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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 highMD adherence in adolescents. The aimof the present studywas 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 lowerWC only when females were exposed to less than 143 min/day of screen time (31.5% of females). No significantMD-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. ; Iberus Talent Pre-doctoral fellowships 2018, under the European Union's H2020 research and innovation programme under Marie Sklodowska-Curie grant 801586 ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, CIBERObn ISCIII-CB15/00043 ; European Commission FOOD-CT-2005-007034 ; HELENA project ; Spanish Ministry of Economy and Competitiveness RYC-2010-05957 RYC-2011-09011 ; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)

Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial e ects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction e ects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction e ects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction e ects between theMDon adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction e ects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same e ect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction e ect was higher in females than in males. ; Iberus Talent Pre-doctoral fellowships 2018, under the European Union's H2020 research and innovation programme under Marie Sklodowska-Curie grant 801586 ; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, CIBERObn ISCIII-CB15/00043 ; European Union (EU) FOOD-CT-2005-007034 ; HELENA project ; Spanish Ministry of Economy and Competitiveness RYC-2010-05957 RYC-2011-09011 ; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)

Few studies have evaluated the association between dietary free sugars intake (FSI) and obesity in adolescents. We examined the relation between FSI and their contributors from the main food groups and obesity in European adolescents. We included 843 adolescents (51.6% male) from the cross-sectional HELENA study with two completed 24 h recalls and anthropometric data. Linear mixed models were applied to investigate the relation between FSI and different anthropometric indices. Odds ratios for having a high body mass index (BMI) were also estimated by multilevel ordinal regression. Total FSI was higher in males than females (102.60 g and 87.58 g, respectively, p < 0.001). No effect was observed between free sugar from the main food groups and BMI. Consumers of FSI from "cakes, pies and biscuits" in males (odd ratio (OR) = 0.455; 95% Confidence interval (CI) 0.251, 0.824) and from "breakfast cereals" in females had a lower probability of having obesity (OR = 0.423; 95%CI 0.204, 0.878), whereas females consuming FSI from 'fruit and vegetables juices' had a higher probability of obesity (OR= 2.733; 95% CI 1.286, 5.810). This study provides no evidence that increased FSI is associated with obesity in adolescents. Further studies are needed to assess the longitudinal exposure to FSI and their effect on obesity development. ; European Community (EC) FOODCT-2005-007034 ; Spanish Government FJCI-2017-34967

Obesity is the result of interactions between genes and environmental factors. Since monogenic etiology is only known in some obesity-related genes, a genetic risk score (GRS) could be useful to determine the genetic predisposition to obesity. Therefore, the aim of our study was to build a GRS able to predict genetic predisposition to overweight and obesity in European adolescents. A total of 1069 adolescents (51.3% female), aged 11–19 years participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were genotyped. The sample was divided in non-overweight (non-OW) and overweight/obesity (OW/OB). From 611 single nucleotide polymorphisms (SNP) available, a first screening of 104 SNPs univariately associated with obesity (p < 0.20) was established selecting 21 significant SNPs (p < 0.05) in the multivariate model. Unweighted GRS (uGRS) was calculated by summing the number of risk alleles and weighted GRS (wGRS) by multiplying the risk alleles to each estimated coefficient. The area under curve (AUC) was calculated in uGRS (0.723) and wGRS (0.734) using tenfold internal cross-validation. Both uGRS and wGRS were significantly associated with body mass index (BMI) (p < .001). Both GRSs could potentially be considered as useful genetic tools to evaluate individual's predisposition to overweight/obesity in European adolescents. ; European Commission FOOD-CT-2005-007034 ; HELENA project ; Spanish Ministry of Economy and Competitiveness RYC-2010-05957 RYC2011-09011 ; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn) ; Iberus Talent Pre-doctoral fellowships under the European Union 801586 ; Instituto de Salud Carlos III CB15/00043

HELENA study received funding from the European Community Sixth RTD Framework Program (Contract FOODCT-2005-007034). E.M.G.-G. holds a Juan de la Cierva-Formación grant from the Spanish Government (FJCI-2017-34967). ; The ethics committees in all countries approved the HELENA study. All countries involved in the study provided good clinical practices and ethical guidelines of the Declaration of Helsinki 1964 (revision of 2000) and the legislation about clinical research in humans. The ethical approval code from the coordinator center was 03/2006; date of approval: February 2006, obtained from the Ethical Committee of clinical research in Aragon (CEICA). ; We are grateful for the support provided by school boards, headmasters, teachers, school staff, and communities and the effort of all study nurses and our data managers. HELENA Study Group: Coordinator: Luis A. Moreno.Core Group members: Luis A. Moreno, Fréderic Gottrand, Stefaan De Henauw, Marcela González-Gross, Chantal Gilbert.Steering Committee: Anthony Kafatos (President), Luis A. Moreno, Christian Libersa, Stefaan De Henauw, Sara Castelló, Fréderic Gottrand, Mathilde Kersting, Michael Sjöstrom, Dénes Molnár, Marcela González-Gross, Jean Dallongeville, Chantal Gilbert, Gunnar Hall, Lea Maes, Luca Scalfi.Project Manager: Pilar Meléndez. 1. Universidad de Zaragoza (Spain): Luis A. Moreno, José A. Casajús, Jesús Fleta, Gerardo Rodríguez, Concepción Tomás, María I. Mesana, Germán Vicente-Rodríguez, Adoración Villarroya, Carlos M. Gil, Ignacio Ara, Juan Fernández Alvira, Gloria Bueno, Olga Bueno, Juan F. León, JesúsMª Garagorri, Idoia Labayen, Iris Iglesia, Silvia Bel, Luis A. Gracia Marco, Theodora Mouratidou, Alba Santaliestra-Pasías, Iris Iglesia, Esther González-Gil, Pilar De Miguel-Etayo, Mary Miguel-Berges, Isabel Iguacel, Azahara Rupérez. 2. Consejo Superior de Investigaciones Científicas (Spain): Ascensión Marcos, Julia Wärnberg, Esther Nova, Sonia Gómez, Ligia Esperanza Díaz, Javier Romeo, Ana Veses, Belén Zapatera, Tamara Pozo, David Martínez. 3. Université de Lille 2 (France): Laurent Beghin, Christian Libersa, Frédéric Gottrand, Catalina Iliescu, Juliana Von Berlepsch. 4. Research Institute of Child Nutrition Dortmund, Rheinische Friedrich–Wilhelms–Universität Bonn (Germany): Mathilde Kersting, Wolfgang Sichert-Hellert, Ellen Koeppen. 5. Pécsi Tudományegyetem (University of Pécs) (Hungary): Dénes Molnar, Eva Erhardt, Katalin Csernus, Katalin Török, Szilvia Bokor, Mrs. Angster, Enikö Nagy, Orsolya Kovács, Judit Répasi. 6. University of Crete School of Medicine (Greece): Anthony Kafatos, Caroline Codrington, María Plada, Angeliki Papadaki, Katerina Sarri, Anna Viskadourou, Christos Hatzis, Michael Kiriakakis, George Tsibinos, Constantine Vardavas, Manolis Sbokos, Eva Protoyeraki, Maria Fasoulaki. 7. Institut für Ernährungs- und Lebensmittelwissenschaften–Ernährungphysiologie. Rheinische Friedrich Wilhelms Universität (Germany): Peter Stehle, Klaus Pietrzik, Marcela González- Gross, Christina Breidenassel, Andre Spinneker, Jasmin Al-Tahan, Miriam Segoviano, Anke Berchtold, Christine Bierschbach, Erika Blatzheim, Adelheid Schuch, Petra Pickert. 8. University of Granada (Spain): Manuel J. Castillo, Ángel Gutiérrez, Francisco B Ortega, Jonatan R Ruiz, Enrique G Artero, Vanesa España, David Jiménez-Pavón, Palma Chillón, Cristóbal Sánchez-Muñoz, Magdalena Cuenca. 9. Istituto Nazionalen di Ricerca per gli Alimenti e la Nutrizione (Italy): Davide Arcella, Elena Azzini, Emma Barrison, Noemi Bevilacqua, Pasquale Buonocore, Giovina Catasta, Laura Censi, Donatella Ciarapica, Paola D'Acapito, Marika Ferrari, Myriam Galfo, Cinzia Le Donne, Catherine Leclercq, Giuseppe Maiani, Beatrice Mauro, Lorenza Mistura, Antonella Pasquali, Raffaela Piccinelli, Angela Polito, Romana Roccaldo, Raffaella Spada, Stefania Sette, Maria Zaccaria. 10. University of Napoli "Federico II" Dept of Food Science (Italy): Luca Scalfi, Paola Vitaglione, Concetta Montagnese. 11. Ghent University (Belgium): Ilse De Bourdeaudhuij, Stefaan De Henauw, Tineke De Vriendt, Lea Maes, Christophe Matthys, Carine Vereecken, Mieke de Maeyer, Charlene Ottevaere, Inge Huybrechts. 12. Medical University of Vienna (Austria): Kurt Widhalm, Katharina Phillipp, Sabine Dietrich, Birgit Kubelka, Marion Boriss-Riedl. 13. Harokopio University (Greece): Yannis Manios, Eva Grammatikaki, Zoi Bouloubasi, Tina Louisa Cook, Sofia Eleutheriou, Orsalia Consta, George Moschonis, Ioanna Katsaroli, George Kraniou, Stalo Papoutsou, Despoina Keke, Ioanna Petraki, Elena Bellou, Sofia Tanagra, Kostalenia Kallianoti, Dionysia Argyropoulou, Stamatoula Tsikrika, Christos Karaiskos. 14. Institut Pasteur de Lille (France): Jean Dallongeville, Aline Meirhaeghe. 15. Karolinska Institutet (Sweden): Michael Sjöstrom, Jonatan R Ruiz, Francisco B. Ortega, María Hagströmer, Anita Hurtig Wennlöf, Lena Hallström, Emma Patterson, Lydia Kwak, Julia Wärnberg, Nico Rizzo. 16. Asociación de Investigación de la Industria Agroalimentaria (Spain): Jackie Sánchez-Molero, Sara Castelló, Elena Picó, Maite Navarro, Blanca Viadel, José Enrique Carreres, Gema Merino, Rosa Sanjuán, María Lorente, María José Sánchez. 17. Campden BRI (United Kingdom): Chantal Gilbert, Sarah Thomas, Elaine Allchurch, Peter Burgess. 18. SIK—Institutet foer Livsmedel och Bioteknik (Sweden): Gunnar Hall, Annika Astrom, Anna Sverkén, Agneta Broberg. 19. Meurice Recherche & Development asbl (Belgium): Annick Masson, Claire Lehoux, Pascal Brabant, Philippe Pate, Laurence Fontaine. 20. Campden & Chorleywood Food Development Institute (Hungary): Andras Sebok, Tunde Kuti, Adrienn Hegyi. 21. Productos Aditivos SA (Spain): Cristina Maldonado, Ana Llorente. 22. Cárnicas Serrano SL (Spain): Emilio García. 23. Cederroth International AB (Sweden): Holger von Fircks, Marianne Lilja Hallberg, Maria Messerer. 24. Lantmännen Food R&D (Sweden): Mats Larsson, Helena Fredriksson, Viola Adamsson, Ingmar Börjesson. 25. European Food Information Council (Belgium): Laura Fernández, Laura Smillie, Josephine Wills. 26. Universidad Politécnica de Madrid (Spain): Marcela González-Gross, Raquel Pedrero-Chamizo, Agustín Meléndez, Jara Valtueña, David Jiménez-Pavón, Ulrike Albers, Pedro J. Benito, Juan José Gómez Lorente, David Cañada, Alejandro Urzanqui, Rosa María Torres, Paloma Navarro. ; The following are available online at https://www.mdpi.com/2072-6 643/13/3/954/s1, Table S1: Mean intake of food PS from ED food for plausible reporter and by BMI, normal weight or overweight/obesity in males and females. Table S2: The association between BMI and PS of most ED food in under-reporters, using multiple linear regression model. Table S3: The association between FMI and portion size of most ED food between gender in under-reporters, using multiple linear regression model. Table S4: Ordinal logistic regression model, the association between BMI categories and ED food portion groups in under-reporters and between gender. ; Obesity prevalence has been simultaneously increasing with high consumption of large food portion sizes (PS). However, there is scarce information on PS of energy-dense (ED) foods as a potential risk factor of obesity in adolescents. In the present study, we investigate the association between the PS of the most ED foods and body composition. A sample of 1889 adolescents (54.4% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional multicenter study (HELENA-CSS) study were included. Most ED foods (e.g., cheese) were selected according to higher fat and/or sugar content and low fiber and water. Linear and ordinal logistic regression models were adjusted for age, physical activity, total energy intake (TEI), and socioeconomic status (SES). Analysis was performed both in those adolescents reporting plausible energy intake according to the approach of Goldberg et al. and in the whole sample. In male plausible reporters, PS from "breakfast cereals" showed a significant and positive association with BMI (beta = 0.012; 0.048). PS from "carbonated soft drinks" in males (OR = 1.001; 95% CI 1.000; 1.002) and "bread and rolls" in females (OR = 1.002; 95% CI 1.000; 1.004) were associated with higher probability of having obesity, while "sweet bakery products" were associated with lower probability of having obesity (OR = 0.996; 95% CI 0.991; 0.999) in females. The present study suggests association between PS of ED foods and obesity in European adolescents. Prospective studies are needed to examine the effect of prolonged exposure to large PS and obesity development. ; European Community Sixth RTD Framework Program FOODCT-2005-007034 ; Spanish Government European Commission FJCI-2017-34967

The authors would like to thank all the participants that took part of the study for their time and effort. We are grateful to Ms. Ana Yara PostigoFuentes for her assistance with the English language. This study is part of Cristina Molina-Hidalgo's Doctoral Thesis conducted in the Official Doctoral Programme in Psychology of the University of Granada, Spain. ; Background: High-intensity interval training (HIIT) is an effective approach to improve physical fitness, but consuming beer, which is a regular practice in many physically active individuals, may interfere with these effects. The purposes of this study were to investigate the effects of a 10-week (2 days/week) HIIT program on cardiorespiratory fitness, muscle strength and power parameters, and also to assess the possible influence on them of a moderate consumption of beer (at least from Monday to Friday) or its alcohol equivalent. Methods: Young (24 ± 6 years old) healthy adults (n = 73, 35 females) were allocated to five groups. Four groups participated in the HIIT intervention program while the fifth group was a control Non-Training group (n = 15). Participants in the training groups chose whether they preferred receiving alcohol or alcohol-free beverages. Those choosing alcohol were randomized to either beer or ethanol intake: (i) T-Beer group (alcohol beer, 5.4%; n = 13) or (ii) T-Ethanol (sparkling water with vodka, 5.4%; n = 14). Those choosing alcohol-free intake were randomized to (iii) T-Water group (sparkling water, 0.0%; n = 16), or (iv) T-0.0Beer group (alcohol-free beer, 0.0%; n = 15). Men ingested 330 ml of the beverage at lunch and 330 ml at dinner; women ingested 330 ml at dinner. Before and after the intervention, maximal oxygen uptake in absolute and relative terms (VO2max.), maximal heart rate, total test duration, hand grip strength and four types of vertical jumps were measured. Results: HIIT induced significant improvements in absolute and relative values of VO2max, and total test duration (all p < 0.05) in all the training groups; also, clinical improvements were found in hand grip strength. These positive effects were not influenced by the regular intake of beer or alcohol. No changes in the vertical jumps occurred in any of the groups. Conclusions: A moderate beer or alcohol intake does not mitigate the positive effect of a 10-week HIIT on physical fitness in young healthy adults. Trial registration: ClinicalTrials.gov ID: NCT03660579. Registered 20 September 2018. Retrospectively registered. ; Centro de Informacion Cerveza y Salud (CICS), Madrid, Spain ; Spanish Government FPU14/04172 FPU15/03960

Incluye material complementario ; Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males. ; Miguel Seral-Cortes, the corresponding author, has received funding from the Iberus Talent Pre-doctoral fellowships 2018, under the European Union's H2020 research and innovation programme under Marie Sklodowska-Curie grant agreement No 801586. Pilar de Miguel-Etayo was supported by ISCIII-CB15/00043 (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, CIBERObn). This work was part of the HELENA Study (http://www.helenastudy.com/). We gratefully acknowledge financial support of the European Community Sixth RTD Framework Programme (contract FOOD-CT-2005-007034). The data for this study were gathered under the auspices of the HELENA project, and further analysis was additionally supported by the Spanish Ministry of Economy and Competitiveness (Grants RYC-2010-05957 and RYC-2011-09011), the Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn).

This article belongs to the Special Issue Advances in Research on Nutrition and Childhood Obesity. On behalf of the HELENA study group. ; Obesity in children and adolescents is a public health problem and diet can play a major role in this condition. We aimed to identify sex-specific dietary patterns (DP) and to evaluate the association with overweight/obesity in European adolescents. We conducted a cross-sectional analysis with 2327 adolescents aged between 12.5 to 17.5 years from a multicenter study across Europe. The body mass index was categorized in "normal weight" and "overweight/obesity". Two non-consecutive 24-h dietary recalls were collected with a computerized self-reported software. Principal component factor analysis was used to identify DP. Mixed-effect logistic regression models were used to evaluate the association between the sex-specific DP and overweight/obesity outcome. As a result, we found three DP in boys (snacking and bread, Mediterranean diet, and breakfast) and four DP in girls (convenience, plant-based and eggs, Western, and breakfast). The association between DP and overweight/obesity highlights that those adolescents with higher adherence to the breakfast DP had lower odds for overweight/obesity, even after the inclusion of covariables in the adjustments. In European adolescents, the breakfast DP positively characterized by breakfast cereals, fruit, milk, and dairy and negatively characterized by sugar-sweetened beverages in boys and negatively characterized by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity. ; The HELENA study received funding from the European Union's Sixth RTD Framework Programme (contracts FOODCT-2007-036196-2 and FOODCT-2005-007034, respectively). Additional support was obtained from the Spanish Ministry of Education (AGL2007-29784-E/ALI). Leandro Teixeira Cacau received a research internship abroad scholarship (grant number 2020/12326-1) from the Sao Paulo Research Foundation (FAPESP). ; Peer reviewed