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© The Authors 2013. Objective: To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness. Design: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a 'Food Choices and Preferences' questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire. Setting: Ten European cities. Subjects: Adolescents (n 2148; aged 12.5-17.5 years). Results: Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P ≤ 0.005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR = 0.33; 95% CI 0.18, 0.59 and OR = 0.56; 95 %CI 0.32, 0.98, respectively). Results persisted across methods. Conclusions: Skipping breakfast does not seem to be related to physical activity, sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings. ; Sources of funding: The HELENA Study took place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT: 2005-007034). This work was also partially supported by the European Union, in the framework of the Public Health Programme (ALPHA project, ref. 2006120); the Swedish Council for Working Life and Social Research (FAS); the Spanish Ministry of Education (grant nos. AP-2008-03806, RYC-2010-05957, RYC-2011-0901); the Spanish Ministry of Health, Maternal, Child Health and Development Network (grant no. RD08/0072 to L.A.M.); the Universidad Politénica of Madrid (grant no. CH/018/2008); and the Swedish Heart-Lung Foundation (grant no. 20090635) ; Peer Reviewed

Objective To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness. Design The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a 'Food Choices and Preferences' questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire. Setting Ten European cities. Subjects Adolescents (n 2148; aged 12·5–17·5 years). Results Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P ≤ 0·005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR = 0·33; 95 % CI 0·18, 0·59 and OR = 0·56; 95 %CI 0·32, 0·98, respectively). Results persisted across methods. Conclusions Skipping breakfast does not seem to be related to physical activity, sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings. ; Sources of funding: The HELENA Study took place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT: 2005-007034). This work was also partially supported by the European Union, in the framework of the Public Health Programme (ALPHA project, ref. 2006120); the Swedish Council for Working Life and Social Research (FAS); the Spanish Ministry of Education (grant nos. AP-2008-03806, RYC-2010-05957, RYC-2011-0901); the Spanish Ministry of Health, Maternal, Child Health and Development Network (grant no. RD08/0072 to L.A.M.); the Universidad Politécnica of Madrid (grant no. CH/018/2008); and the Swedish Heart-Lung Foundation (grant no. 20090635).

On behalf of the HELENA Study Group. ; This study aimed to examine the association between vitamin B6, folate and vitamin B12 biomarkers and plasma fatty acids in European adolescents. A subsample from the Healthy Lifestyle in Europe by Nutrition in Adolescence study with valid data on B-vitamins and fatty acid blood parameters, and all the other covariates used in the analyses such as BMI, Diet Quality Index, education of the mother and physical activity assessed by a questionnaire, was selected resulting in 674 cases (43 % males). B-vitamin biomarkers were measured by chromatography and immunoassay and fatty acids by enzymatic analyses. Linear mixed models elucidated the association between B-vitamins and fatty acid blood parameters (changes in fatty acid profiles according to change in 10 units of vitamin B biomarkers). DHA, EPA) and n-3 fatty acids showed positive associations with B-vitamin biomarkers, mainly with those corresponding to folate and vitamin B12. Contrarily, negative associations were found with n-6:n-3 ratio, trans-fatty acids and oleic:stearic ratio. With total homocysteine (tHcy), all the associations found with these parameters were opposite (for instance, an increase of 10 nmol/l in red blood cell folate or holotranscobalamin in females produces an increase of 15·85 Âmol/l of EPA (P value <0·01), whereas an increase of 10 nmol/l of tHcy in males produces a decrease of 2·06 Âmol/l of DHA (P value <0·05). Positive associations between B-vitamins and specific fatty acids might suggest underlying mechanisms between B-vitamins and CVD and it is worth the attention of public health policies. ; The HELENA study received funding from the European Union's Sixth RTD Framework Programme (contract FOODCT-2005-007034). Additional support was obtained 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). ; Peer Reviewed

Background: Previous studies suggest that dietary protein might play a beneficial role in combating obesity and its related chronic diseases. Total, animal and plant protein intakes and their associations with anthropometry and serum biomarkers in European adolescents using one standardised methodology across European countries are not well documented. ; Objectives: To evaluate total, animal and plant protein intakes in European adolescents stratified by gender and age, and to investigate their associations with cardio-metabolic indicators (anthropometry and biomarkers). ; Methods: The current analysis included 1804 randomly selected adolescents participating in the HELENA study (conducted in 2006–2007) aged 12.5-17.5 y (47% males) who completed two non-consecutive computerised 24-h dietary recalls. Associations between animal and plant protein intakes, and anthropometry and serum biomarkers were examined with General linear Model multivariate analysis. ; Results: Average total protein intake exceeded the recommendations of World Health Organization and European Food Safety Authority. Mean total protein intake was 96 g/d (59% derived from animal protein). Total, animal and plant protein intakes (g/d) were significantly lower in females than in males and total and plant protein intakes were lower in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and higher in obese ones; the direction of the relationship was reversed after adjustments for body weight (g/(kg.d)). The inverse association of plant protein intakes was stronger with BMI z-score and body fat percentage (BF%) compared to animal protein intakes. Additionally, BMI and BF% were positively associated with energy percentage of animal protein. ; Conclusions: This sample of European adolescents appeared to have adequate total protein intake. Our findings suggest that plant protein intakes may play a role in preventing obesity among European adolescents. Further longitudinal studies are needed to investigate the potential beneficial effects observed in this study in the prevention of obesity and related chronic diseases. ; 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 (FAS), the Spanish Ministry of Education, and the Spanish Ministry of Health, Maternal, Child Health and Development Network and the Spanish Ministry of Science and Innovation AGL2007-29784-E. The content of this paper reflect only the authors' views and the rest of HELENA-study members and the European Community is not liable for any use that may be made of the information contained therein. Augusto César F. de Moraes is in receipt of a PhD scholarship from the São Paulo State Research Foundation (FAPESP: proc. 2011/11137-1 and 2011/20662-2) and Postdoctoral Research Fellow scholarship from National Counsel of Technological and Scientific Development (CNPq: proc. 313772/2014-2); Luis A. Moreno was given scholarship of Visiting Professor from Brazilian government by Science without Borders Program by CNPq and CAPES (Coordination of Improvement of Higher Education Personnel) (proc. 007/2012). The GENUD Research Group co-financed by the European Regional Development Fund (MICINN-FEDER).