Final Report Summary - HELENA (Healthy lifestyle in Europe by nutrition in adolescence)
The HELENA project aimed to obtain reliable and comparable data of a representative sample of European adolescents in order to contribute to understanding why health related messages were not as effective as expected in the adolescent population. The requirements for health promoting foods would also be identified and three sensory acceptable products for adolescents would be developed. Therefore, the specific project objectives were to:
1. develop and harmonise innovative methods for the assessment of lifestyle habits of adolescents across Europe with special focus on diet, nutrition and physical activity
2. assess dietary and physical activity patterns as well as nutritional status among European adolescents
3. investigate knowledge and attitudes towards nutrition and physical activity among the targeted groups and establish the main determinants of their food choice and preferences
4. describe regional, cultural, social, genetic and gender differences and similarities across Europe
5. identify adolescents at risk of eating disorders, dislipidemia, obesity and type two diabetes
6. develop a number of healthy foods and identify marketing strategies for consumers in order to improve adolescents' diet
7. develop a lifestyle education programme and test its efficacy in improving adolescents' health.
The target population was of 12.5 to 17.5 years of age with no exclusion criteria. A total of 44 focus groups took place, evenly divided by gender and age. A series of data were collected in five European countries, concerning food and nutrients' intake, food choices and preferences, obesity prevalence, dislipidemia, insulin resistance, vitamin and minerals status, immunological markers for subclinical malnutrition, physical activity and fitness patterns and, finally, variations of the nucleotide sequence in selected genes. Questionnaires were distributed to determine the favourite adolescents' snack as well as the reasons for snacking. A gender analysis of the derived information was also performed and a computer based tool was developed to assess dietary intake.
In addition, data on physical activity among the European adolescents were collected using an objective methodology, namely accelerometry, to avoid difficulties that were associated with methods using self reports. Moreover, the frequency of overweight and obese individuals was determined and the health condition of the adolescents was studied.
Similarities and differences in food selection and meal patterns across the various countries were subsequently analysed. It occurred that snacking between meals was a consistent finding in all cases. Key barriers towards healthy eating were also identified.
In parallel, three new foods with beneficial nutritional profiles were developed through a consumer led process. The alternatives differed considerably in their technological characteristics and their healthiness was safeguarded by nutritional experts. On the whole, the proposals were well accepted by European adolescents; however differences in degrees of 'liking' existed between different countries. The results demonstrated an approach that could be successfully employed by the food industry for the development of both healthy and adolescent-attractive foods.
An intervention study, nested in the cross sectional study, was also performed in four countries. Two alternative diets were designed and tested in female adolescents. Overall, there were no effects of dietary treatment on thirst, nausea, bloating, constipation, flatulence and diarrhoea. On the other hand, a significant reduction of the desire to eat and an increase of fullness occurred using one of the diets.
Finally, two separate web-based tools generating individual tailored advice on eating habits and physical activity were developed. The tools could be used in the context of nutrition and obesity prevention programmes of schools, health services, hospitals, nongovernmental organisations (NGOs), supermarkets, independent professionals and sports clubs.
1. develop and harmonise innovative methods for the assessment of lifestyle habits of adolescents across Europe with special focus on diet, nutrition and physical activity
2. assess dietary and physical activity patterns as well as nutritional status among European adolescents
3. investigate knowledge and attitudes towards nutrition and physical activity among the targeted groups and establish the main determinants of their food choice and preferences
4. describe regional, cultural, social, genetic and gender differences and similarities across Europe
5. identify adolescents at risk of eating disorders, dislipidemia, obesity and type two diabetes
6. develop a number of healthy foods and identify marketing strategies for consumers in order to improve adolescents' diet
7. develop a lifestyle education programme and test its efficacy in improving adolescents' health.
The target population was of 12.5 to 17.5 years of age with no exclusion criteria. A total of 44 focus groups took place, evenly divided by gender and age. A series of data were collected in five European countries, concerning food and nutrients' intake, food choices and preferences, obesity prevalence, dislipidemia, insulin resistance, vitamin and minerals status, immunological markers for subclinical malnutrition, physical activity and fitness patterns and, finally, variations of the nucleotide sequence in selected genes. Questionnaires were distributed to determine the favourite adolescents' snack as well as the reasons for snacking. A gender analysis of the derived information was also performed and a computer based tool was developed to assess dietary intake.
In addition, data on physical activity among the European adolescents were collected using an objective methodology, namely accelerometry, to avoid difficulties that were associated with methods using self reports. Moreover, the frequency of overweight and obese individuals was determined and the health condition of the adolescents was studied.
Similarities and differences in food selection and meal patterns across the various countries were subsequently analysed. It occurred that snacking between meals was a consistent finding in all cases. Key barriers towards healthy eating were also identified.
In parallel, three new foods with beneficial nutritional profiles were developed through a consumer led process. The alternatives differed considerably in their technological characteristics and their healthiness was safeguarded by nutritional experts. On the whole, the proposals were well accepted by European adolescents; however differences in degrees of 'liking' existed between different countries. The results demonstrated an approach that could be successfully employed by the food industry for the development of both healthy and adolescent-attractive foods.
An intervention study, nested in the cross sectional study, was also performed in four countries. Two alternative diets were designed and tested in female adolescents. Overall, there were no effects of dietary treatment on thirst, nausea, bloating, constipation, flatulence and diarrhoea. On the other hand, a significant reduction of the desire to eat and an increase of fullness occurred using one of the diets.
Finally, two separate web-based tools generating individual tailored advice on eating habits and physical activity were developed. The tools could be used in the context of nutrition and obesity prevention programmes of schools, health services, hospitals, nongovernmental organisations (NGOs), supermarkets, independent professionals and sports clubs.