 95% CI: −1.80; −0.07). European girls when they were more sedentary, showed an increase in WC, especially for those who reported they slept adequately. Skipping breakfast was associated with total and AO in adolescents independent of sleep duration.The HELENA-CSS took place with the financial support of the European Community Sixth RTD Framework Program (contract FOOD-CT-2005-007034). This study was also supported by a grant from the Spanish Ministry of Health: Maternal, Child Health and Development Network (numberRD08/0072) and grants from the Spanish Ministry of Education (EX-2008-0641) and the Swedish Heart-Lung Foundation (20090635). And supported by grants from the Spanish Ministry of Science and Innovation (JCI-2010-07055 and RYC-2010-05957). The authors thanked for the contribution of the HELENA Study Group. We are grateful for the financial support to the authors: Dr. Elsie C. O. Forkert was given a post-doctoral schoolarship from the Sao Paulo Research Foundation FAPESP (proc.2018/02887-6). Dr. Augusto César F. De Moraes was given a post-doctoral scholarship from the National Council for Scientific and Technological Development (CNPq: proc. 313772/2014-2) and the São Paulo Research Foundation FAPESP (proc. 2014/13367-2 and 2015/14319-4). Full Prof. Luis A. Moreno was given a scholarship of a visiting professor from São Paulo Research Foundation FAPESP (proc. 2015/11406-3). Dr Prof Heráclito B Carvalho is in receipt of an advanced scientist scholarship from the National Council for Scientific and Technological Development (CNPq: proc. 300951/2015-9)

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

Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? The HELENA Study

Objective: One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between meeting or not meeting the PA and SST recommendations and the consumption of different food groups. Method: Data were obtained from a sample of European adolescents from the multicenter cross-sectional HELENA study. In all, 1448 adolescents from 8 cities were included. PA was objectively measured by accelerometry and dietary intake by 24-hour dietary records. Adolescents were grouped according to PA and SST recommendations. Results: In both sexes, intake of savory snacks was higher in those groups who did not meet any of the recommendations (p < 0.05). For males, those who met both recommendations were more likely to drink/eat milk, yogurt, and water (p < 0.05). Those not meeting recommendations were more likely to drink sugar-sweetened beverages (p < 0.05). For females, those not meeting recommendations were less likely to eat fruits and vegetables and more likely to have a higher intake of fats and oils (p < 0.05). Conclusions: Those adolescents meeting PA and SST recommendations had a higher intake of healthy foods, like fruit and vegetables and dairy products. However, the negative relationship unhealthier food and SST is stronger in males independently of PA. More studies assessing the combined effect of both PA and SST regarding dietary habits in children and adolescents are needed

Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel

Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipid lowering therapy irrespective of the presence of CV risk factors, family history and/or LDL-C levels Those children with FH and cIMT ≥0.4 mm should be carefully monitored to initiate lipid lowering management in the most suitable time. Likewise, all genetically confirmed children with FH and LDL-C levels ≥4.1 mmol/L (160 mg/dL), should be treated with lifestyle changes and LLT irrespective of the cIMT, presence of additional RF or family history of CHD

Associations between macronutrient intake and serum lipid profile depend on body fat in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006–7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total choles- terol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44 % boys) aged 12·5–17·5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous

Dietary Patterns in European and Brazilian Adolescents: Comparisons and Associations with Socioeconomic Factors

Associations between dietary patterns (DP) and socioeconomic factors have been little explored in adolescents. The aim of this study was to identify DP in European and Brazilian adolescents and to investigate their associations with a range of socioeconomic indicators. Adolescents from the HELENA-study and the Household Budget Survey were analyzed. Factor analysis was used to obtain DP. Linear regression was used to examine the association between DP and SES. In Europeans, the Western DP was associated with low education of the mother, high socioeconomic status (boys), older age (boys), and living in cities of the Northern Europe; in Brazilians, the Western DP was associated with high secondary education of the mother, high socioeconomic status and living in Southern areas of the country. The Traditional European DP, in both genders, was associated with high secondary education of the mother and inversely associated with a high socioeconomic status; the Traditional Brazilian DP, was associated with university level education of the mother and older age (boys). The association between DP and socioeconomic factors is relevant for the understanding of food-related practices and highlight the importance of performing a complete assessment of the socioeconomic influence in adolescent’s DP from developed and developing countries.The HELENA study received funding from the European Union’s Sixth RTD Framework Programme (Contracts FOOD-CT-2007-036196-2 and FOODCT-2005-007034, respectively). Additional support was received from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd. (Oslo, Norway), Abbot Científica S.A. (Spain). The HBS was funded by the Ministry of Health of Brazil (agreement number 4652/2005; grant number 25000.202044/2005-16). The funder contributed to the HBS design and conduct of the study. C.A.B. received a fellowship from the Brazilian Federal Agency (Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior-CAPES) and A.M.S.P received financial support by Fundación Cuenca Villoro (Spain) both for the improvement of higher education. D.J.P was supported by a grant from the Spanish Ministry of Science and Innovation—MINECO (RYC-2014-16938)

Relative validity of the Planetary Health Diet Index by comparison with usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet among European adolescents: the HELENA study

Purpose The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. Methods We used cross-sectional data from 1804 adolescents (12.5–17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0–150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. Results Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma β-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. Conclusions The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes