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Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study



Adequate sleep is a critical factor for adolescent's health and health-related behaviors.


(a) to describe sleep duration in European adolescents from nine countries, (b) to assess the association of short sleep duration with excess adiposity and (c) to elucidate if physical activity (PA), sedentary behaviors and/or inadequate food habits underlie this association.


A sample of 3311 adolescents (1748 girls) aged 12.5–17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece, Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study between 2006 and 2008. We measured anthropometric data, sleep duration, PA (accelerometers and questionnaire), television watching and food habits (Food Frequency Questionnaire).


Average duration of daily sleep was 8 h. Shorter sleepers showed higher values of BMI, body fat, waist and hip circumferences and fat mass index (P<0.05), particularly in females. Adolescents who slept <8 h per day were more sedentary, as assessed by accelerometry, and spent more time watching TV (P<0.05). The proportion of adolescents who eat adequate amounts of fruits, vegetables and fish was lower in shorter sleepers than in adolescents who slept 8 h per day, and so was the probability of having adequate food habits (P<0.05). Correlation analysis indicated that short sleep is associated with higher obesity parameters.


In European adolescents, short sleep duration is associated with higher adiposity markers, particularly in female adolescents. This association seems to be related to both sides of the energy balance equation due to a combination of increased food intake and more sedentary habits.

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The HELENA Study was carried out with the financial support of the European Community Sixth RTD Framework Programme (Contract FOODCT-2005-007034). This work was also partially supported by grants from the Spanish Ministry of Education (EX-2008-0641), the Spanish Ministry of Science and Innovation (RYC-2010-05957) and the Swedish Heart-Lung Foundation (20090635). The writing group takes sole responsibility for the content of this article. The content of this paper reflects only the authors’ views, and the European Community is not liable for any use that may be made of the information contained therein.

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Correspondence to M Garaulet.

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Additional information

For HELENA study group see Appendix.



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, Jackie Sánchez, 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, Jesús Fleta, José A Casajús, Gerardo Rodríguez, Concepción Tomás, María I Mesana, Germán Vicente-Rodríguez, Adoración Villarroya, Carlos M Gil, Ignacio Ara, Juan Revenga, Carmen Lachen, Juan Fernández Alvira, Gloria Bueno, Aurora Lázaro, Olga Bueno, Juan F León, Jesús Ma Garagorri, Manuel Bueno, Juan Pablo Rey López, Iris Iglesia, Paula Velasco, Silvia Bel.

 2. Consejo Superior de Investigaciones Científicas (Spain)

Ascensión Marcos, Julia Wärnberg, Esther Nova, Sonia Gómez, Esperanza Ligia Díaz, Javier Romeo, Ana Veses, Mari Angeles Puertollano, Belén Zapatera, Tamara Pozo.

 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 Repásy.

 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-Romero, David Jiménez-Pavón, Palma Chillón.

 9. Istituto Nazionalen di Ricerca per gli Alimenti e la Nutrizione (Italy)

Davide Arcella, Giovina Catasta, Laura Censi, Donatella Ciarapica, Marika Ferrari, Cinzia Le Donne, Catherine Leclerq, Luciana Magrì, Giuseppe Maiani, Rafaela Piccinelli, Angela Polito, Raffaela Spada, Elisabetta Toti.

 10. University of Napoli ‘Federico II’ Department 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.

 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, Katerina Kondaki, Stamatoula Tsikrika, Christos Karaiskos.

 14. Institut Pasteur de Lille (France)

Jean Dallongeville, Aline Meirhaeghe.

 15. Karolinska Institutet (Sweden)

Michael Sjöstrom, Patrick Bergman, María Hagströmer, Lena Hallström, Mårten Hallberg, Eric Poortvliet, Julia Wärnberg, Nico Rizzo, Linda Beckman, Anita Hurtig Wennlöf, Emma Patterson, Lydia Kwak, Lars Cernerud, Per Tillgren, Stefaan Sörensen.

 16. Asociación de Investigación de la Industria Agroalimentaria (Spain)

Jackie Sánchez-Molero, Elena Picó, Maite Navarro, Blanca Viadel, José Enrique Carreres, Gema Merino, Rosa Sanjuán, María Lorente, María José Sánchez, Sara Castelló.

 17. Campden & Chorleywood Food Research Association (United Kingdom)

Chantal Gilbert, Sarah Thomas, Elaine Allchurch, Peter Burguess.

 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, Agustín Meléndez, Pedro J Benito, Javier Calderón, David Jiménez-Pavón, Jara Valtueña, Paloma Navarro, Alejandro Urzanqui, Ulrike Albers, Raquel Pedrero, Juan José Gómez Lorente.

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Garaulet, M., Ortega, F., Ruiz, J. et al. Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes 35, 1308–1317 (2011).

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  • sleep
  • adolescence
  • food intake
  • physical activity

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