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Abstract Background Osteopetrosis comprises a group of inherited disorders that are rare and result in abnormal bone structure. Bone remodeling is extremely inhibited because osteoclasts are nonfunctional or lacking. This condition causes overgrowth of bone with disappearance of the bone marrow, leading to aplastic anemia; obstruction of nerve passages in the skull leads to blindness and often hearing impairment. In most cases, osteopetrosis results in oral complications such as tooth deformation, hypomineralization, and delayed or absent tooth eruption. The only curative treatment is hematopoietic stem cell transplantation (HSCT). The main treatment of the oral complications during childhood and adolescence consists in protecting the erupted teeth against caries disease through prophylactic treatment aimed at optimal oral hygiene through frequent regular dental visits throughout life. Many patients with osteopetrosis require major oral rehabilitation to treat complications of the disease. Improved results of HSCT increase the likelihood that dental professionals will encounter patients with osteopetrosis. Case presentation In this case report, we show that individuals with osteopetrosis who have severe oral complications can be treated successfully if they are treated for osteopetrosis at an early age. The boy had his dental care in pedodontics, and regular multidisciplinary meetings were held for future treatment planning. At the age of 15, he was then referred for rehabilitation. The initial evaluations revealed no further growth in the alveolar bone. The rehabilitation was done stepwise, with extraction of malformed and malpositioned teeth. Initially, the patient received a removable partial denture followed by reconstruction of the width of the alveolar process, titanium implants, temporary fixed bridges, and finally screw-retained titanium–ceramic bridges with titanium frames for the upper and lower jaws. Conclusions The three-year follow-up after loading indicated a stable marginal bone level and optimal oral hygiene as a result of frequent professional oral hygiene care. The patient showed no signs of symptoms from the temporomandibular joint and has adapted to the new jaw relation without any functional or phonetical issues.

En el presente estudio describe el trabajo desarrollado para la creación de la batería ALPHA-Fitness de test de campo para la evaluación de la condición física relacionada con la salud en niños y adolescentes. La batería ALPHA-Fitness basada en la evidencia incluye los siguientes test: 1) test de ida y vuelta de 20 metros para evaluar la capacidad aeróbica, 2) test de fuerza de prensión manual y 3) test de salto de longitud a pies juntos para evaluar la capacidad músculo-esquelética, y 4) el IMC, 5) el perímetro de la cintura, y 6) los pliegues cutáneos (tríceps y subscapular) para evaluar la composición corporal. Además, se incluyen 2 variantes: i) batería ALPHA-Fitness de alta prioridad. Esta variante incluye todos los tests excepto la medida de pliegues cutáneos, y ii) la batería ALPHA-Fitness extendida, que incluye todos los test y además del test de velocidad y agilidad de 4 x 10 m.Hereby we summarize the work developed by the ALPHA (Assessing Levels of Physical Activity) Study and describe the tests included in the ALPHA health-related fitness test battery for children and adolescents. The evidence-based ALPHA-Fitness test battery include the following tests: 1) the 20 m shuttle run test to assess cardiorespiratory fitness; 2) the handgrip strength and 3) standing broad jump to assess musculoskeletal fitness, and 4) body mass index, 5) waist circumference; and 6) skinfold thickness (triceps and subscapular) to assess body composition. Furthermore, we include two versions: 1) the high priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness; and 2) the extended ALPHA health-related fitness tests battery for children and adolescents, which includes all the evidence-based fitness tests plus the 4 x 10 m shuttle run test to assess motor fitness.

The aim of this study was to provide percentiles values for four different aerobic performance tests in 2752 (1,261 girls) Spanish children aged 6 to 17.9 years. Aerobic performance was assessed by the shuttle run test (20mSRT), 1-mile, 1/2-mile and 1/4-mile run/walk tests. Height and weight were measured, and body mass index was calculated. Boys had significantly better score than girls in the studied tests in all age groups, except in 1/4-mile test in 6-7 year old children. Underweight children had similar performance than their normalweight counterparts, and underweight boys had better performance than their obese counterparts. Overweight and obese children had lower performance than their normalweight counterparts. Having percentile values of the most used field tests to measure aerobic performance in youth may help to identify children and adolescents at risk for the major chronic diseases, as well as to evaluate the effects of alternative interventions.El propósito de este estudio fue proporcionar los valores de percentiles para cuatro pruebas de rendimiento aeróbico en 2752 (1261 chicas) niños españoles con edades de 6 a 17,9 años. El rendimiento aeróbico se evalúo mediante la carrera durante 20 minutos (20mSRT), y las pruebas de correr / caminar 1 milla, ½ milla y ¼ de milla. Se midieron el peso y la talla y se calculó el índice de masa corporal. Los chicos tuvieron puntuaciones significativamente mejores que las chicas en las pruebas evaluadas y para todos los grupos de edad, excepto en la prueba de ¼ de milla en el grupo de 6-7 años. Los niños con peso bajo mostraron un rendimiento similar a sus homólogos con peso normal y los primeros tuvieron un rendimiento mejor que sus homólogos obesos. Los niños obesos y con sobrepeso tuvieron un menor rendimiento que sus homólogos con peso normal. El disponer de valores de percentiles para las pruebas empleadas más habitualmente para evaluar el rendimiento aeróbico en los jóvenes podría ayudar a identificar a niños y adolescentes en riesgo de enfermedades crónicas importantes así como a evaluar los efectos de intervenciones alternativas.

Introduction: The influence of socioeconomic status on health-related fitness is not clear. Aim: To examine the influence of socioeconomic status on health-related fitness in adolescents. Methods: A total of 3,259 adolescents (15.0 ± 1.3 y) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) participated in the study. Socioeconomic status was assessed by the family affluence scale (FAS). Speed-agility, muscular strength and cardiorespiratory fitness were assessed. Covariates included total body fat, physical activity and pubertal status. Results: Adolescents with high FAS had significantly higher fitness levels than their peers of lower FAS categories except for speed-agility and handgrip in boys. Overall, the associations observed presented a medium to large effect size. Conclusion: These results suggest that socioeconomic status is positively associated with physical fitness in European adolescents independently of total body fat and habitual physical activity.Introducción: La influencia del estatus socioeconómico sobre la condición física en relación con la salud no está clara. Objetivo: Examinar la influencia del estatus socioeconómico sobre la condición física en relación con la salud en adolescentes. Metodología: Un total de 3259 adolescentes (15,0 ± 1,3 años) del "Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study" (HELENA-CSS) participaron en el estudio. El estatus socioeconómico fue medido con una escala de riqueza familiar "family affluence scale (FAS)". Se midieron velocidad-agilidad, fuerza muscular y capacidad aeróbica. Las covariables incluidas fueron grasa corporal total, actividad física y estadio madurativo. Resultados: Los adolescentes con alto FAS tuvieron significativamente mayores niveles de condición física que aquellos con bajo FAS exceptuando los tests de velocidad-agilidad y fuerza de prensión manual en chicos. En general, las asociaciones observadas presentaron un efecto del tamaño de la muestra (effect size) entre medio y largo. Conclusión: Estos resultados sugieren que el estatus socioeconómico esta positivamente asociado con la condición física en adolescentes Europeos independientemente de la grasa corporal total y el nivel de actividad física.

Introduction: The aim of this study was to evaluate the agreement between the ActiGraph accelerometer and the Bouchard diary to estimate energy expenditure (EE) in a Spanish adolescent population. Methods: Sixty-one Spanish adolescents, aged 12-16 years, were recruited for this study. The Bouchard diary and the ActiGraph were administered for 3 consecutive days. EE estimated by the Bouchard diary was calculated using 2 different MET category values (BD-Bouchard and BD-Bratteby). EE estimated by the ActiGraph was calculated using 3 predictive equations (AC-Trost, AC-Freedson, and AC-Ekelund). Participants with complete 24 h data were also analyzed to control the possible loss of accuracy. Agreement was examined by Pearson and concordance correlations, paired t-test, and Bland-Altman method. Results: Thirty-seven adolescents were included in the analyses with complete 72 h. Relationships between EE calculated by the Bouchard diary and the ActiGraph were high (ranged: r = 0.61-0.78). Concordance correlations were moderate (r c = 0.60) by BD-Bratteby and AC-Trost, and low using BD-Bratteby and AC-Ekelund (r c = 0.15). EE estimated by BD-Bratteby and AC-Trost also showed no significant differences (P> 0.05) and absolutely agree 0.0 ± 5.0 MJ/d (95% confidence interval: ± 0.90 MJ/d), but with wide limits of agreement (± 9.80 MJ/d). Relationships were higher and differences were smaller in the 72 h sample than in the 24 h sample. Conclusions: The Bouchard diary and the ActiGraph showed high relationships, moderate concordance, and large differences to estimate EE in Spanish adolescents. Advantages, disadvantages, and agreements between both instruments must be taking into consideration for health-related research.Introducción: el objetivo de este estudio ha sido evaluar el grado de acuerdo entre el acelerómetro ActiGraph y el diario de Bouchard para estimar el gasto energético (GE) en una población de adolescentes españoles. Métodos: 61 adolescentes españoles con edades comprendidas entre 12-16 años participaron en este estudio. El diario de Bouchard se completó durante 3 días consecutivos y se utilizó el ActiGraph durante ese tiempo. El GE obtenido del diario de Bouchard se calculó usando dos categorías de equivalentes metabólicos (DB-Bouchard y DB-Bratteby). El GE del ActiGraph se calculó mediante 3 ecuaciones de estimación (AC-Trost, AC-Freedson y ACEkelund). También se analizó a los adolescentes con datos completos de 24 h para controlar la posible pérdida de precisión. El acuerdo entre métodos se analizó mediante las correlaciones de Pearson y Concordancia, un t-test y el método de Bland-Altman. Resultados: De 37 adolescentes se obtuvieron datos completos en 72 h. Las correlaciones entre el GE calculado por el diario de Bouchard y el ActiGraph fueron altas (rango: r = 0,61-0,78). Las correlaciones de Concordancia fueron moderadas (rc = 0,60) utilizando DB-Bratteby y AC-Trost, y bajas utilizando DB-Bratteby y ACEkelund (r c = 0,15). El GE estimado por DB-Bratteby y AC-Trost tampoco mostró diferencias significativas (p > 0,05) y acuerdo completo 0,0 ± 5,0 MJ/día (intervalo de confianza al 95%: ± 0,90 MJ/día), aunque los límites de acuerdo fueron muy amplios (± 9,80 MJ/día). Las relaciones fueron mayores y las diferencias menores en la muestra que completó 72 h que en la muestra que completó 24 h. Conclusiones: El diario de Bouchard y el ActiGraph mostraron correlaciones altas, una concordancia moderada y amplias diferencias a la hora de estimar el GE en los adolescentes españoles. Se deben tener en cuenta las ventajas, desventajas y el acuerdo entre ambos instrumentos en las investigaciones relacionadas con la salud.

One of the more frequently applied methods for integrating controls on primary production through satellite data is the Light Use Efficiency (LUE) approach. Satellite indices such as the Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI) and the Shortwave Infrared Water Stress Index (SIWSI) have previously shown promise as predictors of primary production in several different environments. In this study, we evaluate NDVI, EVI and SIWSI derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) satellite sensor against in-situ measurements from central Sudan in order to asses their applicability in LUE-based primary production modeling within a water limited environment. Results show a strong correlation between vegetation indices and gross primary production (GPP), demonstrating the significance of vegetation indices for deriving information on primary production with relatively high accuracy at similar areas. Evaluation of SIWSI however, reveal that the fraction of vegetation apparently is to low for the index to provide accurate information on canopy water content, indicating that the use of SIWSI as a predictor of water stress in satellite data-driven primary production modeling in similar semi-arid ecosystems is limited.

Electron beam optics (particle betatron motion) and trajectory (centroid secular motion) in the FERMI@Elettra free electron laser (FEL) are modeled and experimentally controlled by means of the elegant particle tracking code. This powerful tool, well known to the accelerator community, is here for the first time fully integrated into the Tango-server based high level software of an FEL facility, thus ensuring optimal charge transport efficiency and superposition of the beam Twiss parameters to the design optics. The software environment, the experimental results collected during the commissioning of FERMI@Elettra, and the comparison with the model are described. As a result, a matching of the beam optics to the design values is accomplished and quantified in terms of the betatron mismatch parameter with relative accuracy down to the 10^{-3} level. The beam optics control allows accurate energy spread measurements with sub-keV accuracy in dedicated dispersive lines. Trajectory correction and feedback is achieved to a 5 μm level with the implementation of theoretical response matrices. In place of the empirical ones, they speed up the process of trajectory control when the machine optics is changed, avoid particle losses that may occur during the on-line computation of experimental matrices, and confirm a good agreement of the experimental magnetic lattice with the model.

There is an increasing interest for the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The American Heart Association (AHA) described the ideal cardiovascular health concept as a score of seven cardiovascular health behaviors and factors that can be used to monitor and predict ideal cardiovascular health over time. This study aimed to examine the association of the ideal cardiovascular health (ICH), as defined by the AHA, with liver enzyme levels in European adolescents. A total of 637 adolescents (54.6% females), aged 14.6 ± 1.2 years from nine European countries participated in this cross-sectional study. Blood levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase were measured and the AST/ALT ratio calculated. Ideal cardiovascular health was defined as meeting ideal levels of the following components: four behaviors (smoking, body mass index, physical activity, and diet) and three factors (total cholesterol, blood pressure, and glucose). A higher number of ideal cardiovascular health behaviors, factors, and ideal cardiovascular health index were associated with lower ALT (P < 0.05, P < 0.001, and P < 0.001, respectively) and gamma-glutamyltransferase (P < 0.001, P < 0.01, and P < 0.001, respectively) levels. Similarly, a higher number of ideal cardiovascular health behaviors (P < 0.01), factors (P < 0.01), and ideal cardiovascular health index (P < 0.001) were associated with a higher aspartate aminotransferase to alanine aminotransferase ratio. These findings reinforce the usefulness of the ICH index as an instrument to identify target individuals and promote cardiovascular health in adolescents, and it also extends these observations to the liver manifestation of the metabolic syndrome.

Background and Aim: In adults, there is some evidence that improving diet reduces blood pressure (BP) and the subsequent risk of cardiovascular diseases (CVDs). However, studies that analyse this association in adolescents are still scarce. The objective of the present study was to examine the associations between heart rate, systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP) among European adolescents and usual intake of vegetables, fruits, dairy products, meat, fish, high-sugar foods and savoury snacks., Methods and Results: In total, 2283 adolescents from the HELENA-study (12.5-17.5 years old; 1253 girls) were included. Dietary intake was assessed using two computerized 24-hour dietary recalls. Age, sex, body mass index, maternal educational level, physical activity and Tanner stage were considered as confounders. Associations were examined by mixed model analysis stratified by sex. Tests for trend were assessed by tertiles of intake while controlling for the aforementioned confounders. Dairy products and fish intake were negatively associated with BP and heart rate. Significant decreasing trends were observed for heart rate and BP across tertiles of dairy products, fish intake and high-sugar foods intake (p < 0.05). Significant increasing trends were observed for SBP and MAP across tertiles of savoury snack intake (p < 0.05)., Conclusion: Significant but small inverse associations between fish and dairy products consumption with blood pressure and heart rate have been found in European adolescents. Dietary intervention studies are needed to explore these associations in the context of the modification of several risk factors for the prevention of cardiovascular diseases., (Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Unlabelled: Percentiles 10th, 25th, 50th, 75th and 90th are presented for circulating white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils and basophils in healthy European adolescents (12.5-17.5 years, n = 405, 48.9% boys), considering age, sex, puberty and body mass index (BMI). CD3(+) (mature T cells), CD4(+) (T helper), CD8(+) (T cytotoxic), CD16(+)56(+) (natural killer), CD19(+) (B cells), CD3(+)CD45RA(+), CD4(+)CD45RA(+), CD8(+)CD45RA(+) (naïve), CD3(+)CD45RO(+), CD4(+)CD45RO(+) and CD8(+)CD45RO(+) (memory) lymphocytes were also analysed by immunophenotyping. Girls presented higher WBC, neutrophil, CD3(+)CD45RO(+) and CD4(+)CD45RO(+) cell counts and CD3(+)/CD19(+) ratio, and lower CD3(+)CD45RA(+) and CD4(+)CD45RA(+) counts than boys. Age was associated with higher neutrophil counts and CD3(+)/CD19(+), and lower CD19(+) counts; in boys, with lower CD3(+)CD45RA(+), CD4(+)CD45RA(+) and CD8(+)CD45RA(+) counts as well; in girls, with higher WBC, CD3(+)CD45RO(+) and CD4(+)CD45RO(+) counts. Pubertal maturation in boys was associated with lower WBC and lymphocyte counts; in girls, with higher basophil, CD3(+)CD45RO(+) and CD4(+)CD45RO(+) values. BMI was associated with higher WBC counts; in boys, also with higher lymphocyte counts; in girls, with higher neutrophil, CD4(+), CD3(+)CD45RO(+) and CD4(+)CD45RO(+) counts., Conclusion: Our study provides normative values for circulating immune cells in adolescents, highlighting the importance of considering sex, age, pubertal maturation and BMI when establishing reference ranges for WBC in paediatric populations.

Unlabelled: Early menarche has been associated with adult overweight, cardiovascular risk factors, and other diseases. Little is known about the determinants of menarcheal age (MA). Therefore, the main aim of this study was to examine the associations between early life programming factors and menarcheal age in European adolescents. Secondly, the influence of sociodemographical factors on menarcheal age was also studied. A total of 1,069 European girls from the HELENA cross-sectional study, aged 12.5-17.5 years, were included in this study. Using multilevel linear regression models, a possible association between birth weight and length, ponderal index at birth, gestational age, duration of exclusive breastfeeding, and menarcheal age was examined. Associations between geographical gradient, number of siblings, physical activity (PA), dietary factors, and menarcheal age were also examined. After adjustment, menarcheal age was positively associated with birth weight and length (p = 0.01 and p = 0.01)., Conclusion: These findings confirm that birth weight and length may have a programming effect on menarcheal age. Next to this finding, sociodemographic factors were not associated with menarcheal age.

Background and Objective: Adequate concentrations of leptin, cortisol, and insulin are important for a suitable metabolism and development during adolescence. These hormones jointly with glucose play a major role in fat metabolism and development of childhood obesity. Our main objective was to quantify biomarkers as leptin, cortisol, insulin and glucose status in European adolescents to contribute to establish reference ranges., Methods: A representative sample of 927 adolescents (45% males, 14.9±1.2 years for the overall population) from ten European cities of the HELENA study was used to obtain fasting blood samples for these biomarkers. The percentile distributions were computed by sex and age and percentiles were associated with BMI classification., Results: Serum leptin concentration in adolescents varied significantly according to BMI, sex and age (all p < 0.001). Cortisol presented a tendency to increase with age, both for females and males, while insulin and glucose were stable with age. Leptin and insulin were highest in obese adolescents (p < 0.001), whilst cortisol and glucose did not vary with BMI. Percentiles 5, 25, 50, 75 and 95, for hormones values were, respectively: 1.27, 4.06, 11.54, 26.70 and 65.33 ng/ml for leptin; 5.00, 8.11, 11.14, 15.00 and 24.51 μg/dl for cortisol and 3.65, 6.15, 8.52, 11.90 and 20.53 μlU/ml for insulin., Conclusions: In adolescents, leptin, cortisol, insulin and glucose concentrations are differently affected by age, sex and BMI. Establishment of reference ranges (percentiles) of these biomarkers would be of great interest when pediatricians have to assess the trend of an adolescent to develop obesity years after., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background: Sleep patterns face important changes during adolescence. This can have implications for the immune system, which is regulated by the sleep-wake cycle; however, most studies relating sleep and immune system have been conducted on adults., Objective: To study the relationships between sleep duration, immune cell counts, and cytokines in European adolescents participating in the HELENA Cross-Sectional Study., Methods: Adolescents (12.5-17.5 years; n = 933; 53.9% girls) were grouped according to self-reported sleep duration into <8, 8-8.9 and ≥9 h/night. Blood samples were collected in the morning after an overnight fast to analyze counts of white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils, basophils, the lymphocyte subsets CD3(+), CD4(+), CD8(+), CD45RA(+), CD45RO(+), CD3(-)CD16(+)56(+) and CD19(+), and concentrations of cortisol, CRP, IL-1, IL-2, IL-4, IL-5, IL-6, IL-10, TNF-α and IFN-γ. Pro-/anti-inflammatory and Th1/Th2 cytokine ratios were calculated. Immune parameters were correlated to sleep duration and compared between the three groups., Results: Sleep duration was negatively associated with cortisol levels and WBC, neutrophil, monocyte, CD4(+) and CD4(+)CD45RO(+) counts; in girls it is also negatively associated with IL-5 and IL-6 levels. The 8-8.9 h/night group presented the highest IL-4 values and the lowest pro-/anti-inflammatory and Th1/Th2 cytokine ratios., Conclusion: A sleep duration of 8-8.9 h/night was associated with a healthier immune profile in our adolescents., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background and Aims: Stress is hypothesized to facilitate the development of obesity, whose the foundations are already set during childhood and adolescence. We investigated the relationship between the stress-system, selected mechanisms of energy homeostasis and insulin resistance (IR) in a sample of European adolescents., Methods and Results: Within HELENA-CSS, 723 adolescents (12.5-17.5 years) from 10 European cities provided all the necessary data for this study. Fasting blood samples were collected for cortisol, leptin, insulin and glucose analysis. HOMA-IR was calculated from insulin and glucose concentrations. Adolescents' body fat (BF) %, age and duration of exclusive breastfeeding were assessed. For boys and girls separately, the relationship of cortisol with leptin, insulin, glucose and HOMA-IR was examined by computing Pearson correlation coefficients and Hierarchical Linear Models (HLMs), with 'city' as cluster unit, adjusting for age, BF% and duration of exclusive breastfeeding. In boys, Pearson correlation coefficients illustrated positive correlations of cortisol with insulin (r = 0.144; p = 0.013), glucose (r = 0.315; p < 0.001) and HOMA-IR (r = 0.180; p = 0.002), whilst in girls, this positive relationship was observed for leptin (r = 0.147; p = 0.002), insulin (r = 0.095; p = 0.050) and HOMA-IR (r = 0.099; p = 0.041), but not for glucose (r = 0.054; p = 0.265). Observed associations were independent of adolescents' age, BF% and duration of exclusive breastfeeding after computing HLMs., Conclusion: This study suggests that the stress-system is positively related to mechanisms of energy homeostasis and IR in European adolescents, and reveals a potential small gender difference in this relationship. The hypothesis that stress might facilitate the development of obesity during adolescence is supported., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: The present study aimed to evaluate the relationship between the consumption of selected food groups and insulin resistance, with an emphasis on sugar-sweetened beverages (SSB)., Design: The present research is a large multicentre European study in adolescents, the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study)., Setting: Homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Several anthropometric and lifestyle characteristics were recorded. Dietary assessment was conducted by using a short FFQ., Subjects: The participants were a subset of the original sample (n 546) with complete data on glucose, insulin and FFQ. All participants were recruited at schools., Results: Median (25th, 75th percentile) HOMA-IR was 0.62 (0.44, 0.87). Mean HOMA-IR was significantly higher among adolescents consuming brown bread ≤1 time/week than among those consuming 2-6 times/week (P = 0·011). Mean values of HOMA-IR were also higher in adolescents consuming SSB >5 times/week compared with those consuming less frequently, although a statistically significant difference was detected between those consuming SSB 5-6 times/week and 2-4 times/week (P = 0.049). Multiple linear regression analysis showed that only the frequency of SSB consumption was significantly associated with HOMA-IR after controlling for potential confounders. In particular, it was found that HOMA-IR levels were higher among adolescents consuming SSB 5-6 times/week and ≥1 time/d compared with those consuming ≤1 time/week by 0.281 and 0.191 units, respectively (P = 0.009 and 0.046, respectively)., Conclusions: The present study revealed that daily consumption of SSB was related with increased HOMA-IR in adolescents.

Hereby we summarize the work developed by the ALPHA (Assessing Levels of Physical Activity) Study and describe the tests included in the ALPHA health-related fitness test battery for children and adolescents. The evidence-based ALPHA-Fitness test battery include the following tests: 1) the 20 m shuttle run test to assess cardiorespiratory fitness; 2) the handgrip strength and 3) standing broad jump to assess musculoskeletal fitness, and 4) body mass index, 5) waist circumference; and 6) skinfold thickness (triceps and subscapular) to assess body composition. Furthermore, we include two versions: 1) the high priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness; and 2) the extended ALPHA health-related fitness tests battery for children and adolescents, which includes all the evidence-based fitness tests plus the 4 x 10 m shuttle run test to assess motor fitness.

The aim of the current study was to compare the association of several anthropometric indices, with insulin resistance (IR) proxy measures in European adolescents. The present study comprises 1,097 adolescents aged 12.5-17.5 from ten European cities participating in the HELENA study. Weight, height, waist circumference (WC) and hip circumference, skinfolds thickness, fat mass (FM), fasting plasma glucose (G(F)) and serum insulin (I(F)) levels were measured. HOMA (as indicator of IR body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated. I(F) and HOMA were statistically significantly related to BMI, WC, skinfold sum, WHtR, WHR and FM. BMI, WC, WHtR, skinfold sum and FM displayed similar correlation with I(F) and HOMA as opposed to WHR where lower correlation with IR indices was detected in the overall sample. Similar results were found for boys, girls and underweight/normal weight adolescents. On the other hand, WC and WHtR were found to be more strongly associated with IR proxy measures compared to the rest of anthropometric indices among overweight/obese subjects. Based on the current findings, WC and WHtR could be used, alternatively, to identify the overweight/obese adolescent at risk for developing IR. In addition, all aforementioned anthropometric indices, except WHR, could be used among the underweight/normal weight adolescents.

The aim of this study was to provide percentiles values for four different aerobic performance tests in 2752 (1,261 girls) Spanish children aged 6 to 17.9 years. Aerobic performance was assessed by the shuttle run test (20 mSRT), 1-mile, 1/2-mile and 1/4-mile run/walk tests. Height and weight were measured, and body mass index was calculated. Boys had significantly better score than girls in the studied tests in all age groups, except in 1/4-mile test in 6-7 year old children. Underweight children had similar performance than their normalweight counterparts, and underweight boys had better performance than their obese counterparts. Overweight and obese children had lower performance than their normalweight counterparts. Having percentile values of the most used field tests to measure aerobic performance in youth may help to identify children and adolescents at risk for the major chronic diseases, as well as to evaluate the effects of alternative interventions.

We examined the role of cardiorespiratory fitness (CRF) on the association between physical activity (PA) and abdominal fat content in adolescents. Abdominal fat content was measured by waist circumference, waist-to-height ratio and dual energy X-ray absorptiometry (DXA) at 3 regions (R1, R2, and R3). PA and CRF were assessed by accelerometry and the 20 m-shuttle run test, respectively. Vigorous PA was inversely associated with waist circumference and waist-to-height ratio (β from -0.149 to -0.197; p<0.05). In both CRF groups (i. e., low and high), vigorous and moderate-to-vigorous PA (also average PA in the low CRF group) were inversely associated with abdominal fat (i. e., R1, R2 and R3; β from -0.146 to -0.244; p<0.05). This association did not differ according to CRF group (P for interaction >0.05), yet the percentage of variance in abdominal fat content, when assessed by DXA, explained by PA was slightly higher in adolescents with low CRF (3-8%) compared to those with high CRF (2-4%). The findings indicate that there is not a clear interaction effect of CRF in the association between PA and abdominal fat in adolescents, yet slightly stronger association was observed in the low fit group., (© Georg Thieme Verlag KG Stuttgart · New York.)

The aim of this study was to determine the reliability, feasibility and safety of a health-related fitness test battery administered by Physical Education (PE) teachers in the school setting. Six PE teachers, from three primary schools and three secondary schools, assessed twice (7 days apart) the 20 m shuttle run, handgrip and standing long jump tests, as well as weight, stature, triceps and subscapular thickness and waist circumference in 58 children (age: 6-11 yr) and 80 adolescents (age: 12-18 yr). Feasibility and safety were assessed by researches by means of direct observation. Significant inter-trial differences were found for the standing long jump test (3.8+/-12.7 cm, P<0.05) and for stature (0.73+/-0.8 cm, P<0.001) in children, and for waist circumference in both children and adolescents (-0.82+/-1.2 cm and -0.35+/-0.8 cm respectively, P=0.001). The feasibility and safety items assessed presented a successful answer. Therefore, the results indicate that health-related fitness tests administered by PE teachers are reliable, feasible and safe to be performed in the school setting., (Georg Thieme Verlag KG Stuttgart, New York.)

Purpose: The present study investigates the effect of the Activ-O-Meter, an internet-based computer-tailored physical activity intervention in adolescents in six European centers involved in the HELENA study., Methods: Adolescents (12-17 years old) from Vienna, Ghent, Heraklion, Dortmund, Athens, and Stockholm were randomized into intervention and control schools. Participants in the intervention condition received the computer-tailored advice at baseline and after 1 month. Participants in the control condition received a generic standard advice. Effects were evaluated after 1 (n = 675) and 3 months (n = 494) using multi-level modeling. Physical activity levels were measured using the International Physical Activity Questionnaire for adolescents (IPAQ-A)., Results: After 1 month, the intervention group reported higher levels of moderate (beta = -32.8, 95% CI (confidence interval): -64.2 to -1.4) and vigorous (beta = -28.0, 95% CI: -50.7 to -5.3) physical activity in leisure time, as well as higher levels of cycling for transport (beta = -19.1, 95% CI: -34.4 to -7.6) compared to the control group. After 3 months, when the intervention group had received the tailored feedback twice, intervention effects were even stronger. Favorable changes in physical activity levels of all intensities and in different contexts were found in the tailored group compared to the control group. Among adolescents not reaching the physical activity recommendations at baseline similar effects as in the total sample were found., Conclusions: The data indicated that the computer-tailored physical activity intervention had positive effects on physical activity levels among the adolescents. However, the implementation of the computer-tailored intervention in the schools was not feasible in all countries., (Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: The influence of socioeconomic status on health-related fitness is not clear., Aim: To examine the influence of socioeconomic status on health-related fitness in adolescents., Methods: A total of 3,259 adolescents (15.0 +/- 1.3 y) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) participated in the study. Socioeconomic status was assessed by the family affluence scale (FAS). Speed-agility, muscular strength and cardiorespiratory fitness were assessed. Covariates included total body fat, physical activity and pubertal status., Results: Adolescents with high FAS had significantly higher fitness levels than their peers of lower FAS categories except for speed-agility and handgrip in boys. Overall, the associations observed presented a medium to large effect size., Conclusion: These results suggest that socioeconomic status is positively associated with physical fitness in European adolescents independently of total body fat and habitual physical activity.

Worldwide dietary data for nutrition monitoring and surveillance are commonly derived from food balance sheets (FBS) and household budget surveys (HBS). We have compared food supply from FBS and food availability data from HBS among eighteen European countries and have estimated the extent to which they correlate, focusing on food groups which are comparably captured by FBS and HBS and for which there is epidemiological evidence that they can have a noticeable impact on population mortality. Spearman's correlation coefficient was +0.78 (P < 10- 3) for vegetables (including legumes),+0.76 (P < 10- 3) for fruits, +0.69 (P < 10- 3) for fish and seafood and +0.93 (P < 10- 3) for olive oil. With respect to meat and meat products, the coefficient was lower at +0.39 (P = 0.08). Moreover, we have examined whether the supply (FBS) or the availability (HBS) of food groups known or presumed to have beneficial effect on the occurrence of CHD and total cancer can predict overall, coronary and cancer mortality in ecological analyses. After controlling for purchasing power parity-adjusted gross domestic product and tobacco smoking we found that for vegetables, fruits, fish and seafood, as well as for olive oil, both the FBS and the HBS estimates were inversely associated with all three indicators of mortality, although the number of countries with complete information on all study variables hindered formal statistical documentation (P>0.05 in some instances). FBS and HBS have their own strengths and weaknesses, but they may complement each other in dietary assessments at the population level.