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Calderon Sanchez, JavierAuthorGomez Lorente, Juan JoseAuthorBenito Peinado, Pedro JoséAuthorPedrero Chamizo, RaquelAuthorNavarro Dongil, PalomaAuthorGonzalez-Gross, MarcelaAuthor

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June 9, 2019
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Nutrition and Lifestyle in European Adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

Publicated to: Advances In Nutrition. 5 (5): 615S-623S - 2014-09-01 5(5), DOI: 10.3945/an.113.005678

Authors: Moreno, Luis A; Gottrand, Frederic; Huybrechts, Inge; Ruiz, Jonatan R; Gonzalez-Gross, Marcela; De Henauw, Stefaan

Affiliations

Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France - Author
Jeanne de Flandre Univ Hosp, Natl Inst Hlth & Med Res, Lille, France - Author
Tech Univ Madrid, Fac Phys Act & Sport Sci, Dept Hlth & Human Performance, ImFINE Res Grp, Madrid, Spain - Author
Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium - Author
Univ Granada, Fac Sport Sci, Dept Phys Educ & Sport, PROFITH Promoting Fitness & Hlth Phys Act Res Grp, Granada, Spain - Author
Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Fac Hlth Sci, Zaragoza, Spain - Author
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Abstract

Adolescence is a critical period, because major physical and psychologic changes occur during a very short period of time. Changes in dietary habits may induce different types of nutritional disorders and are likely to track into adulthood. The aim of this review is to describe the key findings related to nutritional status in European adolescents participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. We performed a cross-sectional study in 3528 (1845 females) adolescents aged 12.5-17.5 y. Birth weight was negatively associated with abdominal fat mass in adolescents and serum leptin concentrations (in female adolescents), providing additional evidence for a programming effect of birth weight on energy homeostasis control. Breakfast consumption was associated with lower body fat content and healthier cardiovascular profile. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk and milk products but consume more meat and meat products, fats, and sweets than recommended. For beverage consumption, sugar-sweetened beverages, sweetened milk, low-fat milk, and fruit juice provided the highest amount of energy. Although the intakes of saturated fatty acids (FAs) and salt were high, the intake of polyunsaturated FAs was low. Adolescents spent, on average, 9 h/d of their waking time (66-71% and 70-73% of the registered time in boys and girls, respectively) in sedentary activities. Factors associated with adolescents' sedentary behavior included the following: 1) age; 2) media availability in the bedroom; 3) sleeping time; 4) breakfast consumption; and 5) season. Sedentary time was also associated with cardiovascular risk factors and bone mineral content. In European adolescents, deficient concentrations were identified for plasma folate (15%), vitamin D (15%), pyridoxal 5'-phosphate (5%), beta-carotene (25%), and vitamin E (5%). Scientists and public health authorities should raise awareness of the importance of a healthy and sustainable lifestyle as a foundation of the health of the European population, now and in the future.

Keywords

Beta-caroteneDiet quality indexInsulin-resistanceLow-birth-weightMultiple source methodNutrient intakePhysical-activitySedentary behaviorSleep durationVitamin-d status

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Advances In Nutrition due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2014, it was in position 5/77, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 3.46. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 4.95 (source consulted: FECYT Mar 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-12-05, the following number of citations:

  • WoS: 136
  • Scopus: 154
  • Europe PMC: 46

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-12-05:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 501.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 520 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 9.
  • The number of mentions on the social network X (formerly Twitter): 4 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Austria; Belgium; France; Germany; Greece; Hungary; Italy; Sweden; United Kingdom.

Awards linked to the item

The IUNS and the 20th ICN wish to thank the California Walnut Commission and Mead Johnson Nutrition for generously providing educational grants to support the publication and distribution of proceedings from the 20th ICNr The HELENA study was supported by the European Community sixth RTD Framework Programme (Contract FOOD-CT-2005-007034) Additional support for this study was received from the Spanish Ministry of Education grants AGL2007-29784-E/ALI and AP-2005-3827, Axis-Shield Diagnostics (Oslo, Norway), Abbot Scientific (Spain), Technical University of Madrid grant CH/018/2008, and Spanish Ministry of Science and Innovation grant RYC-2010-05957.