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31 pages, 1 table, 1 figure.-- Other authors: Afinos Study Group.-- Provisional PDF. ; Background Prior studies addressing the impacts of regular physical activity or sedentary habits on the immune system have been conducted in adults and laboratory settings. Thus, it is practically unknown how a healthy active lifestyle could affect low-grade inflammation processes, infections or allergies in young persons. The AFINOS Study was designed to determine the relationship between the regular physical activity levels of adolescents and overweight, infection, and allergies along with the presence of metabolic and immunological biomarkers of a deteriorated health status. A further objective of the AFINOS Study is to assess the health status and lifestyle habits of an adolescent population in an effort to identify any protective factors that could be used as preventive measures, since many chronic diseases and their associated co-morbidities often persist from adolescence into adulthood. ; Methods This study was conducted as three separate sub-studies in three different populations as follows: (a) Study 1 was performed on a population sample of adolescents; (b) Study 2 on the adolescents' parents; and (c) Study 3 on a subset of the adolescents from Study 1. Study 1 assessed health and lifestyle indicators through a questionnaire administered to a representative sample of adolescents from the Madrid Region (n = 2400) aged 13 to 16 years. In Study 2, the parents of the teenagers participating in Study 1 were required to fill out a questionnaire. Finally in Study 3, body composition, physical activity, health-related physical fitness, and blood measurements were determined in a subset (n = 200) of the individuals included in Study 1. ; Discussion This paper describes the rationale, design, and methodologies used in the AFINOS Study. This multidisciplinary, multicenter study seeks to evaluate several aspects of existing relationships between routine physical activity/sedentary behaviour and several health status markers, specifically those related to the immune system. The results of this cross-sectional study will serve for comparisons with the available data obtained in laboratory settings and in adults. In addition, knowledge regarding the health status and lifestyle habits of Spanish adolescents and their parents will be useful for designing preventive measures. ; The AFINOS Study is supported by grant DEP2006-56184-C03-01-02-03/PREV from the Spanish Ministry of Education and Science and co-funded by FEDER funds from European Union. DMG was supported by a scholarship from the Spanish Ministry of Education and Science AP2006-02464. ; Peer reviewed

Objectives: This study compares the adherence of immigrant and Spanish adolescents residing in the Madrid region (Spain) to national dietary recommendations. The factors compared were the consumption of items from the eight basic food groups (vegetables, fruits, bread/cereals, meat, eggs, fish, legumes and milk/dairy products), including the excessive or deficient consumption of eggs, meat and fish. In addition, the evaluation of excessive sweet foods or soft drinks in the diet was also considered. Subsequently, the influence of length of residence on dietary habits was examined. Materials and methods: Self-reported data were co - llected in a cross-sectional survey conducted over the period November 2007 to February 2008. The study participants were a representative sample of adolescents aged 13 to 17 years (n = 2,081, 1,055 girls) living in the Madrid region. Participants were recruited from secondary schools (grades 7th to 10th) randomly selected according to the geographic distribution of adolescents in the region. Results: Immigrant adolescents showed a greater likelihood of not fulfilling recommendations for the consumption of meat, fish, eggs, legumes, bread/cereals, and milk/dairy products. Their diets were also more likely to lack sufficient fish and they also consumed more eggs and more sweet foods and soft drinks than their native counterparts. Spanish adolescents were more likely not to meet recommendations for the intake of vegetables. Length of residence weakly affected dietary habits, with both negative and positive effects observed. Conclusion: The likelihood of not fulfilling dietary recommendations was higher among the immigrant adolescents with the exception of the intake of fruits and vegetables. ; Objetivos: Este estudio compara la adherencia a las recomendaciones nutricionales de adolescentes inmigrantes y españoles residentes en la Comunidad de Madrid, España. Se comparó el consumo de ocho grupos principales de alimentos (verduras, frutas, pan/cereales, carne, huevos, pescado, legumbres, leche/derivados lácteos) incluyendo el consumo excesivo y deficiente de huevos, carne y pescado. También fue valorado el consumo excesivo de dulces y bebidas azucaradas. Posteriormente se analizó la influencia del tiempo de residencia en España sobre los mencionados hábitos de dieta. Material y método: Se llevó a cabo un estudio transversal en el que fueron recogidos datos auto-reportados durante el periodo comprendido entre noviembre 2007 y febrero 2008. Se obtuvo una muestra representativa de adolescentes con edades comprendidas entre 13 y 17 años (n = 2.081, 1.055 mujeres) residentes en la Comunidad de Madrid. Los participantes pertenecían a centros de enseñanza secundaria seleccionados aleatoriamente según la distribución geográfica de los adolescentes en la región. Resultados: Los inmigrantes adolescentes presentaron una mayor probabilidad de no cumplir las recomendaciones nutricionales para el consume de carne, pescado, legumbres, pan/cereales y leche/derivados, de consumir una cantidad insuficiente de pescado y más dulces y bebidas azucaradas que sus compañeros españoles. Los adolescentes españoles mostraron una mayor probabilidad de no cumplir con la recomendación establecida para verduras. El tiempo de residencia afectó débilmente los hábitos de dieta, asociando aspectos tanto positivos como negativos. Conclusiones: La probabilidad de no cumplir las recomendaciones nutricionales fue mayor entre los adolescentes inmigrantes con excepción del consumo de frutas y verduras. ; The AFINOS Study was supported by grant DEP2006- 56184-C03-01-02-03/PREV from the Spanish Ministry of Education and Science and co-funded by FEDER funds from the European Union

Purpose To examine the adherence to the Mediterranean dietary pattern (MDP) in metabolically healthy overweight or obese (MHO) and metabolically unhealthy obese (MUO) European adolescents. Methods In this cross-sectional study, 137 overweight/obese adolescents aged 12-17 years old from the HELENA study were included. Height, weight, waist circumference and skinfold thickness were measured and body mass index and body fat percent were calculated. Systolic and diastolic blood pressure, glucose, HDL cholesterol, triglycerides and cardiorespiratory fitness (20 m shuttle run test) were measured. MHO and MUO phenotypes were categorized following the Jolliffe and Janssen criteria. Two non-consecutive 24 h recalls were used for dietary intake assessment and the adherence to the MDP was calculated using the Mediterranean dietary pattern score (MDP score) (range 0-9). Results A total of 45 (22 girls) adolescents (32.8%) were categorized as MHO. The adherence to the MDP was significantly higher in MHO than in MUO adolescents regardless of age, sex, body fat percentage, energy intake and center (MDP score: 4.6 +/- 1.6 vs. 3.9 +/- 1.5, p = 0.036), but this difference became non-significant after further adjustment for cardiorespiratory fitness. Participants who had a low adherence to the MDP (MDP score <= 4) had a higher likelihood of having MUO phenotype regardless of sex, age, energy intake, center and body fat percentage (OR 2.2; 95% CI 1.01-4.81, p = 0.048). Conclusions Adherence to the MDP might be beneficial to maintain metabolic health in overweight/obese adolescents, yet cardiorespiratory fitness seems to play a key role on the metabolic phenotype. ; The HELENA project was supported by the European Community Sixth RTD Framework Programme (contract FOODCT-2005-007034), by the Education Department of the Government of the Basque Country (PRE_2016_1_0057, PRE_ 2017_2_0224), by the Spanish Ministry of Science and Innovation (RYC-2011-09011), by the University of the Basque Country (GIU14/21), and by the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). Furthermore, the current study was supported by the Spanish Ministry of Health (CIBERobn CB12/03/30038).

[EN]: Introduction: the main objectives of weight-loss interventions are to decrease fat mass while maintaining fatfree mass. Objective: our aim was to address effectiveness body composition changes in overweight adolescents assessed by different body composition methods following an obesity intervention programme. Material and methods: the life-style intervention was multi-disciplinary, with 13 months follow-up. Participants were 13-to-16 year-old overweight, or obese, Spanish adolescents. The adolescents (n = 156; 54.8% females) had body composition measured with anthropometry, dual-energy X-ray absorptiometry and air-displacement plethysmography. All measurements were made at baseline, and after 2- and 13-months. Repeated measures analysis of covariance to compare mean anthropometric changes over time and the Bonferroni correction were applied. Imputation of anthropometric measures was performed. Results: a high significant decrease in fat mass index was achieved in males after 2-and 13-months of intervention as measured by anthropometry (1.16 and 1.56 kg / m2, respectively), X-ray absorptiometry (1.51 and 1.91 kg / m2) and plethysmography (2.13 and 2.44 kg/m2). Moreover, a short and long-term maintenance of fat-and fat-free mass index was observed by X-ray absorptiometry in females (0.94 and 0.68 kg/m2). Conclusion: our multidisciplinary approach to lifestyle intervention has a favourable impact on body fat mass and fat-free mass index as well as waist-to-height ratio, over 13 months intervention in overweight and obese adolescents. ; [ES]: Introducción: el principal objetivo de las intervenciones de pérdida de peso es disminuir la masa grasa manteniendo la masa libre de grasa. Objetivo: evaluar la efectividad de una intervención multidisciplinar en la composición corporal de adolescentes con sobrepeso, evaluados mediante diferentes métodos de composición corporal. Material y métodos: la intervención fue multidisciplinar sobre el estilo de vida, aplicada durante 13 meses. Los participantes eran adolescentes entre 13 y 16 años con sobrepeso y obesidad. Los adolescentes (n = 156; 54,8% mujeres) fueron evaluados mediante antropometría, absorciometría dual de rayos X y pletismografía por desplazamiento de aire. Todas las mediciones se realizaron al inicio, a los 2 y a los 13 meses. Se aplicaron análisis de la covarianza de medidas repetidas y la corrección de Bonferroni. Se realizó la imputación de las medidas antropométricas. Resultados: se logró una alta disminución significativa en el índice de masa grasa en los hombres después de 2 y 13 meses de intervención, según antropometría (1,16 y 1,56 kg/m2, respectivamente), absorciometría de rayos X (1,51 y 1,91 kg/m2) y pletismografía (2,13 y 2,44 kg/m2). Por otra parte, el mantenimiento a corto y largo plazo de la grasa y libre de grasa en el índice de masa fue observado por absorciometría de rayos X en las mujeres (0,94 y 0,68 kg/m2). Conclusión: la intervención multidisciplinar sobre estilo de vida tiene un impacto favorable en la masa grasa corporal y el índice de masa libre de grasa, así como en la relación cintura-altura, durante 13 meses de intervención en adolescentes con sobrepeso y obesidad. ; The study was supported by: the Ministry of Health, Social Services and Equality; the Spanish Government (Carlos III Institute of Health. FIS. Grant PI051080, PI051579). ; Peer reviewed

Background: Some SNPs related to lipid and energy metabolism may be implicated not only in the development of obesity and associated comorbidities, but also in the weight loss response after a nutritional intervention. Objective: In this context, the present study analyzed four SNPs located within four genes known to be associated with obesity and other obesity-related complications, and their putative role in a weight-loss intervention in overweight/obese adolescents. Methods: The study population consisted of 199 overweight/obese adolescents (13-16 yr old) undergoing 10 weeks of a weight loss multidisciplinary intervention: the EVASYON programme (www.estudioevasyon.org). Adolescents were genotyped for 4 SNPs, and anthropometric measurements and biochemical markers were analyzed at the beginning and after the intervention. Results: Interestingly, APOA5(rs662799) was associated with the baseline anthropometric and biochemical outcomes, whereas FTO (rs9939609) seemed to be related with the change of these values after the 10-week intervention. The other two SNPs, located in the CETP (rs1800777) and the APOA1 (rs670) genes, showed important relationships with adiposity markers. Specifically, a combined model including both SNPs turned up to explain up to 24% of BMI-SDS change after 10 weeks of the multidisciplinary intervention, which may contribute to under - stand the weight loss response. Conclusion: Common variants in genes related to lipid and energy metabolism may influence not only biochemical outcomes but also weight loss response after a multidisciplinary intervention carried out in obese/overweight adolescents. ; Antecedentes: Algunas variantes genéticas relacionadas con el metabolismo lipídico y energético pueden estar implicadas en la respuesta a una intervención nutricional además de estar asociadas con el desarrollo de obesidad y comorbilidades asociadas. Objetivo: En este sentido, este artículo analiza cuatro polimorfismos situados en cuatro genes que han sido previamente asociados con la obesidad u otras complicaciones asociadas a la misma, así como su posible papel en la respuesta a una intervención para la pérdida de peso en adolescentes con sobrepeso u obesidad. Métodos: La población en estudio está formada por 199 adolescentes con sobrepeso u obesidad (13-16 años) llevando a cabo una intervención multidisciplinar de 10 semanas para la pérdida de peso: programa EVASYON (www.estudioevasyon.org). Los adolescentes fueron genotipados para los 4 SNPs y tanto al comienzo como al final de la intervención se analizaron marcadores bioquímicos y se tomaron medidas antropométricas. Resultados: Rs662799 del gen APOA5 se asoció al inicio con parámetros antropométricos y bioquímicos, mientras que el rs9939609 del gen FTO parecía estar asociado con el cambio de estas variables tras 10 semanas de intervención. Las variantes rs1800777 del gen CETP y rs670 del gen APOA1 mostraron una importante asociación con marcadores de adiposidad. Concretamente, un modelo combinado incluyendo los dos polimorfismos logró explicar hasta un 24% del cambio en el IMC-SDS tras 10 semanas de intervención. Conclusión: Variantes genéticas previamente relacionadas con el metabolismo lipídico y energético, pueden repercutir no solamente en valores bioquímicos sino también en la respuesta a una intervención multidisciplinar para la pérdida de peso en adolescentes con sobrepeso u obesidad. ; Research relating to this abstract was funded by grants from the Health Research Fund from the Carlos III Health Institute from Ministry of Health and Consumption, FIS (PI051579, PI051080) for the EVASYON project, Línea Especial, Nutrición y Obesidad (University of Navarra), CIBERobn and RETICS (Gob Navarra). The scholarships to A. Moleres from the Navarra Government is fully acknowledged.

Lin, Y. et al. ; [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). Many thanks to Petra Pickert, Anke Carstensen and Rosa Maria Torres for their contribution to laboratory work.

8 páginas, 1 figura, 2 tablas ; Celiac disease (CD) is an immune-mediated enteropathy involving genetic and environmental factors, whose interaction influences disease risk. The intestinal microbiota, including viruses and bacteria, could play a role in the pathological process leading to gluten intolerance. In this study, we investigated the prevalence of pathogens in the intestinal microbiota of infants at familial risk of developing CD. We included 127 full-term newborns with at least one first-degree relative with CD. Infants were classified according to milk-feeding practice (breastfeeding or formula feeding) and HLA-DQ genotype (low, intermediate or high genetic risk). The prevalence of pathogenic bacteria and viruses was assessed in the faeces of the infants at 7 days, 1 month and 4 months of age. The prevalence of Clostridium perfringens was higher in formula-fed infants than in breast-fed over the study period, and that of C. difficile at 4 months. Among breastfed infants, a higher prevalence of enterotoxigenic E. coli (ETEC) was found in infants with the highest genetic risk compared either to those with a low or intermediate risk. Among formula-fed infants, a higher prevalence of ETEC was also found in infants with a high genetic risk compared to those of intermediate risk. Our results show that specific factors, such as formula feeding and the HLA-DQ2 genotype, previously linked to a higher risk of developing CD, influence the presence of pathogenic bacteria differently in the intestinal microbiota in early life. Further studies are warranted to establish whether these associations are related to CD onset later in life. ; This work was supported by grants AGL2011-25169, AGL2014-52101-P and AGL2007-66126-C03-03/ALI (YS and FP) from the Spanish Ministry of Economy and Competitiveness (MINECO). The scholarship to MO from CSIC (JAEpre) and the contract to ABP from the European Union's Seventh Framework Program under the grant agreement no 613979 (MyNewGut) are also fully acknowledged. ; Peer reviewed

On behalf of the HELENA study group. ; [Background and aims] Inflammation may influence the cardio-metabolic profile which relates with the risk of chronic diseases. This study aimed to assess the inflammatory status by metabolic health (MH)/body mass index (BMI) category and to assess how inflammatory markers can predict the cardio-metabolic profile in European adolescents, considering BMI. [Methods and results] A total of 659 adolescents (295 boys) from a cross-sectional European study were included. Adolescents were classified by metabolic health based on age- and sex-specific cut-off points for glucose, blood pressure, triglycerides, high density cholesterol and BMI. C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin (IL-6), complement factors (C3, C4) and cell adhesion molecules were assessed. [Results] Metabolically abnormal (MA) adolescents had higher values of C3 (p < 0.001) and C4 (p = 0.032) compared to those metabolically healthy (MHy). C3 concentrations significantly increased with the deterioration of the metabolic health and BMI (p < 0.001). Adolescents with higher values of CRP had higher probability of being in the overweight/obese-MH group than those allocated in other categories. Finally, high C3 and C4 concentrations increased the probability of having an unfavorable metabolic/BMI status. [Conclusions] Metabolic/BMI status and inflammatory biomarkers are associated, being the CRP, C3 and C4 the most related inflammatory markers with this condition. C3 and C4 were associated with the cardio-metabolic health consistently. ; The HELENA Study was supported by the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034) and the Stockholm County Council. This analysis was also supported by the Spanish Ministry of Science and Innovation (JCI-2010-07055) and the gs4:European Regional Development Fund (FEDER). CCS is supported by the Spanish Ministry of Economy and Competitiveness (BES-2014-068829). FBO is supported by a grant from the Spanish Ministry of Science and Innovation (RYC-2011-09011). AIR was funded by a Juan de la Cierva-Formación stipend from the Ministry of Economy and Competitiveness of the Spanish Government (FJCI-2014-19795). ; Peer Reviewed

Associations between dietary patterns (DP) and socioeconomic factors have been little explored in adolescents. The aim of this study was to identify DP in European and Brazilian adolescents and to investigate their associations with a range of socioeconomic indicators. Adolescents from the HELENA-study and the Household Budget Survey were analyzed. Factor analysis was used to obtain DP. Linear regression was used to examine the association between DP and SES. In Europeans, the Western DP was associated with low education of the mother, high socioeconomic status (boys), older age (boys), and living in cities of the Northern Europe; in Brazilians, the Western DP was associated with high secondary education of the mother, high socioeconomic status and living in Southern areas of the country. The Traditional European DP, in both genders, was associated with high secondary education of the mother and inversely associated with a high socioeconomic status; the Traditional Brazilian DP, was associated with university level education of the mother and older age (boys). The association between DP and socioeconomic factors is relevant for the understanding of food-related practices and highlight the importance of performing a complete assessment of the socioeconomic influence in adolescent's DP from developed and developing countries. ; Sources of Funding: the HELENA study received funding from the European Union's Sixth RTD Framework Programme (Contracts FOOD-CT-2007-036196-2 and FOODCT-2005-007034, respectively). Additional support was received from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd. (Oslo, Norway), Abbot Científica S.A. (Spain). The HBS was funded by the Ministry of Health of Brazil (agreement number 4652/2005; grant number 25000.202044/2005-16). C.A.B. received a fellowship from the Brazilian Federal Agency (Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior-CAPES) and A.M.S.P received financial support by Fundación Cuenca Villoro (Spain) both for the improvement of higher education. D.J.P was supported by a grant from the Spanish Ministry of Science and Innovation—MINECO (RYC-2014-16938). ; Peer Reviewed

Associations between dietary patterns (DP) and socioeconomic factors have been little explored in adolescents. The aim of this study was to identify DP in European and Brazilian adolescents and to investigate their associations with a range of socioeconomic indicators. Adolescents from the HELENA-study and the Household Budget Survey were analyzed. Factor analysis was used to obtain DP. Linear regression was used to examine the association between DP and SES. In Europeans, the Western DP was associated with low education of the mother, high socioeconomic status (boys), older age (boys), and living in cities of the Northern Europe; in Brazilians, theWestern DP was associated with high secondary education of the mother, high socioeconomic status and living in Southern areas of the country. The Traditional European DP, in both genders, was associated with high secondary education of the mother and inversely associated with a high socioeconomic status; the Traditional Brazilian DP, was associated with university level education of the mother and older age (boys). The association between DP and socioeconomic factors is relevant for the understanding of food-related practices and highlight the importance of performing a complete assessment of the socioeconomic influence in adolescent's DP from developed and developing countries. ; Sources of Funding: the HELENA study received funding from the European Union's Sixth RTD Framework Programme (Contracts FOOD-CT-2007-036196-2 and FOODCT-2005-007034, respectively). Additional support was received from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd. (Oslo, Norway), Abbot Científica S.A. (Spain). The HBS was funded by the Ministry of Health of Brazil (agreement number 4652/2005; grant number 25000.202044/2005-16). The funder contributed to the HBS design and conduct of the study. C.A.B. received a fellowship from the Brazilian Federal Agency (Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior-CAPES) and A.M.S.P received financial support by Fundación Cuenca Villoro (Spain) both for the improvement of higher education. D.J.P was supported by a grant from the Spanish Ministry of Science and Innovation—MINECO (RYC-2014-16938). Acknowledgements all the adolescents who made the HELENA-study possible and the families participating in the HBS-Brazil.

Associations between dietary patterns (DP) and socioeconomic factors have been little explored in adolescents. The aim of this study was to identify DP in European and Brazilian adolescents and to investigate their associations with a range of socioeconomic indicators. Adolescents from the HELENA-study and the Household Budget Survey were analyzed. Factor analysis was used to obtain DP. Linear regression was used to examine the association between DP and SES. In Europeans, the Western DP was associated with low education of the mother, high socioeconomic status (boys), older age (boys), and living in cities of the Northern Europe; in Brazilians, the Western DP was associated with high secondary education of the mother, high socioeconomic status and living in Southern areas of the country. The Traditional European DP, in both genders, was associated with high secondary education of the mother and inversely associated with a high socioeconomic status; the Traditional Brazilian DP, was associated with university level education of the mother and older age (boys). The association between DP and socioeconomic factors is relevant for the understanding of food-related practices and highlight the importance of performing a complete assessment of the socioeconomic influence in adolescent's DP from developed and developing countries. ; The HELENA study received funding from the European Union's Sixth RTD Framework Programme (Contracts FOOD-CT-2007-036196-2 and FOODCT-2005-007034, respectively). Additional support was received from the Spanish Ministry of Education (AGL2007-29784-E/ALI), Axis-Shield Diagnostics Ltd. (Oslo, Norway), Abbot Científica S.A. (Spain). The HBS was funded by the Ministry of Health of Brazil (agreement number 4652/2005; grant number 25000.202044/2005-16). The funder contributed to the HBS design and conduct of the study. C.A.B. received a fellowship from the Brazilian Federal Agency (Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior-CAPES) and A.M.S.P received financial support by Fundación Cuenca Villoro (Spain) both for the improvement of higher education. D.J.P was supported by a grant from the Spanish Ministry of Science and Innovation—MINECO (RYC-2014-16938).

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

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