More physically active and leaner adolescents have higher energy intake

J Pediatr. 2014 Jan;164(1):159-166.e2. doi: 10.1016/j.jpeds.2013.08.034. Epub 2013 Oct 3.


Objective: To test whether youths who engage in vigorous physical activity are more likely to have lean bodies while ingesting relatively large amounts of energy. For this purpose, we studied the associations of both physical activity and adiposity with energy intake in adolescents.

Study design: The study subjects were adolescents who participated in 1 of 2 cross-sectional studies, the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study (n = 1450; mean age, 14.6 years) or the European Youth Heart Study (EYHS; n = 321; mean age, 15.6 years). Physical activity was measured by accelerometry, and energy intake was measured by 24-hour recall. In the HELENA study, body composition was assessed by 2 or more of the following methods: skinfold thickness, bioelectrical impedance analysis, plus dual-energy X-ray absorptiometry or air-displacement plethysmography in a subsample. In the EYHS, body composition was assessed by skinfold thickness.

Results: Fat mass was inversely associated with energy intake in both studies and using 4 different measurement methods (P ≤ .006). Overall, fat-free mass was positively associated with energy intake in both studies, yet the results were not consistent across measurement methods in the HELENA study. Vigorous physical activity in the HELENA study (P < .05) and moderate physical activity in the EYHS (P < .01) were positively associated with energy intake. Overall, results remained unchanged after adjustment for potential confounding factors, after mutual adjustment among the main exposures (physical activity and fat mass), and after the elimination of obese subjects, who might tend to underreport energy intake, from the analyses.

Conclusion: Our data are consistent with the hypothesis that more physically active and leaner adolescents have higher energy intake than less active adolescents with larger amounts of fat mass.

Keywords: BIA; BMI; BMR; Basal metabolic rate; Bioelectrical impedance; Body mass index; DIAT; DXA; Dietary Intake Assessment Tool; Dual-energy X-ray absorptiometry; EYHS; European Youth Heart Study; HELENA; Healthy Lifestyle in Europe by Nutrition in Adolescence; METs; MSM; Metabolic equivalents; Multiple Source Method; TEE; Total energy expenditure.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity / physiology*
  • Adolescent
  • Body Mass Index
  • Child
  • Cross-Sectional Studies
  • Energy Intake / physiology*
  • Europe
  • Female
  • Humans
  • Life Style*
  • Male
  • Motor Activity / physiology*
  • Nutritional Status*