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How eating behaviours associate to body composition in European adolescents: a cross-sectional analysis from the HELENA study

European Journal of Clinical Nutrition (2026)Cite this article

Subjects

Abstract

Background

Adolescence is a key developmental stage marked by physiological and behavioural changes. Eating behaviour, modifiable and sex-dependent, may be altered and linked to future health issues. This cross-sectional study aims to assess whether eating behaviours and body composition are associated in an adolescent sample.

Methods

Participants aged 12.5–17.5 years were recruited from 10 European cities, with valid data on age, sex, socio-demographic status, body composition and physical activity and who had also completed the specific eating behaviour questionnaire “Eating Behaviour and Weight Problems Inventory for Children”. Different linear regression models were adjusted for relevant confounders, and ANCOVA models were performed.

Results

Eating Behaviours related to weight concerns, dietary restraint, emotional eating, fear of weight gain, healthy nutrition and figure dissatisfaction were strongly positively associated with higher Body Mass Index (BMI), Fat Mass Index (FMI) and Waist Circumference (WC), especially in males (betas resulting from the association between these behavioural subscales and body composition in males, ranged from 0.174 to 0.974 for BMI, 0.172 to 0.930 for FMI, and 0.128 to 0.889 for WC). The strongest association was detected in the weight concerns subscale for both males and females.

Conclusion

Eating behaviours across all domains are significantly linked to body composition, with variations depending on the specific behavioural domain and the adolescent’s sex. These findings are critical for identifying specific behavioural patterns that contribute to obesity and related health issues, providing new insights for more targeted prevention strategies during this crucial stage of development.

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Fig. 1: Flow chart of the sample selection process.
Fig. 2: Forest plot of the association of EWI-C subscales and BMI, FMI, and WC.

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Data availability

The data that support the findings of this study are not publicly available due to ethical restrictions and privacy concerns but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to acknowledge all the adolescents and their families who voluntarily participated in the study and the members involved in it. The authors would like to thank the members of the HELENA study group.

Funding

This HELENA Study was carried out with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034).

Author information

Authors and Affiliations

  1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

    Andrea Jimeno-Martínez, Miguel Seral-Cortés, Ivie Maneschy, Azahara I. Rupérez & Luis A. Moreno

  2. Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain

    Andrea Jimeno-Martínez, Miguel Seral-Cortés, Ivie Maneschy, Azahara I. Rupérez & Luis A. Moreno

  3. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

    Andrea Jimeno-Martínez, Miguel Seral-Cortés, Ivie Maneschy, Azahara I. Rupérez & Luis A. Moreno

  4. CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain

    Miguel Seral-Cortés, Ivie Maneschy, Marcela González-Gross & Luis A. Moreno

  5. Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, Vienna, Austria

    Kurt Widhalm

  6. Faculty of Medicine, University of Crete, Herakleion, Greece

    Anthony Kafatos

  7. AdventHealth Research Institute, Neuroscience, FL, USA

    Cristina Molina-Hidalgo

  8. Clinical and Exercise Physiology Research Group (EFFECTS 262), Department of Medical Physiology, University of Granada, Granada, Spain

    Cristina Molina-Hidalgo

  9. ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain

    Marcela González-Gross

  10. Immunonutrition Research Group, Department of Metabolism & Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain

    Sonia Gómez-Martínez & Esther Nova

  11. Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Stefaan De Henauw

  12. Department of Paediatrics, Medical School, University of Pécs, Pécs, Hungary

    Dénes Molnár

  13. Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy

    Romana Roccaldo

  14. University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, Lille, France

    Laurent Béghin

  15. Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital Ruhr-University Bochum, Bochum, Germany

    Mathilde Kersting

  16. Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany

    Christina Breidenassel

  17. Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece

    Yannis Manios

  18. Department of Physiology, University of Granada, Granada, Spain

    Angel Gutierrez & Giannis Arnaoutis

  19. Universidad de Zaragoza, Zaragoza, Spain

    Luis A. Moreno, José A. Casajús, Jesús Fleta, Gerardo Rodríguez, Concepción Tomás, María I. Mesana, Germán Vicente-Rodríguez, Adoración Villarroya, Carlos M. Gil, Ignacio Ara, Juan Fernández Alvira, Gloria Bueno, Olga Bueno, Juan F. León, Jesús Mª Garagorri, Idoia Labayen, Iris Iglesia, Silvia Bel, Luis A. Gracia Marco, Theodora Mouratidou, Alba Santaliestra-Pasías, Esther González-Gil, Pilar De Miguel-Etayo, Cristina Julián, Mary Miguel-Berges, Isabel Iguacel, Azahara Rupérez & Miguel Seral-Cortes

  20. Consejo Superior de Investigaciones Científicas, Madrid, Spain

    Ascensión Marcos, Julia Wärnberg, Esther Nova, Sonia Gómez, Ligia Esperanza Díaz, Javier Romeo, Ana Veses, Belén Zapatera, Tamara Pozo & David Martínez

  21. Université de Lille 2, Lille, France

    Laurent Beghin, Christian Libersa, Frédéric Gottrand, Catalina Iliescu & Juliana Von Berlepsch

  22. Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany

    Mathilde Kersting, Wolfgang Sichert-Hellert & Ellen Koeppen

  23. Pécsi Tudományegyetem (University of Pécs), Pécs, Hungary

    Dénes Molnar, Eva Erhardt, Katalin Csernus, Katalin Török, Szilvia Bokor, Mrs. Angster, Enikö Nagy, Orsolya Kovács & Judit Répasi

  24. University of Crete School of Medicine, Crete, Greece

    Anthony Kafatos, Caroline Codrington, María Plada, Angeliki Papadaki, Katerina Sarri, Anna Viskadourou, Christos Hatzis, Michael Kiriakakis, George Tsibinos, Constantine Vardavas, Manolis Sbokos, Eva Protoyeraki & Maria Fasoulaki

  25. Institut für Ernährungs- und Lebensmittelwissenschaften – Ernährungphysiologie. Rheinische Friedrich Wilhelms Universität, Bonn, Germany

    Peter Stehle, Klaus Pietrzik, Marcela González-Gross, Christina Breidenassel, Andre Spinneker, Jasmin Al-Tahan, Miriam Segoviano, Anke Berchtold, Christine Bierschbach, Erika Blatzheim, Adelheid Schuch & Petra Pickert

  26. University of Granada, Granada, Spain

    Manuel J. Castillo, Ángel Gutiérrez, Francisco B. Ortega, Jonatan R. Ruiz, Enrique G. Artero, Vanesa España, David Jiménez-Pavón, Palma Chillón, Cristóbal Sánchez-Muñoz & Magdalena Cuenca

  27. Istituto Nazionalen di Ricerca per gli Alimenti e la Nutrizione, Rome, Italy

    Davide Arcella, Elena Azzini, Emma Barrison, Noemi Bevilacqua, Pasquale Buonocore, Giovina Catasta, Laura Censi, Donatella Ciarapica, Paola D’Acapito, Marika Ferrari, Myriam Galfo, Cinzia Le Donne, Catherine Leclercq, Giuseppe Maiani, Beatrice Mauro, Lorenza Mistura, Antonella Pasquali, Raffaela Piccinelli, Angela Polito, Romana Roccaldo, Raffaella Spada, Stefania Sette & Maria Zaccaria

  28. University of Napoli “Federico II” Dept of Food Science, Napoli, Italy

    Luca Scalfi, Paola Vitaglione & Concetta Montagnese

  29. Ghent University, Ghent, Belgium

    Ilse De Bourdeaudhuij, Stefaan De Henauw, Tineke De Vriendt, Lea Maes, Christophe Matthys, Carine Vereecken, Mieke de Maeyer, Charlene Ottevaere & Inge Huybrechts

  30. Medical University of Vienna, Vienna, Austria

    Kurt Widhalm, Katharina Phillipp, Sabine Dietrich & Birgit Kubelka Marion Boriss-Riedl

  31. Harokopio University, Athens, Greece

    Yannis Manios, Eva Grammatikaki, Zoi Bouloubasi, Tina Louisa Cook, Sofia Eleutheriou, Orsalia Consta, George Moschonis, Ioanna Katsaroli, George Kraniou, Stalo Papoutsou, Despoina Keke, Ioanna Petraki, Elena Bellou, Sofia Tanagra, Kostalenia Kallianoti, Dionysia Argyropoulou, Stamatoula Tsikrika & Christos Karaiskos

  32. Institut Pasteur de Lille, Lille, France

    Jean Dallongeville & Aline Meirhaeghe

  33. Karolinska Institutet, Stockholm, Sweden

    Michael Sjöstrom, Jonatan R. Ruiz, Francisco B. Ortega, María Hagströmer, Anita Hurtig Wennlöf, Lena Hallström, Emma Patterson, Lydia Kwak, Julia Wärnberg & Nico Rizzo

  34. Asociación de Investigación de la Industria Agroalimentaria, Valencia, Spain

    Jackie Sánchez-Molero, Sara Castelló, Elena Picó, Maite Navarro, Blanca Viadel, José Enrique Carreres, Gema Merino, Rosa Sanjuán, María Lorente & María José Sánchez

  35. Campden BRI, Chipping Campden, UK

    Chantal Gilbert, Sarah Thomas, Elaine Allchurch & Peter Burgess

  36. SIK - Institutet foer Livsmedel och Bioteknik, Gothenburg, Sweden

    Gunnar Hall, Annika Astrom, Anna Sverkén & Agneta Broberg

  37. Meurice Recherche & Development asbl, Anderlecht, Belgium

    Annick Masson, Claire Lehoux, Pascal Brabant, Philippe Pate & Laurence Fontaine

  38. Campden & Chorleywood Food Development Institute, Budapest, Hungary

    Andras Sebok, Tunde Kuti & Adrienn Hegyi

  39. Productos Aditivos SA, Barcelona, Spain

    Cristina Maldonado & Ana Llorente

  40. Cárnicas Serrano SL, Valencia, Spain

    Emilio García

  41. Cederroth International AB, Falun, Sweden

    Holger von Fircks, Marianne Lilja Hallberg & Maria Messerer

  42. Lantmännen Food R&D, Stockholm, Sweden

    Mats Larsson, Helena Fredriksson, Viola Adamsson & Ingmar Börjesson

  43. European Food Information Council, Brussels, Belgium

    Laura Fernández, Laura Smillie & Josephine Wills

  44. Universidad Politécnica de Madrid, Madrid, Spain

    Marcela González-Gross, Raquel Pedrero-Chamizo, Agustín Meléndez, Jara Valtueña, David Jiménez-Pavón, Ulrike Albers, Pedro J. Benito, Juan José Gómez Lorente, David Cañada, Alejandro Urzanqui, Rosa María Torres & Paloma Navarro

Authors
  1. Andrea Jimeno-Martínez
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  2. Miguel Seral-Cortés
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  3. Ivie Maneschy
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  4. Azahara I. Rupérez
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  5. Kurt Widhalm
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  6. Anthony Kafatos
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  7. Cristina Molina-Hidalgo
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  8. Marcela González-Gross
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  9. Sonia Gómez-Martínez
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  10. Esther Nova
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  11. Stefaan De Henauw
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  12. Dénes Molnár
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  13. Romana Roccaldo
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  14. Laurent Béghin
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  15. Mathilde Kersting
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  16. Christina Breidenassel
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  17. Yannis Manios
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  18. Angel Gutierrez
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  19. Giannis Arnaoutis
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  20. Luis A. Moreno
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Consortia

on behalf of the HELENA Study Group

  • Luis A. Moreno
  • , José A. Casajús
  • , Jesús Fleta
  • , Gerardo Rodríguez
  • , Concepción Tomás
  • , María I. Mesana
  • , Germán Vicente-Rodríguez
  • , Adoración Villarroya
  • , Carlos M. Gil
  • , Ignacio Ara
  • , Juan Fernández Alvira
  • , Gloria Bueno
  • , Olga Bueno
  • , Juan F. León
  • , Jesús Mª Garagorri
  • , Idoia Labayen
  • , Iris Iglesia
  • , Silvia Bel
  • , Luis A. Gracia Marco
  • , Theodora Mouratidou
  • , Alba Santaliestra-Pasías
  • , Iris Iglesia
  • , Esther González-Gil
  • , Pilar De Miguel-Etayo
  • , Cristina Julián
  • , Mary Miguel-Berges
  • , Isabel Iguacel
  • , Azahara Rupérez
  • , Miguel Seral-Cortes
  • , Ascensión Marcos
  • , Julia Wärnberg
  • , Esther Nova
  • , Sonia Gómez
  • , Ligia Esperanza Díaz
  • , Javier Romeo
  • , Ana Veses
  • , Belén Zapatera
  • , Tamara Pozo
  • , David Martínez
  • , Laurent Beghin
  • , Christian Libersa
  • , Frédéric Gottrand
  • , Catalina Iliescu
  • , Juliana Von Berlepsch
  • , Mathilde Kersting
  • , Wolfgang Sichert-Hellert
  • , Ellen Koeppen
  • , Dénes Molnar
  • , Eva Erhardt
  • , Katalin Csernus
  • , Katalin Török
  • , Szilvia Bokor
  • , Mrs. Angster
  • , Enikö Nagy
  • , Orsolya Kovács
  • , Judit Répasi
  • , Anthony Kafatos
  • , Caroline Codrington
  • , María Plada
  • , Angeliki Papadaki
  • , Katerina Sarri
  • , Anna Viskadourou
  • , Christos Hatzis
  • , Michael Kiriakakis
  • , George Tsibinos
  • , Constantine Vardavas
  • , Manolis Sbokos
  • , Eva Protoyeraki
  • , Maria Fasoulaki
  • , Peter Stehle
  • , Klaus Pietrzik
  • , Marcela González-Gross
  • , Christina Breidenassel
  • , Andre Spinneker
  • , Jasmin Al-Tahan
  • , Miriam Segoviano
  • , Anke Berchtold
  • , Christine Bierschbach
  • , Erika Blatzheim
  • , Adelheid Schuch
  • , Petra Pickert
  • , Manuel J. Castillo
  • , Ángel Gutiérrez
  • , Francisco B. Ortega
  • , Jonatan R. Ruiz
  • , Enrique G. Artero
  • , Vanesa España
  • , David Jiménez-Pavón
  • , Palma Chillón
  • , Cristóbal Sánchez-Muñoz
  • , Magdalena Cuenca
  • , Davide Arcella
  • , Elena Azzini
  • , Emma Barrison
  • , Noemi Bevilacqua
  • , Pasquale Buonocore
  • , Giovina Catasta
  • , Laura Censi
  • , Donatella Ciarapica
  • , Paola D’Acapito
  • , Marika Ferrari
  • , Myriam Galfo
  • , Cinzia Le Donne
  • , Catherine Leclercq
  • , Giuseppe Maiani
  • , Beatrice Mauro
  • , Lorenza Mistura
  • , Antonella Pasquali
  • , Raffaela Piccinelli
  • , Angela Polito
  • , Romana Roccaldo
  • , Raffaella Spada
  • , Stefania Sette
  • , Maria Zaccaria
  • , Luca Scalfi
  • , Paola Vitaglione
  • , Concetta Montagnese
  • , Ilse De Bourdeaudhuij
  • , Stefaan De Henauw
  • , Tineke De Vriendt
  • , Lea Maes
  • , Christophe Matthys
  • , Carine Vereecken
  • , Mieke de Maeyer
  • , Charlene Ottevaere
  • , Inge Huybrechts
  • , Kurt Widhalm
  • , Katharina Phillipp
  • , Sabine Dietrich
  • , Birgit Kubelka Marion Boriss-Riedl
  • , Yannis Manios
  • , Eva Grammatikaki
  • , Zoi Bouloubasi
  • , Tina Louisa Cook
  • , Sofia Eleutheriou
  • , Orsalia Consta
  • , George Moschonis
  • , Ioanna Katsaroli
  • , George Kraniou
  • , Stalo Papoutsou
  • , Despoina Keke
  • , Ioanna Petraki
  • , Elena Bellou
  • , Sofia Tanagra
  • , Kostalenia Kallianoti
  • , Dionysia Argyropoulou
  • , Stamatoula Tsikrika
  • , Christos Karaiskos
  • , Jean Dallongeville
  • , Aline Meirhaeghe
  • , Michael Sjöstrom
  • , Jonatan R. Ruiz
  • , Francisco B. Ortega
  • , María Hagströmer
  • , Anita Hurtig Wennlöf
  • , Lena Hallström
  • , Emma Patterson
  • , Lydia Kwak
  • , Julia Wärnberg
  • , Nico Rizzo
  • , Jackie Sánchez-Molero
  • , Sara Castelló
  • , Elena Picó
  • , Maite Navarro
  • , Blanca Viadel
  • , José Enrique Carreres
  • , Gema Merino
  • , Rosa Sanjuán
  • , María Lorente
  • , María José Sánchez
  • , Chantal Gilbert
  • , Sarah Thomas
  • , Elaine Allchurch
  • , Peter Burgess
  • , Gunnar Hall
  • , Annika Astrom
  • , Anna Sverkén
  • , Agneta Broberg
  • , Annick Masson
  • , Claire Lehoux
  • , Pascal Brabant
  • , Philippe Pate
  • , Laurence Fontaine
  • , Andras Sebok
  • , Tunde Kuti
  • , Adrienn Hegyi
  • , Cristina Maldonado
  • , Ana Llorente
  • , Emilio García
  • , Holger von Fircks
  • , Marianne Lilja Hallberg
  • , Maria Messerer
  • , Mats Larsson
  • , Helena Fredriksson
  • , Viola Adamsson
  • , Ingmar Börjesson
  • , Laura Fernández
  • , Laura Smillie
  • , Josephine Wills
  • , Marcela González-Gross
  • , Raquel Pedrero-Chamizo
  • , Agustín Meléndez
  • , Jara Valtueña
  • , David Jiménez-Pavón
  • , Ulrike Albers
  • , Pedro J. Benito
  • , Juan José Gómez Lorente
  • , David Cañada
  • , Alejandro Urzanqui
  • , Rosa María Torres
  •  & Paloma Navarro

Contributions

All authors contributed significantly to the development of this work, as described below. AJM conceived the present work, performed the analyses, and wrote the manuscript; MSC. assisted with data analysis and revised the manuscript; IM, AIR, and LM provided detailed revisions and corrections to the manuscript. LM additionally was the coordinator and designed the study. All other authors (KW, AK, CMH, MGG, SGM, EN, SDH, DM, RR, LB, MK, CB, YM, AG, GA) read and critically reviewed the manuscript, and were responsible for obtaining the data in their respective countries.

Corresponding author

Correspondence to Miguel Seral-Cortés.

Ethics declarations

Competing interests

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.

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Jimeno-Martínez, A., Seral-Cortés, M., Maneschy, I. et al. How eating behaviours associate to body composition in European adolescents: a cross-sectional analysis from the HELENA study. Eur J Clin Nutr (2026). https://doi.org/10.1038/s41430-026-01709-2

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