Dietary Patterns and Their Relationship With the Perceptions of Healthy Eating in European Adolescents: The HELENA Study.

: The aim of this study was to identify dietary patterns (DPs) in European adolescents and to examine the association between perceptions of healthy eating and the obtained DPs. A multinational cross-sectional study was carried out in adolescents aged 12.5 to 17.5 years and 2,027 (44.9% males) were considered for analysis. A self-reported questionnaire with information on food choices and preferences, including perceptions of healthy eating, and two 24-hour dietary recalls were used. Principal component analysis was used to obtain sex-specific DPs, and linear analyses of covariance were used to compare DPs according to perceptions of healthy eating. Three and four DPs for boys and girls were obtained. In boys and girls, there were significant associations between some perceptions about healthy food and the Breakfast-DP ( < 0.05). In boys, Breakfast-DP and Healthy Beverage-DP were associated with the perception of the own diet as healthy ( < 0.05). Healthy Beverage-DP was associated with those disliking fruits and vegetables ( < 0.05). Girls considering the own diet as healthy were associated with Mediterranean-DP, Breakfast-DP, and Unhealthy Beverage and Meat-DP ( < 0.05). The perception of snacking as a necessary part of a healthy diet was associated with Breakfast-DP in both genders ( < 0.05). In European adolescents, perceptions of healthy eating were mainly associated with a DP characterized by foods consumed at breakfast. Future studies should further explore these findings in order to implement health promotion programs to improve healthy eating habits in adolescents.