Public Health Nutrition

Monitoring and surveillance

Nutritional knowledge in European adolescents: results from the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study

Wolfgang Sichert-Hellerta1, Laurent Beghina2, Stefaan De Henauwa3, Evangelia Grammatikakia4, Lena Hallströma5, Yannis Maniosa4, María I Mesanaa6, Dénes Molnára7, Sabine Dietricha8, Raffaela Piccinellia9, Maria Pladaa10, Michael Sjöströma5, Luis A Morenoa6 and Mathilde Kerstinga1 c1 c2 on behalf of the HELENA Study Group

a1 Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms Universität Bonn, Heinstueck 11, D-44225 Dortmund, Germany

a2 EA-3925, Université Lille, 2 Droit et Santé, IFR 114, IMPRT et Faculté de Médecine and CIC-9301-CH&U-Inserm CHRU de Lille, Lille, France

a3 Department of Health, Ghent University, Ghent, Belgium

a4 Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

a5 Unit for Preventive Nutrition, Department of Bioscience and Nutrition, Karolinska Institutet, Huddinge, Sweden

a6 Growth, Exercise, Nutrition and Development (GENUD) Research Group, Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

a7 University of Pecs, Pecs, Hungary

a8 Division of Clinical Nutrition and Prevention, Medical University of Vienna, Vienna, Austria

a9 INRAN: National Research Institute on Food and Nutrition, Rome, Italy

a10 Preventive Medicine & Nutrition Unit, University of Crete, Heraklion, Crete, Greece


Objective To build up sufficient knowledge of a ‘healthy diet’. Here, we report on the assessment of nutritional knowledge using a uniform method in a large sample of adolescents across Europe.

Design A cross-sectional study.

Setting The European multicentre HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study conducted in 2006–2007 in ten cities in Austria, Belgium, France, Germany, Greece (one inland and one island city), Hungary, Italy, Spain and Sweden.

Subjects A total of 3546 adolescents (aged 12·5–17·5 years) completed a validated nutritional knowledge test (NKT). Socio-economic variables and anthropometric data were considered as potential confounders.

Results NKT scores increased with age and girls had higher scores compared with boys (62 % v. 59 %; P < 0·0001). Scores were approximately 10 % lower in ‘immigrant’ adolescents or in adolescents with ‘immigrant’ mothers. Misconceptions with respect to the sugar content in food or in beverages were found. Overall, there was no correlation between BMI values and NKT scores. After categorization according to BMI, scores increased significantly with BMI group only in boys. These differences disappeared after controlling for socio-economic status (SES). Smoking status and educational level of the mother influenced the NKT scores significantly in boys, as well as the educational levels of both parents in girls.

Conclusions Nutritional knowledge was modest in our sample. Interventions should be focused on the lower SES segments of the population. They should be initiated at a younger age and should be combined with environmental prevention (e.g. healthy meals in school canteens).

(Received April 30 2010)

(Accepted May 10 2011)

(Online publication August 02 2011)


c1 Corresponding author: Email

c2 Address for correspondence: Forschungsinstitut fuer Kinderernaehrung (FKE) D-44225 Dortmund, Heinstueck 11, Germany.


See Appendix for full list of HELENA Study Group members.