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Multicenter Study
. 2021 Jan 30;13(2):474.
doi: 10.3390/nu13020474.

Mediterranean Diet, Screen-Time-Based Sedentary Behavior and Their Interaction Effect on Adiposity in European Adolescents: The HELENA Study

Miguel Seral-Cortes  1 , Sergio Sabroso-Lasa  2 , Alexandro Bailo-Aysa  3 , Marcela Gonzalez-Gross  4   5   6 , Dénes Molnár  7 , Laura Censi  8 , Cristina Molina-Hidalgo  9 , Frederic Gottrand  10 , Stefaan De Henauw  11 , Yannis Manios  12 , Christina Mavrogianni  12 , Kurt Widhalm  13 , Anthony Kafatos  14 , Jean Dallongeville  15 , Luis A Moreno  1   4 , Luis Mariano Esteban  16 , Idoia Labayen  17 , Pilar De Miguel-Etayo  1   4 , On Behalf Of The Helena Study Group
Affiliations
Multicenter Study

Mediterranean Diet, Screen-Time-Based Sedentary Behavior and Their Interaction Effect on Adiposity in European Adolescents: The HELENA Study

Miguel Seral-Cortes et al. Nutrients. .

Abstract

Childhood obesity is a worldwide epidemic. Mediterranean diet (MD) is inversely associated with childhood obesity, but the interaction with other environmental factors, such screen time, might influence the health benefits of a high MD adherence in adolescents. The aim of the present study was to assess whether an association between MD and screen time exists in European adolescents. Moreover, we also explored whether sedentary time has a modulatory effect on the association between MD and adiposity. Adherence to the MD (24 h recalls), screen time (questionnaire), pubertal development, body mass index (BMI), fat mass index (FMI) and waist circumference (WC) were evaluated in 2053 adolescents (54.7% females), aged 12.5-17.5 years. In females, MD adherence was associated with lower BMI and FMI only when they were exposed to less than 338 min/day of screen time (81.8% of females); MD adherence was also associated with lower WC only when females were exposed to less than 143 min/day of screen time (31.5% of females). No significant MD-screen time interaction was observed in males. In conclusion, screen-time-based sedentary behaviours had a modulatory effect in the association between MD adherence and adiposity in European female adolescents.

Keywords: Mediterranean diet; adiposity; adolescents; gender and HELENA; sedentary time.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. The content of this article reflects the authors’ views alone, and the European Community is not liable for any use that may be made of the information contained herein.

Figures

Figure 1
Figure 1
Flow chart of the sample selection process. Abbreviations: FAS, family affluence scale; BMI, body mass index; FMI, fat mass index and WC, waist circumference.
Figure 2
Figure 2
Distribution of screen time (% displayed) among HELENA participants by sex.
Figure 3
Figure 3
Matrix panel of interaction models on (a) BMI (body mass index), (b) WC (waist circumference), (c) FMI (fat mass index); and MD (Mediterranean diet) according to screen time modulation in females. In order to design the representation of the distribution in HELENA adolescents, different lines were traced as reference points to observe the slope of the studied population according to the sedentary time. A positive gradient represents the MD acting as risk factor, while a negative gradient shows the MD acting as protective factor.
Figure 3
Figure 3
Matrix panel of interaction models on (a) BMI (body mass index), (b) WC (waist circumference), (c) FMI (fat mass index); and MD (Mediterranean diet) according to screen time modulation in females. In order to design the representation of the distribution in HELENA adolescents, different lines were traced as reference points to observe the slope of the studied population according to the sedentary time. A positive gradient represents the MD acting as risk factor, while a negative gradient shows the MD acting as protective factor.
See this image and copyright information in PMC

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