title: Health inequalities in urban adolescents: role of physical activity, diet, and genetics.
abstract: OBJECTIVE
  Coordinated European projects relying on standardized methods are needed to identify health inequalities across Europe. This study aimed to compare fitness, fatness, and cardiometabolic risk between urban adolescents from the south and center-north of Europe and to explore whether physical activity (PA) and other factors might explain these differences.
  
  
  METHODS
  The Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional project comprised 3528 adolescents from the south (4 cities) and central-north (6 cities) of Europe, 1089 of whom provided blood samples for analysis. Fitness (strength, speed-agility, and cardiorespiratory fitness), total and abdominal fatness (anthropometry and bioelectrical impedance), and cardiometabolic risk (z scores including fitness, fatness, blood lipids, insulin resistance, and blood pressure) were assessed. The analyses were adjusted for socioeconomic factors, objectively measured PA (accelerometry), total energy intake and diet quality, and genetic variants of the FTO rs9939609 polymorphism.
  
  
  RESULTS
  Adolescents from southern Europe were less fit and fatter according to all markers (P < .001). Differences in cardiometabolic risk scores were not consistent. Adolescents from the south were less active and this would largely explain the differences observed in speed-agility and cardiorespiratory fitness. Differences in total and abdominal fatness could not be explained by PA, energy intake, diet quality, or FTO rs9939609 polymorphism.
  
  
  CONCLUSIONS
  Fitness and fatness levels indicate that urban adolescents from the south are less healthy than those from central-northern Europe. Our data suggest that differences in PA might explain differences in important health-related fitness components, yet factors explaining the differences in fatness encountered remain unknown.
authors.affiliation: PROFITH (PROmoting FITness and Health through physical activity) research group, Department of Physical Education and Sports, Faculty of Sport Sciences, and.
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.forename: Idoia
authors.initials: I
authors.lastname: Labayen
authors.forename: David
authors.initials: D
authors.lastname: Martínez-Gómez
authors.forename: Germán
authors.initials: G
authors.lastname: Vicente-Rodriguez
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cuenca-García
authors.forename: Luis
authors.initials: L
authors.lastname: Gracia-Marco
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Laurent
authors.initials: L
authors.lastname: Beghin
authors.forename: Dénes
authors.initials: D
authors.lastname: Molnar
authors.forename: Angela
authors.initials: A
authors.lastname: Polito
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.forename: Marcela
authors.initials: M
authors.lastname: González-Gross
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.forename: Christina
authors.initials: C
authors.lastname: Breidenassel
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Castillo
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004032:Diet; D005060:Europe; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000235:genetics*; D012959:Socioeconomic Factors; D014504:Urban Health
keywords: adolescence; body-fat distribution; cardiovascular disease risk factors; fatness; obesity; physical fitness