Attention capacity in European adolescents: role of different health-related factors. The HELENA study


We compared the level of attention capacity between adolescents from the center and south of Europe. The study included 627 European adolescents (54% girls), aged 12.5–17.5 years, who participated in the HELENA Study. The d2 Test of Attention was administered to assess attention capacity. The main results showed that adolescents from the south of Europe had significantly higher score in attention capacity compared with adolescents from central Europe (score + 8.1; 95%CI, 2.44–13.61) after adjustment for age, sex, socioeconomic indicators, body mass index, cardiorespiratory fitness and diet quality index (p = 0.012).

Conclusion: Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from central Europe independently of sociodemographic and health-related factors. These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student’s capacities.

What is Known?
• Attention is a crucial capacity during adolescence.
• Several health-related factors (i.e., physical activity, fitness or fatness) may influence attention capacity in adolescents.
What is New?
• Adolescents from the south of Europe had higher levels of attention capacity than their counterparts from the center, after accounting for socioeconomic factors, fitness, fatness and quality of diet.
• These differences should be taken into account by educational institutions when promoting new approaches for putting into the practice student’s capacities.

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Fig. 1



body mass index


d2 Test of Attention


family affluence scale


Programme for International Student Assessment


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The authors thank children and adolescents who participated in the study and their parents and teachers for their collaboration. We also acknowledge the members involved in field work for their efforts.


The HELENA study is made possible by the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT 20056007034) and the Spanish Ministry of Science and Innovation (RYC-2010-05957 and RYC-2011-09011). IEC was supported by the Spanish Ministry of Science and Innovation (FJCI-2014-19,563) and received a scholarship from the Alicia Koplowitz Foundation for a brief stay in the Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia. This study takes place thanks to the additional funding from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES).

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IEC had full access to all of the data in the study. Study concept and design: LAM, FBO, CCS, and IEC. Acquisition of data: JV, NM, CPL, MGG, KW, and MK. Statistical analysis: FBO, CCS, and IEC. Interpretation of data: FBO, CCS, IEC, AOP, and AK. Drafting of the manuscript: IEC. Critical revision of the manuscript for important intellectual content: all authors.

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Correspondence to Irene Esteban-Cornejo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Communicated by Mario Bianchetti

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Esteban-Cornejo, I., Cadenas-Sanchez, C., Vanhelst, J. et al. Attention capacity in European adolescents: role of different health-related factors. The HELENA study. Eur J Pediatr 176, 1433–1437 (2017).

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  • Attention capacity
  • Adolescence
  • Geographical discrepancies
  • Europe