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BACKGROUND/OBJECTIVES: The objective of the study is to describe the hydration status and to assess the main food- and/or fluid intake-associated factors in healthy adolescents. SUBJECTS/METHODS: A total of 194 adolescents from the city of Zaragoza aged 12.5-17.5 years (99 males) participating in the 'Healthy Lifestyle in Europe by Nutrition in Adolescence' (HELENA) cross-sectional study were included. First morning urine was collected, and osmolality was determined by freezing point depression osmometer. A self-reported computer-based 24-h dietary recall was applied the same day of the urine collection. Analysis of variance, Kruskal-Wallis procedure or Pearson's [chi square] analyses was used to examine the group associations. RESULTS: Seventy-one percent of adolescents did not meet the European Food Safety Agency (EFSA) recommendations for average total water intake (TWI), and 68% had high first morning urine osmolality values. TWI and the proportion of those meeting EFSA reference values significantly (P < 0.05) decreased with increased osmolality. Males who met the EFSA recommendations consumed significantly (P < 0.05) more plain water (1035.13 vs 582.68 ml) and dairy drinks (368.13 vs 226.68 ml) than those who did not. In females, the consumption of water (1359.41 vs 620.44 ml) and sugar-sweetened beverages (214.61 vs 127.42 ml) was significantly higher in those meeting the EFSA recommendations than in those who did not. First morning urine osmolality was associated with vegetables (unstandardized β -0.6;95% confidence interval (CI): - 1.02 and -0.18) and fruits intake (β -0.41;95% CI: -0.63 and -0.19) in males and with dairy drinks (β: -0.39;95% CI: - 0.76 and -0.02) and fruits (β: -0.41;95% CI: -0.73 and -0.10) in females. CONCLUSIONS: There was a high prevalence of inadequate TWI and high urine osmolality among these Spanish adolescents. Lower urine osmolality was associated with higher consumption of vegetables in males, dairy drinks in females and fruits in both males and females. European Journal of Clinical Nutrition (2016) 541-547; doi: 10.1038/ejcn.2015.203; published online 16 December 2015, INTRODUCTION Water is essential for all functions of the body. (1) Total body water, as a percentage of body mass, varies as a function of body composition (from 50 to [...]

BACKGROUND: Dietary patterns, physical activity (PA) and sedentary behaviours are some of the main behavioural determinants of obesity; their combined influence in children has been addressed in a limited number of studies. SUBJECTS/METHODS: Children (16 228) aged 2-9 years old from eight European countries participated in the baseline survey of the IDEFICS study. A subsample of 11 674 children (50.8% males) were included in the present study. Children's food and beverage consumption (fruit and vegetables (F&V) and sugar-sweetened beverages (SSBs)), PA and sedentary behaviours were assessed via parental questionnaires. Sex-specific cluster analysis was applied to identify behavioural clusters. Analysis of covariance and logistic regression were applied to examine the association between behavioural clusters and body composition indicators (BCIs). RESULTS: Six behavioural clusters were identified (C1-C6) both in boys and girls. In both sexes, clusters characterised by high level of PA (C1 and C3) included a large proportion of older children, whereas clusters characterised by low SSB consumption (C5 and C6) included a large proportion of younger children. Significant associations between derived clusters and BCI were observed only in boys; those boys in the cluster with the highest time spent in sedentary activities and low PA had increased odds of having a body mass index z-score (odds ratio (OR) = 1.33;95% confidence interval (CI) = (1.01, 1.74)) and a waist circumference z- score (OR = 1.41; 95%CI = (1.06, 1.86)) greater than one. CONCLUSION: Clusters characterised by high sedentary behaviour, low F&V and SSB consumption and low PA turned out to be the most obesogenic factors in this sample of European children. European Journal of Clinical Nutrition (2015) 69, 811-816; doi:10.1038/ejcn.2015.76; published online 3 June 2015, INTRODUCTION Changes in multiple lifestyle behaviours contributing to energy imbalance are required in successful multi-factorial approaches of obesity prevention. (1) Dietary patterns, physical activity (PA) and sedentary behaviours are some [...]

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 >4h/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 >4h/day was associated with higher adherence to the 'confectionary and snacking' and lower adherence with 'health conscious' DP. Also, studying between 2 and 4h 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. European Journal of Clinical Nutrition (2014) 68, 300-308;doi:10.1038/ejcn.2013.170; published online 18 September 2013 Keywords: sedentary behaviours; dietary patterns; television; adolescents, INTRODUCTION Dietary pattern (DP) analysis has emerged as an alternative and complementary approach to addressing diet-diseases associations. (1) Traditional analysis in nutritional epidemiology typically reflects diet in relation to a [...]

BACKGROUND/OBJECTIVES: Individual lifestyle behaviours have independently been associated with cardiovascular diseases (CVD) risk factors in children. This study aimed to identify clustered lifestyle behaviours (dietary, physical activity (PA) and sedentary indicators) and to examine their association with CVD risk factors in children aged 2-9 years. SUBJECTS/METHODS: Participants included 4619 children (51.6% boys) from eight European countries participating in the IDEFICS cross-sectional baseline survey (2007-2008). Insulin resistance, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, sum of two skinfolds and systolic blood pressure (SBP) z-scores were summed to compute a CVD risk score. Cluster analyses stratified by sex and age groups (2 to < 6 years; 6-9 years) were performed using parental-reported data on fruit, vegetables and sugar-sweetened beverages (SSB) consumption, PA performance and television video/DVD viewing. RESULTS: Five clusters were identified. Associations between CVD risk factors and score, and clusters were obtained by multiple linear regression using cluster 5 ('low beverages consumption and low sedentary') as the reference cluster. SBP was positively associated with clusters 1 ('physically active'; β = 1.34;95% confidence interval (CI): 0.02, 2.67), 2 ('sedentary'; β = 1.84; 95% CI: 0.57, 3.11), 3 ('physically active and sedentary'; β = 1.45;95% CI: 0.15, 2.75) and 4 ('healthy diet'; β = 1.83;95% CI: 0.50, 3.17) in older boys. A positive association was observed between CVD risk score and clusters 2 (b = 0.60;95% CI: 0.20, 1.01), 3 (b = 0.55;95% CI: 0.14, 0.97) and 4 (β = 0.60, 95% CI: 0.18, 1.02) in older boys. CONCLUSIONS: Low television/video/DVD viewing levels and low SSB consumption may result in a healthier CVD profile rather than having a diet rich in fruits and vegetables or being physically active in (pre-)school children. European Journal of Clinical Nutrition (2013) 67, 848-854; doi:10.1038/ejcn.2013.84; published online 1 May 2013 Keywords: cardiovascular diseases; lifestyle; diet; exercise; sedentary lifestyle; child, INTRODUCTION Increased risk of CVD is characterized by a cluster of metabolic abnormalities, such as abdominal obesity, atherogenic dyslipemia, hypertension, insulin resistance and glucose intolerance. (1) CVD remains the leading [...]