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Abstract Background During the post-communist transition period, political, economic, and social changes affected the lifestyles of the Lithuanian population, including their nutritional habits. However, people of lower socio-economic position were more vulnerable to these changes. The aim of the present study was to evaluate the trends in selected food habits of the Lithuanian adult population by their level of education and place of residence from 1994 to 2010. Methods The data were obtained from nine biannual cross-sectional postal surveys of Lithuanian health behaviours, beginning in 1994. Each survey used a randomly selected nationally representative sample of 3000 inhabitants aged 20-64 drawn from the population register. In total, 7358 men and 9796 women participated in these surveys. Questions about food consumption were included within all health behaviour questionnaires. Results During the transition period, use of vegetable oil in cooking and the frequency of consumption of fresh vegetables increased, use of butter on bread decreased, and the proportion of women drinking high-fat milk declined. Lithuanians with higher education reported more frequent use of vegetable oil in cooking as well as daily consumption of fresh vegetables than those with a lower level of education. Consumption of high-fat milk was inversely associated with educational background. In addition, the proportion of persons spreading butter on bread increased with higher education level. The greatest urban-rural difference was observed in high-fat milk consumption. The increase in the use of vegetable oil in cooking, and the reduction of spreading butter on bread was more evident among less educated and rural inhabitants. Meanwhile, a greater proportion of the rural population, compared to urban, reduced their use of butter on bread. Daily consumption of fresh vegetables increased most among highly educated Lithuanians. Conclusions The data from our study indicate beneficial dietary changes among the Lithuanian adult population. In general, those with a higher level of education had healthier food habits than those with low education. The educational gradient in analyzed food habits, except the use of vegetable oil, enlarged. A higher proportion of the rural population, compared to urban, reduced their usage of butter on bread. However, consumption of high-fat milk was greatest in the rural population. Our data highlight the need for future food and nutrition policies, as well as health promotion programmes, targeting the whole population, particularly those with lower education and living in rural areas.

Abstract Background Since regaining of independence in 1990, Lithuania has been undergoing substantial political, economic, and social changes that affected the nutrition habits of population. Dietary changes might have impact on the trends of dietary related risk factors of chronic diseases. The aim of the study was to compare trends in diet and lipid profile of Lithuanian rural population aged 25-64 during two decades of transition period (1987-2007). Methods Four cross-sectional surveys were conducted within the framework of the Countrywide Integrated Noncommunicable Diseases Intervention Programme in five regions of Lithuania in 1987, 1993, 1999, and 2007. For each survey, a stratified independent random sample was drawn from the lists of the inhabitants aged 25-64 years registered at the primary health care centres. Altogether 3127 men and 3857 women participated in the surveys. 24-hour recall was used for evaluation of dietary habits. Serum lipids were determined using enzymatic methods. Predicted changes of serum cholesterol were calculated by Keys equation. Results The percentage of energy from saturated fatty acids has decreased from 18.0 to 15.1 among men and from 17.6 to 14.8 among women over the period of 20 years. The average share of polyunsaturated fatty acids in total energy intake increased from 5.3% to 7.1% among men and from 4.9% to 7.3% among women. The mean intake of cholesterol declined among women. Favourable trends in fatty acids composition were caused by increased use of vegetable oil for cooking and replacement of butter spread with margarine. Since 1987, the mean value of total cholesterol has decreased by 0.6 mmol/l. Total dietary effect accounts for a 0.26 mmol/l (43.3%) decline in serum cholesterol among men and 0.31 mmol/l (50.8%) decline among women. Conclusions Improvement in the quality of fat intake was observed in Lithuanian rural population over two decades of transition period. Positive changes in diet, mainly reduction in saturated fatty acids intake, contributed to decline in serum cholesterol level. Strengthening of favourable trends in nutrition habits in Lithuanian population should be one of the most important strategies of cardiovascular diseases prevention.

Background: This study aimed to examine the associations between anthropometric measurements in childhood and adulthood as well as the effect of childhood body mass index (BMI) and skinfold thickness in the prediction of adult cardiovascular risk factors., Methods: The Study subjects were participants of the Kaunas Cardiovascular Risk Cohort study. They were 12-13 years old at the time of the baseline survey (1977) and 48-49 years old in the 35-year follow-up survey (2012, n = 506). In childhood, height, weight, subscapular and triceps skinfold thickness measurements were taken. In 2012, health examination involved measurements of blood pressure (BP), BMI, waist circumference, glucose, lipids, and high-sensitivity C-reactive protein (CRP) levels. Logistic regression models were fitted to assess the associations of childhood BMI and skinfold thicknesses as well as BMI gain with cardiovascular risk factors in middle age. All logistic regression models were adjusted for sex, physical activity level, alcohol consumption, smoking and family history of obesity., Results: Over 35 years of follow-up, BMI gain was greater in men than in women. Anthropometric measurements in childhood significantly correlated with values measured in adulthood. The highest correlation coefficients were defined for weight and BMI measurements (in girls r = 0.56 and r = 0.51 respectively; in boys r = 0.45 and r = 0.41 respectively, P < 0.001). Mean values of change in BMI were similar in all quintiles of childhood BMI; however, prevalence of adult obesity increased considerably with increasing quintiles. The risk of adult obesity, metabolic syndrome, hyperglycaemia or type 2 diabetes, and elevated level of high-sensitivity CRP increased with a rise in childhood BMI and skinfold thicknesses, irrespectively of BMI gain from childhood to adulthood. No relationship was found between childhood anthropometric measurements and arterial hypertension, raised level of triglycerides or reduced level of HDL cholesterol. Gain in BMI from childhood to adulthood was associated with increased odds of all above-mentioned risk factors independently of childhood BMI., Conclusions: Risk of metabolic syndrome, hyperglycaemia and diabetes, and elevated high-sensitivity CRP may be affected by childhood BMI and skinfold thickness, while risk of hypertension, raised triglycerides and reduced HDL cholesterol is associated more strongly with BMI gain from childhood to adulthood.

Background: The majority of chronic disease is caused by risk factors which are mostly preventable. Effective interventions to reduce these risks are known and proven to be applicable to a variety of settings. Chronic disease is generally developed long before the fatal outcome, meaning that a lot of people spend a number of years in poor health. Effective prevention measures can prolong lives of individuals and significantly improve their quality of life. However, the methods to measure cost-effectiveness are a subject to much debate. The Economics of Chronic Diseases project aims to establish the best possible methods of measuring cost-effectiveness as well as develop micro-simulation models apt at projecting future burden of chronic diseases, their costs and potential savings after implementation of cost-effective interventions., Method: This research project will involve eight European countries: Bulgaria, Finland, Greece, Lithuania, The Netherlands, Poland, Portugal and the United Kingdom (UK). A literature review will be conducted to identify scientific articles which critically review the methods of cost-effectiveness. Contact will be made health economists to inform and enrich this review. This evidence will be used as a springboard for discussion at a meeting with key European stakeholders and experts with the aim of reaching a consensus on recommendations for cost-effectiveness methodology. Epidemiological data for coronary heart disease, chronic kidney disease, type 2 diabetes and chronic obstructive pulmonary disease will be collected along with data on time trends in three major risk factors related to these diseases, specifically tobacco consumption, blood pressure and body mass index. Economic and epidemiological micro-simulation models will be developed to asses the future distributions of risks, disease outcomes, healthcare costs and the cost-effectiveness of interventions to reduce the burden of chronic diseases in Europe., Discussion: This work will help to establish the best methods of measuring cost-effectiveness of health interventions as well as test a variety of scenarios to reduce the risk factors associated with selected chronic diseases. The modelling projections could be used to inform decisions and policies that will implement the best course of action to curb the rising incidence of chronic diseases.

Background: Since regaining of independence in 1990, Lithuania has been undergoing substantial political, economic, and social changes that affected the nutrition habits of population. Dietary changes might have impact on the trends of dietary related risk factors of chronic diseases. The aim of the study was to compare trends in diet and lipid profile of Lithuanian rural population aged 25-64 during two decades of transition period (1987-2007)., Methods: Four cross-sectional surveys were conducted within the framework of the Countrywide Integrated Noncommunicable Diseases Intervention Programme in five regions of Lithuania in 1987, 1993, 1999, and 2007. For each survey, a stratified independent random sample was drawn from the lists of the inhabitants aged 25-64 years registered at the primary health care centres. Altogether 3127 men and 3857 women participated in the surveys. 24-hour recall was used for evaluation of dietary habits. Serum lipids were determined using enzymatic methods. Predicted changes of serum cholesterol were calculated by Keys equation., Results: The percentage of energy from saturated fatty acids has decreased from 18.0 to 15.1 among men and from 17.6 to 14.8 among women over the period of 20 years. The average share of polyunsaturated fatty acids in total energy intake increased from 5.3% to 7.1% among men and from 4.9% to 7.3% among women. The mean intake of cholesterol declined among women. Favourable trends in fatty acids composition were caused by increased use of vegetable oil for cooking and replacement of butter spread with margarine. Since 1987, the mean value of total cholesterol has decreased by 0.6 mmol/l. Total dietary effect accounts for a 0.26 mmol/l (43.3%) decline in serum cholesterol among men and 0.31 mmol/l (50.8%) decline among women., Conclusions: Improvement in the quality of fat intake was observed in Lithuanian rural population over two decades of transition period. Positive changes in diet, mainly reduction in saturated fatty acids intake, contributed to decline in serum cholesterol level. Strengthening of favourable trends in nutrition habits in Lithuanian population should be one of the most important strategies of cardiovascular diseases prevention.