Cardiovascular disease is the leading cause of mortality worldwide and is driven by atherosclerosis, which develops from a young age. Several lifestyle factors, including diet, physical activity, physical fitness, and sleep quality, influence cardiovascular health. However, limited research has investigated the association of nutritional knowledge with long-term health outcomes. This study assessed the association between adolescents’ nutritional knowledge and adulthood dietary habits, physical fitness, and cardiovascular risk factors. This longitudinal cohort study included 143 adolescents aged 12.5–17.5 years who were reevaluated as young adults (22–31 years) after a follow-up period of 10–14 years. The study was conducted in four European centers: Ghent (Belgium), Lille (France), Rome (Italy), and Zaragoza (Spain). Nutritional knowledge was assessed during adolescence and adulthood using the Nutritional Knowledge Test. Cardiovascular health was evaluated based on HDL and non-HDL cholesterol levels, blood pressure, body mass index, glycemia, and calculation of modified Pathobiological Determinants for Atherosclerosis in Youth (mPDAY) cardiovascular risk scores. Diet Quality Index (DQI), Planetary Health Diet Index (PHDI), ultra-processed food consumption, cardiorespiratory fitness (CRF) and upper-body muscular strength were also assessed. Spearman correlational analysis was used to identify associations between adolescents’ nutritional knowledge and cardiovascular, dietary, and physical fitness parameters in adulthood. Correlation analysis showed that greater nutritional knowledge during adolescence was associated with a better dietary quality in adulthood, as reflected by a higher DQI (p = 0.004; r = 0.25; 95

Background & aims: Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. Methods: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. Results: Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). Conclusions: Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. Clinical trial registry number: Clinicaltrials.gov NCT02899416. (c) 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Background: Enteral nutrition is necessary when nutritional status is poor and oral intake is insufficient or impossible. Although it has been suspected to reduce spontaneous oral feeding, no study has formally assessed the influence of enteral nutrition on pediatric oral intake. The present study aimed to evaluate variation in oral feeding intake after enteral nutrition initiation, and to identify factors influencing oral feeding. Methods: This retrospective cohort study included 149 pediatric patients from two French tertiary care hospitals, who received home enteral nutrition from 2009 to 2022. The patients were aged 2 months to 17 years (median age 3 years, interquartile range 1.3-9.2). Oral and enteral intakes were assessed when enteral nutrition was initiated (M0), and again at M3 (n = 123), M6 (n = 129), and M12 (n = 134) followups, based on dieticians' and home services' reports. Oral feeding and body mass index z score variations during follow-ups were evaluated using a linear mixed regression model, including "time" as a fixed effect and "patient" as a random effect. Factors associated with oral feeding changes were assessed using a model interaction term. Results: Oral intake did not vary significantly (P = 0.99) over time and accounted for 47.4% +/- 27.4%, 46.9% +/- 27.4%, 48.4% +/- 28.2%, and 46.6% +/- 26.9% of the ideal recommended daily allowance (calculated for the ideal weight for height) at M0, M3, M6, and M12, respectively. Delivery method (nasogastric tube versus gastrostomy), prematurity, underlying disease, history of intrauterine growth retardation, and speech therapy intervention did not influence oral intake. Administration (i.e., exclusively continuous nocturnal infusion versus daytime bolus) led to different oral intake development, although oral intake also differed at M0. Conclusions: Enteral nutrition, although increasing total energy intake, does not alter oral feeding during the first year of administration. Only the mode of administration might influence oral intake. (c) 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Rationale: Cardiovascular diseases are the leading cause of mortality worldwide and originate in the first decades of life. A better understanding of their early determinants would allow for better prevention. The impact of processed food consumption and diet quality on adult cardiovascular health are well documented but have never been assessed during adolescence. Our objective was to evaluate the impact of processed food consumption and diet quality during adolescence on adult cardiovascular status, using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score. Methods: The HEalthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included 3528 adolescents (12.5 – 17.5 years) during 2006–2007, 236 of them were reassessed between 2016 – 2020 as young adults (21 – 32 years) including PDAY score assessment. Ultra-processed food (UPF), fructose from processed food (FPF), and diet quality index (DQI) were evaluated by three nonconsecutive 24h dietary recalls at adolescence. A multivariable linear regression analysis was performed to identify nutritional parameters during adolescence having an impact on cardiovascular risk in adulthood. Results: An increase of 1 portion (100g) UPF was significantly associated with a higher PDAY risk score (p=0.009) and non-HDL cholesterol (p=0.003). An increase of 10 points DQI was inversely associated with the PDAY risk score (p=0.012), non-HDL cholesterol (p=0.027) and BMI (p<0.001). The tercile that consumed the higher FPF had a significant higher blood pressure (p=0.039) and BMI (p=0.049) than the one that consumed the least. Conclusion: UPF and FPF consumption during adolescence are associated with an increase of cardiovascular risk factors at adulthood whereas a high DQI seems to be protective suggesting that modification of nutrition habits in adolescence could improve future cardiovascular health. Disclosure of Interest: None declared

La période des 1000 premiers jours de vie est reconnue comme étant une fenêtre de vulnérabilité pouvant avoir un impact à long terme sur la santé des individus. La cohorte PENSINE (Périnatalité, environnement, santé intestinale et nutrition de l'enfant) vise à évaluer l'impact de l'allaitement sur la santé intestinale de l'enfant. L'objectif principal de ce travail est de caractériser la cohorte PENSINE et la comparer à la population générale ayant accouché dans la maternité (groupe MAT) réalisant l'étude. La cohorte prospective PENSINE vise à déterminer l'impact de l'allaitement sur la santé intestinale des enfants à l'âge de 4 ans à partir de couples mère/enfant inclus à la maternité participant à l'étude. Les 180 premiers couples mère/enfant inclus ont été caractérisés et comparés à la population de la même maternité (groupe MAT) n'ayant pas participé à l'étude sur des variables d'intérêt de façon à identifier les spécificités de la cohorte. En réponse au critère d'évaluation principal, le groupe d'enfants allaités exclusivement pendant au moins 3 mois (AM) a été comparé au groupe d'enfants ayant reçu un allaitement artificiel et/ou mixte (AAm) selon ces mêmes variables d'intérêt afin d'évaluer l'homogénéité de la cohorte. Comparativement au groupe MAT, l'âge maternel moyen à l'accouchement (32,2 ± 4,3 vs 31,3 ± 5,3 ans ; p < 0,01), le terme moyen (40 + 1 ± 1,0 vs 39 + 2 ± 1,2 SA ; p < 0,001) et le taux d'allaitement exclusif pendant le séjour à la maternité (78,5 vs 60,0 % ; p < 0,001), étaient plus élevés dans la cohorte PENSINE, alors que le taux de prématurité était plus faible (1,6 vs 7,1 % ; p < 0,01). Le taux d'accouchement par voie basse (83,3 vs 81,2 % ; p = 0,47), le poids moyen de l'enfant à la naissance (3431 ± 416 vs 3363 ± 468 g ; p = 0,06) et la proportion de filles (57,6 vs 50,3 % ; p = 0,09) n'étaient pas différents entre les deux groupes. Excepté le taux d'allaitement exclusif pendant le séjour à la maternité, aucune différence significative n'était retrouvée pour ces mêmes variables entre les sous-groupes AM et AAm de la cohorte PENSINE. Cette analyse préliminaire montre que la cohorte PENSINE possède des spécificités par rapport à la population totale de la maternité. Il existe toutefois une homogénéité des données de naissance entre les enfants ayant été allaité exclusivement ou non lors des 3 premiers mois de vie. Ces informations seront à prendre en considération lors des analyses des variables cliniques, anthropométriques et biologiques afin d'évaluer leur impact sur la santé intestinale de l'enfant sain.

The first 1000 days of life is a critical period that contributes significantly to the programming of an individual's future health. Among the many changes that occur during this period early in life, there is growing evidence that the establishment of healthy gut microbiota plays an important role in the prevention of both short- and long-term health problems. Numerous publications suggest that the quality of the gut microbiota colonisation depends on several dietary factors, including breastfeeding. In this respect, a relationship between breastfeeding and the risk of inflammatory bowel disease (IBD) has been suggested. IBDs are chronic intestinal diseases, and perinatal factors may be partly responsible for their onset. We review the existence of links between breastfeeding and IBD based on experimental and clinical studies. Overall, despite encouraging experimental data in rodents, the association between breastfeeding and the development of IBD remains controversial in humans, partly due to the considerable heterogeneity between clinical studies. The duration of exclusive breastfeeding is probably decisive for its lasting effect on IBD. Thus, specific improvements in our knowledge could support dietary interventions targeting the gut microbiome, such as the early use of prebiotics, probiotics or postbiotics, in order to prevent the disease.

Cardiovascular diseases are the leading cause of mortality worldwide. These diseases originate in childhood, and a better understanding of their early determinants and risk factors would allow better prevention. The BELINDA (BEtter LIfe by Nutrition During Adulthood) study is a 10–14-year follow-up of the HEalthy Lifestyle in Europe by Nutrition in Adolescence study (the HELENA study, a European cross-sectional study in adolescents). The study aims to evaluate cardiovascular risk using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score during young adulthood (21–32 years), and to examine the impact of risk factors identified during adolescence (12.5–17.5 years). Our secondary objective is to compare the characteristics of the BELINDA study population with the HELENA population not participating in the follow-up study. The HELENA study recruited 3528 adolescents during 2006–2007 and reassessed 232 of them 10–14 years later as young adults. We assessed clinical status, anthropometry, nutrition, physical activity (including sedentary behavior), physical fitness, and mental health parameters, and collected biological samples (blood, stool, and hair). Dietary intake, and physical activity and fitness data were also collected. A multivariable linear regression model will be used for the analysis of the primary outcome. A Chi-square and T-test were conducted for the comparison of the descriptive data (gender, age, weight, height, body mass index (BMI), and maternal school level) between participating and non-participating BELINDA adolescents. When comparing the 1327 eligible subjects with the 232 included in the BELINDA study, no significant differences regarding gender (p = 0.72), age (p = 0.60), height (p = 0.11), and weight (p = 0.083) at adolescence were found. However, the participating population had a lower BMI (20.4 ± 3.1 kg/m2 versus 21.2 ± 3.6 kg/m2; p < 0.001) and a higher maternal educational level (46.8% high school or university level versus 38.6%; p = 0.027) than the HELENA population who did not participate in the BELINDA study. The complete phenotyping obtained at adolescence through the HELENA study is a unique opportunity to identify adolescent risk factors for cardiovascular diseases. This paper will serve as a methodological basis for future analysis of this study.

Les maladies cardiovasculaires constituent la première cause de mortalité à l’échelle européenne et mondiale. Leur développement débute tôt dans la vie, modulé par des profils alimentaires et d’activité physique qu’il est nécessaire d’identifier dès l’adolescence. L’étude BELINDA (Better Life by Nutrition During Adulthood , 2016–2020) a réévalué 10 à 14 ans plus tard des adolescents ayant participé à l’étude HELENA (2006–2007), devenus jeunes adultes. L’objectif principal de l’étude BELINDA est d’évaluer le risque cardiovasculaire chez le jeune adulte (21 à 32 ans) grâce au score PDAY ( Pathobiological Determinants for Atherosclerosis in Youth ), afin d’identifier rétrospectivement des profils alimentaires et d’activité physique à risque présents dès l’adolescence (12,5 à 17,5 ans). L’objectif secondaire est d’analyser l’évolution de données de nutrition et d’activité physique entre l’adolescence et l’âge adulte. L’étude HELENA a inclus 3528 adolescents dans 10 centres en Europe. Quatre de ces 10 centres ont participé à cette nouvelle étude transversale BELINDA (Lille, Gand, Rome et Saragosse), visant à réévaluer ces sujets 10 à 14 ans plus tard, en tant que jeunes adultes, lors d’une visite « clinique » pendant laquelle étaient collectés des données biologiques (sang, selles, cheveux), de nutrition (questionnaires) et d’activité/de condition physique (accéléromètres et tests). La première analyse a pour objectif de comparer les sujets HELENA inclus dans BELINDA ( n = 232) avec les sujets HELENA non inclus des 4 centres participants ( n = 1095), en fonction du sexe, âge, poids, taille, indice de masse corporelle, et niveau d’étude de la mère. Les analyses programmées concernent le score PDAY et l’évolution des paramètres nutritionnels et d’activité physique de cette population. Il n’y a pas de différences significatives entre les sujets HELENA non inclus et inclus dans BELINDA en ce qui concerne le genre (respectivement 55,3 % filles versus 54,5 % ; p = 0,83), l’âge (14,8 ans ± 1,2 versus 14,8 ans ± 1,2 ; p = 0,94) et la taille (165,1 cm ± 9,1 versus 166,3 cm ± 8,9 ; p = 0,087). Cependant, les sujets HELENA ayant participé à BELINDA ont un poids (58,0 kg ± 12,1 versus 56,3 kg ± 10,9 ; p = 0,043) et un IMC (21,2 kg/m 2 ± 3,6 versus 20,3 kg/m 2 ± 2,8 ; p < 0,001) significativement plus faibles et une mère ayant un niveau d’étude significativement plus élevé (38,6 % ayant terminé le lycée versus 46,8 % ; p = 0,027) que les sujets HELENA n’ayant pas participé à BELINDA. Les différences de poids et d’IMC entre ces deux populations sont probablement liées au niveau éducatif maternel plus élevé des sujets HELENA inclus dans BELINDA, traduisant un biais de recrutement comme faiblesse de l’étude BELINDA. Cependant, son design innovant et son approche à la fois clinique, biologique et de style de vie sur un suivi à long terme devrait permettre une meilleure évaluation du risque cardiovasculaire du jeune adulte et l’identification de nouveaux profils à risque chez l’adolescent.

Introduction The first 1000 days of life could contribute to individual susceptibility to the later development of chronic non-communicable diseases. Nutrition in early life appears to be an important determinant factor for a sustainable child’s health. In this study, we propose to investigate the impact of exclusive breast feeding on gut health in children. Methods and analysis A prospective cohort of newborns (n=350) will be recruited at birth and followed up to 4 years of age. The main objective is to evaluate the link between exclusive breast feeding for at least 3 months and the gut health of the child at 4 years. The primary endpoint of assessment of gut health will be based on the non-invasive measurement of faecal secretory IgA (sIgA) as a sensitive biomarker of the intestinal ecosystem. The presence of gastrointestinal disorders will be defined according to the clinical criteria of Rome IV. Information on parent’s nutritional habits and life style, breastfeeding duration and child’s complementary feeding will be collected along the follow-up. Cord blood cells and plasma at birth will be purified for further analysis. The meconium and stools collected at birth, 6 months, 2 years and 4 years of age will allow sIgA analysis. Ethics and dissemination This clinical study has obtained the approval from the national ethical committee. We plan to publish the results of the study in peer-review journals and by means of national and international conference. Trial registration number NCT04195425 .

Introduction : Les maladies cardiovasculaires représentent la première cause de mortalité dans le monde et sont, pour la plupart, causées par la formation de plaques athérogènes. Ces dernières apparaissent dès l'adolescence et leur croissance dépend de nombreux facteurs de risque non modifiables (âge, genre) et modifiables (profil lipidique, pression artérielle, glycémie, tabagisme, indice de masse corporelle). La nutrition, l'activité physique et la condition physique sont des éléments complexes ayant démontré leur impact significatif, dans le cadre d'études majoritairement transversales, sur les facteurs de risque modifiables.Matériel & Méthodes : L'objectif de ce travail est alors d'identifier de façon longitudinale des paramètres de nutrition, d'activité physique et de condition physique à l'adolescence ayant un impact sur le risque cardiovasculaire à l'âge adulte. Ces analyses sont basées sur les données des étude HELENA et BELINDA. L'étude HELENA (2006 - 2007) a inclus 3528 adolescents âgés de 12,5 à 17,5 ans dans 10 pays d'Europe et a collecté de nombreuses données nutritionnelles, d'activité physique, de condition physique, anthropométriques et biologiques. L'étude BELINDA (2016 - 2020) est une cohorte nichée ayant refait les mêmes analyses, une décennie plus tard, chez 232 sujets de 4 centres (Gand, Lille, Rome et Saragosse). L'identification des paramètres d'intérêt a été réalisée selon des ressources bibliographiques et les données disponibles au sein de ces deux cohortes. Leur impact sur le risque cardiovasculaire a été évalué selon un modèle statistique multivarié. Le risque cardiovasculaire a été évalué selon les facteurs de risque cardiovasculaires modifiables et le score de risque cardiovasculaire PDAY (Pathobiological Determinants for Atherosclerosis in Youth). Les paramètres identifiés comme les plus pertinents quant à leur potentiel prédicteur du risque cardiovasculaire feront l'objet d'études plus spécifiques.Résultats : L'analyse bibliographique a mis en évidence 13 paramètres d'intérêt, dont 8 de nutrition, 2 d'activité physique et 3 de condition physique. L'adhésion aux indices alimentaires diet quality index et planetary health diet index, les connaissances alimentaires et l'endurance cardiorespiratoire sont les paramètres identifiés comme cardioprotecteurs, à l'inverse de la consommation d'aliments ultra transformés et de la force des membres supérieurs. Une analyse approfondie à propos des connaissances alimentaires a mis en évidence leur impact bénéfique, à long terme, sur la pression artérielle des adultes et leur comportement alimentaire.Discussion : Le diet quality index, le planetary health diet index, les connaissances alimentaires, la consommation d'aliments ultra transformés, l'endurance cardiorespiratoires et la force des membres supérieurs à l'adolescence ont été démontrés comme des paramètres impactant significativement le risque cardiovasculaire à l'âge adulte. Des approches précoces utilisant ces outils semblent alors pertinentes pour identifier des clusters de populations à risque et prévenir le risque cardiovasculaire dès le jeune âge.