title: Do adolescents accurately evaluate their diet quality? The HELENA study.
abstract: The aim of this study was to assess the diet quality awareness and associated factors in a large sample of European adolescents.
  
  
  
  The study included 3389 healthy adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. The adolescents' diet quality was based on repeated 24 h recalls and scored into a Diet Quality Index for Adolescents (DQI-A) considering four components: meal, equilibrium, diversity and quality. A self-rated diet quality questionnaire was administered to adolescents to assess their dietary awareness. The association of DQI-A with dietary awareness was studied using a linear mixed model including the center as the random effect and dietary awareness as the fixed effect.
  
  
  
  There was a positive association between DQI-A scores and diet quality perception levels (p < 0.0001). The mean DQI-A was 59.0 (SD = 14.8) in adolescents with a low dietary awareness compared with 65.4 (SD = 12.6) in adolescents with high dietary awareness (p < 0.0001). Similar results were found for all the DQI components. When analyses were stratified, we found a significant heterogeneity across the nutritional status, with no significant association between DQI-A and dietary awareness level in obese adolescents, but a positive association in overweight, normal and undernourished groups. We found also a significant heterogeneity associated with the lunch location (school or home). No other factor affected dietary awareness (gender, pubertal status and maternal educational level).
  
  
  
  European adolescents evaluate well their food quality whatever their pubertal status, gender and parental educational level, except for the obese who are not able to assess their diet quality. Improving the dietary awareness in obese adolescents might help to induce behavioral changes.
authors.affiliation: Univ. Lille, Inserm, CHU Lille, UMR995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France. Electronic address: jeremy.vanhelst@chru-lille.fr.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Vanhelst
authors.affiliation: Univ. Lille, Inserm, CHU Lille, UMR995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Béghin
authors.affiliation: Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.affiliation: University of Crete School of Medicine, Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Heraclion, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Odysseas
authors.initials: O
authors.lastname: Androutsos
authors.affiliation: Private Medical University Salzburg, Dept. of Pediatrics, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.affiliation: Agricultural Research Council - Research Center on Food and Nutrition - C.R.A. NUT (Formerly INRAN), Roma, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mauro
authors.affiliation: Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.affiliation: Forschungsinstitut fur Kindererna hrung, Institut ander Rheinischen Friedrich-Wilhelms-Universitat Bonn, Dortmund, Germany.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Kersting
authors.affiliation: Univ. Lille, Inserm, CHU Lille, UMR995 - LIRIC - Lille Inflammation Research International Center, F-59000 Lille, France; Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: Assessment; Awareness; Epidemiology study; Nutrition; Youth