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Nutrition and Health (including climate and ecological aspects)

Breakfast consumption and its relationship with diet quality and adherence to Mediterranean diet in European adolescents: the HELENA study

European Journal of Clinical Nutrition volume 76, pages 1690–1696 (2022)Cite this article

Subjects

Abstract

Objective

The aim of the current study is to analyze the associations between breakfast consumption and adherence to diet quality index (DQI) and Mediterranean Diet Score (MDS) in European adolescents.

Methods

A multinational cross-sectional study was carried out in 1804 adolescents aged 12.5–17.5 years. The Food Choices and Preferences questionnaire was used to ascertain breakfast consumption (consumers, occasional consumers and skippers), and two non-consecutive 24 h dietary recalls were used to estimate the total daily intake and to calculate the subsequent DQI and MDS. Mixed linear regression models were used to examine the relationship between breakfast consumption and DQI-A and MDS. Age, maternal education, BMI, country and total energy intake were included as covariates.

Results

In both sexes, significant differences were observed among the breakfast consumption categories. In both boys and girls, breakfast consumers had significantly higher DQI indices than those adolescents who skipped breakfast regularly (p < 0.001). Regarding total MDS, in both boys and girls, breakfast consumers had a higher total MDS than breakfast skippers (p < 0.001), however, no associations were shown between occasional breakfast consumers and DQI indices and MDS.

Conclusion

Breakfast consumption has been linked with better dietary quality scores compared with those children who usually skip breakfast. Promotion of regular breakfast consumption in adolescents could be an effective strategy to improve the overall diet quality.

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Fig. 1: Proportion of breakfast consumers, occasional breakfast consumers and breakfast skippers of the study sample by sex.
Fig. 2: Mean diet quality indices of the study sample by sex.
Fig. 3: Mean Mediterranean Diet Score of the study sample by sex.

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Data availability

The data generated or analyzed during this study can be found within the published article.

References

  1. Gibney MJ, Barr SI, Bellisle F, Drewnowski A, Fagt S, Hopkins S, et al. Towards an evidence-based recommendation for a balanced breakfast-a proposal from the international breakfast research initiative. Nutrients. 2018;10. https://doi.org/10.3390/nu10101540.

  2. Bi H, Gan Y, Yang C, Chen Y, Tong X, Lu Z. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr. 2015;18:3013–9. https://doi.org/10.1017/s1368980015000257.

    Article  PubMed  Google Scholar 

  3. Monzani A, Ricotti R, Caputo M, Solito A, Archero F, Bellone S, et al. A Systematic review of the association of skipping breakfast with weight and cardiometabolic risk factors in children and adolescents. What Should we better investigate in the future? Nutrients. 2019;11. https://doi.org/10.3390/nu11020387.

  4. O'Neil CE, Byrd-Bredbenner C, Hayes D, Jana L, Klinger SE, Stephenson-Martin S. The role of breakfast in health: definition and criteria for a quality breakfast. J Acad Nutr Diet. 2014;114:S8–S26. https://doi.org/10.1016/j.jand.2014.08.022.

    Article  PubMed  Google Scholar 

  5. Murakami K, Livingstone MBE, Fujiwara A, Sasaki S. Breakfast in Japan: findings from the 2012 National Health and Nutrition Survey. Nutrients. 2018;10. https://doi.org/10.3390/nu10101551.

  6. Wang M, Zhong JM, Wang H, Zhao M, Gong WW, Pan J, et al. Breakfast consumption and its associations with health-related behaviors among school-aged adolescents: a cross-sectional study in Zhejiang Province, China. Int J Environ Res Public Health. 2016;13. https://doi.org/10.3390/ijerph13080761.

  7. Giménez-Legarre N, Miguel-Berges ML, Flores-Barrantes P, Santaliestra-Pasías AM, Moreno LA. Breakfast characteristics and its association with daily micronutrients intake in children and adolescents-a systematic review and meta-analysis. Nutrients. 2020;12. https://doi.org/10.3390/nu12103201.

  8. Giménez-Legarre N, Flores-Barrantes P, Miguel-Berges ML, Moreno LA, Santaliestra-Pasías AM. Breakfast characteristics and their association with energy, macronutrients, and food intake in children and adolescents: a systematic review and meta-analysis. Nutrients. 2020;12. https://doi.org/10.3390/nu12082460.

  9. Badrasawi M, Anabtawi O, Al-Zain Y. Breakfast characteristics, perception, and reasons of skipping among 8th and 9th-grade students at governmental schools, Jenin governance, West Bank. BMC Nutr. 2021;7:42 https://doi.org/10.1186/s40795-021-00451-1.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Julián C, Huybrechts I, Gracia-Marco L, González-Gil EM, Gutiérrez Á, González-Gross M, et al. Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study. Osteoporos Int. 2018;29:1329–40. https://doi.org/10.1007/s00198-018-4427-7.

    Article  PubMed  CAS  Google Scholar 

  11. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348:2599–608. https://doi.org/10.1056/NEJMoa025039

    Article  PubMed  Google Scholar 

  12. Arvaniti F, Panagiotakos DB. Healthy indexes in public health practice and research: a review. Crit Rev Food Sci Nutr. 2008;48:317–27. https://doi.org/10.1080/10408390701326268

    Article  PubMed  Google Scholar 

  13. Vyncke K, Cruz Fernandez E, Fajo-Pascual M, Cuenca-Garcia M, De Keyzer W, Gonzalez-Gross M, et al. Validation of the Diet Quality Index for Adolescents by comparison with biomarkers, nutrient and food intakes: the HELENA study. Br J Nutr. 2013;109:2067–78. https://doi.org/10.1017/s000711451200414x.

    Article  PubMed  CAS  Google Scholar 

  14. Iaccarino Idelson P, Scalfi L, Valerio G. Adherence to the Mediterranean Diet in children and adolescents: a systematic review. Nutr Metab Cardiovasc Dis. 2017;27:283–99. https://doi.org/10.1016/j.numecd.2017.01.002.

    Article  PubMed  CAS  Google Scholar 

  15. Martínez-González MA, Salas-Salvadó J, Estruch R, Corella D, Fitó M, Ros E, et al. Benefits of the Mediterranean Diet: insights from the PREDIMED study. Prog Cardiovasc Dis. 2015;58:50–60. https://doi.org/10.1016/j.pcad.2015.04.003.

    Article  PubMed  Google Scholar 

  16. Grammatikopoulou MG, Gkiouras K, Daskalou E, Apostolidou E, Theodoridis X, Stylianou C, et al. Growth, the Mediterranean diet and the buying power of adolescents in Greece. J Pediatr Endocrinol Metab. 2018;31:773–80. https://doi.org/10.1515/jpem-2018-0039.

    Article  PubMed  Google Scholar 

  17. Bacopoulou F, Landis G, Rentoumis A, Tsitsika A, Efthymiou V. Mediterranean diet decreases adolescent waist circumference. Eur J Clin Investig. 2017;47:447–55. https://doi.org/10.1111/eci.12760.

    Article  Google Scholar 

  18. Leech RM, Worsley A, Timperio A, McNaughton SA. Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality. Nutr Res Rev. 2015;28:1–21. https://doi.org/10.1017/S0954422414000262.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Monteagudo C, Palacin-Arce A, Bibiloni Mdel M, Pons A, Tur JA, Olea-Serrano F, et al. Proposal for a Breakfast Quality Index (BQI) for children and adolescents. Public Health Nutr. 2013;16:639–44. https://doi.org/10.1017/s1368980012003175.

    Article  PubMed  Google Scholar 

  20. Lazarou C, Matalas AL. Breakfast intake is associated with nutritional status, Mediterranean diet adherence, serum iron and fasting glucose: the CYFamilies study. Public Health Nutr. 2015;18:1308–16. https://doi.org/10.1017/s1368980014001967.

    Article  PubMed  Google Scholar 

  21. Fayet-Moore F, Kim J, Sritharan N, Petocz P Impact of Breakfast Skipping and Breakfast Choice on the Nutrient Intake and Body Mass Index of Australian Children. Nutrients. 2016;8 https://doi.org/10.3390/nu8080487.

  22. Moreno LA, De Henauw S, González-Gross M, Kersting M, Molnár D, Gottrand F, et al. Design and implementation of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. Int J Obes. 2008;32 Suppl 5:S4–11. https://doi.org/10.1038/ijo.2008.177.

    Article  Google Scholar 

  23. Cochran WG. Sampling techniques. 2nd ed. New York: John Wiley and Sons Inc.; 1963. p. 134–5.

  24. Béghin L, Castera M, Manios Y, Gilbert CC, Kersting M, De Henauw S, et al. Quality assurance of ethical issues and regulatory aspects relating to good clinical practices in the HELENA Cross-Sectional Study. Int J Obes. 2008;32 Suppl 5:S12–18. https://doi.org/10.1038/ijo.2008.179.

    Article  Google Scholar 

  25. Nagy E, Vicente-Rodriguez G, Manios Y, Béghin L, Iliescu C, Censi L, et al. Harmonization process and reliability assessment of anthropometric measurements in a multicenter study in adolescents. Int J Obes. 2008;32 Suppl 5:S58–65. https://doi.org/10.1038/ijo.2008.184.

    Article  Google Scholar 

  26. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Diethelm K, Huybrechts I, Moreno L, De Henauw S, Manios Y, Beghin L, et al. Nutrient intake of European adolescents: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr. 2014;17:486–97. https://doi.org/10.1017/S1368980013000463.

    Article  PubMed  Google Scholar 

  28. Vereecken CA, Covents M, Matthys C, Maes L. Young adolescents' nutrition assessment on computer (YANA-C). Eur J Clin Nutr.2005;59:658–67. https://doi.org/10.1038/sj.ejcn.1602124.

    Article  PubMed  CAS  Google Scholar 

  29. Harttig U, Haubrock J, Knüppel S, Boeing H, Consortium E. The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. Eur J Clin Nutr. 2011;65 Suppl 1:S87–91. https://doi.org/10.1038/ejcn.2011.92.

    Article  PubMed  Google Scholar 

  30. Huybrechts I, Vereecken C, De Bacquer D, Vandevijvere S, Van Oyen H, Maes L, et al. Reproducibility and validity of a diet quality index for children assessed using a FFQ. Br J Nutr. 2010;104:135–44. https://doi.org/10.1017/s0007114510000231.

    Article  PubMed  CAS  Google Scholar 

  31. VIG. De actieve voedingsdriehoek: een praktische voedings- en beweeggids (The Active Food Pyramid: A Practical Guide to Diet and Physical Activity) Brussels: Vlaams Instituut voor Gezondheidspromotie (VIG); 2006.

  32. Jimenez-Pavon D, Sese MA, Huybrechts I, Cuenca-Garcia M, Palacios G, Ruiz JR, et al. Dietary and lifestyle quality indices with/without physical activity and markers of insulin resistance in European adolescents: the HELENA study. Br J Nutr. 2013;110:1919–25. https://doi.org/10.1017/s0007114513001153.

    Article  PubMed  CAS  Google Scholar 

  33. Aparicio-Ugarriza R, Cuenca-Garcia M, Gonzalez-Gross M, Julian C, Bel-Serrat S, Moreno LA, et al. Relative validation of the adapted Mediterranean Diet Score for Adolescents by comparison with nutritional biomarkers and nutrient and food intakes: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Public Health Nutr. 2019;22:2381–97. https://doi.org/10.1017/s1368980019001022.

    Article  PubMed  Google Scholar 

  34. Hallström L, Vereecken CA, Ruiz JR, Patterson E, Gilbert CC, Catasta G, et al. Breakfast habits and factors influencing food choices at breakfast in relation to socio-demographic and family factors among European adolescents. The HELENA Study. Appetite. 2011;56:649–57. https://doi.org/10.1016/j.appet.2011.02.019.

    Article  PubMed  Google Scholar 

  35. Mielgo-Ayuso J, Valtueña J, Cuenca-García M, Gottrand F, Breidenassel C, Ferrari M, et al. Regular breakfast consumption is associated with higher blood vitamin status in adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. 2017. https://doi.org/10.1017/S1368980016003645.

  36. Hopkins LC, Sattler M, Steeves EA, Jones-Smith JC, Gittelsohn J. Breakfast consumption frequency and its relationships to overall diet quality, using Healthy Eating Index 2010, and Body Mass Index among adolescents in a low-income urban setting. Ecol Food Nutr. 2017;56:297–311. https://doi.org/10.1080/03670244.2017.1327855.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ostachowska-Gasior A, Piwowar M, Kwiatkowski J, Kasperczyk J, Skop-Lewandowska A. Breakfast and other meal consumption in adolescents from Southern Poland. Int J Environ Res Public Health. 2016;13. https://doi.org/10.3390/ijerph13050453.

  38. Keski-Rahkonen A, Kaprio J, Rissanen A, Virkkunen M, Rose RJ. Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr. 2003;57:842–53. https://doi.org/10.1038/sj.ejcn.1601618.

    Article  PubMed  CAS  Google Scholar 

  39. Sila S, Ilić A, Mišigoj-Duraković M, Sorić M, Radman I, Šatalić Z. Obesity in adolescents who skip breakfast is not associated with physical activity. Nutrients. 2019;11. https://doi.org/10.3390/nu11102511.

  40. Gikas AT JK, Perdikaki P. Breakfast skipping and its association with other unhealthy food habits among Greek high school adolescents. Ann Gastroenterol. 2003;16:321–7.

    Google Scholar 

  41. Gil Á, Martinez de Victoria E, Olza J. Indicators for the evaluation of diet quality. Nutr Hosp. 2015;31(Suppl 3):128–44. https://doi.org/10.3305/nh.2015.31.sup3.8761.

    Article  PubMed  Google Scholar 

  42. Mounayar R, Jreij R, Hachem J, Abboud F, Tueni M. Breakfast intake and factors associated with adherence to the Mediterranean Diet among Lebanese High School Adolescents. J Nutr Metab. 2019;2019:2714286 https://doi.org/10.1155/2019/2714286.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Santos TSS, Julián C, Vincenzi SL, de Andrade DF, Slater B, de Assis MAA, et al. A new measure of health motivation influencing food choices and its association with food intakes and nutritional biomarkers in European adolescents. Public Health Nutr. 2020:1-11. https://doi.org/10.1017/S1368980019004658.

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Acknowledgements

The authors would like to acknowledge all the adolescents and their families who voluntarily participated in the study and the members involved in it. The authors would like to thank the members of the HELENA study group: Co-ordinator: 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. 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, Jesús Mª 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, Cristina Julián, Mary Miguel-Berges, Isabel Iguacel, Azahara Rupérez. 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.: Université de Lille 2 (France): Laurent Beghin, Christian Libersa, Frédéric Gottrand, Catalina Iliescu, Juliana Von Berlepsch. Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn (Germany): Mathilde Kersting, Wolfgang Sichert-Hellert, Ellen Koeppen. Pécsi Tudományegyetem (University of Pécs) (Hungary): Dénes Molnar, Eva Erhardt, Katalin Csernus, Katalin Török, Szilvia Bokor, Mrs. Angster, Enikö Nagy, Orsolya Kovács, Judit Répasi. 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. 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. 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. 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. University of Napoli “Federico II” Dept of Food Science (Italy): Luca Scalfi, Paola Vitaglione, Concetta Montagnese. 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. Medical University of Vienna (Austria): Kurt Widhalm, Katharina Phillipp, Sabine Dietrich, Birgit Kubelka Marion Boriss-Riedl. 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. Institut Pasteur de Lille (France): Jean Dallongeville, Aline Meirhaeghe. 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. 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. Campden BRI (United Kingdom): Chantal Gilbert, Sarah Thomas, Elaine Allchurch, Peter Burgess. SIK - Institutet foer Livsmedel och Bioteknik (Sweden): Gunnar Hall, Annika Astrom, Anna Sverkén, Agneta Broberg. Meurice Recherche & Development asbl (Belgium): Annick Masson, Claire Lehoux, Pascal Brabant, Philippe Pate, Laurence Fontaine. Campden & Chorleywood Food Development Institute (Hungary): Andras Sebok, Tunde Kuti, Adrienn Hegyi. Productos Aditivos SA (Spain): Cristina Maldonado, Ana Llorente. Cárnicas Serrano SL (Spain): Emilio García. Cederroth International AB (Sweden): Holger von Fircks, Marianne Lilja Hallberg, Maria Messerer. Lantmännen Food R&D (Sweden): Mats Larsson, Helena Fredriksson, Viola Adamsson, Ingmar Börjesson. European Food Information Council (Belgium): Laura Fernández, Laura Smillie, Josephine Wills. 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.

Funding

The HELENA Study was carried out with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034). Additionally, the first author, NGL received financial support by Fundación Cuenca Villoro (Spain). This analysis was also supported by the Spanish Ministry of Science and Innovation [JCI-2010-07055] with the contribution of the European Regional Development Fund (FEDER). The content of this article 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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Author notes

  1. Deceased: Michael Sjöström.

Authors and Affiliations

  1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

    Natalia Giménez-Legarre, Alba M. Santaliestra-Pasías & Luis A. Moreno

  2. Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain

    Natalia Giménez-Legarre, Alba M. Santaliestra-Pasías & Luis A. Moreno

  3. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

    Natalia Giménez-Legarre, Alba M. Santaliestra-Pasías & Luis A. Moreno

  4. Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud, Carlos III, Madrid, Spain

    Alba M. Santaliestra-Pasías, Marcela González-Gross & Luis A. Moreno

  5. Department of Public Health, Ghent University, Ghent, Belgium

    Stefaan De Henauw

  6. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden

    Maria Forsner & Michael Sjöström

  7. ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain

    Marcela González-Gross

  8. Department of Nutrition and Food Sciences-Nutritional Physiology, University of Bonn, Bonn, Germany

    Marcela González-Gross

  9. Department of Medical Physiology. School of Medicine, University of Granada, Granada, Spain

    Lucas Jurado-Fasoli

  10. PROmoting FITness and Health through Physical Activity Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain

    Lucas Jurado-Fasoli

  11. University of Crete, School of Medicine, Heraklion, Greece

    Anthony Kafatos

  12. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece

    Eva Karaglani & Christina-Paulina Lambrinou

  13. Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary

    Dénes Molnár

  14. Division Gastroenterology and Hepatology, Dept. Med II, MedUniv Vienna, Vienna, Austria

    Kurt Widhalm

  15. Department of Pediatrics, Private Medical University, Salzburg, Austria

    Kurt Widhalm

Authors
  1. Natalia Giménez-Legarre
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  2. Alba M. Santaliestra-Pasías
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  11. Michael Sjöström
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  13. Luis A. Moreno
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Contributions

SH, MGG, AK, DM, MS, KW and LAM conceived and designed the study. NGL, AMSP and LAM conducted the interpretation of data. NGL, AMSP, SH, MF, MGG, LJF, AK, EK, CPL, DM, MS, KW, LAM critically reviewed the manuscript. NGL, AMSP and LAM wrote the paper. All the authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Alba M. Santaliestra-Pasías.

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Competing interests

The authors declare no competing interests.

Ethics approval

The HELENA study was performed following the ethical guidelines of the Declaration of Helsinki 1964, and the ethical committee of each centre approved the study.

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Giménez-Legarre, N., Santaliestra-Pasías, A.M., De Henauw, S. et al. Breakfast consumption and its relationship with diet quality and adherence to Mediterranean diet in European adolescents: the HELENA study. Eur J Clin Nutr 76, 1690–1696 (2022). https://doi.org/10.1038/s41430-022-01177-4

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