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Purpose: Breakfast consumption has been recommended as part of a healthy diet. Recently, ready-to-eat cereals (RTEC) became more popular as a breakfast item. Our aim was to analyse the dietary characteristics of an RTEC breakfast in European adolescents and to compare them with other breakfast options. Methods: From the European multi-centre HELENA study, two 24-h dietary recalls of 3137 adolescents were available. Food items (RTEC or bread, milk/yoghurt, fruit) and macro- and micronutrient intakes at breakfast were calculated. Cross-sectional regression analyses were adjusted for gender, age, socio-economic status and city. Results: Compared to bread breakfasts (39 %) and all other breakfasts (41.5 %), RTEC breakfast (19.5 %) was associated with improved nutrient intake (less fat and less sucrose; more fibre, protein and some micronutrients like vitamin B, calcium, magnesium and phosphorus) at the breakfast occasion. Exceptions were more simple sugars in RTEC breakfast consumers: more lactose and galactose due to increased milk consumption, but also higher glucose and fructose than bread consumers. RTEC consumers had a significantly higher frequency (92.5 vs. 50.4 and 60.2 %) and quantity of milk/yoghurt intake and a slightly higher frequency of fruit intake (13.4 vs. 10.9 and 8.0 %) at breakfast. Conclusions: Among European adolescents, RTEC consumers showed a more favourable nutrient intake than consumers of bread or other breakfasts, except for simple sugars. Therefore, RTEC may be regarded as a good breakfast option as part of a varied and balanced diet. Nevertheless, more research is warranted concerning the role of different RTEC types in nutrient intake, especially for simple sugars. [ABSTRACT FROM AUTHOR]

Objective. We aimed to estimate the attributable fraction of systolic (SBP) and diastolic blood pressure (DBP) that can be explained by family socioeconomic factors (FSFs) in adolescents using two observational studies. Methods. Participants were recruited by multistage random cluster in two cross-sectional studies performed in Europe [Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, n = 3308] and Brazil [Brazilian Cardiovascular Adolescent Health (BRACAH) study, n = 991]. SBP and DBP were measured, and FSFs (socioeconomic status and parental education) were self-reported in both studies. The correlations of SBP and DBP with FSFs were examined by multilevel linear regression through two different models (hierarchical and fully adjusted). The generalized attributable fractions of the FSFs were estimated by comparing the models. Results. Our results showed a significant inverse relationship between parental education (father and mother) and SBP in European boys. The higher generalized attributable fraction to SBP was observed in boys (13.2-22.4%). In girls, we found lower generalized attributable fractions to DBP (10.8-12.1% in Brazilian girls and 3.1-3.8% in European girls). Conclusions. Our findings revealed a significant inverse relationship between parental education and SBP in European boys. FSF also significantly influenced blood pressure in adolescents, mainly in Brazilian adolescents. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM PUBLISHER]

Food-based dietary guidelines (FBDG) aim to address the nutritional requirements at population level in order to prevent diseases and promote a healthy lifestyle. Diet quality indices can be used to assess the compliance with these FBDG. The present study aimed to investigate whether the newly developed Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to FBDG, and whether adherence to these FBDG effectively leads to better nutrient intakes and nutritional biomarkers in adolescents. Participants included 1804 European adolescents who were recruited in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Dietary intake was assessed by two, non-consecutive 24 h recalls. A DQI-A score, considering the components' dietary quality, diversity and equilibrium, was calculated. Associations between the DQI-A and food and nutrient intakes and blood concentration biomarkers were investigated using multilevel regression analysis corrected for centre, age and sex. DQI-A scores were associated with food intake in the expected direction: positive associations with nutrient-dense food items, such as fruits and vegetables, and inverse associations with energy-dense and low-nutritious foods. On the nutrient level, the DQI-A was positively related to the intake of water, fibre and most minerals and vitamins. No association was found between the DQI-A and total fat intake. Furthermore, a positive association was observed with 25-hydroxyvitamin D, holo-transcobalamin and n-3 fatty acid serum levels. The present study has shown good validity of the DQI-A by confirming the expected associations with food and nutrient intakes and some biomarkers in blood. [ABSTRACT FROM PUBLISHER]

Objectives: To examine the independent and combined association of physical activity (PA) and sedentary behavior (SB) on both systolic (SBP) and diastolic blood pressure (DBP) in adolescents from two observational studies. Methods: Participants from two cross-sectional studies, one conducted in Europe (n = 3,308; HELENA study) and the other in Brazil (n = 991; BRACAH study), were selected by complex sampling. Systolic and diastolic blood pressure (outcomes), PA and SB, both independently and combined, and potential confounders were analyzed. Associations were examined by multilevel linear regression. Results: Performing the recommended amount of PA (≥60 min/d) attenuated the effect of SB on DBP in BRACAH study girls and in boys from both studies. In contrast, PA did not attenuate the effects of SB on the SBP of girls in the HELENA study. The combination of less than recommended levels of PA with 2–4 h/d of sedentary behavior was found to be associated with increased SBP in boys from both studies. Conclusions: Meeting current PA recommendations could mediate the association between SB and DBP in both sexes. In boys, the joint effect of low levels of PA and excessive sedentary activity increases SBP levels. Longitudinal studies are required to confirm these findings. [ABSTRACT FROM AUTHOR]

The authors’ aim in this cross-sectional study was to characterize levels of objectively measured physical activity and sedentary time in adolescents from 9 European countries. The study comprised 2,200 European adolescents (1,184 girls) participating in the HELENA cross-sectional study (2006–2008). Physical activity was measured by accelerometry and was expressed as average intensity (counts/minute) and amount of time (minutes/day) spent engaging in moderate- to vigorous-intensity physical activity (MVPA). Time spent in sedentary behaviors was also objectively measured. Cardiorespiratory fitness was measured by means of the 20-m shuttle run test. Level of maternal education was reported by the adolescents. A higher proportion of boys (56.8% of boys vs. 27.5% of girls) met the physical activity recommendations of at least 60 minutes/day of MVPA. Adolescents spent most of the registered time in sedentary behaviors (9 hours/day, or 71% of the registered time). Both average intensity and MVPA were higher in adolescents with high cardiorespiratory fitness, and sedentary time was lower in the high-fitness group. There were no physical activity or sedentary time differences between maternal education categories. These data provide an objective measure of physical activity and amount of time spent in sedentary behaviors in a relatively large number of European adolescents. [ABSTRACT FROM PUBLISHER]

Abstract: Objective: To measure the carotid intima-media-thickness (cIMT) and to assess its determinant factors in healthy adolescents. Methods: 319 adolescents aged 12.5–17.5 years (135 boys, 184 girls) were enrolled in this cross-sectional study. cIMT and carotid diameter were measured by high-resolution B-mode ultrasound. Anthropometric parameters, blood pressure, physical activity (PA), aerobic fitness and dietary intakes were assessed. Socioeconomic status was determined with the family affluence scale (FAS 4). Serum biological markers (lipids, glucose, high-sensitivity C-reactive protein, soluble adhesion molecules) were measured in a subsample of 96 adolescents. Results: Multiple regression analysis showed that cIMT was positively associated with truncal fat (p = 0.021) and negatively with FAS 4 (p = 0.002) independently of age and blood pressure. There were no significant associations between cIMT and PA, fitness and dietary intakes. In the subsample soluble intercellular adhesion molecule 1 was positively correlated with cIMT (p = 0.017), independently of truncal fat, age and blood pressure. Conclusions: Low socioeconomic conditions and increased truncal fat are associated with greater carotid intima-media-thickness in adolescents. [Copyright &y& Elsevier]

Backgroud: Several lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents.Methods: Participants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pécs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringá/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed.Results: The Healthy Eating cluster was negatively associated with DBP in European girls, β=-2.46 (-4.62; -0.30), and with SBP in Brazilian boys, β=-2.79 (-3.10; -0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, β=4.54 (1.29; 7.79), and in Brazilian boys, β=4.10 (0.80; 7.40).Conclusion: The Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents. [ABSTRACT FROM AUTHOR]