Diet as moderator in the association of adiposity with inflammatory biomarkers among adolescents in the HELENA study

Aline Arouca, Luis A. Moreno, Esther M. Gonzalez-Gil, Ascensión Marcos, Kurt Widhalm, D. Molnár, Yannis Manios, Frederic Gottrand, Anthony Kafatos, Mathilde Kersting, Michael Sjöström, Francisco J. Amaro-Gahete, Marika Ferrari, Inge Huybrechts, Marcela Gonzalez-Gross, Stefaan de Henauw, Nathalie Michels

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Aim: Our aim is to demonstrate that a healthy diet might reduce the relation between adiposity and inflammation, whereas an unhealthy diet may increase the effect of adiposity on inflammatory biomarkers. Methods: In 618 adolescents (13–17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake determined by a self-administered computerized 24-h recall. A 9-point Mediterranean diet score and an antioxidant-rich diet score were used as dietary parameters and tested as moderator. Total body fat was represented by the sum of six skinfold thicknesses and central adiposity by waist circumference. A set of inflammation-related biomarkers was used as outcome: a pro/anti-inflammatory interleukins ratio, TGFβ-1, C-reactive protein, TNF-α, 3 cell adhesion molecules, and 3 types of immune cells; gamma-glutamyltransferase (GGT) and homocysteine were used as cardiovascular disease risk biomarkers, and alanine transaminase (ALT) as liver dysfunction biomarker. Multiple linear regression analyses tested moderation by diet in the adiposity-inflammation association and were adjusted for age, sex, country, puberty, socioeconomic status. Results: Both the Mediterranean and antioxidant-rich diet, and overall and central adiposity, were important in the moderation. Diet was a significant protective moderator in the effect of adiposity on the pro/anti-inflammatory interleukins ratio, TGFβ-1, GGT, and ALT. Conclusion: In conclusion, in some cases, a diet rich in antioxidants and essential nutrients may attenuate the concentration of inflammatory biomarkers caused by adiposity, whereas a poor diet appears to contribute to the onset of early oxidative stress signs.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalEuropean Journal of Nutrition
Publication statusAccepted/In press - Jun 15 2018



  • Adiposity
  • Adolescents
  • Low-grade inflammation
  • Mediterranean diet score

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Arouca, A., Moreno, L. A., Gonzalez-Gil, E. M., Marcos, A., Widhalm, K., Molnár, D., Manios, Y., Gottrand, F., Kafatos, A., Kersting, M., Sjöström, M., Amaro-Gahete, F. J., Ferrari, M., Huybrechts, I., Gonzalez-Gross, M., de Henauw, S., & Michels, N. (Accepted/In press). Diet as moderator in the association of adiposity with inflammatory biomarkers among adolescents in the HELENA study. European Journal of Nutrition, 1-14.