000096039 001__ 96039 000096039 005__ 20230830110638.0 000096039 0247_ $$2doi$$a10.1017/S1368980019001022 000096039 0248_ $$2sideral$$a112955 000096039 037__ $$aART-2019-112955 000096039 041__ $$aeng 000096039 100__ $$aAparicio-Ugarriza, R. 000096039 245__ $$aRelative 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 000096039 260__ $$c2019 000096039 5060_ $$aAccess copy available to the general public$$fUnrestricted 000096039 5203_ $$aObjective: To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers. Design: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years. Setting: Nine European countries. Participants: European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated. Results: Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, ß-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05). Conclusions: zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents. 000096039 536__ $$9info:eu-repo/grantAgreement/ES/MEC/AGL2007-29784-E/ALI$$9info:eu-repo/grantAgreement/EUR/FP6/FOOD-CT-2005-007034 000096039 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/ 000096039 590__ $$a3.182$$b2019 000096039 591__ $$aPUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH$$b50 / 193 = 0.259$$c2019$$dQ2$$eT1 000096039 591__ $$aNUTRITION & DIETETICS$$b43 / 89 = 0.483$$c2019$$dQ2$$eT2 000096039 592__ $$a1.21$$b2019 000096039 593__ $$aMedicine (miscellaneous)$$c2019$$dQ1 000096039 593__ $$aPublic Health, Environmental and Occupational Health$$c2019$$dQ1 000096039 593__ $$aNutrition and Dietetics$$c2019$$dQ1 000096039 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000096039 700__ $$aCuenca-Garcia, M. 000096039 700__ $$aGonzalez-Gross, M. 000096039 700__ $$0(orcid)0000-0002-8374-3410$$aJulian, C. 000096039 700__ $$aBel-Serrat, S. 000096039 700__ $$0(orcid)0000-0003-0454-653X$$aMoreno, L.A.$$uUniversidad de Zaragoza 000096039 700__ $$aBreidenassel, C. 000096039 700__ $$aKersting, M. 000096039 700__ $$aArouca, A.B. 000096039 700__ $$aMichels, N. 000096039 700__ $$0(orcid)0000-0002-3726-1066$$aMouratidou, T. 000096039 700__ $$aManios, Y. 000096039 700__ $$aDallongeville, J. 000096039 700__ $$aGottrand, F. 000096039 700__ $$aWidhalm, K. 000096039 700__ $$aKafatos, A. 000096039 700__ $$aMolnar, D. 000096039 700__ $$aDe Henauw, S. 000096039 700__ $$aGunter, M.J. 000096039 700__ $$aHuybrechts, I. 000096039 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería 000096039 773__ $$g22, 13 (2019), 2381-2397$$pPublic health nutr.$$tPublic Health Nutrition$$x1368-9800 000096039 8564_ $$s403373$$uhttps://zaguan.unizar.es/record/96039/files/texto_completo.pdf$$yVersión publicada 000096039 8564_ $$s34169$$uhttps://zaguan.unizar.es/record/96039/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000096039 909CO $$ooai:zaguan.unizar.es:96039$$particulos$$pdriver 000096039 951__ $$a2023-08-30-10:58:03 000096039 980__ $$aARTICLE