Mediterranean Diet, Screen-Time-Based Sedentary Behavior and Their Interaction Effect on Adiposity in European Adolescents: The HELENA Study.

Childhood obesity is a worldwide epidemic. Mediterranean diet (MD) is inversely associated with childhood obesity, but the interaction with other environmental factors, such screen time, might influence the health benefits of a high MD adherence in adolescents. The aim of the present study was to assess whether an association between MD and screen time exists in European adolescents. Moreover, we also explored whether sedentary time has a modulatory effect on the association between MD and adiposity. Adherence to the MD (24 h recalls), screen time (questionnaire), pubertal development, body mass index (BMI), fat mass index (FMI) and waist circumference (WC) were evaluated in 2053 adolescents (54.7% females), aged 12.5-17.5 years. In females, MD adherence was associated with lower BMI and FMI only when they were exposed to less than 338 min/day of screen time (81.8% of females); MD adherence was also associated with lower WC only when females were exposed to less than 143 min/day of screen time (31.5% of females). No significant MD-screen time interaction was observed in males. In conclusion, screen-time-based sedentary behaviours had a modulatory effect in the association between MD adherence and adiposity in European female adolescents.

Associations between insulin resistance and three B-vitamins in European adolescents: the HELENA study / Asociaciones entre la resistencia a la insulina y tres vitaminas del grupo B en adolescentes europeos: el estudio HELENA

Objective: To assess whether adolescents with high body mass index (BMI), or fat mass index (FMI), in combination with insulin resistance (assessed with the Homeostatic Model Assessment [HOMA] index), had also lower blood vitamin B6, folate and vitamin B12 concentrations. Methods and materials: Six hundred and fifteen adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, with data on B-vitamins (both intakes and status), and BMI, FMI, HOMA, were selected. Intakes were assessed by two non-consecutive 24-h recalls. B-vitamins biomarkers were measured by chromatography and immunoassay. Analysis of covariance was applied to elucidate the differences in B-vitamins between combinations of groups defined according to the median of the z-scores of markers of body composition and insulin sensitivity. Results: When considering energy intakes and education of the mother in the model, in females, vitamin B6 intakes were higher in the high BMI/ high HOMA group than in the high BMI-low HOMA group. Similarly, vitamin B6 intakes were higher in the high FMI/high HOMA group than in the low FMI/low HOMA group. Plasma vitamin B12 was significantly lower in males in the high FMI/high HOMA group than in the low FMI/low HOMA group, keeping also significant their trends throughout the groups, a fact that can be observed also for females (p < 0.05). Conclusion: Adolescents with combined higher adiposity and higher HOMA insulin sensitivity showed lower vitamin B12 plasma concentrations. These differences do not seem to be explained by dietary vitamin B12 intake (AU)

Objetivo: evaluar si los adolescentes con mayor índice de masa corporal (IMC), o de masa grasa (IMG), en combinación con la resistencia a la insulina (medida con el Modelo de Valoración Homeostática [índice HOMA]), ingieren y tienen valores más bajos de vitamina B6, folato y vitamina B12. Métodos y materiales: seiscientos quince adolescentes participantes en el estudio Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA), con valores de ingesta y concentraciones de las vitaminas B6, folato y B12, e IMC, IMG y HOMA, fueron seleccionados. Las ingestas se midieron mediante dos recuerdos de 24 horas no consecutivos. Los biomarcadores de las vitaminas fueron obtenidos mediante cromatografía e inmunoensayo. Se aplicó el análisis de la covarianza para evaluar las diferencias entre las vitaminas (ingesta y concentraciones) entre las combinaciones de los grupos definidos según las medianas de los valores z de los marcadores de la composición corporal y de la sensibilidad a la insulina. Resultados: considerando la ingesta energética y la educación de la madre en el modelo en chicas, las ingestas de vitamin B6 fueron mayores en el grupo de mayor IMC/mayor HOMA que en el grupo mayor IMC/menor HOMA. Del mismo modo, el grupo constituido por mayor IMG/mayor HOMA presentó mayores ingestas de esta vitamina que el grupo formado por la combinación entre menor IMG/menor HOMA. La vitamina B12 plasmática en chicos fue significativamente menor en el grupo formado por mayor IMG/mayor HOMA que en el grupo menor IMG/menor HOMA, manteniendo también la tendencia significativa en los grupos, lo que también se puede observar en las chicas (p < 0.05). Conclusiones: los adolescentes con mayor adiposidad en combinación con una mayor sensibilidad a la insulina mostraron menores valores de vitamina B12 plasmática. Estas diferencias no parecen estar explicadas por diferencias en la ingesta de vitamina B12 (AU)

Dietary behaviour, food and nutrient intake of women do not change during pregnancy in Southern Ethiopia.

Although pregnant women are required to increase food and nutrient intake to accommodate for the increased nutritional demands, information on dietary behaviour and nutrient intake is limited. This study aimed to identify the adequacy and differences in intake between pregnant and non-pregnant women in a rural community of Butajira district, Southern Ethiopia. Simple random sampling was used to recruit 159 pregnant and 164 non-pregnant women. An interactive multiple pass 24-h recall survey was used to evaluate the food and nutrient intake of the study participants. Except for iron, vitamin A and C, intakes of macro and micronutrient were below the recommendations. Almost all study participants were deficient in energy, protein, calcium, folate and niacin intakes. There was no significant difference in the mean dietary intake of all nutrients between pregnant and non-pregnant women (p > 0.05). The prevalence of inadequacy was comparable between pregnant and non-pregnant women in all of the nutrient intakes except for Zn, where the prevalence of inadequacy was much higher among the pregnant women. Nearly all (99.0%) of the pregnant women were deficient in niacin, folate and calcium. Although all pregnant women considered it important to increase food intake during pregnancy, only a quarter of women reported to do so. In conclusion, pregnant women in the rural community of Butajira district do not make significant dietary intake adjustments to account for increased nutrient needs during pregnancy. In food insecure areas, such as ours, nutritional counselling complemented with supplementary feeding programmes could be key to ensure adequate dietary intake. © 2016 John Wiley & Sons Ltd.

Reference values for leptin, cortisol, insulin and glucose, among European adolescents and their association with adiposity: The HELENA Study / Valores de referencia para leptina, cortisol, insulina y glucosa entre los adolescentes europeos y su asociación con adiposidad: estudio HELENA

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 gluco- se 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 (AU)

Objetivo: Concentraciones adecuadas de leptina, corti- sol e insulina son importantes para un metabolismo normal durante la adolescencia, puesto que valores alterados de estas hormonas, junto con la glucosa, se asocian con el desarrollo de la obesidad infantil. Nuestro principal objetivo fue cuantificar estos marcadores en adolescentes europeos con el fin de establecer rangos de referencia. Métodos: Muestras de sangre procedentes de 927 adolescentes en ayunas (14,9 ± 1,2 años, 45% varones, estudio HELENA), fueron analizadas para cuantificar la leptina, cortisol, insulina y glucosa. Las distribuciones de percentiles se determinaron teniendo en cuenta el sexo y la edad. También se estudió la asociación entre percentiles y la clasificación del IMC. Resultados: La concentración de leptina en suero variaba significativamente con el IMC, el sexo y la edad (todos p<0,001). El cortisol presentó una tendencia a aumentar con la edad, tanto para varones como mujeres, mientras que la insulina y la glucosa eran estables con la edad. La leptina y la insulina fueron más altas en los adolescentesobesos (p <0,001), mientras que el cortisol y glucosa no variaron con el IMC. Los percentiles 5, 25, 50, 75 y 95, para los valores de hormonas fueron, respectivamente: 1.27, 4.06, 11.54, 26.70 y 65.33 ng/ml para la lepti- na; 5.00, 8.11, 11.14, 15.00 y 24.51 µg/dl para el cortisol y 3.65, 6.15, 8.52, 11.90 y 20.53 µlU/ml de insulina. Conclusiones: En los adolescentes, las concentraciones de referencia de leptina, cortisol, insulina y glucosa se ven afectados de manera diferente según la edad, el sexo y el IMC (AU)