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Trabajo presentado a las XXIV Jornadas Internacionales de Nutrición Práctica, celebradas en la Fundación Pablo VI (Madrid) los días 12 y 13 de febrero de 2020.

HELENA study group., [Aim]: To assess if a healthy diet might attenuate the positive sedentary–inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers., [Methods]: In 618 adolescents (13–17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors–inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status., [Results]: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters., [Conclusion]: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation., The HELENA Study was carried out with the financial support of the European Community Sixth RTD Framework Programme (Contract FOODCT-2005-007034).

Background: An adequate nutritional status of antioxidant vitamins (vitamins A, C, E) and β-carotene is essential especially during childhood and adolescence, because of their important roles in cell growth and development. Currently, there are no physiological reference values for blood concentration of these vitamins and β-carotene in apparently healthy European adolescents. The aim of the current study was to obtain reliable and comparable data of antioxidant vitamins and β-carotene in a cross-sectional study, within HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence), which was conducted in a representative sample of adolescents from ten European cities. Material and Methods: From a subsample of 1,054 adolescents (males= 501) of the HELENA Cross Sectional Study with an age range of 12.5 to 17.49 years, fasting blood samples were taken and analyzed for vitamins A, E, C, and β-carotene status. As specific reference values for adolescents are missing, percentile distribution by age and sex is given. Results: Mean concentrations were the following: Retinol: 356.4 ± 107.9 cm/mL; α-tocopherol: 9.9 ± 2.1 μg/mL; vitamin C: 10.3 ± 3.3 mg/L; and β-carotene: 245.6 ± 169.6 cm/mL. Females showed higher α-tocopherol and vitamin C values compared with males and 17-year-old boys had higher retinol levels than the same-aged girls (p = 0.018). Retinol serum concentrations increased significantly according to age in both gender, but girls had also significantly increasing β-carotene levels by age. Conclusions: For the first time, concentrations of antioxidant vitamins and pro-vitamin β-carotene have been obtained in a representative sample of apparently healthy European adolescents. These data can contribute to the establishment of reference ranges in adolescents. © 2011 Hans Huber Publishers, Hogrefe AG, Bern.

[ES]: Fundamentos: La Dieta Mediterránea es un conjunto de recomendaciones nutricionales inspiradas en la forma en que tradicionalmente se ha comido en los países mediterráneos. El objetivo del estudio fue investigar los patrones de consumo de alimentos en estudiantes que vivían en régimen de pensión completa en residencias universitarias, determinando si se ajustaban a las recomendaciones de la Dieta Mediterránea. También se analizó la influencia del número y género de los residentes y tipo de restauración sobre la ingesta. Métodos: Se estudiaron 163 estudiantes, alojados en 20 residencias universitarias de Madrid en régimen de pensión completa. Los hábitos alimentarios fueron evaluados mediante cuestionarios de frecuencia de consumo de alimentos y las características de las residencias se preguntaron a los responsables de las mismas. Resultados: Los jóvenes no seguían las recomendaciones propuestas para la Dieta Mediterránea. Concretamente, comían más cantidad de carne, dulces y aperitivos que la recomendada, y por el contrario su dieta era pobre en frutas, cereales, patatas y frutos secos. El tamaño de la residencia influía en el consumo de algunos grupos de alimentos. Conclusiones: Los jóvenes españoles están cambiando sus hábitos de consumo, alejándose del patrón de la Dieta Mediterránea y de los posibles beneficios que aporta., [EN]: Background: The Mediterranean diet is a modern nutritional recommendation originally inspired by the traditional dietary patterns of Mediterranean countries, mainly Greece, Italy and Spain. The aim of this study was to investigate the food consumption pattern of the student Spanish population living at full board in university colleges, and to evaluate if they follow the consumption advisories for the Mediterranean diet. The influence on intake of number, gender of residents and type of restoration was also analyzed. Methods: The sample consisted of 163 students lodged at full board in university residences from Madrid (Spain). The dietary habits were evaluated by a self-administered food frequency questionnaire, and the residence characteristics were asked to the corresponding headmaster. Results: Young people studied did not adhere to the recommendations of consumption for the Mediterranean diet. Specifically, they ated more meat, sweets and snacks than recommended, and their diet was poor in fruits, cereals, potatoes and dried fruits. The residence size had an influence on the average consumption of certain food groups. Conclusion: The results indicated a possibility of changing nutritional habits among the young Spanish population moving away from the benefits of the Mediterranean diet.

On behalf of the UP&DOWN Study Group., [Objective]: To examine the association between cardiorespiratory fitness (CRF) at baseline and cardiovascular disease (CVD) risk in 6- to 10-year-olds (cross-sectional) and 2 years later (8- to 12-year-olds [longitudinal]) and whether changes with age in CRF are associated with CVD risk in children aged 8 to 12 years. [Patients and Methods]: Spanish primary schoolchildren (n=236) aged 6 to 10 years participated at baseline. Of the 23 participating primary schools, 22% (n=5) were private schools and 78% (n=18) were public schools. The dropout rate at 2-year follow-up was 9.7% (n=23). The 20-m shuttle run test was used to estimate CRF. The CVD risk score was computed as the mean of 5 CVD risk factor standardized scores: sum of 2 skinfolds, systolic blood pressure, insulin/glucose, triglycerides, and total cholesterol/high-density lipoprotein cholesterol. [Results]: At baseline, CRF was inversely associated with single CVD risk factors (all P0.85; P, This work was supported by grant DEP 2010-21662-C04-00 (DEP 2010-21662-C04-01: DEP 2010-21662-C04-02: DEP 2010-21662-C04-03: DEP 2010-21662-C04-04) from the National Plan for Research: Development and Innovation (R+D+i) MICINN and by grant FPU15/05337 from the Spanish Ministry of Education.

Resumen del trabajo presentado al International Symposium on Immunonutrition (10th Anniversary), celebrado en Madrid (España) del 17 al 19 de julio de 2017., [Background and Objective]: Inflammation has been related to obesity and its associated pathologies, such as cardiovascular diseases and metabolism alterations. Adipose tissue excess leads to elevated inflammatory biomarkers, although there is still a lack of knowledge on children and adolescents, particularly in a very special group such as subjects with Down syndrome (DS). This study was aimed to evaluate possible associations between inflammatory biomarkers and obesity in a sample of children and adolescents with DS and without DS (controls)., [Methods]: A total of 502 children and adolescents (101 with DS) aged 10–20 years-old, were recruited in this UP&DOWN substudy. Insulin, leptin, TNF-α, adiponectin, galactain3, visfatin and cortisol were selected as inflammatory biomarkers. Height and weight were measured and Body Mass Index (BMI) was calculated. Pearson correlations were executed., [Results]: 65.3% and 31.9% of the volunteers had values below the level of detection in the visfatin (0.156 ng/ml) and insulin (1.00 pg/ml) test respectively. BMI was higher in DS than in controls (p < 0.001). Galactin-3 and adiponectin levels were lower in DS than in controls (p < 0.001). BMI was positively correlated with leptin and insulin and negatively with adiponectin in both groups. On the other hand, BMI positively correlated with TNF-α and cortisol in the control group and negatively with visfatin in the DS group (all p < 0.05)., [Conclusions]: These results point out that children and adolescents with SD have a peculiar inflammatory behaviour. An exhaustive study of the relationships between body composition and inflammatory biomarkers should be further evaluated in this group of population., DEP 2010-21662-C04-00 grants from the National Plan for Research, Development and Innovation (R + D + i) MICINN.

Background and aims: Adipocytokines may have a key role in the development of atherosclerosis and type 2 diabetes. The purpose of this study was to examine the independent and joint associations of physical activity (PA), cardiorespiratory fitness (CRF) and muscular fitness (MF) with adiponectin and leptin in adolescents. Methods and results: A sample of 198 adolescents (96 girls), aged 13-17-year, was selected. Participants completed anthropometric measurements (height, weight, and waist circumference) and percentage of body fat (%BF) was estimated by bioelectrical impedance. PA was measured by accelerometer for 7-day. The 20-m shuttle-run test was used to assess CRF and two MF tests (handgrip strength and standing broad jump) were used to create an MF score. A cluster score of health status (0-3 risks) was created. Serum adiponectin and plasma leptin were also determined. Regression analyses controlling for age, sex, pubertal status and waist circumference showed that PA was not significantly associated with adiponectin and vigorous PA showed a significant inverse association with leptin. Both CRF and MF were significantly and inversely associated with adiponectin and leptin. Further analyses revealed that the 'healthy' group (0 risks) had significantly lower adiponectin and leptin than 'medium-healthy' (1 risk) and 'unhealthy' (2-3 risks) status groups. Conclusions: PA, CRF and MF are inversely and jointly associated with adiponectin and leptin concentrations in adolescents. © 2010 Elsevier B.V.

Diet quality is influenced by socio-economic and geographical factors. The present study sought to assess whether adolescents' diet quality is affected by their parents' socio-economic status and whether the relationship between these factors is similar in northern and southern Europe. Data collected in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries were analysed. Dietary intake data were recorded via repeated 24 h recalls (using specifically developed HELENA Dietary Intake Assessment Tool software) and converted into an adolescent-specific Diet Quality Index (DQI-AM). Socio-economic status was estimated through parental educational level (Par-Educ-Lev) and parental occupation level (Par-Occ-Lev) as reported by the adolescents in a specific questionnaire. The DQI-AM data were then analysed as a function of Par-Educ-Lev and Par-Occ-Lev in northern European countries (Austria, Belgium, France, Germany and Sweden) and southern European countries (Greece, Italy and Spain). We studied a total of 1768 adolescents (age 14·7 (sd 1·3) years; percentage of girls: 52·8 %; 1135 and 633 subjects from northern and southern Europe, respectively). On average, the DQI-AM score was higher in southern Europe than in northern Europe (69·1 (sd 0·1) v. 60·4 (sd 2·8), respectively; PP interaction = 0·004 for the mother and 0·06 for the father). The DQI was also positively correlated with Par-Occ-Lev (all P trends P interaction = 0·51 for the mother and 0·50 for the father). In conclusion, Par-Educ-Lev and Par-Occ-Lev are associated with diet quality in adolescents in Europe. However, this association differs between northern Europe and southern Europe.

This report aims (1) to examine the association between seasonality and physical activity (PA) and sedentary time in European adolescents and (2) to investigate whether this association was influenced by geographical location (Central-North versus South of Europe), which implies more or less extreme weather and daylight hours. Valid data on PA, sedentary time and seasonality were obtained in 2173 adolescents (1175 females; 12.5-17.5 years) included in this study. Physical activity and sedentary time were measured by accelerometers. ANCOVA was conducted to analyse the differences in PA and sedentary time across seasons. Results showed that girls had lower levels of moderate to vigorous PA (MVPA) and average PA, and spent more time in sedentary activities in winter compared with spring (all P0.05). Stratified analyses showed differences in PA and sedentary time between winter and spring in European girls from Central-North of Europe (P0.05 for sedentary time). There were no differences between PA and sedentary time across seasonality in boys. In conclusion, winter is related with less time spent in MVPA, lower average PA and higher time spent in sedentary activities in European adolescent girls, compared with spring. These differences seem to mainly occur in Central-North Europe.

© 2015 Japan Pediatric Society. Background: Effective preventive interventions for both eating disorders and obesity in adolescence should be focused on shared risk factors. We analyzed the association between television (TV) viewing time and the risk of eating disorders, as well as the potential role of obesity in this association. Methods: The sample consisted of a total of 3458 Spanish adolescents, aged 13-18.5 years, from the Food and Assessment of the Nutritional Status of Adolescents (AVENA) and Physical Activity as a Preventive Measure of the Development of Overweight, Obesity, Allergies, Infections, and Cardiovascular Risk Factors in Adolescents (AFINOS) studies. Adolescents' TV time was assessed by self-report. Body mass index was calculated and the adolescents were classified into non-overweight and overweight-obesity. The risk of eating disorders was evaluated using the SCOFF questionnaire. Results: Adolescents who watched TV >1 h/day had a higher risk for eating disorders, compared with those adolescents who watch TV

Objectives: This study was designed to compare the risk of having an eating disorder (ED) among immigrant and native adolescents living in Madrid and to determine the possible influence of length of residence (LOR) on the risk of the immigrants. Methods: A cross-sectional survey was conducted from november 2007 to february 2008 in a representative sample of adolescents aged 13 to 17 years (n = 2,077, 1,052 girls) living in the Madrid region. Data were collected using the Spanish version of the SCOFF Eating Disorders Questionnaire. Further factors considered were country of birth, LOR and several biological, sociodemographic, lifestyle and health-related variables. Results: According to the three logistic regression models constructed, female immigrant adolescents on the whole showed a greater ED risk (OR = 1.95; 95%CI 1.29- 2.95; p = 0.001) than native adolescents. Moreover, the likelihood of ED was higher among female immigrants living in Spain for, Objetivos: Este estudio fue diseñado para comparar el riesgo de trastornos de conducta alimentaria (TCA) entre adolescentes nativos e inmigrantes residentes en Madrid, así como para determinar la posible influencia del tiempo de residencia en el riesgo de los inmigrantes. Métodos: Se llevó a cabo un estudio transversal durante el periodo comprendido entre noviembre 2007 y febrero 2008 sobre una muestra representativa de adolescentes residentes en Madrid, con edades de entre 13 y 17 años (n = 2.077, 1.052 mujeres). Los datos se recogieron usando la versión española del cuestionario SCOFF para la detección de trastornos alimentarios. Otros factores considerados fueron el país de nacimiento, el tiempo de residencia y diversas variables biológicas, socio-demográficas, relativas a estilo de vida y la salud. Resultados: Según los tres modelos de regresión logística construidos, las mujeres adolescentes inmigrantes en conjunto mostraron un mayor riesgo de TCA (OR = 1,95; 95%CI 1,29-2,95; p = 0,001) que las nativas. Además, la probabilidad de sufrir TCA fue mayor entre las adolescentes inmigrantes con una residencia en España < 6 años que en las nativas (OR = 2,44; 95%CI 1,42-4,18; p = 0,001), mientras que no se encontraron diferencias entre las adolescentes nativas y las inmigrantes con un tiempo de residencia ≥ 6 años. No se observaron diferencias en el riesgo de TCA entre los adolescentes varones nativos y los inmigrantes, tanto en conjunto como según tiempo de residencia. Conclusiones: La condición de inmigrante y el tiempo de residencia son factores relevantes a la hora de considerar el riesgo de TCA en adolescentes residentes en Madrid

[Background] An objective diagnosis of sedentary behaviour as well as of the physical activity and fitness levels in youth and to better understand how lifestyle is associated with cardiovascular disease risk factors and other phenotypes is of clinical and public health interest, and might be informative for developing intervention studies focused on the promotion of physical activity in these population. The aim of this methodological paper is to describe the design and assessment in the UP&DOWN study. [Methods/Design] The UP&DOWN study is a multi-center follow-up design where 2225 Spanish primary and secondary schoolchildren from Cadiz and Madrid, respectively, as well as 110 Spanish adolescents with Down syndrome from Madrid and Toledo were recruited to be assessed. Nine main measurement categories are assessed: i) socio-demographic and early determinants; ii) environmental determinants; iii) physical activity and sedentary behaviour; iv) health-related fitness; v) blood pressure and resting heart rate; vi) mental health; vii) dietary patterns; viii) blood samples; and ix) genetic analysis. During the 3-yr follow-up study, socio-demographic and early determinants, and genetic analysis are only assessed in the first year. Blood sampling is assessed in the first year and the third year (2nd follow-up), and all the other measurements are assessed every year. [Discussion] The findings of the UP&DOWN study may help the Health Information Systems and policy makers to identify the target population for primary prevention and health promotion policies, and to develop and test preventive strategies. Moreover, these data will allow following the trends at population level, as well as to modify/adapt/create new evidence-based physical activity guidelines at national level. The findings will also serve as a scientific platform for interventional studies. This study was supported by the DEP 2010-21662-C04-00 (DEP 2010-21662-C04-01, DEP 2010-21662-C04-02, DEP 2010-21662-C04-03, DEP 2010-21662-C04-04) RYC-2010-05957 grants from the National Plan for Research, Development and Innovation (R + D + i) MICINN.

Objectives: This study was designed to compare the risk of having an eating disorder (ED) among immigrant and native adolescents living in Madrid and to determine the possible influence of length of residence (LOR) on the risk of the immigrants. Methods: A cross-sectional survey was conducted from november 2007 to february 2008 in a representative sample of adolescents aged 13 to 17 years (n = 2,077, 1,052 girls) living in the Madrid region. Data were collected using the Spanish version of the SCOFF Eating Disorders Questionnaire. Further factors considered were country of birth, LOR and several biological, socio-demographic, lifestyle and health-related variables. Results: According to the three logistic regression models constructed, female immigrant adolescents on the whole showed a greater ED risk (OR = 1.95; 95%CI 1.29-2.95; p = 0.001) than native adolescents. Moreover, the likelihood of ED was higher among female immigrants living in Spain for

What is already known about this subject Eating disorders are among the public health issues facing adolescents. An excess of body fat has been associated with an increased risk of these disorders. The association of physical fitness with eating disorders has not yet been analysed in adolescents. What this study adds This study confirms that the overweight and obesity increase the risk of developing eating disorders. The present study shows that there is an inverse association between physical fitness levels and the risk of eating disorders. This study suggests that physical fitness might attenuate the influence of overweight on the development of eating disorders in adolescents. BACKGROUND: Eating disorders together with the overweight and obesity are important health concerns in adolescents. OBJECTIVE: To analyse the individual and combined influence of overweight and physical fitness on the risk of developing eating disorders in Spanish adolescents. METHODS: The sample consisted of 3571 adolescents (1864 females), aged 13 to 18.5 years, from Spain who participated in the AVENA and AFINOS studies. The risk of eating disorders was evaluated using the SCOFF questionnaire. Body mass index was calculated and the adolescents were classified into two groups: overweight (including obesity) and non-overweight according to Cole's cut-off points. Cardiorespiratory fitness in the AVENA Study was assessed by the 20-m shuttle-run test and the overall physical fitness level was self-reported in the AFINOS Study. RESULTS: Overweight adolescents had a higher risk of developing eating disorders than non-overweight adolescents (odds ratio [OR]¿=¿4.91, 95% confidence interval [CI]: 3.63-6.61 in the AVENA Study and OR¿=¿2.45, 95% CI: 1.83-3.22 in the AFINOS Study). Also, adolescents with medium and low levels of physical fitness had a higher risk of developing eating disorders (OR¿=¿1.51, 95% CI: 1.05-2.16, and OR¿=¿2.25, 95% CI: 1.60-3.19, respectively, in the AVENA Study, and OR¿=¿1.73, 95% CI: 1.37-2.17, and OR¿=¿4.11 95% CI: 2.98-5.65, respectively, in the AFINOS Study) than adolescents with high levels of physical fitness. In both studies, the combined influence of overweight and physical fitness showed that adolescents with lower levels of physical fitness had an increased risk of developing eating disorders in both non-overweight and overweight groups. CONCLUSIONS: Physical fitness might attenuate the influence of overweight on the development of eating disorders in adolescents.

El texto está disponible para cualquiera que se registre previamente en http://www.katedrakelloggs.com .- 18. Nutrición y trastornos del comportamiento alimentario 283-293, 11 páginas, 6 tablas.-Manual Práctico de Nutrición y Salud Kellogg’s, obra colectiva de visión multidisciplinar que surge a propuesta del colectivo médico ante la necesidad de recibir formación en materia de nutrición. Existen numerosos manuales de nutrición, pero en esta ocasión se ofrece una edición de consulta rápida, fácil acceso y manejo para utilizar durante la atención al paciente. Se trata de una herramienta práctica, dirigida a profesionales de la salud que en su día a día tienen contacto directo con la población, para transmitir una recomendación adaptada a cada individuo, a su edad, sexo, estado fisiológico y a las diferentes situaciones patológicas.

BACKGROUND: Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. Therefore it is important to investigate associations between dietary and physical activity behavior, the two most important lifestyle behaviors influencing our energy balance and body composition. The objective of the present study is to describe the relationship between energy, nutrient and food intake and the physical activity level among a large group of European adolescents. METHODS: The study comprised a total of 2176 adolescents (46.2% male) from ten European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Dietary intake and physical activity were assessed using validated 24-h dietary recalls and self-reported questionnaires respectively. Analyses of covariance (ANCOVA) were used to compare the energy and nutrient intake and the food consumption between groups of adolescents with different physical activity levels (1st to 3rd tertile). RESULTS: In both sexes no differences were found in energy intake between the levels of physical activity. The most active males showed a higher intake of polysaccharides, protein, water and vitamin C and a lower intake of saccharides compared to less active males. Females with the highest physical activity level consumed more polysaccharides compared to their least active peers. Male and female adolescents with the highest physical activity levels, consumed more fruit and milk products and less cheese compared to the least active adolescents. The most active males showed higher intakes of vegetables and meat, fish, eggs, meat substitutes and vegetarian products compared to the least active ones. The least active males reported the highest consumption of grain products and potatoes. Within the female group, significantly lower intakes of bread and cereal products and spreads were found for those reporting to spend most time in moderate to vigorous physical activity. The consumption of foods from the remaining food groups, did not differ between the physical activity levels in both sexes. CONCLUSION: It can be concluded that dietary habits diverge between adolescents with different self-reported physical activity levels. For some food groups a difference in intake could be found, which were reflected in differences in some nutrient intakes. It can also be concluded that physically active adolescents are not always inclined to eat healthier diets than their less active peers.

On behalf of the HELENA study group., OBJECTIVES: Nutritional factors in early life may have long-term physiologic effects in humans. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play important roles in protecting against cardiovascular disease (CVD) risk. Our aim was to examine the association of birth weight (BW) with serum long chain polyunsaturated fatty acids (LCPUFA) profile in adolescents. SUBJECTS AND METHODS: A total of 772 European adolescents (56.3% females) aged 14.7 ± 1.2 years were included in this study. Information on BW and gestational age was obtained from parental records. DHA, EPA and arachidonic acid (AA) concentrations were measured in serum phospholipids. Alfa-linolenic (ALA), linoleic (LA), AA, EPA and DHA intakes assessed by a computer based 24h dietary recall. Gender, gestational age, pubertal status, body mass index, center and total energy and LCPUFA intakes were used as confounders in all the analyses. RESULTS: BW was significantly associated with serum DHA and EPA (both adjusted P

Jiménez-Pavón, D.;Nova, Esther;Gómez, Sonia;Diaz, L. E.;Romeo, J.;Veses, Ana M.;Zapatera, Belén;Pozo, Tamara; et al. Martinez, D. Marcos, Ascensión, OBJECTIVE: To examine the independent association of total and central body fat and cardiorespiratory fitness with markers of insulin resistance after controlling for several potential confounders in European adolescents participating in the HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional) study. METHODS: We conducted a cross sectional study (the HELENA-CSS) which comprised 1053 (12.5-17.5 years) adolescents from 10 European cities. Weight, height, waist circumference and skinfold thickness were measured, and body mass index (BMI) was calculated. Cardiorespiratory fitness was measured by the 20-m shuttle run test. Markers of insulin resistance were fasting insulin and glucose, and homeostasis model assessment (HOMA). RESULTS: HOMA and insulin were positively associated with BMI, skinfolds and waist circumference after controlling for center, age, pubertal status and cardiorespiratory fitness (all P ? 0.01). HOMA and insulin were negatively associated with cardiorespiratory fitness in adolescents with moderate to high levels of total and central body fat (all P ? 0.01). CONCLUSIONS: HOMA and insulin were associated with total and central body fat in European adolescents. Moreover, cardiorespiratory fitness explained a part of the HOMA and insulin variance in those adolescents with moderate to high levels of total and central body fat, and also, to some extent, in those with low to middle fat mass.

To assess the iron status among European adolescents through selected biochemical parameters in a cross-sectional study performed in 10 European cities. SUBJECTS/METHODS: Iron status was defined utilising biochemical indicators. Iron depletion was defined as low serum ferritin (SF8.5 mg/l) plus iron depletion. Iron deficiency anaemia (IDA) was defined as ID with haemoglobin (Hb) below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged ¿15 years. Enzyme linked immunosorbent assay was used as analytical method for SF, sTfR and C-reactive protein (CRP). Subjects with indication of inflammation (CRP >5 mg/l) were excluded from the analyses. A total of 940 adolescents aged 12.5-17.49 years (438 boys and 502 girls) were involved. RESULTS: The percentage of iron depletion was 17.6%, significantly higher in girls (21.0%) compared with boys (13.8%). The overall percentage of ID and IDA was 4.7 and 1.3%, respectively, with no significant differences between boys and girls. A correlation was observed between log (SF) and Hb (r = 0.36, P < 0.01), and between log (sTfR) and mean corpuscular haemoglobin (r = -0.30, P < 0.01). Iron body stores were estimated on the basis of log (sTfR/SF). A higher percentage of negative values of body iron was recorded in girls (16.5%) with respect to boys (8.3%), and body iron values tended to increase with age in boys, whereas the values remained stable in girls. CONCLUSIONS: To ensure adequate iron stores, specific attention should be given to girls at European level to ensure that their dietary intake of iron is adequate., The HELENA Study was supported financially by the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034).

Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. A better insight in the clustering of those behaviors, could help to identify groups who are at risk in developing chronic diseases. This study examines the prevalence and clustering of physical activity, sedentary and dietary patterns among European adolescents and investigates if the identified clusters could be characterized by socio-demographic factors. METHODS: The study comprised a total of 2084 adolescents (45.6% male), from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity and sedentary behavior were measured using self-reported questionnaires and diet quality was assessed based on dietary recall. Based on the results of those three indices, cluster analyses were performed. To identify gender differences and associations with socio-demographic variables, chi-square tests were executed. RESULTS: Five stable and meaningful clusters were found. Only 18% of the adolescents showed healthy and 21% unhealthy scores on all three included indices. Males were highly presented in the cluster with high levels of moderate to vigorous physical activity (MVPA) and low quality diets. The clusters with low levels of MVPA and high quality diets comprised more female adolescents. Adolescents with low educated parents had diets of lower quality and spent more time in sedentary activities. In addition, the clusters with high levels of MVPA comprised more adolescents of the younger age category. CONCLUSION: In order to develop effective primary prevention strategies, it would be important to consider multiple health indices when identifying high risk groups.

Trabajo presentado al II Congreso de la Federación Española de Sociedades de Nutrición, Alimentación y Dietética FESNAD: "Hacia una alimentación responsable" celebrado del 3 al 5 de Marzo de 2010 en Barcelona (España).

Introduction and objectives: To investigate the association between objective measures of sedentary behavior and cardiovascular risk factors (CRFs) in adolescents. A secondary aim was to evaluate the degree of association between overall and abdominal adiposity and CRFs. Methods: This cross-sectional study involved 210 adolescents aged 13-17 years. Measurements were made of the sum of the skinfold thicknesses at six locations (sum6), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), and apolipoproteins A-1 and B-100. A CRF score was calculated from the mean arterial pressure (MAP) and TG, HDL-C and glucose levels. Sedentary behavior was assessed over 7 days using an accelerometer. Participants were divided into tertiles according to sedentary behavior and into low and high levels of overall (sum6) and abdominal (WC) adiposity. Results: Adolescents with a high level of sedentary behavior had less favorable SBP, TG and glucose levels and CRF scores. Adolescents with a high level of overall adiposity demonstrated significant differences in five of the 11 variables analyzed (i.e. DBP, LDL-C, TC, apolipoprotein B-100 and CRF score), while adolescents with a high level of abdominal adiposity had differences in eight (i.e. SBP, MAP, HDL-C, LDL-C, TG, TC, apolipoprotein B-100 and CRF score). Adolescents with high levels of both overall and abdominal adiposity and sedentary behavior had the least favorable CRF scores. Conclusions: Sedentary behavior was associated with CRFs in adolescents, especially in obese adolescents. Abdominal adiposity seemed to play a more significant role in the development of CRFs than overall adiposity.