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Vulvar lesions are clinically challenging for physicians because the differential diagnosis may include many entities. Vulvar edema is one of the most frequent symptoms and is normally attributed to a local cause. Herein, we present a case report of vulvar Crohn disease (VCD) in a 9-year-old girl, in which skin lesions preceded the systemic gastrointestinal symptoms. Both clinical features and histopathological findings guided us to an early Crohn disease (CD) diagnosis. Dermatologists often have the opportunity to detect systemic diseases at early stages. A good knowledge of the CD skin manifestations could lead to an early CD diagnosis, especially in children. The suspicion of CD in those cases in which cutaneous involvement precedes digestive symptoms is crucial to prevent future psychological and physical consequences.

Background Coronavirus disease 2019 (COVID-19) is a systemic multi-organ viral illness. Previous studies have found that many patients had a procoagulant state and/or severe hypoxemia with relatively well-preserved lung mechanics. Mechanisms underlying the damage to vascular tissues are not well-elucidated yet. Histological data in COVID-19 patients are still limited and are mainly focused on post-mortem analysis. Given that the skin is affected by COVID-19 and the relative ease of its histological examination, we aimed to examine the histology of skin lesions in COVID-19 patients to better understand the disease's pathology. Methods Five skin lesions from COVID-19 adult patients were selected for a deep histological tissue examination. Results A strong vasculopathic reaction pattern based on prominent vascular endothelial and myointimal cell growth was identified. Endothelial cell distortion generated vascular lumen obliteration and striking erythrocyte and serum extravasation. Significant deposition of C4d and C3 throughout the vascular cell wall was also identified. A regenerative epidermal hyperplasia with tissue structure preservation was also observed. Conclusions COVID-19 could comprise an obliterative microangiopathy consisting on endothelial and myointimal growth with complement activation. This mechanism, together with the increased vascular permeability identified, could contribute to obliteration of the vascular lumen and hemorrhage in COVID-19. Thus, anticoagulation by itself could not completely reverse vascular lumen obliteration, with consequent increased risk of hemorrhage. Findings of this study could contribute to a better understanding of physiopathological mechanisms underlying COVID-19 on living patients and could help further studies find potential targets for specific therapeutic interventions in severe cases.

Background: Severe coronavirus disease 2019 (Covid-19) is a systemic multi-organ viral invasion. Previous studies found that many patients had a procoagulant state and/or severe hypoxemia with relatively well-preserved lung mechanics. Mechanisms underlying the vascular and its surrounding tissue are not well known yet. Histological data in Covid-19 tissues´ patients are still limited and mainly focused on post-mortem analysis. Since SARS-CoV-2 largely affects cutaneous tissue, we aim to examine in depth skin lesions related to Covid-19 in order to understand better how the disease might affect living tissue.Methods: Five skin lesions from Covid-19 adult patients were selected for histological tissue examination. Vast amount of data of immunohistochemistry (IHC) and direct immunofluorescent (DIF) were part of the assessment. Results: A common strong vasculopathic reaction pattern based on prominent vascular endothelial and myointimal cellgrowth was identified. Endothelial cell distortion generated vascular lumen obliteration and a strike erythrocyte and serum extravasation. Extensive significant vascular C4d and C3 deposition throughout vascular cell wall was also identified. A regenerative epidermal hyperplasia with tissue structure preservation was found. Conclusions: Covid-19 could comprise an obliterative micro-angiopathy consisting on endothelial and myointimal intensive growth with complement activation. This mechanism, together with increased vascular permeability identified, could contribute to obliterative vascular lumen and hemorrhage in Covid-19. Activation of the complement and angiogenic pathways could have an important role in inducing and maintaining this vasculopathic reaction pattern. Thus, anticoagulation by itself could not completely reverse vascular lumen obliteration, with consequent hemorrhagic increased risk associated. Skin is the largest organ in the body, the most accessible one and can mirror other organs of the body. Findings of this study could contribute to a better understanding of physio-pathological mechanisms underlying SARS-CoV-2 infection on living tissue and could help further studies find potential targets for specific therapeutic interventions in Covid-19 severe patients.

Rosacea fulminans (RF) is a rare dermatological condition which occurs exclusively in women and it is characterized by a sudden onset of painful papules, pustules, cysts, and nodules on the face. A 28-year-old woman was referred to our clinic due to a painful facial eruption within the 13th week of her second pregnancy. After physical examination, the diagnosis of RF during pregnancy was established. Several treatments were used: mupirocin ointment, topical zinc oxide, topical erythromycin, oral erythromycin, metronidazole gel, oral metronidazole, oral amoxiciline, and oral prednisone. Finally, the patient was started on 5% permethrin cream with complete clearing of the lesions. Nowadays, a wide range of treatments for rosacea is available: topical metronidazole, oral metronidazole, topical ivermectin, oral tetracyclines, oral isotretinoin, systemic steroids, photodynamic therapy, or pulsed dye laser. However, in pregnant patients, the treatment alternatives are limited. We consider that 5% permethrin cream could be an effective, cheap, and safe treatment not only in regular patients with rosacea but also in pregnant women, representing an important alternative in the context of pregnancy when therapeutic options are limited. To our knowledge, this is the first case of rosacea treated with 5% permethrin cream in monotherapy during pregnancy.

Palisaded encapsulated neuroma is a rare, benign neural tumor. The involvement of the glans penis is rare; few cases have been reported. We present a 52-year-old man with a five-month course of a solitary painless lesion of the glans penis. Full excision of the nodule was performed. Histopathological and immunohistochemical analyses and examination was consistent with a palisaded encapsulated neuroma. We describe one of a few existing cases of this kind of tumor in the glans penis.

This study aimed to assess the effect of rehydration during and after acute aerobic submaximal exercise on total homocysteine (tHcy) concentrations and related parameters in physically active adult males. Twenty trained males (29.4 ± 7.9 years old) completed four exercise tests: two without rehydration during exercise (NH1 and NH2), one with rehydration during exercise using water (H1) and one with rehydration during exercise using an isotonic sports drink (H2). After finishing the exercise tests, subjects followed a rehydration protocol for 2 h. Serum tHcy, vitamin B12, folate, creatine and creatinine were analysed before, after and at 2, 6 and 24 h after exercise. Data were analysed with and without correcting for haemoconcentration to assess the changes in tHcy related. The methylenetetrahydrofolate reductase (MTHFR) 677TT genotype was also analysed. THcy (uncorrected by haemoconcentration) increased significantly after exercise (P

ObjectiveThe present study aimed to examine the association between different breakfast consumption patterns and vitamin intakes and blood vitamin concentrations in European adolescents.DesignBreakfast consumption was assessed by a questionnaire. Vitamin intake was calculated from two 24 h recalls. Blood vitamin and total homocysteine (tHcy) concentrations were analysed from fasting blood samples.SettingThe European Commission-funded HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.SubjectsParticipants were 1058 (52·8 % females) European adolescents (aged 12·5–17·5 years) from ten cities.ResultsLower vitamin D and vitamin C concentrations were observed in male and female breakfast skippers than in consumers (PPPP6and vitamin E than occasional consumers (PConclusionsRegular breakfast consumption is associated with higher blood vitamin D and cobalamin concentrations in males and with higher vitamin D and holo-transcobalamin and lower tHcy concentrations in females. Moreover, breakfast consumption is associated with high intakes of vitamin D and total folate in both sexes, and with high intakes of vitamin B6and vitamin E in females.

Hailey-Hailey disease (HHD) or chronic benign familial pemphigus is an autosomal dominant genodermatosis with complete penetrance characterized by painful vesicles, erosions, and macerated intertriginous skin. We present a 66-year-old woman with a personal 35-year history of pruritic recurrent vesicles and erosions in both axillae and inguinal folds. HHD was confirmed by cutaneous biopsy. Past treatments had failed, including topical corticosteroids, antibiotics and oral doxycycline, minocycline, dapsone, and acitretin. Phototherapy and intralesional injection of toxin botulinum A was performed in the axillae. The patient was started on naltrexone 6.25 mg nightly. Six weeks later, complete clearing was observed. At typical doses, naltrexone blocks μ and δ opiod receptors, thereby blocking the union of β-endorphins at those sites. Paradoxically, at low doses, the partial binding to those receptors leads to a homeostatic increase of opioid receptors and an upregulation of endogenous opioids. Low-dose naltrexone (LDN) may also exert an anti-inflammatory action through its antagonist effect on toll-like receptor 4 found on macrophages. We consider that LDN is an effective and safe alternative for the HHD, representing an important progress in the management of this disease with limited therapeutic options.

Low vitamin D is usual, however, data are limited for elite team players. The aim was to investigate the vitamin D levels in Football Club Barcelona (FCB) first division players of six sport modalities. Ninety-five elite male players (27.3 ± 4.6 y) belonging to FCB provided data for vitamin D throughout a season. In this study, 25(OH)D was measured in serum by chemiluminescent immunoassay. Outdoor/indoor training and supplementation were also considered. Total mean 25(OH)D concentrations were 91.9 ± 23.1 nmol/L in all players, with higher mean levels among supplemented players (94.7 ± 24.3 nmol/L). Around 25% of the team players were below optimal levels (&lt, 75 nmol/L), but none were below 50 nmol/L. Caucasian, supplemented football and handball players had the highest mean vitamin D concentrations over the whole year, whereas basketball players (indoor training) had the lowest ones. The highest rate of vitamin D insufficiency was found in spring (40%). A positive significant effect was observed for the interaction between indoor/outdoor training and supplementation with 25(OH)D concentrations (p &lt, 0.05). Those team players training outdoors with supplementation had higher total vitamin D concentrations than those with indoors training and/or supplementation. A positive interaction of outdoor training with supplementation exists to determine 25(OH)D concentrations in team players.

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., Sources of Funding: 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). 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).

On behalf of the HELENA study group: et al., [Objectives]: To determine dietary patterns (DPs) and explain the highest variance of vitamin B6, folate, and B12 intake and related concentrations among European adolescents., [Methods]: A total of 2173 adolescents who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence study met the eligibility criteria for the vitamin B intake analysis (46% boys) and 586 adolescents for the biomarkers analysis (47% boys). Two non-consecutive, 24-h, dietary recalls were used to assess the mean intakes. Concentrations were measured by chromatography and immunoassay testing. A reduced rank regression was applied to elucidate the combined effect of food intake of vitamin B and related concentrations., [Results]: The identified DPs (one per vitamin B intake and biomarker and by sex) explained a variability between 34.2% and 23.7% of the vitamin B intake and between 17.2% and 7% of the biomarkers. In the reduced rank regression models, fish, eggs, cheese, whole milk and buttermilk intakes were loaded positively for vitamin B intake in both sexes; however, soft drinks and chocolate were loaded negatively. For the biomarkers, a higher variability was observed in the patterns in terms of food loads such as alcoholic drinks, sugars, and soft drinks. Some food items were loaded differently between intakes and biomarkers such as fish products, which was loaded positively for intakes but negatively for plasma folate in girls., [Conclusions]: The identified DPs explained up to 34.2% and 17.2% of the variability of the vitamin B intake and plasma concentrations, respectively, in European adolescents. Further studies are needed to elucidate the factors that determine such patterns., HELENA study received funding from the European Union’s Sixth RTD Framework Programme (Contract FOODCT-2005-007034). Additional support from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd (Oslo, Norway), Abbot Científica S.A. (Spain). This analysis was also supported by the Spanish Ministry of Science and Innovation (JCI-2010-07055) with the contribution of the European Regional Development Fund (FEDER). The first author is supported by a grant from the Spanish Carlos III Health Institute: RD08/0072/0025 (Red SAMID: Maternal, Child Health and Development Research Network).

ObjectiveTo investigate dietary sources of Ca and vitamin D (VitD) intakes, and the associated sociodemographic and lifestyle factors, among European adolescents.DesignLinear regression mixed models were used to examine sex-specific associations of Ca and VitD intakes with parental education, family affluence (FAS), physical activity and television (TV) watching while controlling for age, Tanner stage, energy intake and diet quality.SettingThe Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA)Cross-Sectional Study.SubjectsAdolescents aged 12·5–17·5 years (n 1804).ResultsMilk and cheese were the main sources of Ca (23 and 19 % contribution to overall Ca intake, respectively). Fish products were the main VitD source (30 % contribution to overall VitD intake). Ca intake was positively associated with maternal education (β=56·41; 95 % CI 1·98, 110·82) and negatively associated with TV viewing in boys (β=–0·43; 95 % CI −0·79, −0·07); however, the significance of these associations disappeared when adjusting for diet quality. In girls, Ca intake was positively associated with mother’s (β=73·08; 95 % CI 34·41, 111·74) and father’s education (β=43·29; 95 % CI 5·44, 81·14) and FAS (β=37·45; 95 % CI 2·25, 72·65). This association between Ca intake and mother’s education remained significant after further adjustment for diet quality (β=41·66; 95 % CI 0·94, 82·38). Girls with high-educated mothers had higher Ca intake.ConclusionsLow-educated families with poor diet quality may be targeted when strategizing health promotion programmes to enhance dietary Ca.

Adequate nutrition is needed for the accrual of bone mass during the pre- and postpubertal growth periods. This study aimed to examine the associations between dietary calcium, vitamin D (calciferol), and milk intakes and 25-hydroxyvitamin D [25(OH)D] status and bone mineral content (BMC) and bone mineral density (BMD) in Spanish adolescents, aged 12.5-17.5 years, participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS). Bone mass was measured with dual-energy X-ray absorptiometry and diet via 2 nonconsecutive 24-h dietary recalls (n=227; 48% males). A random subsample of 101 adolescents (46% males) had available measures of 25(OH)D. Multiple linear regression was applied. Significant adjusted associations were observed in males, among milk intakes and BMC and BMD. Also in males, whole-body, head, and right arm BMD were positively related to calcium intakes. In females, 25(OH)D was positively related among others to whole-body, subtotal, and left and right arm BMC and BMD. It could be speculated that diet is not a limiting factor of bone mass development in this group of healthy adolescents, and further research on the effect of other factors in addition to diet in a larger sample should be undertaken.

11 páginas, 2 figuras, 3 tablas..-Valtueña, J.,Moreno, L.A, et al., Evidence indicates low 25-hydroxyvitamin D [(25(OH)D] concentrations in European adolescents. Identification of potential determinants is therefore essential to guide public health initiatives aiming at optimizing vitamin D status across Europe. The aim of the study was to identify potential influencing factors of 25(OH)D concentrations in European adolescents aged 12.5 to 17.5 y, participating in the multi-centre cross-sectional Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. A subset of 1,006 participants (46.8% males) was drawn from the main study. Measures of body composition, biochemical markers, socioeconomic status, dietary intake, physical activity, fitness, sleep time and vitamin D genetic polymorphism (rs1544410) were assessed. Stepwise multivariate linear regression analysis was conducted stratified by gender. In males, linear regression of 25(OH)D, suggested that (1) winter season (β= -0.364; p

The aim of this document (written by professionals in physical activity and health EXERNET - Red Española de Investigación en Ejercicio Físico y Salud-) is to propose a list of recommendations about the practice of the physical and sport activity that in an individual, familiar and institutional level, help to prevent and manage the obesity in childs and teenagers.El propósito del presente documento es proponer desde el grupo de expertos en ejercicio físico y salud de EXERNET (Red Española de Investigación en Ejercicio Físico y Salud) una serie de recomendaciones sobre la práctica de la actividad física y deportiva que a nivel individual, familiar e institucional ayuden a prevenir y tratar la obesidad infantil y juvenil, basadas en la evidencia científica actual.

El propósito del presente documento es proponer desde el grupo de expertos en ejercicio físico y salud de EXERNET (Red Española de Investigación en Ejercicio Físico y Salud) una serie de recomendaciones sobre la práctica de la actividad física y deportiva que a nivel individual, familiar e institucional ayuden a prevenir y tratar la obesidad infantil y juvenil, basadas en la evidencia científi ca actual. Sin financiación 0.747 JCR (2016) Q4, 68/81 Nutrition & Dietetics 0.400 SJR (2016) Q3, 1567/2886 Medicine (miscellaneous), 73/131 Nutrition and Dietetics No data IDR 2016 UEM

Current research in adults indicates that fruit and vegetable (FAV) consumption increases serum levels of vitamins C, E and folate of β-carotene and reduces homocysteine concentrations. The aim of the present study was to examine the association of FAV consumption on vitamin intakes and their impact on blood vitamin concentrations in European adolescents.This multi-center cross-sectional study included 702 (53.7% females) adolescents, aged 12.50-17.49 years, from 10 European cities. Two independent self-administered 24 h dietary recalls were used to estimate the adolescent's diet. The total energy, vitamins and FAV consumption were calculated. Adolescents were categorized into three groups: (i) very low FAV intake (200 g/day); (ii) low FAV consumption (200-399 g/day) and (iii) adequate FAV consumption (⩾400 g/day). Adolescent's fasted blood samples were taken for their analysis on vitamin concentrations.The main results showed that those adolescents meeting the FAV recommendation, classified as FAV adequate consumers, presented higher intake of energy and some vitamins as B6, total folic acid, C, E and β-carotene compared with FAV very low consumers (P0.05). Regarding their blood status, male adolescents who had a very low FAV consumption presented lower plasma folate, RBC folate blood concentrations compared with adequate FAV consumers (P0.05). Female adequate FAV consumers had higher concentrations of pyridoxal phosphate (PLP), plasma folate, RBC folate, vitamin C, β-carotene and α-tocopherol compared with very low and low consumers (P0.05).Having a FAV dairy intake above 400 g/day is associated with higher vitamin intake and blood vitamin concentrations, especially for antioxidant and B-vitamins concentrations.

There is a lack of studies that analyze the association between micronutrient-related biomarker status and physical fitness in adolescents. In the present study, biochemical parameters for iron and vitamin status were studied, along with objective measures of physical fitness in healthy male and female European adolescents. One thousand eighty-nine adolescents (580 girls, 12.5-17.5 yr) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were included. Hierarchical linear models were performed to determine the associations between micronutrient biomarkers and physical fitness. Age, seasonality, latitude, body mass index, menarche (in girls), and physical activity were used as covariates. For cardiorespiratory fitness, concentrations of hemoglobin, retinol, and vitamin C in male adolescents and β-carotene and 25(OH)D in female adolescents were associated with maximal oxygen consumption. For muscular fitness, concentrations of hemoglobin, β-carotene, retinol, and α-tocopherol in male adolescents and β-carotene and 25(OH)D in female adolescents were associated with better performance of the standing long jump test. In summary, concentrations of hemoglobin and most antioxidant vitamins in male adolescents and β-carotene and 25(OH)D in female adolescents were positively associated with cardiorespiratory and muscular fitness, after controlling for relevant confounders. The associations between physical fitness and iron or vitamin status observed in this cross-sectional study in adolescents should be followed up by a study specifically designed to evaluate causal relationships. Copyright © 2012 the American Physiological Society.

Background: Vitamin D is essential for a vast number of physiologic processes, and thus adequate levels are necessary or advantageous for optimal health. During childhood and adolescence, an adequate vitamin D status is needed due to its important role in cell growth, skeletal structure, and development. Aims: To review the extraskeletal effects of vitamin D, focusing especially on children. Methods: Narrative review. Results: Low vitamin D concentrations seem to be significantly associated with all-cause mortality. Regular sunlight exposure and vitamin D supplementation in early childhood may offer protection against the development of type 1 diabetes. Epidemiological evidence supports the importance of adequate vitamin D levels for the prevention of a number of cancers, mainly breast and colorectal ones. There seems to be an inverse relation between 25(OH)D serum concentrations and cardiovascular diseases, some components of the metabolic syndrome, and physical fitness. Conclusions: Lifestyle and appropriate nutrition may prevent the long-term effect of hypovitaminosis D beyond mineral and bone metabolism.

there is hardly any reference in scientific literature regarding anthropometric characteristics, body composition and somatotype of hand Basque pelota players (pelotaris).the aim of this research was to analyze and compare the anthropometry features and body composition of professional pelotaris and under-23 (U23) pelotaris, to create an anthropometric profile of this sport.the participants were ten U23 pelotaris, and eight professional pelotaris. Anthropometric measurements were taken following the International Society of Advancement of Kinanthropometry (ISAK) protocol. Fat mass (FM) was calculated using the Yushasz equation modified by Carter and muscle mass (MM) using Lee equation. For the somatotype components, the Carter y Heath equation was applied. The hydration level (kg of body water) of the players was measured with a four-pole kind bioelectrical impedance (BIA) analyzer. Spss was used for the statistical analysis.professional pelotaris have significantly lower FM (p0.05) and lower sum of 4, 6 and 8 skinfolds (p = 0.001), higher MM (p = 0.015), and a less endomorphic somatotype (p0.001) than U23 pelotaris. Professionals have a greater amount of body water (p = 0.001) and a larger bistyloid diameter (p = 0.014). Professional pelotaris have a morphotype characterized by a low FM 8.9 ± 1.1% and medium MM 47 ± 1.7%, height of 183.0 ± 7.1 cm and BM of 85.9 ± 7.6 kg.The main results of the present study show that non-modifiable anthropometric features by training (e.g. height, arm span and wrist breadth) are important to become a professional pelotaris. Moreover, training and diet related features have been showed to be better in professional pelotaris (low FM, higher MM and high body water amount) than U23 pelotaris.Introducción: casi no hay ninguna referencia sobre las características antropométricas, la composición corporal y el somatotipo de la mano de los jugadores de pelota vasca (pelotaris) en la literatura científica. Objetivos: el objetivo de esta investigación fue comparar la composición corporal de pelotaris profesionales y sub-23 para crear el perfil antropométrico de este deporte. Métodos: participaron diez pelotaris sub-23 y ocho pelotaris profesionales. Las medidas antropométricas fueron recogidas siguiendo el protocolo de la Sociedad Internacional de Promoción de Protocolo Cineantropometría (ISAK). La masa grasa (FM) se calculó utilizando la ecuación Yushasz modificada por Carter, y la masa muscular (MM) mediante la ecuación de Lee. Los componentes del somatotipo fueron estimados mediante la ecuación Carter y Heath. El nivel de hidratación de los pelotaris se midió con un analizador tetrapolar de impedancia bioeléctrica (BIA). Resultados: los pelotaris profesionales tienen significativamente menor FM (en % (p = 0,001); en kg (p = 0,025) y en los sumatorios de 4, 6 y 8 pliegues cutáneos (p = 0,001); mayor MM (p = 0,015) y un menor componente endomórfico (p0,001) que los pelotaris sub-23. Asimismo, los profesionales tienen una mayor cantidad de agua corporal (p = 0,001) y un diámetro mayor biestiloideo de muñeca (p = 0,014). Los pelotaris profesionales son un morfotipo caracterizado por una baja FM (8,9 ± 1,1%) y una intermedia MM (47 ± 1,7%), además de tener una altura de 183,0 ± 7,1 cm y un peso de 85,9 ± 7,6 kg. Conclusión: los principales resultados de este estudio mostraron que las características antropométricas no modificables por el entrenamiento (por ejemplo, altura, envergadura y diámetro de la muñeca) son componentes importantes para convertirse en un pelotari profesional. Por otra parte, las características relacionadas con el entrenamiento y la dieta han mostrado ser mejores en los pelotaris profesionales (menor FM y mayor MM).

Source: doi: 10.3945/ajcn.115.120873 Background:Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys.Objective:This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe.Design:The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography–tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data.Results:An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations Conclusions:Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.

Background: This cross-sectional study aimed to look for an association in young children between whole body bone mineral content (BMC) and areal bone mineral density (aBMD) and dairy consumption as well as sedentary behaviour (SB) and physical activity (PA). Moreover, we investigated whether there was an interaction effect between dairy consumption and SB or PA on BMC and aBMD. Methods: Healthy children (6-12 years) were recruited from primary schools. Body composition and whole body bone mass were measured with dual-energy X-ray absorptiometry (DXA), dairy consumption was assessed with a food frequency questionnaire (FFQ) and PA and SB with an accelerometer. In total, 272 children underwent a DXA scan. Complete FFQ data were available for 264 children and 210 children had matching data from accelerometry recordings. Regression analyses were used to study the associations between (1) BMC and aBMD and (2) dairy consumption, SB and PA, adjusting for age, gender, pubertal stage, height and body composition. Results: Dairy consumption was positively associated with whole body BMC and aBMD (absolute value as well as z-score), after correction for relevant confounders. SB was negatively associated with aBMD z-score and light PA was positively associated with both BMC and aBMD z-score. No gender differences were found. Moreover, an interaction effect between vigorous PA (VPA) and dairy consumption on aBMD (z-score) and BMC z-score was found, indicating that children with both high VPA and high dairy consumption had higher values for BMC and aBMD of the whole body minus the head. Conclusion: Already at young age, PA and dairy consumption positively influence whole body bone mass assessed by DXA. Moreover, this study indicates clearly that SB is negatively associated with whole body bone density. Promoting regular PA and sufficient dairy consumption in young children and limiting SB can be expected to positively influence their bone mass accumulation, which can help in the prevention of osteoporosis later in life.

International audience; Objective: To assess the relationships among physical activity, measured objectively, and attention capacity in European adolescents.Study design: The study included 273 adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Participants wore a uniaxial accelerometer for 7 days to measure physical activity. The d2 Test of Attention was administered to assess attention capacity. Multivariate analyses were used to study the association of attention capacity with each measure of physical activity. Receiver operating characteristic analysis was performed to determine thresholds that best discriminate between low and good attention capacity.Results: After controlling for potential confounding variables (age, sex, body mass index, parental educational level, fat mass, aerobic fitness, and center), adolescents' attention capacity test performances were significantly and positively associated with longer time spent in moderate or moderate-to-vigorous physical activity (MVPA) in free-living conditions (P < .05). Receiver operating characteristic curve analyses revealed that the physical activity thresholds that best discriminated between low/good attention capacities were ≥41 min·day−1 for moderate, ≥12 min·day−1 for vigorous, and ≥58 min·day−1 for MVPA.Conclusion:These findings suggest that promoting MVPA may be have a beneficial effect on attention capacity, an important component of cognition, in adolescents.

Aim: To assess the dietary iron intake and the iron status of Spanish junior athletes and its importance on performance, and to discuss abount the consequences of an iron deficiency. Material and methods: Forty six soccer and eleven basketball players aged 17-21 years (mean age 18.2 +1.1) who played in the Spanish national junior soccer and basketball league, respectively, who had neither drugs, medicines intake nor illness during the study which altered the appetite or some studies parameters, took part in the study. Dietary intake was assessed by means of a 7-day weighed food intake record. Iron status was evaluated by means of a complete hemogram, serum iron, ferritin, transferrin and TIBC. Results: Mean iron intake was 19.24±4.58 mg/day. Mean analytical data were all between reference ranges. Basketball players had higher intake levels compared with soccer ones (22.1+6.4 and 19.2+3.9 mg/day, respectively; p< 0.05 ). Nevertheless, basketball players had lower levels of mean red blood cells, haemoglobin, hematocrit and the mean corpuscular volumes comparing with soccer players. Conclusions: During adolescence, iron requirements are very high which could place adolescent athletes in a high risk group for iron deficiency and iron deficiency anaemia. In the current research, the population studied shows an acceptable iron status although there are 3% of iron deficiency anaemia cases. Key words / palabras calve : iron | spanish junior athletes | soccer players | basketball players | performance | hierro | atletas junior espanoles | jugadores de baloncesto | jugadores de futbol | desarrollo Resumen Objetivos: Valorar la ingesta diaria y el estatus de hierro de los atletas junior espanoles y su importancia sobre el rendimiento, asi como lo que respecta a las consecuencias que tiene una deficiencia de hierro. Material y metodos: Cuarenta y seis jugadores de futbol y once de baloncesto con edades comprendidas entre los 17 y 21 anos (la media de edad 18.2 + 1.1) que jugaban en la liga junior nacional de futbol y baloncesto, respectivamente, y que no tomaban drogas, medicinas ni presentaban ninguna enfermedad durante el desarrollo del estudio que pudiera alterar el apetito o algunos de los parametros objeto de estudio, tomaron parte en este estudio. La ingesta dietetica se cuantifico mediante la tecnica de registro de consumo de alimentos durante 7 dias consecutivos. El estatus de hierro se evaluo por un completo hemograma, hierro serico, ferritina, transferritina y TIBC. Resultados: La media de ingesta de hierro fue de 19.74±4.58 mg/dia. Los datos analiticos significativos estaban todos entre los rangos de referencia. Los jugadores de baloncesto presentaron una ingesta significativamente superior que los de futbol (22.1±6.4 y 19.2±3.9 mg/dia). Sin embargo, los jugadores de baloncesto presentaron valores inferiores para los hematies, hemoglobina, hematocrito y de los valores corpusculares medios al compararlos con los jugadores de futbol. Conclusiones: Durante la adolescencia estan aumentadas las necesidades de hierro, por lo que los adolescentes deportistas podrian ser un grupo de riesgo de padecer deficiencia de hierro y anemia del deportista. En la presente investigacion, la poblacion objeto de estudio presenta unos valores aceptables de estatus en hierro pero habiendo un 3% de casos con anemia por deficiencia de hierro. doi:10.5232/ricyde2006.00405 --------------------------------------------------------------------- References/referencias Biancotti PP, Caropreso A, Di Vincenzo GC, Ganzit GP, Gribaudo CG. Hematological status in a group of male athletes of different sports. J Sports Med Phys Fitness. 1992;32(1):70-5. PMid:1405578 Brownlie T, Utermohlen V, Hinton PS, Giordano C, Haas JD. 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The purpose of this study was to identify the relevance of a set of risk factors for insulin resistance in adolescents from Europe and to consider their possible gender-specific associations. The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) was conducted in 1053 European adolescents (mean age, 14.9 years) in a school setting in 9 countries. Three anthropometric markers of body fat and a dietary index were calculated. Total energy intake was estimated from a questionnaire. C-reactive protein, leptin, and vitamin D were assessed, and physical activity, cardiorespiratory fitness, and muscular strength were measured. Center, socioeconomic status, pubertal status, and season were used as potential confounders. The main outcome was the homeostasis model assessment used as a marker of insulin resistance. Correlations, analyses of covariance, and logistic regression models were used. In males, leptin was the only risk factor for insulin resistance after adjusting for confounders including markers of body fat (odds ratios (ORs) from 1.49 to 1.60). In females, leptin, vitamin D, and fitness were the remaining independent risk factors for insulin resistance after adjustments (OR 2.11; 95% confidential interval (CI) 1.29-3.45; OR 0.50, 95% CI 0.31-0.80; and OR 0.54, 95% CI 0.33-0.87, respectively). Our observations suggest a gender dimorphism in the identification of risk factors for high insulin resistance. Preventive strategies should focus on improving modifiable factors such as cardiorespiratory fitness and on ensuring vitamin D sufficiency. Randomized controlled trials focusing on these strategies are necessary to test their efficacy.

© 2014, Springer-Verlag Berlin Heidelberg. Purpose: To evaluate total, energy-adjusted dietary fiber (DF), water-soluble fiber (WSF), and water-insoluble fiber (WIF) intakes in European adolescents and to investigate their association with indicators of adiposity and serum biomarkers. Methods: This study, conducted from 2006 to 2007, included 1804 adolescents aged 12.5–17.5 years (47 % males) from eight European cities completing two non-consecutive computerized 24-h dietary recalls. GLM multivariate analysis was used to investigate associations. Results: Mean DF intake (20 g/day) of the sample met the European Food Safety Authority recommendation, but was below those of the World Health Organization and of the Institute of Medicine. Total DF, WSF and WIF intakes were higher in males (P, The HELENA-study took place with the financial support of the European Community Sixth RTD Framework Programme. This work was also partially supported by the European Union, in the framework of the Public Health Programme, the Swedish Council for Working Life and Social Research, the Spanish Ministry of Education, Spanish Ministry of Science and Innovation (AGL2007-29784-E) and the Spanish Ministry of Health, Maternal, Child Health and Development Network

High levels of homocysteine (Hcy) have been identified as a cardiovascular risk factor. Regarding physical exercise, the results are contradictory.The aim of this study was to determine the influence of maximal intensity exercise and submaximal constant exercise on total serum homocysteine concentrations (tHcy) and other related parameters.Ten physically active male subjects (mean age: 23.51 ± 1.84), performed two treadmill tests, a maximal test and a stable submaximal test at an intensity of 65% of maximal oxygen uptake (VO2max). Serum concentrations of tHcy, Folate, Vitamin B12 and creatinine were analysed before and after each test.Significant increase in serum tHcy concentrations after the maximal (p0.05) and submaximal (p0.01) tests were observed. Folate and vitamin B12 concentrations also increased significantly after both tests (p0.05). Creatinine levels increased only after the maximal test (p0.001). A statistically significant inverse relationship was found between folate and tHcy concentrations (p0.05) at all the measurement points.THcy levels increased significantly after acute exercise in both maximum and submaximal intensity exercises.Introducción: Niveles altos de Homocisteína (Hcy) se han identificado como un factor de riesgo cardiovascular. En relación con la práctica de ejercicio físico, los resultados son contradictorios. Objetivos: El objetivo del presente estudio fue determinar la influencia de ejercicios agudos máximo y submáximo sobre las concentraciones de homocisteína total (tHcy) y otros parámetros sanguíneos relacionados. Material y métodos: Diez varones (23,5 ± 1,8 AÑOs) físicamente activos realizaron una prueba incremental máxima y otra submáxima a una intensidad del 65% del consumo máximo de oxígeno (VO2max) en tapiz rodante. Se analizaron antes y después las concentraciones de tHcy, folato, vitamina B12 y creatinina séricas. Resultados: Las concentraciones de tHcy séricas aumentaron significativamente tras las pruebas de intensidad máxima (p0,05) y submáxima (p0,01). El folato y la vitamina B12 también aumentaron significativamente tras ambas pruebas (p0,05). Las concentraciones de creatinina aumentaron significativamente únicamente en la prueba máxima (p0,001). Se encontró una relación inversa entre los niveles de folato y de tHcy en todos los puntos (p0,05). Conclusión: Se observaron niveles altos de homocisteína después del ejercicio agudo tanto máximo como submáximo.

BACKGROUND AND AIMS The association between bone turnover markers and bone mass in adolescence is not clear. We aimed to evaluate the associations between bone turnover markers and bone mineral content (BMC), density (BMD) and area (BMA). SUBJECTS A total of 56 adolescents (25 boys, 12.5-17.5 years) participated in the study. METHODS Bone mass and physical activity (PA) were measured using dual energy X-ray absorptiometry and accelerometers. Osteocalcin and amino-terminal propeptide of type I procollagen (PINP), as markers of bone formation, and beta-isomer of the C-terminal telopeptide of type I collagen, as marker of bone resorption were also measured. Sexual maturation, weight, height and average PA were considered as confounders. RESULTS Positive correlations (Pearson) were observed among the three bone turnover markers (r = 0.7-0.9). Stepwise multiple linear regression analyses showed that PINP was strong and negatively associated with BMC, BMD and BMA in girls, explaining 24.9% of the variance in BMC, 25.6% in BMD and 16.3% in BMA. CONCLUSION PINP is a strong predictor of bone related variables in pubertal girls.

La adolescencia es un período de crecimiento y desarrollo crítico e importante para la adquisición de hábitos saludables, en los que tanto la alimentación como la actividad física tienen un papel destacado. Junto con el primer año de vida, los requerimientos de energía y nutrientes son mayores que en cualquier otro periodo. Dentro de la nutrición, las vitaminas se ven involucradas en múltiples procesos celulares y tisulares, y sus deficiencias se vinculan a enfermedades crónicas degenerativas en la edad adulta como las cardiovasculares, cáncer, diabetes y osteoporosis, pero cuyos factores de riesgo se establecen a edades más tempranas. Las concentraciones sanguíneas de vitaminas están influenciadas en gran medida por la ingesta dietética, pero existen otros factores del individuo, entre los que cabe citar la composición corporal, la actividad física y condición física que, junto a la genética, podrían desempeñar un papel crucial. La presente memoria de Tesis Doctoral tiene como objetivo analizar el estado en vitaminas liposolubles y su relación con diversos factores de salud, entre los que destacan la composción corporal, hábitos dietéticos, actividad física y condición física en adolescentes Europeos. El trabajo está basado en los datos del estudio HELENA (“Healthy Lifestyle in Europe by Nutrition in Adolescence”). Se han analizado un total de 1089 adolescentes procedentes de diez ciudades en nueve paises europeos. Los principales resultados de este trabajo indican; a) La existencia de un estado deficiente en vitaminas liposolubles en adolescentes Europeos, especialmente de vitamina D, que alcanza valores del 80%. b) La estación del año, la latitud, el índice de masa corporal, la condición física, la ingesta de calcio dietético, los suplementos vitamínicos y la edad son las variables más relacionadas con el estado de vitamina D. c) A su vez, la capacidad cardiorrespiratoria puede predecir los niveles de vitamina D en los chicos, mientras que la fuerza muscular y masa magra parecen influir en los niveles de vitamina D en las chicas. La grasa corporal y el índice de masa corporal se correlaccionan negativamente con los niveles de vitamina D, especialmente en chicos. d) Un estado de vitamina D óptimo provoca una mejora de la masa ósea sólo cuando se tiene un nivel adecuado de actividad física. e) Se identifica la necesidad de establecer un consenso sobre los rangos aceptables y puntos de corte para las concentraciones sanguíneas de estas vitaminas en este grupo de población, ya que los actuales están extrapolados de la población adulta ABSTRACT Adolescence is a critical period of physiological growth and development as well as for the acquisition of healthy behaviors where both diet and physical activity play a major role. Apart from the first year of life, both energy and nutrient requirements are greatest during adolescence and the way to spend this energy by movement is also crucial. Vitamins are specifically involved in multiple cellular and tissue processes, and there is increasing evidence that deficiencies at these early ages could contribute to risk factors of chronic diseases like cardiovascular and cerebrovascular disease, cancer, diabetes and osteoporosis in adulthood, regardless data are scarce for younger ages. Vitamin concentrations are largely influenced by diet but other individual factors like body composition, physical activity or fitness together with genetics could play also an important role. The current thesis analyzes the liposoluble vitamin status in European adolescents and their relation with several health related factors, like body composción, dietary intake, physical activity and fitness. The work is based on data from the HELENA study ("Healthy Lifestyle in Europe by Nutrition in Adolescence"), for which a total of 1089 adolescents from ten different cities, in nine European countries were recruited. The main outcomes of this thesis are: a) There is a high liposoluble vitamin deficiency prevalence in European adolescents, specifically for vitamin D, which is presenting almost 80% of the adolescents. b) Season, latitude, BMI, fitness, dietary calcium intake, supplements intake and age are highly related to 25(OH)D concentrations found in European adolescents. c) Cardiorespiratory fitness may predict 25(OH)D concentrations in male adolescents, whereas upper limbs muscular strength and FFM may predict 25(OH)D concentrations in young females. Fat mass and BMI are inversely related to 25(OH)D concentrations, especially in males. d) The effect of 25(OH)D concentrations on bone mineral content in adolescents depends on physical activity levels. e) There is a need to establish a consensus on acceptable ranges and cut-offs of blood concentrations of these vitamins during adolescence, as currently they are extrapolated from adults.

The aim of the study was to examine the association of muscular strength with markers of insulin resistance in European adolescents. The study comprised a total of 1,053 adolescents (499 males; 12.5-17.5 years) from ten European cities participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study. Muscular strength was measured by the handgrip strength and standing long jump tests. Cardiorespiratory fitness was measured by the 20-m shuttle run test. Fasting insulin and glucose were measured and the homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) indices were calculated. Weight, height, waist circumference and skinfold thickness were measured, and body mass index (BMI) was calculated. In males, the handgrip strength and standing long jump tests were negatively associated with fasting insulin and HOMA (all P < 0.05) after controlling for pubertal status, country and BMI or waist circumference. When skinfold thickness was included in the model, the association became non-signiWcant. In females, the standing long jump test was negatively associated with fasting insulin and HOMA (all P < 0.001) after controlling for pubertal status, country and surrogate markers of total or central body fat (BMI, waist circumference or skinfold thickness). Findings were retained in males, but not in females after controlling for cardiorespiratory fitness. The findings of the present study suggest that preventive strategies should focus not only on decreasing fatness and increasing cardiorespiratory fitness but also on enhancing muscular strength. © Springer-Verlag 2011.

It is important to be able to evaluate vitamin status correctly at any age, but this is especially vital during adolescence since there are higher requirements for healthy growth and development. However, there are no currently available B-vitamin reference values for healthy adolescents. The aim of the present study is to assess the vitamin B status in European adolescents in order to contribute to the development of reference values for selected B-vitamins and total homocysteine (tHcy). Within the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study, a sub sample of 1051 (499 males, 552 females) adolescents from ten European cities aged 12.5 to 17.49 were analyzed for fasting plasma folate (PF), red blood cell (RBC) folate, serum cobalamin (Cbl), holo-transcobalamin (Holo-TC), Vitamin B(6) (PLP), and tHcy. The level of significance was set at P < .05. Following the current cut-off for adults, 2% had low Cbl and 5% had low holo-TC concentrations. Low concentrations of both PF and RBC folate were identified in 10%. Five percent had PLP concentrations

This study aims to analyse the association of European adolescents' ready-to-eat-cereal (RTEC) consumption frequency with their dietary intake by applying the concept of diet quality index and nutritional status.From the multi-centre European HELENA study, relevant data were available in 1,215 adolescents (12.5-17.5 years). RTEC consumption was identified from a food frequency questionnaire. A diet quality index, daily nutrient intakes and daily milk/yoghurt and fruit intake were calculated from two 24-h dietary recalls. BMI, waist and hip circumference and body fat were measured for body composition. Cross-sectional regression analyses were adjusted for sex, age, socio-economic status, city and breakfast skipping. Differences in sub-regions within Europe were explored.RTEC consumers showed a more favourable daily micronutrient intake (vitamin B2, B5, B7, D, calcium, phosphorus and potassium), a better diet quality index, more frequent fruit (57 vs. 51%) and milk/yoghurt consumption (81.2 vs. 56%) and less breakfast skipping (25.1 vs. 36.7%). No differences in energy and macronutrient intake were observed. Daily RTEC consumers were 57% less likely to be overweight than RTEC non-consumers but did not differ in glucose and lipid status (N = 387).This is the first comprehensive pan-European survey elucidating socio-demographic determinants of European adolescents' RTEC consumption and indicating better dietary habits in RTEC consumers. The improved dietary profile was reflected in a more beneficial body composition. Our results have also shown the advantage of using an all-integrating diet quality index by capturing the diet complexity.

Objective:Neuromedin B (NMB) is a bombesin-like peptide, which inhibits food intake and modulates stress-related behaviour. An NMB gene polymorphism (P73T) has been earlier associated with obesity and abnormal eating behaviour in adults.Methods:The association between four NMB polymorphisms and obesity-related phenotypes was investigated in the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (n1144, 12-17-year-old European adolescents). This population was genotyped for the NMB rs1107179, rs17598561, rs3809508 and rs1051168 (P73T) polymorphisms. Obesity was defined according to Cole et al. (BMJ 2000; 320:1240-1243) criteria; eating behaviour was assessed by the Eating Behaviour and Weight Problems Inventory for Children (EWI-C) and the food choices and preferences questionnaires. Familial socioeconomic status (SES) was assessed through the parents educational level.Results:Only the genotype distribution of rs3809508 differed according to obesity status, as the TT genotype was more frequent in obese than in non-obese adolescents (8.6% vs 3.1%, P=0.05; adjusted odds ratio for obesity (95% confidence interval): 2.85 (1.11-7.31), P=0.03). Moreover, TT subjects had higher body mass index (22.8±4.4 kg m-2 vs 21.33.7 kg m -2, P=0.02), waist circumference (75.8±9.7 cm vs 72.2±9.3 cm, P=0.006), waist-to-hip ratio (0.84±0.14 vs 0.79±0.07, P

Background: This study aimed: (i) to describe the patterns of commuting to school in urban Spanish adolescents; and (ii) to examine the associations between active commuting to school (ACS) and socio-economic factors.Methods: From the AVENA Study, 2183 adolescents (1142 females) aged 13-18.5 years were gathered. Mode and time of transportation to school were self-reported by the adolescents. Parental education level (primary, secondary or university degree), parental professional level (managerial, skilled worker or unskilled worker/unemployed) and the type of school (public or private) were self-reported by the parents. The relationships between ACS and socio-economic factors were analysed by binary logistic regression.Results: Nearly

Purpose This study aims to analyse the association of European adolescents’ ready-to-eat-cereal (RTEC) consumption frequency with their dietary intake by applying the concept of diet quality index and nutritional status. Methods From the multi-centre European HELENA study, relevant data were available in 1,215 adolescents (12.5–17.5 years). RTEC consumption was identified from a food frequency questionnaire. A diet quality index, daily nutrient intakes and daily milk/yoghurt and fruit intake were calculated from two 24-h dietary recalls. BMI, waist and hip circumference and body fat were measured for body composition. Cross-sectional regression analyses were adjusted for sex, age, socio-economic status, city and breakfast skipping. Differences in sub-regions within Europe were explored. Results RTEC consumers showed a more favourable daily micronutrient intake (vitamin B2, B5, B7, D, calcium, phosphorus and potassium), a better diet quality index, more frequent fruit (57 vs. 51 %) and milk/yoghurt consumption (81.2 vs. 56 %) and less breakfast skipping (25.1 vs. 36.7 %). No differences in energy and macronutrient intake were observed. Daily RTEC consumers were 57 % less likely to be overweight than RTEC non-consumers but did not differ in glucose and lipid status (N = 387). Conclusion This is the first comprehensive pan-European survey elucidating socio-demographic determinants of European adolescents’ RTEC consumption and indicating better dietary habits in RTEC consumers. The improved dietary profile was reflected in a more beneficial body composition. Our results have also shown the advantage of using an all-integrating diet quality index by capturing the diet complexity.

On behalf of the HELENA Study Group., We examined the association of physical activity (PA), cardiovascular fitness (CVF) and fatness with total homocysteine (tHcy) concentrations in European adolescents. The present study comprised 713 European adolescents aged 14.8±1.2 y (females 55.3%) from the multicenter HELENA cross-sectional study. PA was assessed through accelerometry, CVF by the 20-m shuttle run test, and body fat by skinfold thicknesses with the Slaughter equation. Plasma folate, cobalamin, and tHcy concentrations were measured. To examine the association of tHcy with PA, CVF, and fatness after controlling for a set of confounders including age, maturity, folate, cobalamin, creatinine, smoking, supplement use, and methylenetetrahydrofolate reductase 677 genotype (CC 47%, CT 43%, TT 10%), bivariate correlations followed by multiple regression models were performed. In the bivariate correlation analysis, tHcy concentrations were slightly negatively correlated (p, The HELENA study has taken place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034). Additional support came in the form of by grants from the Spanish Ministry of Education (EX-2007-1124, EX-2008-0641, AP2006-02464; AGL2007-29784-E/ ALI; AP-2005-3827), the Spanish Ministry of Economy and Competitiveness (RYC-2010-05957), Universidad Politécnica de Madrid (CH/018/2008), Swedish Council for Working Life and Social Research, the ALPHA study, a European Union-funded study, in the framework of the Public Health Programme (Ref: 2006120), and the Spanish Ministry of Health: Maternal, Child Health and Development Network (number RD08/0072).