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1.  Sedentary behaviours and its association with bone mass in adolescents: the HELENA cross-sectional study 
BMC Public Health  2012;12:971.
Background
We aimed to examine whether time spent on different sedentary behaviours is associated with bone mineral content (BMC) in adolescents, after controlling for relevant confounders such as lean mass and objectively measured physical activity (PA), and if so, whether extra-curricular participation in osteogenic sports could have a role in this association.
Methods
Participants were 359 Spanish adolescents (12.5-17.5 yr, 178 boys,) from the HELENA-CSS (2006–07). Relationships of sedentary behaviours with bone variables were analysed by linear regression. The prevalence of low BMC (at least 1SD below the mean) and time spent on sedentary behaviours according to extracurricular sport participation was analysed by Chi-square tests.
Results
In boys, the use of internet for non-study was negatively associated with whole body BMC after adjustment for lean mass and moderate to vigorous PA (MVPA). In girls, the time spent studying was negatively associated with femoral neck BMC. Additional adjustment for lean mass slightly reduced the negative association between time spent studying and femoral neck BMC. The additional adjustment for MVPA did not change the results at this site. The percentage of girls having low femoral neck BMC was significantly smaller in those participating in osteogenic sports (≥ 3 h/week) than in the rest, independently of the cut-off selected for the time spent studying.
Conclusions
The use of internet for non-study (in boys) and the time spent studying (in girls) are negatively associated with whole body and femoral neck BMC, respectively. In addition, at least 3 h/week of extra-curricular osteogenic sports may help to counteract the negative association of time spent studying on bone health in girls.
doi:10.1186/1471-2458-12-971
PMCID: PMC3508981  PMID: 23148760
Bone health; Sedentary behaviours; Adolescents; Physical activity and extra-curricular participation in sports
2.  Main characteristics and participation rate of European adolescents included in the HELENA study 
Archives of Public Health  2012;70(1):14.
Background
Participation rate and response rate are key issues in a cross sectional large-scale epidemiological study. The objective of this paper is to describe the study population and to evaluate participation and response rate as well as the key nutritional status variables in male and female adolescents involved in the HELENA study.
Methods
A multi-stage random cluster sampling with a target sample of 3000 adolescents aged [12.5 to 17.5] years, stratified for geographical location and age, was carried out. Information for participants and non-participants (NP) was compared, and participation and response rates to specific questionnaires were discussed.
Results
3,865 adolescents aged [12.5 to 17.5] years (1,845 females) participated in the HELENA study, of whom 1,076 (568 females) participated in the blood sampling. 3,528 (1,845 females) adolescents were finally kept for statistical analysis. Participation rates for the schools and classes differed importantly between countries. The participation rate of pupils within the participating classes also differed importantly between countries. Sex ratio, mean age and BMI were similar between NP and participating adolescents within each centre, and in the overall sample. For all the questionnaires included in the database, the response rate of questionnaires was high (more than 80% of questions were completed).
Conclusion
From this study it could be concluded that participation rate differed importantly between countries, though no bias could be identified when comparing the key study variables between participants and non-participants. Response rate for questionnaires was very high. Future studies investigating lifestyle and health in adolescents can optimize their methods when considering the opportunities and barriers observed in the HELENA study.
doi:10.1186/0778-7367-70-14
PMCID: PMC3490738  PMID: 22958310

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