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Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents

Authors

  • M. Cuenca-García,

    Corresponding author
    1. Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
    2. Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Institute of Karolinska, Huddinge, Sweden
    • Corresponding author: Magdalena Cuenca-García, Department of Medical Physiology, School of Medicine. University of Granada. Avenida Madrid 12; 18012 Granada, Spain. Tel: +34 958 243540, Fax: +34 958 246179, E-mail: mmcuenca@ugr.es

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  • F. B. Ortega,

    1. Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
    2. Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Institute of Karolinska, Huddinge, Sweden
    3. Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain
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  • J. R. Ruiz,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Institute of Karolinska, Huddinge, Sweden
    2. Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain
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  • M. González-Gross,

    1. ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Technical University of Madrid, Madrid, Spain
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  • I. Labayen,

    1. Department of Nutrition and Food Sciences, University of the Basque Country, UPV/EHU, Vitoria, Spain
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  • R. Jago,

    1. Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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  • D. Martínez-Gómez,

    1. Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
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  • J. Dallongeville,

    1. Department of Epidemiology and Public Health, Lille Pasteur Institute, University of Lille, Lille, France
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  • S. Bel-Serrat,

    1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencias de la Salud, University of Zaragoza, Zaragoza, Spain
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  • A. Marcos,

    1. Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
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  • Y. Manios,

    1. Department of Nutrition and Dietetics, University of Harokopio, Athens, Greece
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  • C. Breidenassel,

    1. Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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  • K. Widhalm,

    1. Division of Clinical Nutrition and Prevention, Department of Pediatrics, School of Medicine, University of Vienna, Vienna, Austria
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  • F. Gottrand,

    1. Inserm U995, University of Lille2, Lille, France
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  • M. Ferrari,

    1. National Research Institute for Food and Nutrition, Rome, Italy
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  • A. Kafatos,

    1. Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Crete, Greece
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  • D. Molnár,

    1. Department of Pediatrics, University of Pécs, Pécs, Hungary
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  • L. A. Moreno,

    1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencias de la Salud, University of Zaragoza, Zaragoza, Spain
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  • S. De Henauw,

    1. Department of Public Health, University of Ghent, Ghent, Belgium
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  • M. J. Castillo,

    1. Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
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  • M. Sjöström,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Institute of Karolinska, Huddinge, Sweden
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  • and on behalf of the HELENA study group

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    • The names of people involved in the HELENA Study Group can be found online as Appendix 1.

Abstract

To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5–17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet.

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