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Background: The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. Methods: Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5–7) and non-ideal (0–4). Results: A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). Conclusion: Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents. [ABSTRACT FROM AUTHOR]

Background/Objectives: To assess dietary patterns (DPs) in European adolescents and to examine their relationship with healthy eating determinants. Subject/Methods: A total of 2205 European adolescents, aged 12.5–17.5 years, were measured. A self-reported questionnaire was completed and dietary intake was measured by 24 h-dietary recalls. Principal component analysis was performed to obtain DPs. Analyses of covariance was used to examine the associations. Results: Four DPs for boys and six DPs for girls were obtained. Boys with healthier DPs, i.e. "plant-based" and "breakfast", had lower availability of soft drinks at home, higher perception of benefits of healthy eating and higher awareness of what is a healthy diet. Girls with healthy DPs ("Mediterranean", "plant-based", "healthy breakfast") had significantly higher fruits and lower soft drinks availability, higher perception of benefits, lower perception of barriers for a healthy eating and higher awareness of what is a healthy diet. Conclusion: Healthier DPs were related with availability of healthy foods, perceived benefits and awareness of the diet. In contrast, those with other patterns had lower availability of fruits and higher availability of soft drinks at home, no perception of the benefits of healthy eating and they were aware that their diet was not healthy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggest that dietary protein might play a beneficial role in combating obesity and its related chronic diseases. Total, animal and plant protein intakes and their associations with anthropometry and serum biomarkers in European adolescents using one standardised methodology across European countries are not well documented. Objectives: To evaluate total, animal and plant protein intakes in European adolescents stratified by gender and age, and to investigate their associations with cardio-metabolic indicators (anthropometry and biomarkers). Methods: The current analysis included 1804 randomly selected adolescents participating in the HELENA study (conducted in 2006-2007) aged 12.5-17.5 y (47% males) who completed two non-consecutive computerised 24-h dietary recalls. Associations between animal and plant protein intakes, and anthropometry and serum biomarkers were examined with General linear Model multivariate analysis. Results: Average total protein intake exceeded the recommendations of World Health Organization and European Food Safety Authority. Mean total protein intake was 96 g/d (59% derived from animal protein). Total, animal and plant protein intakes (g/d) were significantly lower in females than in males and total and plant protein intakes were lower in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and higher in obese ones; the direction of the relationship was reversed after adjustments for body weight (g/(kg.d)). The inverse association of plant protein intakes was stronger with BMI z-score and body fat percentage (BF%) compared to animal protein intakes. Additionally, BMI and BF% were positively associated with energy percentage of animal protein Conclusions: This sample of European adolescents appeared to have adequate total protein intake. Our findings suggest that plant protein intakes may play a role in preventing obesity among European adolescents. Further longitudinal studies are needed to investigate the potential beneficial effects observed in this study in the prevention of obesity and related chronic diseases. [ABSTRACT FROM AUTHOR]

Objective: The present study assessed whether compliance with the Food-Based Dietary Guidelines is related to habitual fatty acid (FA) intake and blood lipid parameters. Methods: Dietary information was collected by two non-consecutive 24-h recalls in 1804 European adolescents. Compliance with the Food-Based Dietary Guidelines was expressed by calculating the Diet Quality Index for Adolescents (DQI-A). Blood samples were collected in a randomly selected subset (n = 552). Relations between FA intake/serum concentrations and DQI-A were tested with multilevel regression analysis to correct for the study design (clustering within cities). Analyses were stratified for gender; age was entered as a covariate. Results: Better DQI-A scores were related to increased proportional intakes of energy from total fat, saturated FA, monounsaturated FA, and cholesterol (P < 0.001), whereas no significant association was observed with polyunsaturated FA intakes. In adolescents with higher compared with lower DQI-A scores, dairy products contributed more (21.0% versus 12.7%) and low-nutrient, energy-dense items contributed less (17.2% versus 26.3%) to the intake of total fat. A positive association was observed between the DQI-A scores and serum concentrations of eicosapentaenoic acid and docosahexaenoic acid (all P < 0.005). The latter, however, was significant only in girls. In boys, higher DQI-A scores were inversely associated with serum cholesterol concentrations (P < 0.05). Conclusion: Although compliance with the Food-Based Dietary Guidelines was not always associated with a favorable FA intake pattern, a significant favorable association with some serum biomarkers was observed. This outcome underlines the importance of considering dietary habits instead of single-nutrient intakes. [ABSTRACT FROM AUTHOR]