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1. Parental Perceptions of Children’s Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017

Author: Ximena Ramos Salas, Marta Buoncristiano, Julianne Williams, Maryam Kebbe, Angela Spinelli, Paola Nardone, Ana Rito, Vesselka Duleva, Sanja Musić Milanović, Marie Kunesova, Radka Taxová Braunerová, Tatjana Hejgaard, Mette Rasmussen, Lela Shengelia, Shynar Abdrakhmanova, Akbota Abildina, Zhamyila Usuopva, Jolanda Hyska, Genc Burazeri, Aušra Petrauskiene, Iveta Pudule, Victoria Farrugia Sant’Angelo, Enisa Kujundzic, Anna Fijałkowska, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Elena Bogova, Andrea Gualtieri, Marta García Solano, Enrique Gutiérrez-González, Sanavbar Rakhmatullaeva, Maya Tanrygulyyeva, Nazan Yardim, Daniel Weghuber, Päivi Mäki, Kenisha Russell Jonsson, Gregor Starc, Petur Benedikt Juliusson, Mirjam M. Heinen, Cecily Kelleher, Sergej Ostojic, Stevo Popovic, Viktoria Anna Kovacs, Dilorom Akhmedova, Nathalie J. Farpour-Lambert, Harry Rutter, Bai Li, Khadichamo Boymatova, Ivo Rakovac, Kremlin Wickramasinghe, and Joao Breda
Subjects: childhood obesity, parental perceptions, weight, world health organization/europe, childhood obesity surveillance initiative, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child’s weight status. The purpose of this study was to measure parental perceptions of their child’s weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children’s weight status as “underweight,” “normal weight,” “a little overweight,” or “extremely overweight.” We categorized children’s (6–9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child’s weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child’s weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child’s weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child’s weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24). Overall, parents’ BMI was not strongly associated with the underestimation of children’s weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child’s weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents’ knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
Published: 2021
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2. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6–9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015–2017

Author: Stephen Whiting, Marta Buoncristiano, Peter Gelius, Karim Abu-Omar, Mary Pattison, Jolanda Hyska, Vesselka Duleva, Sanja Musić Milanović, Hana Zamrazilová, Tatjana Hejgaard, Mette Rasmussen, Eha Nurk, Lela Shengelia, Cecily C. Kelleher, Mirjam M. Heinen, Angela Spinelli, Paola Nardone, Akbota Abildina, Shynar Abdrakhmanova, Gulmira Aitmurzaeva, Zhamyila Usuopva, Iveta Pudule, Aušra Petrauskiene, Victoria Farrugia Sant’Angelo, Enisa Kujundzic, Stevo Popovic, Anne-Siri Fismen, Ingunn Holden Bergh, Anna Fijalkowska, Ana Isabel Rito, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Andrea Gualtieri, Marta García-Solano, Enrique Gutiérrez-González, Zulfinissio Abdurrahmonova, Khadichamo Boymatova, Nazan Yardim, Maya Tanrygulyyeva, Daniel Weghuber, Karin Schindler, Dragana Stojisavljević, Aida Filipović Hadžiomeragić,, Eliza Markidou Ionnaidu, Wolfgang Ahrens, Maria Hassapidou, Viktoria Anna Kovacs, Sergej M. Ostojic, Lubica Ticha, Gregor Starc, Kenisha Russell Jonsson, Igor Spiroski, Harry Rutter, Romeu Mendes, Julianne Williams, Ivo Rakovac, and João Breda
Subjects: physical inactivity, surveillance, sedentary behaviour, active transport, active play, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6–9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). Method: The fourth COSI data collection round was conducted in 2015–2017, using a standardized protocol that included a family form completed by parents with specific questions about their children’s PA, screen time, and sleep duration. Results: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for 1 h/day, 8.2–85.6% were not members of a sport or dancing club, 17.7–94.0% walked or cycled to school each day, 32.3–80.0% engaged in screen time for
Published: 2020
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3. Prevalence of Severe Obesity among Primary School Children in 21 European Countries

Author: Angela Spinelli, Marta Buoncristiano, Viktoria Anna Kovacs, Agneta Yngve, Igor Spiroski, Galina Obreja, Gregor Starc, Napoleón Pérez, Ana Isabel Rito, Marie Kunešová, Victoria Farrugia Sant’Angelo, Jørgen Meisfjord, Ingunn Holden Bergh, Cecily Kelleher, Nazan Yardim, Iveta Pudule, Ausra Petrauskiene, Vesselka Duleva, Agneta Sjöberg, Andrea Gualtieri, Maria Hassapidou, Jolanda Hyska, Genc Burazeri, Constanta Huidumac Petrescu, Mirjam Heinen, Hajnalka Takacs, Hana Zamrazilová, Tulay Bagci Bosi, Elena Sacchini, Ioannis Pagkalos, Alexandra Cucu, Paola Nardone, Paul Gately, Julianne Williams, and João Breda
Subjects: Obesity, BMI, Childhood Obesity Surveillance Initiative, Europe, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Background: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6–9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. Objectives: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. Method: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child’s age and mother’s educational level, were performed in a select group of countries. Results:A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7–1.3 and 0.7–1.5, respectively) to 5.5% (95% CI 4.9–6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6–9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child’s age did not show a clear pattern. Severe obesity was more common among children whose mother’s educational level was lower. Conclusions: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
Published: 2019
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4. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017

Author: Ana Isabel Rito, Marta Buoncristiano, Angela Spinelli, Benoit Salanave, Marie Kunešová, Tatjana Hejgaard, Marta García Solano, Anna Fijałkowska, Lela Sturua, Jolanda Hyska, Cecily Kelleher, Vesselka Duleva, Sanja Musić Milanović, Victoria Farrugia Sant’Angelo, Shynar Abdrakhmanova, Enisa Kujundzic, Valentina Peterkova, Andrea Gualtieri, Iveta Pudule, Aušra Petrauskienė, Maya Tanrygulyyeva, Rakhmatulloev Sherali, Constanta Huidumac-Petrescu, Julianne Williams, Wolfgang Ahrens, and João Breda
Subjects: Breastfeeding, Birth weight, Childhood obesity, WHO/Europe, COSI Europe, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Background: In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity. Objectives: It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. Method: Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children’s standardized weight and height measurements followed a common WHO protocol. Information on the children’s birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. Results: The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16–1.28] and 1.12 [1.07–1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17–1.36] and 1.05 [0.99–1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. Conclusion: The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.
Published: 2019
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5. Iron Status in Pregnant Women in Latvia: An Epidemiological, Cross-Sectional, Multicenter Study According to WHO and UK Criteria

Author: Roberta Rezgale, Iveta Pudule, Vinita Cauce, Kristine Klaramunta Antila, Violeta Bule, Gunta Lazdane, Dace Rezeberga, and Laila Meija
Subjects: iron deficiency, anaemia, pregnancy, Medicine (General), R5-920
Abstract: Background and Objectives: During pregnancy, iron deficiency anaemia is a common problem associated with health risks for both the mother and her foetus/infant. This study aimed to investigate the prevalence of iron deficiency, iron deficiency anaemia, and related dietary patterns in pregnant women in Latvia. Materials and Methods: This cross-sectional, multicentre study included pregnancy data from 974 women. The sample selection was based on the stratification principle (population of women of childbearing age in regions of Latvia). Maternal demographic details, anthropometric measurements, iron status, dietary patterns, and supplementation information were obtained from maternal files and during interviews held in eight outpatient departments of medical institutions and maternity departments. The prevalence was assessed. Chi-square tests and logistic regression were used to identify associations between iron deficiency and sociodemographic characteristics, dietary patterns, and iron supplement intake during pregnancy. The criterion used for the diagnosis of iron deficiency anaemia is a Hb level Results: The observed prevalence of anaemia was 2.8% in the first trimester, 7.9% in the second trimester, and 27.0% in the third trimester. The prevalence of iron deficiency was 46.7% in the first trimester, 78.1% in the second trimester, and 91.7% in the third trimester. No associations with dietary patterns were found. Single women had 1.85 times the odds (95% CI 1.07 to 3.18) of being anaemic than married women. Conclusions: Iron deficiency affects a large proportion of pregnant women in Latvia in all trimesters, with iron deficiency anaemia affecting pregnant women in the third trimester. Monitoring and intervention should be performed in a timely and more targeted manner.
Published: 2022
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6. Assessment of Iodine and Selenium Nutritional Status in Women of Reproductive Age in Latvia

Author: Vija Veisa, Ieva Kalere, Tatjana Zake, Ieva Strele, Marina Makrecka-Kuka, Sabine Upmale-Engela, Andrejs Skesters, Dace Rezeberga, Aivars Lejnieks, Iveta Pudule, Daiga Grinberga, Biruta Velika, Maija Dambrova, and Ilze Konrade
Subjects: iodine, urinary iodine concentration (UIC), thyroid, pregnancy, autoimmunity, selenium, Medicine (General), R5-920
Abstract: Background and Objectives: Adequate dietary intake of iodine and selenium is essential during pregnancy. While iodine is vital for maternal thyroid function and fetal development, selenium contributes to the regulation of thyroid function and thyroid autoimmunity. This study aimed to assess the consumption of iodine- and selenium-containing products by women of reproductive age and the iodine and selenium nutritional status of pregnant women in Latvia. Materials and Methods: Population health survey (2010–2018) data were used to characterize dietary habits in women of reproductive age. Additionally, 129 pregnant women in the first trimester were recruited; they completed a questionnaire and were tested for thyroid function, urinary iodine concentration (UIC), and serum selenium and selenoprotein P levels. Results: The use of some dietary sources of iodine (e.g., milk and dairy products) and selenium (e.g., bread) has decreased in recent years. Less than 10% of respondents reported the use of iodized salt. The use of supplements has become more common (reported by almost 50% of respondents in 2018). Dietary habits were similar in pregnant women, but the use of supplements was even higher (almost 70%). Nevertheless, most supplements used in pregnancy had insufficient contents of iodine and selenium. Thyroid function was euthyreotic in all women, but 13.9% of participants had a thyroid peroxidase antibodies (TPO-ab) level above 60 IU/mL. The median UIC (IQR) was 147.2 (90.0–248.1) μg/gCr, and 52.8% of pregnant women had a UIC below 150 μg/gCr. The mean selenium (SD) level was 101.5 (35.6) μg/L; 30.1% of women had a selenium level below 80 μg/L. The median selenoprotein P level was 6.9 (3.1–9.0) mg/L. Conclusions: Iodine nutrition in Latvian population of pregnant women was near the lower limit of adequate and a third of the population had a selenium deficiency. Supplements were frequently used, but most did not contain the recommended amounts of iodine and selenium.
Published: 2021
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7. A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI)

Author: Julianne Williams, Marta Buoncristiano, Paola Nardone, Ana Isabel Rito, Angela Spinelli, Tatjana Hejgaard, Lene Kierkegaard, Eha Nurk, Marie Kunešová, Sanja Musić Milanović, Marta García-Solano, Enrique Gutiérrez-González, Lacramioara Aurelia Brinduse, Alexandra Cucu, Anna Fijałkowska, Victoria Farrugia Sant’Angelo, Shynar Abdrakhmanova, Iveta Pudule, Vesselka Duleva, Nazan Yardim, Andrea Gualtieri, Mirjam Heinen, Silvia Bel-Serrat, Zhamyla Usupova, Valentina Peterkova, Lela Shengelia, Jolanda Hyska, Maya Tanrygulyyeva, Ausra Petrauskiene, Sanavbar Rakhmatullaeva, Enisa Kujundzic, Sergej M. Ostojic, Daniel Weghuber, Marina Melkumova, Igor Spiroski, Gregor Starc, Harry Rutter, Giulia Rathmes, Anne Charlotte Bunge, Ivo Rakovac, Khadichamo Boymatova, Martin Weber, and João Breda
Subjects: nutrition, child, obesity, surveillance, health, noncommunicable diseases, Nutrition. Foods and food supply, TX341-641
Abstract: Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015–2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children’s parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks “every day”, “most days (four to six days per week)”, “some days (one to three days per week)”, or “never or less than once a week”. We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance.
Published: 2020
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8. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

Author: Mark A Bellis, Karen Hughes, Nicola Leckenby, Lisa Jones, Adriana Baban, Margarita Kachaeva, Robertas Povilaitis, Iveta Pudule, Gentiana Qirjako, Betül Ulukol, Marija Raleva, and Natasa Terzic
Subjects: Public aspects of medicine, RA1-1270
Abstract: Objective To evaluate the association between adverse childhood experiences – e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration – and the health of young adults in eight eastern European countries. Methods Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10 696 respondents – 59.7% female – aged 18–25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide. Findings Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32–2.15) – for physical inactivity – to 48.53 (95% CI: 31.98–76.65) – for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population. Conclusion Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.
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9. Trends in Adolescent Substance Use: Analysis of HBSC Data for Four Eastern European Countries, 1994–2018

Author: Tomas Vaičiūnas, Monika Žemaitaitytė, Shannon Lange, Mindaugas Štelemėkas, Leila Oja, Janina Petkevičienė, Anna Kowalewska, Iveta Pudule, Jaanika Piksööt, and Kastytis Šmigelskas
Subjects: adolescent, substance use, trends, eastern Europe, HBSC, Cross-Sectional Studies, Eastern European People, Adolescent, Alcohol Drinking, Substance-Related Disorders, Adolescent Behavior, Health, Toxicology and Mutagenesis, Prevalence, Public Health, Environmental and Occupational Health, Humans, Electronic Nicotine Delivery Systems, Child
Abstract: The aim of the study was to analyze the trends of adolescent substance use in four eastern European countries over the time period from 1994 to 2018. The four countries in focus were selected based on their shared historical backgrounds and major economic and social transformations experienced. Methods: Two decades (1993/1994–2017/2018) of repeated cross-sectional data from the Estonian, Latvian, Lithuanian, and Polish Health Behaviour in School-aged Children survey were used. Data comprised 42,169 school children 15 years of age (9th grade). The following categories of substance use were included: regular alcohol consumption and drunkenness, tobacco smoking, electronic cigarette smoking, and cannabis use. Trends in substance use over time were tested using Jonckheere’s trend test. Results: Prevalence of substance use among adolescents over time revealed that the Baltic states and Poland have faced relatively different temporal trends. In the Baltic states, there was a general increase during the period of 1994–2002, which was followed by a period of peaking or stability between 2002–2010, and then decreasing trends of these risky behaviors from 2010 onwards. In Poland, the same period had less consistent patterns, with decreasing trends starting much earlier on. The prevalence of cannabis use, which had been measured since 2006, had its own unique pattern with many fluctuations within and between countries. Conclusions: The findings on the prevalence of substance use among adolescents from 1994 to 2018 revealed that the Baltic states and Poland have faced relatively different temporal trends. These countries might be facing new public health challenges in a near future, e.g., use of electronic cigarettes and cannabis use among adolescents.
Published: 2022
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10. S02-1 Physical activity and sedentary behaviour of children aged 6-9 in Europe: an analysis within the Childhood Obesity Surveillance Initiative (COSI)

Author: Stephen Whiting, Marta Buoncristiano, Peter Gelius, Karim Abu-Omar, Mary Pattison, Jolanda Hyska, Vesselka Duleva, Sanja Musić Milanović, Hana Zamrazilová, Tatjana Hejgaard, Mette Rasmussen, Eha Nurk, Lela Shengelia, Cecily C Kelleher, Mirjam M Heinen, Angela Spinelli, Paola Nardone, Akbota Abildina, Shynar Abdrakhmanova, Gulmira Aitmurzaeva, Zhamyila Usuopva, Iveta Pudule, Aušra Petrauskiene, Victoria Farrugia Sant’ Angelo, Enisa Kujundzic, Stevo Popovic, Anne-Siri Fismen, Ingunn Holden Bergh, Anna Fijalkowska, Ana Isabel Rito, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Andrea Gualtieri, Marta García-Solano, Enrique Gutiérrez-González, Zulfinissio Abdurrahmonova, Khadichamo Boymatova, Nazan Yardim, Maya Tanrygulyyeva, Daniel Weghuber, Karin Schindler, Dragana Stojisavljević, Aida Filipović Hadžiomeragić, Eliza Markidou Ionnaidu, Wolfgang Ahrens, Maria Hassapidou, Viktoria Anna Kovacs, Sergej M Ostojic, Lubica Ticha, Gregor Starc, Kenisha Russell Jonsson, Igor Spiroski, Harry Rutter, Romeu Mendes, Julianne Williams, Ivo Rakovac, and João Breda
Subjects: Public Health, Environmental and Occupational Health
Abstract: Background Children are becoming less physically active for a variety of interrelated reasons. The availability of opportunities for safe active playgrounds, recreational activities and active transport has decreased, while time spend on sedentary screen-based activities has increased. This study aimed to evaluate physical activity (PA), sedentary and sleep behaviours of children aged 6-9 years in Europe using data from the WHO Childhood Obesity Surveillance Initiative (COSI). Methods The fourth COSI data collection round was conducted in 36 countries from 2015-2018 using a standardized protocol including a family form completed by parents with specific questions about diet and physical activity-related behaviours. Results Nationally representative data from the 24 countries, who filled in the non-mandatory family record form, were included. Information on PA, screen-time and sleep behaviours of 137,807 children were analysed. Pooled analysis showed that: one in two children walked or cycled to school every day; one in two children were members of a sport or dancing club; around 40 % of children spent at least two hours per day watching TV or using electronic devices; around four in five children were actively or vigorously playing each day; around 88 % of children slept for at least nine hours per night. Country specific analyses showed pronounced differences in prevalence estimates between countries. Conclusions While the severity of the problem varies between countries, physical inactivity and sedentary behaviours are common across the European Region. Policy makers across the Region must do more in order to increase opportunities for young people to participate in daily activities. Furthermore, they should explore solutions to reduce the amount of time spend on sedentary activities, in order to halt the rise in overweight and obesity.
Published: 2022

11. S02-2 Socioeconomic determinants of physical activity, sleep and screen time among children aged 6-9 years of age in Europe

Author: Sanja Music Milanovic, Marta Buoncristiano, Helena Križan, Giulia Rathmes, Julianne Williams, Jolanda Hyska, Vesselka Duleva, Hana Zamrazilová, Tatjana Hejgaard, Maja Bæksgaard Jørgensen, Benoît Salanave, Lela Shengelia, Cecily C Kelleher, Angela Spinelli, Paola Nardone, Shynar Abdrakhmanova, Zhamilya Usupova, Iveta Pudule, Ausra Petrauskiene, Victoria Farrugia Sant'Angelo, Enisa Kujundžic, Anna Fijałkowska, Ana Isabel Rito, Alexandra Cucu, Lacramioara Aurelia Brinduse, Valentina Peterkova, Andrea Gualtieri, Marta García-Solano, Enrique Gutiérrez-González, Khadichamo Boymatova, Mahmut S Yardim, Maya Tanrygulyyeva, Marina Melkumova, Daniel Weghuber, Eha Nurk, Päivi Mäki, Ingunn Holden Bergh, Sergej M Ostojic, Kenisha Russell Jonsson, Igor Spiroski, Harry Rutter, Wolfgang Ahrens, Ivo Rakovac, Stephen Whiting, and João Breda
Subjects: Public Health, Environmental and Occupational Health
Abstract: Background Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan). Methods COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questionnaire filled by parents. Among these, the paper focused on the following behaviours: Transportation to and from schools, Time spent on practising sports, Time spent on actively/vigorously playing, Time spent watching TV or using electronic devices and Hours of sleep per night. For the paper purpose, countries were grouped in 4 macro-regions according to United Nations “Standard Country or Area Codes for Statistical Use”. Results Findings indicated that a high prevalence of motorized school transport among children of employed parents in Southern Europe. The highest prevalence of insufficient sports and active play was among families from West-Central Asia who meet the end of the month with troubles, the highest prevalence of excessive screen time is among families from Eastern Europe, where both parents have a low level of education and the highest prevalence of insufficient sleep is among families from West-Central Asia where both parents have a high level of education. Conclusions There are important differences in the socioeconomic determinants of PA, sleep and screen related behaviours both between countries and sub-regions across the WHO European Region. This analysis of results from the COSI survey provides important insights that can help guide policy makers to take action to address the childhood obesity epidemic.
Published: 2022

12. Self-reported suicidal behaviours and associated factors in the general population of Latvia (2010–2018)

Author: Krista Mieze, Anda Kivite-Urtane, Daiga Grinberga, Biruta Velika, Iveta Pudule, and Elmars Rancans
Subjects: Psychiatry and Mental health
Abstract: Background: Latvia has the second highest suicide rate in the European Union – with a total population age-standardized suicide rate of 16.1 per 100,000 inhabitants. Aims: We aimed to assess the prevalence of different types of self-reported suicidal behaviours in Latvia and determine the associated sociodemographic and health-related factors. Methods: This study was based on secondary data obtained from the Health Behaviour Among Latvian Adult Population survey. A representative sample of the general population was used, aged 15 to 64 years in 2010, 2012, 2014; and 15 to 74 years in 2016 and 2018 ( n = 16,084). Respondents were asked to report the occurrence of life weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts during the previous year. We assessed socio-demographics and health-related factors associated with suicidality. We performed univariate analysis and constructed stepwise multivariate logistic regression models. Results: In 2010 to 2018, 15.6% of responders reported some type of suicidal behaviour (95% CI [15.1, 16.2]). Sociodemographic factors – including non-cohabitation status and Latvian nationality – were associated with mild (life-weariness and death wishes) and serious (suicidal ideation, plans to commit suicide, suicide attempts) types of behaviour. Older age was associated with mild suicidal behaviours, whereas lower educational levels were associated with serious suicidal behaviours. Diagnosed depression, self-reported depression, self-reported anxiety, stress, low mood, alcohol intake habits with heavy drinking episodes (less than monthly, monthly and weekly), perceived health as average or below average, disuse of primary health services were associated with mild and serious types of suicidal behaviour. Current smoking status and absenteeism were associated with mild suicidal behaviour types. Self-reported insomnia, having at least two somatic diagnoses, occasional smoking status, absenteeism with 11 or more days in the last year, receiving disability pension were associated with serious suicidal behaviour types. Musculoskeletal diseases exhibited preventive effects. Conclusions: Our findings indicate that certain groups of individuals might exhibit greater vulnerability to suicidality.
Published: 2023

13. Association between road safety habits and risky health behaviours in Latvian adult population

Author: Aija Bukova-Zideluna, Anita Villerusa, and Iveta Pudule
Subjects: alcohol, family doctor, use of seat belt, Social Sciences, road safety, human activities, smoking
Abstract: The study examined the road safety habits of the adult population of Latvia in relation to risky health behaviours (smoking, excessive alcohol consumption, no regular health check-ups at the family doctor). Data of Health Behaviour among the Latvian Adult Population for five consecutive surveys for the years 2010–2018 were analysed. Results: The use of seat belts has increased slightly – from 93.5% to 95.6% in the front seat of the vehicle, from 52.4% to 56.3% in the rear seat of the vehicle (p < 0,001). Of the 10,731 respondents, 30.8% (N = 3309; 95% CI 30.0–31.7) were daily smokers, 14.8% (N = 1593; 95% CI 14.2–15.5) had excessive alcohol consumption habits, 25.9% (N = 2779; 95% CI 25.1–26.7) had not visited their family doctor during the last year. Higher odds for seat belt use were observed among respondents without excessive alcohol consumption (OR = 2.1), non-smokers (OR = 1.5–1.8), and those, who had visited their family doctor last year (OR = 1.2–1.3). Multivariate regression analysis showed risky behaviour is an independent factor associated with road safety habits.
Published: 2022

14. Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries:The World Health Organization European Childhood Obesity Surveillance Initiative—COSI 2015–2017

Author: Aušra Petrauskienė, João Breda, Stevo Popovic, Sanja Musić Milanović, Elena Sacchini, Viktoria Anna Kovacs, Eliza Markidou Ioannidou, Angela Spinelli, Khadichamo Boymatova, Akbota Abildina, Andrea Gualtieri, Martin Weber, Kenisha Russell Jonsson, Jolanda Hyska, Cecily Kelleher, Päivi Mäki, Dragana Stojisavljević, Igor Spiroski, Daniel Weghuber, Maria Hassapidou, Ľubica Tichá, Shynar Abdrakhmanova, Marie Kunešová, Sergej M. Ostojic, Ivo Rakovac, Lütfiye Hilal Özcebe, Valentina Peterkova, Alexandra Cucu, Aida Filipović Hadžiomeragić, Marina Melkumova, Enisa Kujundžić, Maya Tanrygulyyeva, Eha Nurk, Tatjana Hejgaard, Victoria Farrugia Sant'Angelo, Petur Benedikt Juliusson, Paola Nardone, Vesselka Duleva, Zhamilya Usupova, Gregor Starc, Benoît Salanave, Anne-Siri Fismen, Marta García-Solano, Marta Buoncristiano, Sanavbar Rakhmatulleoeva, Julianne Williams, Karin Schindler, Ana Isabel Rito, Mirjam M. Heinen, Anna Fijałkowska, Lela Shengelia, María Ángeles Dal Re Saavedra, Iveta Pudule, Harry Rutter, and Lacramioara Aurelia Brinduse
Subjects: Male, Pediatric Obesity, obesity, malnutrition, prevention, thinness, Endocrinology, Diabetes and Metabolism, Geographic variation, Overweight, Saúde Pública, World Health Organization, World health, Childhood obesity, Body Mass Index, WHO, Thinness, SDG 3 - Good Health and Well-being, Prevalence, medicine, Humans, Child, SDG 2 - Zero Hunger, Portugal, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, Obesity, Europe, Malnutrition, European Childhood Obesity Surveillance Initiative, Female, Underweight, medicine.symptom, business, Body mass index, Estilos de Vida e Impacto na Saúde, Demography
Abstract: In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6–9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Austria: Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Republic of Austria; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: Ministry of Health of the Czech Republic, grants AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Cyprus: not available; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development; Finland: Finnish Institute for Health and Welfare; France: Santé publique France, the French Agency for Public Health; Georgia: WHO; Greece: International Hellenic University and Hellenic Medical Association for Obesity; Hungary: WHO Country Office for Hungary; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; North Macedonia: funded by the Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health in the country. WHO country office provided support for training and data management; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russian Federation: WHO; San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority; Serbia: World Health Organization (Ref. File 2015-540940); Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR; Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Sweden: Public Health Agency of Sweden; Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion
Published: 2021

15. Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)

Author: Eliza Markidou Ioannidou, Alexandra Cucu, Tatjana Hejgaard, Andrea Gualtieri, Angela Spinelli, Enisa Kujundžić, Iveta Pudule, Harry Rutter, Lacramioara Aurelia Brinduse, Shynar Abdrakhmanova, Ľubica Tichá, Ana Isabel Rito, Marta García-Solano, Marina Melkumova, Eha Nurk, Sergej M. Ostojic, Jolanda M. A. Boer, Márta Bakacs, Dragana Stojisavljević, Maria Hassapidou, Igor Spiroski, Ronit Endevelt, Nabil Seyidov, Lela Shengelia, Maya Tanrygulyyeva, Vladyslav Zbanatskyi, Hana Zamrazilová, Nazan Yardim, Aušra Petrauskienė, Zhamilya Usupova, Vesselka Duleva, Benoît Salanave, Sanja Musić Milanović, Else Karin Grøholt, Francesco Branca, Anna Fijałkowska, Khadichamo Boymatova, Julianne Williams, Isabelle Moyersoen, Martin Weber, Karen McColl, Ivo Rakovac, Aida Filipović Hadžiomeragić, Gregor Starc, Daniel Weghuber, Dilorom Akhmedova, Marta Buoncristiano, Zulfiya Abdurrahmonova, Wolfgang Ahrens, Kenisha Russell Jonsson, Jolanda Hyska, Valentina Peterkova, Natalia Silitrari, João Breda, Päivi Mäki, Cecily Kelleher, and Victoria Farrugia Sant'Angelo
Subjects: Pediatric Obesity, Endocrinology, Diabetes and Metabolism, Physical activity, Overweight, World Health Organization, hildren, methodology, obesity, surveillance, Childhood obesity, Pediatric Obesity / epidemiology, SDG 3 - Good Health and Well-being, Environmental health, medicine, Prevalence, Humans, Obesity, Child, Children, Exercise, Data collection, Surveillance, Schools, Portugal, business.industry, Potential risk, Public Health, Environmental and Occupational Health, Methodology, Sedentary behavior, medicine.disease, Europe, Normal weight, European Childhood Obesity Surveillance Initiative, COSI, medicine.symptom, business, Estilos de Vida e Impacto na Saúde
Abstract: Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI)has resulted in a surveillance system which provides regular, reliable, timely, andaccurate data on children's weight status—through standardized measurement ofbodyweight and height—in the WHO European Region. Additional data on dietaryintake, physical activity, sedentary behavior, family background, and schoolenvironments are collected in several countries. In total, 45 countries in the EuropeanRegion have participated in COSI. The first five data collection rounds, between 2007and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI,data are collected according to a common protocol, using standardized instrumentsand procedures. The systematic collection and analysis of these data enables inter-country comparisons and reveals differences in the prevalence of childhood thinness,overweight, normal weight, and obesity between and within populations. Furthermore,it facilitates investigation of the relationship between overweight, obesity, and poten-tial risk or protective factors and improves the understanding of the development ofoverweight and obesity in European primary-school children in order to supportappropriate and effective policy responses. The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. Bulgaria: Ministry of Health, National Center of Public Health and Analyses, and WHO Regional Office for Europe. Bosnia and Herzegovina: WHO country office support for training and data management. Croatia: Ministry of Health, Croatian Institute of Public Health, and WHO Regional Office for Europe. Czechia: Ministry of Health of the Czech Republic, grant number 17-31670A and MZCR—RVO EU 00023761. Denmark: Danish Ministry of Health. Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development. Finland: Finnish Institute for Health and Welfare. France: Santé publique France (the French Agency for Public Health). Georgia: WHO. Greece: International Hellenic University and Hellenic Medical Association for Obesity. Hungary: WHO Country Office for Hungary. Ireland: Health Service Executive. Italy: Ministry of Health. Kazakhstan: Ministry of Health of the Republic of Kazakhstan, WHO, and UNICEF. Kyrgyzstan: World Health Organization. Latvia: Ministry of Health and Centre for Disease Prevention and Control. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. North Macedonia: Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health; WHO country office provides support for training and data management. Norway: the Norwegian Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Institute of Public Health. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates, and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry, Educational Ministry, and Social Security Institute and Health Authority. Serbia: WHO and the WHO Country Office (2015-540940 and 2018/873491-0). Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR. Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system. Spain: Spanish Agency for Food Safety and Nutrition. Sweden: Public Health Agency of Sweden. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection. Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion
Published: 2021

16. Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6–9‐year‐old children from 19 countries from the WHO European region

Author: Shynar Abdrakhmanova, Iveta Pudule, Harry Rutter, Lacramioara Aurelia Brinduse, Marta Buoncristiano, Daniel Weghuber, Ivo Rakovac, Mirjam M. Heinen, Alexandra Cucu, Julianne Williams, Anna Fijałkowska, Enrique Gutiérrrez-González, Maya Tanrygulyyeva, Ana Isabel Rito, Radka Taxová Braunerová, Enisa Kujundžić, Lela Shengelia, Khadichamo Boymatova, Igor Spiroski, Ausra Petrauskiene, Zhamilya Usupova, Marie Kunešová, Angela Spinelli, Andrea Gualtieri, Eha Nurk, Vesselka Duleva, Martin Weber, Silvia Bel-Serrat, Zulfiya Abdurrahmonova, João Breda, Sanja Musić Milanović, Ingunn Holden Bergh, Ľubica Tichá, Sergej M. Ostojic, Paola Nardone, Tatjana Hejgaard, Jolanda Hyska, Elena Sacchini, Cecily Kelleher, A Tülay Bağci Bosi, and Victoria Farrugia Sant'Angelo
Subjects: Pediatric Obesity, Internationality, Endocrinology, Diabetes and Metabolism, Psychological intervention, Carbonated Beverages, Saúde Pública, Pediatric Obesity / epidemiology, Childhood Obesity Surveillance Initiative, soft drinks, Surveys and Questionnaires, Vegetables, Medicine, Child, Pediatric Obesity / prevention & control, education.field_of_study, Access to Healthy Foods, European region, SDG 11 - Sustainable Cities and Communities, Europe, COSI, vegetables, Population, World Health Organization, Childhood obesity, Odds, children, SDG 3 - Good Health and Well-being, Urbanization, Environmental health, Humans, education, Consumption (economics), Portugal, business.industry, Public Health, Environmental and Occupational Health, fruit, Feeding Behavior, medicine.disease, Diet, Cross-Sectional Studies, Fruit, rural, Soft drink, business, urban, Estilos de Vida e Impacto na Saúde
Abstract: In order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urban–rural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6–9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30–80% and 30–90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1–2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Austria: Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Republic of Austria; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17-31670 A and MZČR–RVO EÚ 00023761; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; North Macedonia: COSI in North Macedonia is funded by the Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health in the country. WHO country office provides support for training and data management; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Serbia: This study was supported by the World Health Organization (Ref. File 2015-540940); Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion
Published: 2021

17. Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries—WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017)

Author: Anne‐Siri Fismen, Marta Buoncristiano, Julianne Williams, Arnfinn Helleve, Shynar Abdrakhmanova, Márta Bakacs, Ingunn Holden Bergh, Khadichamo Boymatova, Vesselka Duleva, Anna Fijałkowska, Marta García‐Solano, Andrea Gualtieri, Enrique Gutiérrez‐González, Tatjana Hejgaard, Constanta Huidumac‐Petrescu, Jolanda Hyska, Cecily C. Kelleher, Lene Kierkegaard, Enisa Kujundžić, Marie Kunešová, Sanja Musić Milanović, Paola Nardone, Eha Nurk, Sergej M. Ostojic, Lütfiye Hilal Ozcebe, Valentina Peterkova, Ausra Petrauskiene, Iveta Pudule, Sanavbar Rakhmatulleoeva, Ivo Rakovac, Ana Isabel Rito, Harry Rutter, Elena Sacchini, Dragana Stojisavljević, Victoria Farrugia Sant'Angelo, Lela Shengelia, Angela Spinelli, Igor Spiroski, Maya Tanrygulyyeva, Zhamilya Usupova, Daniel Weghuber, and João Breda
Subjects: Parents, medicine.medical_specialty, Pediatric Obesity, Endocrinology, Diabetes and Metabolism, Psychological intervention, Food habits, 030209 endocrinology & metabolism, food habits, World Health Organization, Saúde Pública, Childhood obesity, 03 medical and health sciences, 0302 clinical medicine, Childhood Obesity Surveillance Initiative, children, Environmental health, Surveys and Questionnaires, medicine, Humans, Social inequality, 030212 general & internal medicine, Child, Socioeconomic status, Socioeconomic differences, food haits, social inequalities, socioeconomic differences, 2. Zero hunger, Consumption (economics), Portugal, Public health, 1. No poverty, Public Health, Environmental and Occupational Health, Feeding Behavior, medicine.disease, 3. Good health, Diet, Europe, Cross-Sectional Studies, Socioeconomic Factors, COSI, Psychology, Estilos de Vida e Impacto na Saúde
Abstract: Background: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. Methods: The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. Results: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. Conclusion: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17-31670 A and MZČ–VO EÚ 00023761; Denmark: Danish Ministry of Health; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russian Federation: WHO; San Marino: Health Ministry, Educational Ministry; Serbia: This study was supported by the World Health Organization (Ref. File 2015-540940); Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank. The CO-CREATE project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No. 774210. info:eu-repo/semantics/publishedVersion
Published: 2021

18. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. 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Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. 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Aounallah-Skhiri , Joana Araújo , Inger Ariansen , Tahir Aris , Raphael E Arku , Nimmathota Arlappa , Krishna K Aryal , Thor Aspelund , Felix K Assah , Maria Cecília F Assunção , May Soe Aung , Juha Auvinen , Mária Avdicová , Shina Avi , Ana Azevedo , Mohsen Azimi-Nezhad , Fereidoun Azizi , Mehrdad Azmin , Bontha V Babu , Maja Bæksgaard Jørgensen , Azli Baharudin , Suhad Bahijri , Jennifer L Baker , Nagalla Balakrishna , Mohamed Bamoshmoosh , Maciej Banach , Piotr Bandosz , José R Banegas , Joanna Baran , Barbagallo CM, Alberto Barceló , Amina Barkat , Aluisio Jd Barros , Mauro Virgílio Gomes Barros , Abdul Basit , Joao Luiz D Bastos , Iqbal Bata , Anwar M Batieha , Rosangela L Batista , Zhamilya Battakova , Assembekov Batyrbek , Louise A Baur , Robert Beaglehole , Silvia Bel-Serrat , Antonisamy Belavendra , Habiba Ben Romdhane , Judith Benedics , Mikhail Benet , Ingunn Holden Bergh , Salim Berkinbayev , Antonio Bernabe-Ortiz , Gailute Bernotiene , Heloísa Bettiol , Jorge Bezerra , Aroor Bhagyalaxmi , Sumit Bharadwaj , Santosh K Bhargava , Zulfiqar A Bhutta , Hongsheng Bi , Yufang Bi , Daniel Bia , Elysée Claude Bika Lele, Mukharram M Bikbov , Bihungum Bista , Dusko J Bjelica , Peter Bjerregaard , Espen Bjertness , Marius B Bjertness , Cecilia Björkelund , Katia V Bloch , Anneke Blokstra , Simona Bo , Martin Bobak , Lynne M Boddy , Bernhard O Boehm , Heiner Boeing , Jose G Boggia , Elena Bogova , Carlos P Boissonnet , Stig E Bojesen , Marialaura Bonaccio , Vanina Bongard , Alice Bonilla-Vargas , Matthias Bopp , Herman Borghs , Lien Braeckevelt , Lutgart Braeckman , Marjolijn Ce Bragt , Imperia Brajkovich , Francesco Branca , Juergen Breckenkamp , João Breda , Hermann Brenner , Lizzy M Brewster , Garry R Brian , Lacramioara Brinduse , Sinead Brophy , Graziella Bruno , H Bas Bueno-de-Mesquita , Anna Bugge , Marta Buoncristiano , Genc Burazeri , Con Burns , Antonio Cabrera de León , Joseph Cacciottolo , Hui Cai , Tilema Cama , Christine Cameron , José Camolas , 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Cottel , Chris Cowell , Cora L Craig , Amelia C Crampin , Ana B Crujeiras , Semánová Csilla , Alexandra M Cucu , Liufu Cui , Felipe V Cureau , Ewelina Czenczek-Lewandowska , Graziella D'Arrigo , Eleonora d'Orsi , Liliana Dacica , María Ángeles Dal Re Saavedra , Jean Dallongeville , Camilla T Damsgaard , Rachel Dankner , Thomas M Dantoft , Parasmani Dasgupta , Saeed Dastgiri , Luc Dauchet , Kairat Davletov , Guy De Backer , Dirk De Bacquer , Giovanni de Gaetano , Stefaan De Henauw , Paula Duarte de Oliveira , David De Ridder , Karin De Ridder , Susanne R de Rooij , Delphine De Smedt , Mohan Deepa , Alexander D Deev , Vincent Jr DeGennaro , Abbas Dehghan , Hélène Delisle , Francis Delpeuch , Stefaan Demarest , Elaine Dennison , Katarzyna Dereń , Valérie Deschamps , Meghnath Dhimal , Augusto F Di Castelnuovo , Juvenal Soares Dias-da-Costa , María Elena Díaz-Sánchez , Alejandro Diaz , Zivka Dika , Shirin Djalalinia , Visnja Djordjic , Ha Tp Do , Annette J Dobson , Maria Benedetta Donati , 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, Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen Gironella , Aleksander Giwercman , Konstantinos Gkiouras , Justyna Godos , Sibel Gogen , Marcel Goldberg , Rebecca A Goldsmith , David Goltzman , Santiago F Gómez , Aleksandra Gomula , Bruna Goncalves Cordeiro da Silva , Helen Gonçalves , David A Gonzalez-Chica , Marcela Gonzalez-Gross , Margot González-Leon , Juan P González-Rivas , Clicerio González-Villalpando , María-Elena González-Villalpando , Angel R Gonzalez , Frederic Gottrand , Antonio Pedro Graça , Sidsel Graff-Iversen , Dušan Grafnetter , Aneta Grajda , Maria G Grammatikopoulou , Ronald D Gregor , Tomasz Grodzicki , Else Karin Grøholt , Anders Grøntved , Giuseppe Grosso , Gabriella Gruden , Dongfeng Gu , Emanuela Gualdi-Russo , Pilar Guallar-Castillón , Andrea Gualtieri , Elias F Gudmundsson , Vilmundur Gudnason , Ramiro Guerrero , Idris Guessous , Andre L Guimaraes , Martin C Gulliford , Johanna Gunnlaugsdottir , Marc J Gunter , Xiu-Hua Guo , Yin Guo , Prakash C Gupta , Rajeev Gupta , Oye Gureje , Beata Gurzkowska , 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Huiart , Constanta Huidumac Petrescu , Martijn Huisman , Abdullatif Husseini , Chinh Nguyen Huu , Inge Huybrechts , Nahla Hwalla , Jolanda Hyska , Licia Iacoviello , Jesús M Ibarluzea , Mohsen M Ibrahim , Norazizah Ibrahim Wong , M Arfan Ikram , Violeta Iotova , Vilma E Irazola , Takafumi Ishida , Muhammad Islam , Sheikh Mohammed Shariful Islam , Masanori Iwasaki , Jeremy M Jacobs , Hashem Y Jaddou , Tazeen Jafar , Kenneth James , Kazi M Jamil , Konrad Jamrozik , Imre Janszky , Edward Janus , Juel Jarani , Marjo-Riitta Jarvelin , Grazyna Jasienska , Ana Jelakovic , Bojan Jelakovic , Garry Jennings , Anjani Kumar Jha , Chao Qiang Jiang , Ramon O Jimenez , Karl-Heinz Jöckel , Michel Joffres , Mattias Johansson , Jari J Jokelainen , Jost B Jonas , Jitendra Jonnagaddala , Torben Jørgensen , Pradeep Joshi , Farahnaz Joukar , Dragana P Jovic , Jacek J Jóźwiak , Anne Juolevi , Gregor Jurak , Iulia Jurca Simina , Vesna Juresa , Rudolf Kaaks , Felix O Kaducu , Anthony Kafatos , Eero O Kajantie , Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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, Yves Martin-Prevel , Rosemarie Martin , Reynaldo Martorell , Eva Martos , Katharina Maruszczak , Stefano Marventano , Luis P Mascarenhas , Shariq R Masoodi , Ellisiv B Mathiesen , Prashant Mathur , Alicia Matijasevich , Tandi E Matsha , Christina Mavrogianni , Artur Mazur , Jean Claude N Mbanya , Shelly R McFarlane , Stephen T McGarvey , Martin McKee , Stela McLachlan , Rachael M McLean , Scott B McLean , Breige A McNulty , Sounnia Mediene Benchekor , Jurate Medzioniene , Parinaz Mehdipour , Kirsten Mehlig , Amir Houshang Mehrparvar , Aline Meirhaeghe , Jørgen Meisfjord , Christa Meisinger , Ana Maria B Menezes , Geetha R Menon , Gert Bm Mensink , Maria Teresa Menzano , Alibek Mereke , Indrapal I Meshram , Andres Metspalu , Haakon E Meyer , Jie Mi , Kim F Michaelsen , Nathalie Michels , Kairit Mikkel , Karolina Milkowska , Jody C Miller , Cláudia S Minderico , G K Mini , Juan Francisco Miquel , Mohammad Reza Mirjalili , Daphne Mirkopoulou , Erkin Mirrakhimov , Marjeta 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Theodoridis , Lutgarde Thijs , Nihal Thomas , Betina H Thuesen , Lubica Tichá , Erik J Timmermans , Anne Tjonneland , Hanna K Tolonen , Janne S Tolstrup , Murat Topbas , Roman Topór-Madry , Liv Elin Torheim , María José Tormo , Michael J Tornaritis , Maties Torrent , Laura Torres-Collado , Stefania Toselli , Giota Touloumi , Pierre Traissac , Thi Tuyet-Hanh Tran , Dimitrios Trichopoulos , Antonia Trichopoulou , Oanh Th Trinh , Atul Trivedi , Lechaba Tshepo , Maria Tsigga , Shoichiro Tsugane , Azaliia M Tuliakova , Marshall K Tulloch-Reid , Fikru Tullu , Tomi-Pekka Tuomainen , Jaakko Tuomilehto , Maria L Turley , Gilad Twig , Per Tynelius , Themistoklis Tzotzas , Christophe Tzourio , Peter Ueda , Eunice Ugel , Flora Am Ukoli , Hanno Ulmer , Belgin Unal , Zhamyila Usupova , Hannu Mt Uusitalo , Nalan Uysal , Justina Vaitkeviciute , Gonzalo Valdivia , Susana Vale , Damaskini Valvi , Rob M van Dam , Johan Van der Heyden , Yvonne T van der Schouw , Koen Van Herck , Hoang Van Minh , Natasja M Van Schoor , Irene Gm van Valkengoed , Dirk Vanderschueren , Diego Vanuzzo , Anette Varbo , Gregorio Varela-Moreiras , Patricia Varona-Pérez , Senthil K Vasan , Tomas Vega , Toomas Veidebaum , Gustavo Velasquez-Melendez , Biruta Velika , Giovanni Veronesi , Wm Monique Verschuren , Cesar G Victora , Giovanni Viegi , Lucie Viet , Salvador Villalpando , Paolo Vineis , Jesus Vioque , Jyrki K Virtanen , Marjolein Visser , Sophie Visvikis-Siest , Bharathi Viswanathan , Mihaela Vladulescu , Tiina Vlasoff , Dorja Vocanec , Peter Vollenweider , Henry Völzke , Ari Voutilainen , Sari Voutilainen , Martine Vrijheid , Tanja Gm Vrijkotte , Alisha N Wade , Aline Wagner , Thomas Waldhör , Janette Walton , Elvis Oa Wambiya , Wan Mohamad Wan Bebakar , Wan Nazaimoon Wan Mohamud , Rildo de Souza Wanderley Júnior , Ming-Dong Wang , Ningli Wang , Qian Wang , Xiangjun Wang , Ya Xing Wang , Ying-Wei Wang , S Goya Wannamethee , Nicholas Wareham , Adelheid Weber , Niels Wedderkopp , Deepa Weerasekera , Daniel Weghuber , Wenbin Wei , Aneta Weres , Bo Werner , Peter H Whincup , Kurt Widhalm , Indah S Widyahening , Andrzej Wiecek , Rainford J Wilks , Johann Willeit , Peter Willeit , Julianne Williams , Tom Wilsgaard , Bogdan Wojtyniak , Roy A Wong-McClure , Andrew Wong , Jyh Eiin Wong , Tien Yin Wong , Jean Woo , Mark Woodward , Frederick C Wu , Jianfeng Wu , Li Juan Wu , Shouling Wu , Haiquan Xu , Liang Xu , Nor Azwany Yaacob , Uruwan Yamborisut , Weili Yan , Ling Yang , Xiaoguang Yang , Yang Yang , Nazan Yardim , Mehdi Yaseri , Tabara Yasuharu , Xingwang Ye , Panayiotis K Yiallouros , Moein Yoosefi , Akihiro Yoshihara , Qi Sheng You , San-Lin You , Novie O Younger-Coleman , Safiah Md Yusof , Ahmad Faudzi Yusoff , Luciana Zaccagni , Vassilis Zafiropulos , Ahmad A Zainuddin , Seyed Rasoul Zakavi , Farhad Zamani , Sabina Zambon , Antonis Zampelas , Hana Zamrazilová , Maria Elisa Zapata , Abdul Hamid Zargar , Ko Ko Zaw , Tomasz Zdrojewski , Kristyna Zejglicova , Tajana Zeljkovic Vrkic , Yi Zeng , Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muc, Magdalena, Mugoša, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Ei K Nang, Ei, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, Cristina, Pagkalos, Ioanni, Pahomova, Elena, de Paiva, Karina Mary, Pajak, Andrzej, Palli, Domenico, Palloni, Alberto, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Pandey, Arvind, Panza, Francesco, Papandreou, Dimitrio, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pascanu, Ionela M, Pasquet, Patrick, Patel, Nikhil D, Pecin, Ivan, Pednekar, Mangesh S, Peer, Nasheeta, Pei, Gao, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Marco A, Pérez-Farinós, Napoleón, Pérez, Cynthia M, Peterkova, Valentina, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Petrauskiene, Ausra, Pettenuzzo, Emanuela, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pierannunzio, Daniela, Pigeot, Iri, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pistelli, Francesco, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N, Plans-Rubió, Pedro, Poh, Bee Koon, Pohlabeln, Hermann, Pop, Raluca M, Popovic, Stevo R, Porta, Miquel, Posch, Georg, Poudyal, Anil, Poulimeneas, Dimitrio, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A, Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Lui, Rezaianzadeh, Abba, Ribas-Barba, Lourde, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, de Wit, Tobias F Rinke, Rito, Ana, Ritti-Dias, Raphael M, Rivera, Juan A, Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021

19. Assessment of Iodine and Selenium Nutritional Status in Women of Reproductive Age in Latvia

Author: Tatjana Zake, Daiga Grinberga, Vija Veisa, Ieva Strele, Ilze Konrade, Ieva Kalere, Aivars Lejnieks, Sabine Upmale-Engela, Biruta Velika, Iveta Pudule, Dace Rezeberga, Maija Dambrova, Marina Makrecka-Kuka, and Andrejs Skesters
Subjects: Medicine (General), Population, chemistry.chemical_element, Physiology, Nutritional Status, Iodine, Article, thyroid, Selenium, R5-920, Thyroid peroxidase, Selenium deficiency, Pregnancy, medicine, Humans, Sodium Chloride, Dietary, education, education.field_of_study, biology, business.industry, iodine, Thyroid, autoimmunity, food and beverages, General Medicine, medicine.disease, Latvia, Diet, Iodised salt, medicine.anatomical_structure, urinary iodine concentration (UIC), chemistry, biology.protein, Female, Thyroid function, business
Abstract: Background and Objectives: Adequate dietary intake of iodine and selenium is essential during pregnancy. While iodine is vital for maternal thyroid function and fetal development, selenium contributes to the regulation of thyroid function and thyroid autoimmunity. This study aimed to assess the consumption of iodine- and selenium-containing products by women of reproductive age and the iodine and selenium nutritional status of pregnant women in Latvia. Materials and Methods: Population health survey (2010–2018) data were used to characterize dietary habits in women of reproductive age. Additionally, 129 pregnant women in the first trimester were recruited, they completed a questionnaire and were tested for thyroid function, urinary iodine concentration (UIC), and serum selenium and selenoprotein P levels. Results: The use of some dietary sources of iodine (e.g., milk and dairy products) and selenium (e.g., bread) has decreased in recent years. Less than 10% of respondents reported the use of iodized salt. The use of supplements has become more common (reported by almost 50% of respondents in 2018). Dietary habits were similar in pregnant women, but the use of supplements was even higher (almost 70%). Nevertheless, most supplements used in pregnancy had insufficient contents of iodine and selenium. Thyroid function was euthyreotic in all women, but 13.9% of participants had a thyroid peroxidase antibodies (TPO-ab) level above 60 IU/mL. The median UIC (IQR) was 147.2 (90.0–248.1) μg/gCr, and 52.8% of pregnant women had a UIC below 150 μg/gCr. The mean selenium (SD) level was 101.5 (35.6) μg/L, 30.1% of women had a selenium level below 80 μg/L. The median selenoprotein P level was 6.9 (3.1–9.0) mg/L. Conclusions: Iodine nutrition in Latvian population of pregnant women was near the lower limit of adequate and a third of the population had a selenium deficiency. Supplements were frequently used, but most did not contain the recommended amounts of iodine and selenium.
Published: 2021

20. Childhood overweight and obesity in Europe: Changes from 2007 to 2017

Author: Marta Buoncristiano, Angela Spinelli, Julianne Williams, João Breda, Napoleón Pérez-Farinós, Aušra Petrauskienė, Marie Kunešová, Ana Isabel Rito, Knut-Inge Klepp, Paola Nardone, Marta García-Solano, Vesselka Duleva, Ivo Rakovac, Cecily Kelleher, Gregor Starc, Saion Chatterjee, Enrique Gutiérrez-González, Iveta Pudule, Else Karin Grøholt, and Maria Hassapidou
Subjects: Male, obesity, Pediatric Obesity, temporal trend, Endocrinology, Diabetes and Metabolism, prevalence, Psychological intervention, Overweight, World Health Organization, Childhood obesity, World health, Body Mass Index, Childhood Obesity Surveillance Initiative, children, Environmental health, Prevalence, medicine, Humans, Child, Schools, High prevalence, Portugal, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, Obesity, Europe, Eastern european, Childhood Overweight, Female, COSI, medicine.symptom, business, Estilos de Vida e Impacto na Saúde
Abstract: The Childhood Obesity Surveillance Initiative (COSI) routinely measures height andweight of primary school children aged 6–9 years and calculates overweight andobesity prevalence within the World Health Organization (WHO) European Regionusing a standard methodology. This study examines the trends in the prevalence ofoverweight and obesity from the first round of COSI carried out in 2007/2008 to thelatest of 2015/2017 in 11 European countries in which data were collected for atleast three rounds. In total 303,155 children were measured. In general, the preva-lence of overweight and obesity among boys and girls decreased in countries withhigh prevalence (Southern Europe) and remained stable or slightly increased in North-ern European and Eastern European countries included in the analysis. Among boys, the highest decrease in overweight (including obesity) was observed in Portugal (from40.5% in 2007/2008 to 28.4 in 2015/2017) and in Greece for obesity (from 30.5% in2009/2010 to 21.7% in 2015/2017). Lithuania recorded the strongest increase in theproportion of boys with overweight (from 24.8% to 28.5%) and obesity (from 9.4% to12.2%). The trends were similar for boys and girls in most countries. Several countriesin Europe have successfully implemented policies and interventions to counteract theincrease of overweight and obesity, but there is still much to be done. The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The Ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in the countries included in this study was made possible through funding from: Bulgaria: Ministry of Health, National Center of Public Health and Analyses, and WHO Regional Office for Europe; Czechia: WHO grants AZV MZČR 17-31670 A MZČR-RVO EÚ 00023761, World Health Organization Regional Office for Europe, and WHO country office; Greece: International Hellenic University and Hellenic Medical Association for Obesity; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Latvia: Ministry of Health and Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences, Lithuanian Science Council, and WHO; Norway: Ministry of Health and Norwegian Institute of Public Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates, and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Slovenia: Ministry of Education and Science and Sport of the Republic of Slovenia within the SLOfit surveillance system; and Spain: Spanish Agency for Food Safety and Nutrition (AESAN). info:eu-repo/semantics/publishedVersion
Published: 2021

21. Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6‐ to 9‐year‐old children from 24 countries in the WHO European region

Author: Giulia Rathmes, Julianne Williams, Sergej M. Ostojic, Eha Nurk, Mahmut S. Yardim, Igor Spiroski, Lela Shengelia, Shynar Abdrakhmanova, João Breda, Päivi Mäki, Vesselka Duleva, Maya Tanrygulyyeva, Khadichamo Boymatova, Angela Spinelli, Tatjana Hejgaard, Enrique Gutiérrez-González, Valentina Peterkova, Anna Fijałkowska, Paola Nardone, Marta Buoncristiano, Victoria Farrugia Sant'Angelo, Maja Bæksgaard Jørgensen, Ausra Petrauskiene, Ivo Rakovac, Jolanda Hyska, Wolfgang Ahrens, Sanja Musić Milanović, Ingunn Holden Bergh, Alexandra Cucu, Andrea Gualtieri, Enisa Kujundžić, Iveta Pudule, Harry Rutter, Lacramioara Aurelia Brinduse, Daniel Weghuber, Hana Zamrazilová, Cecily Kelleher, Kenisha Russell Jonsson, Helena Križan, Stephen Whiting, Ana Isabel Rito, Benoît Salanave, Marina Melkumova, Zhamilya Usupova, and Marta García-Solano
Subjects: Pediatric Obesity, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Physical activity, physical activity, Child Behavior, Saúde Pública, World Health Organization, Childhood obesity, Pediatric Obesity / epidemiology, Screen time, Childhood Obesity Surveillance Initiative, SDG 3 - Good Health and Well-being, sedentary behavior, medicine, Humans, Social inequality, Child, Exercise, Socioeconomic status, media_common, sleep hygiene, Sleep hygiene, Portugal, social inequalities, business.industry, Public Health, Environmental and Occupational Health, Sedentary behavior, medicine.disease, Europe, Cross-Sectional Studies, Social Class, Socioeconomic Factors, COSI, Sedentary Behavior, Sleep, business, Estilos de Vida e Impacto na Saúde, Demography, Diversity (politics)
Abstract: Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from: Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe. Albania: World Health Organization (WHO) Country Office Albania and the WHO Regional Office for Europe. Bulgaria: WHO Regional Office for Europe. Czech Republic: Ministry of Health of the Czech Republic, grant nr. AZV MZČR 17-31670 A and MZČR–RVO EÚ 00023761. Denmark: The Danish Ministry of Health. France: Santé publique France, the French Agency for Public Health. Georgia: WHO. Ireland: Health Service Executive. Italy: Italian Ministry of Health; Italian National Institute of Health (Istituto Superiore di Sanità). Kazakhstan: the Ministry of Health of the Republic of Kazakhstan within the scientific and technical program. Kyrgyzstan: World Health Organization. Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry. Spain: the Spanish Agency for Food Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. info:eu-repo/semantics/publishedVersion
Published: 2021

22. Prevalence of Severe Obesity among Primary School Children in 21 European Countries

Author: João Breda, Jørgen Meisfjord, Viktoria Anna Kovacs, Napoleón Pérez, Julianne Williams, Angela Spinelli, Paola Nardone, Agneta Yngve, Genc Burazeri, Andrea Gualtieri, Mirjam M. Heinen, Ana Isabel Rito, Alexandra Cucu, Jolanda Hyska, Tülay Bağcı Bosi, Gregor Starc, Ingunn Holden Bergh, Maria Hassapidou, Vesselka Duleva, Constanta Huidumac Petrescu, Marie Kunešová, Ioannis Pagkalos, Hajnalka Takacs, Hana Zamrazilová, Marta Buoncristiano, Ausra Petrauskiene, Paul Gately, Agneta Sjöberg, Iveta Pudule, Elena Sacchini, Igor Spiroski, Nazan Yardim, Victoria Farrugia Sant'Angelo, Galina Obreja, and Cecily Kelleher
Subjects: 0301 basic medicine, Male, Pediatric Obesity, Health (social science), Cross-sectional study, Epidemiology, Overweight, Pediatrics, 0302 clinical medicine, Childhood Obesity Surveillance Initiative, Prevalence, Child, lcsh:RC620-627, Nutrition and Dietetics, Schools, Pediatrik, Public Health, Global Health, Social Medicine and Epidemiology, Obesity, Morbid, Näringslära, Europe, lcsh:Nutritional diseases. Deficiency diseases, Female, COSI, medicine.symptom, lcsh:Nutrition. Foods and food supply, Research Article, medicine.medical_specialty, Childhood Obesity, Adolescent, 030209 endocrinology & metabolism, lcsh:TX341-641, World Health Organization, Childhood obesity, World health, 03 medical and health sciences, BMI, Physiology (medical), Environmental health, medicine, Humans, Obesity, Students, 030109 nutrition & dietetics, Portugal, business.industry, Severe obesity, medicine.disease, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Cross-Sectional Studies, epidemiology, Risk factors, Body mass index, sense organs, business, 616-056.52 [udc], Estilos de Vida e Impacto na Saúde
Abstract: Background: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6–9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. Objectives: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. Method: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child’s age and mother’s educational level, were performed in a select group of countries. Results:A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7–1.3 and 0.7–1.5, respectively) to 5.5% (95% CI 4.9–6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6–9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child’s age did not show a clear pattern. Severe obesity was more common among children whose mother’s educational level was lower. Conclusions: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
Published: 2019

23. Physical activity, screen time, and sleep duration of children aged 6-9 years in 25 countries:An analysis within the WHO european childhood obesity surveillance initiative (COSI) 2015-2017

Author: Mette Rasmussen, Tatjana Hejgaard, Kenisha Russell Jonsson, Ivo Rakovac, Aida Filipović Hadžiomeragić, Sanja Musić Milanović, Stephen Whiting, Anne Siri Fismen, Zulfinissio Abdurrahmonova, Marta García-Solano, Paola Nardone, Wolfgang Ahrens, Ana Isabel Rito, Khadichamo Boymatova, Eha Nurk, Maria Hassapidou, Shynar Abdrakhmanova, Gregor Starc, Peter Gelius, Lela Shengelia, Dragana Stojisavljević, Enrique Gutiérrez-González, Maya Tanrygulyyeva, Angela Spinelli, Sergej M. Ostojic, Victoria Farrugia Sant'Angelo, Nazan Yardim, Igor Spiroski, Ausra Petrauskiene, Karin Schindler, Mirjam M. Heinen, Ingunn Holden Bergh, Akbota Abildina, Andrea Gualtieri, Lubica Ticha, Vesselka Duleva, Mary Pattison, Julianne Williams, Cecily Kelleher, Alexandra Cucu, Eliza Markidou Ionnaidu, Enisa Kujundzic, Anna Fijałkowska, Karim Abu-Omar, Marta Buoncristiano, Iveta Pudule, Valentina Peterkova, Harry Rutter, Lacramioara Aurelia Brinduse, Jolanda Hyska, Zhamyila Usuopva, Hana Zamrazilová, João Breda, Stevo Popovic, Viktoria Anna Kovacs, Romeu Mendes, Daniel Weghuber, Gulmira Aitmurzaeva, and Instituto de Saúde Pública da Universidade do Porto
Subjects: Male, Parents, 0301 basic medicine, Gerontology, Pediatric Obesity, Health (social science), 0302 clinical medicine, Duration (project management), Child, Children, lcsh:RC620-627, Physical inactivity, Sedentary behaviour, Active transport, active play, Surveillance, Schools, Europe, lcsh:Nutritional diseases. Deficiency diseases, surveillance, Female, COSI, Club, Europa, lcsh:Nutrition. Foods and food supply, Research Article, Sports, Sleep duration, 030209 endocrinology & metabolism, lcsh:TX341-641, Motor Activity, World Health Organization, Childhood obesity, Health(social science), Screen Time, 03 medical and health sciences, Screen time, Leisure Activities, SDG 3 - Good Health and Well-being, Physiology (medical), sedentary behaviour, active transport, active play, medicine, Humans, Exercise, Recreation, 030109 nutrition & dietetics, Portugal, business.industry, medicine.disease, Mental health, WHO European Childhood Obesity Surveillance Initiative, physical inactivity, Active play, Sleep, business, Active transport, Estilos de Vida e Impacto na Saúde
Abstract: Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). Method: The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. Results: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for 1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for
Published: 2021

24. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region

Author: Ana Isabel Rito, Enrique Gutiérrez-González, Ausra Petrauskiene, Shynar Abdrakhmanova, Eha Nurk, João Breda, Katharina Maruszczak, Andrea Gualtieri, Benoît Salanave, Dragana Stojisavljević, Enisa Kujundžić, Igor Spiroski, Tatjana Hejgaard, Gregor Starc, Marta García-Solano, Anna Fijałkowska, Philippa Simmonds, Stefanie Vandevijvere, Sanja Musić Milanović, Mahmut S. Yardim, Vesselka Duleva, Kremlin Wickramasinghe, Sergej M. Ostojic, Zhamilya Usupova, Iveta Pudule, Angela Spinelli, Maya Tanrygulyyeva, Ingunn Holden Bergh, Marta Buoncristiano, Harry Rutter, Paola Nardone, Julianne Williams, Constanta Huidumac-Petrescu, Radka Taxová Braunerová, Lela Shengelia, Zulfiya Abdurrahmonova, Wolfgang Ahrens, Valentina Peterkova, Jolanda Hyska, Päivi Mäki, Kenisha Russell Jonsson, Victoria Farrugia Sant'Angelo, Cecily Kelleher, and Elena Sacchini
Subjects: Pediatric Obesity, Inequality, children, obesity, overweight, socioeconomic status, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Population, Psychological intervention, 030209 endocrinology & metabolism, Context (language use), Overweight, Saúde Pública, World Health Organization, World health, 03 medical and health sciences, 0302 clinical medicine, Childhood Obesity Surveillance Initiative, Environmental health, medicine, Prevalence, Humans, 030212 general & internal medicine, Obesity, education, Child, Socioeconomic status, Children, media_common, education.field_of_study, Portugal, Public Health, Environmental and Occupational Health, medicine.disease, Socioeconomic Status, Europe, Cross-Sectional Studies, Social Class, Socioeconomic Factors, COSI, medicine.symptom, Psychology, Estilos de Vida e Impacto na Saúde
Abstract: Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6–9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities. The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The Ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in the countries was made possible through funding from: Albania: World Health Organization (WHO) Country Office Albania and the WHO Regional Office for Europe. Bulgaria: WHO Regional Office for Europe. Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe. Czechia: Ministry of Health of the Czech Republic, grant nr. 17-31670A and MZCR—RVO EU 00023761. Denmark: The Danish Ministry of Health. France: Santé publique France, the French Agency for Public Health. Georgia: WHO. Ireland: Health Service Executive. Italy: Italian Ministry of Health; Italian National Institute of Health (Istituto Superiore di Sanità). Kazakhstan: the Ministry of Health of the Republic of Kazakhstan within the scientific and technical program. Kyrgyzstan: World Health Organization. Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro. Poland, National Health Program, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health; Russian Federation: WHO. San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority. Spain: the Spanish Agency for Food Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection. Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion
Published: 2021

25. Mobilizing governments and society to combat obesity: Reflections on how data from the WHO European Childhood Obesity Surveillance Initiative are helping to drive policy progress

Author: Julianne Williams, Maria Teresa Menzano, Lachlan Mitchell, Nazan Yardim, Igor Spiroski, Marta Buoncristiano, João Breda, Lela Shengelia, Ana Isabel Rito, Karen McColl, Vesselka Duleva, Iveta Pudule, Daniela Galeone, Angela Spinelli, Ivo Rakovac, Mirjam M. Heinen, Sanja Musić Milanović, Victoria Farrugia Sant'Angelo, and Cecily Kelleher
Subjects: medicine.medical_specialty, Economic growth, Pediatric Obesity, Endocrinology, Diabetes and Metabolism, Commit, Overweight, World Health Organization, Childhood obesity, children, obesity, policy, schools, Political science, medicine, Humans, Políticas de Saúde, Obesity, Child, Children, Schools, Scope (project management), Portugal, Public health, Public Health, Environmental and Occupational Health, medicine.disease, Policy, Work (electrical), Action (philosophy), European Childhood Obesity Surveillance Initiative, Government, COSI, medicine.symptom, Estilos de Vida e Impacto na Saúde
Abstract: To meet the need for regular and reliable data on the prevalence of overweight andobesity among children in Europe, the World Health Organization (WHO) EuropeanChildhood Obesity Surveillance Initiative (COSI) was established in 2007. Theresulting robust surveillance system has improved understanding of the public healthchallenge of childhood overweight and obesity in the WHO European Region. For the past decade, data from COSI have helped to inform and drive policy action onnutrition and physical activity in the region. This paper describes illustrative examplesof how COSI data have fed into national and international policy, but the real scopeof COSI's impact is likely to be much broader. In some countries, there are signs thatpolicy responses to COSI data have helped halt the rise in childhood obesity. As thecountries of the WHO European Region commit to pursuing United Action for BetterHealth in Europe in WHO's new European Programme of Work, COSI provides anexcellent example of such united action in practice. Further collaborative action willbe key to tackling this major public health challenge which affects children through-out the region The authors gratefully acknowledge support through a grant from the Russian government in the context of the WHO European Office for the Prevention and Control of NCDs. The Ministries of Health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in the countries featured in this paper was made possible through funding from: Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health, and WHO Regional Office for Europe; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Latvia: Centre for Disease Prevention and Control, Ministry of Health, Latvia; Malta: Ministry of Health; North Macedonia: funded by the Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health. WHO country office provides support for training and data management; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion
Published: 2021

26. Parental Perceptions of Children's Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017

Author: Petur Benedikt Juliusson, Mirjam M. Heinen, Ana Isabel Rito, Victoria Farrugia Sant'Angelo, Vesselka Duleva, Anna Fijałkowska, Kenisha Russell Jonsson, Julianne Williams, Akbota Abildina, Daniel Weghuber, João Breda, Stevo Popovic, Cecily Kelleher, Bai Li, Viktoria Anna Kovacs, Radka Taxová Braunerová, Maya Tanrygulyyeva, Sanja Musić Milanović, Lela Shengelia, Angela Spinelli, Ivo Rakovac, Genc Burazeri, Päivi Mäki, Iveta Pudule, Harry Rutter, Sergej M. Ostojic, Lacramioara Aurelia Brinduse, Marie Kunešová, Enisa Kujundzic, Alexandra Cucu, Sanavbar Rakhmatullaeva, Maryam Kebbe, Khadichamo Boymatova, Dilorom Akhmedova, Enrique Gutiérrez-González, Marta Buoncristiano, Ausra Petrauskiene, Andrea Gualtieri, Nathalie Farpour-Lambert, Mette Rasmussen, Shynar Abdrakhmanova, Kremlin Wickramasinghe, Nazan Yardim, Gregor Starc, Zhamyila Usuopva, Tatjana Hejgaard, Jolanda Hyska, Elena Bogova, Ximena Ramos Salas, Paola Nardone, Marta García Solano, and Valentina Peterkova
Subjects: Male, Parents, Pediatric Obesity, Health Knowledge, Attitudes, Practice, Health (social science), Pediatric Obesity* / epidemiology, Overweight, Body Mass Index, Childhood Obesity Surveillance Initiative, Pediatric Obesity* / diagnosis, Surveys and Questionnaires, Medicine, TX341-641, parental perceptions, Nutritional diseases. Deficiency diseases, Child, Pediatric Obesity/diagnosis, Europe, Parental Perceptions, COSI, medicine.symptom, Underweight, childhood obesity, Research Article, RC620-627, Childhood Obesity, World Health Organization/Europe, Overweight/epidemiology, World Health Organization, Childhood obesity, childhood obesity surveillance initiative, Physiology (medical), Humans, Parental perception, world health organization/europe, Portugal, Nutrition. Foods and food supply, Overweight / epidemiology, business.industry, Body Weight, weight, medicine.disease, Weight, Obesity, Confidence interval, Rural area, business, Body mass index, Demography, Estilos de Vida e Impacto na Saúde
Abstract: Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child’s weight status. The purpose of this study was to measure parental perceptions of their child’s weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children’s weight status as “underweight,” “normal weight,” “a little overweight,” or “extremely overweight.” We categorized children’s (6–9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child’s weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child’s weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child’s weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child’s weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24). Overall, parents’ BMI was not strongly associated with the underestimation of children’s weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child’s weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents’ knowledge and perceptions, as well as the sociocultural contexts in which children and families live. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding by: Albania: World Health Organization through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, World Health Organization Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and World Health Organization Regional Office for Europe; Czechia: Grants AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Denmark: Danish Ministry of Health; France: French Public Health Agency; Georgia: World Health Organization; Ireland: Health Service Executive; Italy: Ministry of Health; Istituto Superiore di sanità (National Institute of Health); Kazakhstan: Ministry of Health of the Republic of Kazakhstan and World Health Organization Country Office; Latvia: n/a; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and World Health Organization; Malta: Ministry of Health; Montenegro: World Health Organization and Institute of Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support of Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russia (Moscow): n/a; San Marino: Health Ministry; Educational Ministry; Social Security Institute; the Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: World Health Organization Country Office in Tajikistan and Ministry of Health and Social Protection; and Turkmenistan: World Health Organization Country Office in Turkmenistan and Ministry of Health. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated. info:eu-repo/semantics/publishedVersion
Published: 2021

27. Waist circumference and waist-to-height ratio in 7-year-old children-WHO Childhood Obesity Surveillance Initiative

Author: Cecily Kelleher, Tereza Metelcová, Julianne Williams, Lauren Lissner, Radka Taxová Braunerová, Ingunn Holden Bergh, Enrique Gutiérrez-González, João Breda, Mirjam M. Heinen, Ivo Rakovac, Vesselka Duleva, Iveta Pudule, Harry Rutter, Agneta Sjöberg, Marta Buoncristiano, J. Vignerova, Hana Zamrazilová, Agneta Yngve, Marie Kunešová, Maria Hassapidou, Aušra Petrauskienė, Marek Brabec, Igor Spiroski, V Hainer, and Philippa Simmonds
Subjects: Male, Percentile, Pediatric Obesity, Waist, Endocrinology, Diabetes and Metabolism, World Health Organization, Childhood obesity, Body Mass Index, medicine, Humans, Child, Abdominal obesity, Waist-to-height ratio, Waist-Height Ratio, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, Circumference, Obesity, Body Height, Obesity, Abdominal, Female, medicine.symptom, Waist Circumference, business, Body mass index, Demography
Abstract: Childhood obesity is a serious global health problem. Waist circumference (WC) and waist-to-height ratio (WHtR) reflect body fat distribution in children. The objectives of this study were to assess WC and WHtR in 7-year-old children and to determine body mass index (BMI), WC, and WHtR differences in children from 10 selected countries across Europe (Bulgaria, Czechia, Greece, Ireland, Latvia, Lithuania, North Macedonia, Norway, Spain, and Sweden) participating in the World Health Organization (WHO) Europe Childhood Obesity Surveillance Initiative (COSI). The 50th and 90th percentile of WC (according to COSI and "Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS" (IDEFICS) cutoff values) and WHtR above 0.5 were used as measures of abdominal obesity in a unique sample of 38,975 children aged 7.00-7.99 years. Southern European countries, including Greece and Spain, showed significantly higher BMI, WC, and WHtRin both genders (p < 0.0001) than Eastern and Northern Europe. The highest values for WC were observed in Greece (60.8 ± 7.36 cm boys; 60.3 ± 7.48 cm girls), North Macedonia (60.4 ± 7.91 cm boys; 59.0 ± 8.01 cm girls), and Spain (59.7 ± 6.96 cm boys; 58.9 ± 6.77 cm girls). WC and WHtRin may add an information about the occurrence of central obesity in children.
Published: 2020

28. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. Murtagh, Kamel Ajlouni, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Xiangjun Wang, Lars Lind, Macia Enguerran, Marjeta Mišigoj-Duraković, Bo Werner, Jean-Michel Gaspoz, Kyungwon Oh, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Felix Kaducu, Ramon O. Jimenez, Jonathan E. Shaw, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Parvina Mukhtorova, Eha Nurk, Bhawesh Koirala, Óscar Lopes, Ana Jelakovic, Karolina Milkowska, Magda Gasull, Regina Heidinger-Felso, Marcela González-Gross, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Tran Quoc Bao, José Boggia, Daniela Galeone, Josep Redon, Matthias Bopp, Abbas Rezaianzadeh, Dusko Bjelica, Amir Houshang Mehrparvar, Felipe F. Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. Casajús, Guang Ning, Emmanuella Magriplis, Laura Censi, Graziella Bruno, Valentina Peterkova, Angelique Chan, Yvonne T. van der Schouw, Charalambos Hadjigeorgiou, Anjani Kumar Jha, Toomas Veidebaum, Thamara Hubler Figueiró, Jana Kratenova, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ya Xing Wang, Oscar Noboa, Romana Roccaldo, Sara Magnacca, Johan Sundström, Peter Stehle, Tania Lopez, Francis Delpeuch, Julianne Williams, Ellisiv B. Mathiesen, Leanne M. Riley, Claudia M. Hormiga, Joanne Katz, Ekaterina Stoyanova, Heloisa Bettiol, Gabriele Nagel, Alireza Khosravi, Lars Bo Andersen, João Breda, Jørgen Meisfjord, Ahmad Faudzi Yusoff, Marjeta Majer, Robert Beaglehole, Caleb Ochimana, Shynar Abdrakhmanova, George S. Stergiou, Blanca Sandra Ruiz-Betancourt, Leon A. Simons, Eng Joo Tan, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Liv Elin Torheim, Seppo Koskinen, Assembekov Batyrbek, Jaakko Tuomilehto, Marjo-Riitta Järvelin, Ming-Hui Zhao, Krista Fischer, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, James E. Bennett, Yuna He, Matsuda Fumihiko, Qi Sheng You, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Thet Thet Mu, Yves Martin-Prével, Rafael N. Pichardo, Gailute Bernotiene, Pietro Amedeo Modesti, Frederick C. W. Wu, Chandini Nekkantti, Daniela Rodrigues, Tandi E. Matsha, Mihai Gafencu, Xingwang Ye, Salar Rahimikazerooni, Trevor S. Ferguson, Christophe Tzourio, Marie Zins, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Lourdes Ribas-Barba, Nalan Uysal, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Iraj Mohebbi, Heiner Boeing, Jorge Mota, Jana Námešná, Maria Tsigga, Zivka Dika, Gulmira Aitmurzaeva, Xu Lin, Valéria Regecová, Herman Schargrodsky, Stevo Popovic, Amelia C. Crampin, Hannu Uusitalo, André Luiz Sena Guimarães, Ali Esmaeili, Catherine Kyobutungi, Virginija Dulskiene, Diego Augusto Santos Silva, David De Ridder, Lizzy M. Brewster, Hashem Jaddou, Eunice Ugel, José Camolas, Azli Baharudin, Idris Guessous, Sok King Ong, Tabara Yasuharu, Ali Ghanbari, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Bruna Gonçalves Cordeiro da Silva, Gonzalo Valdivia, Gyulli M. Kazakbaeva, Takuro Furusawa, Pawel Kurjata, Diego Vanuzzo, Marvin Cervantes-Loaiza, Karen Morgan, Mostafa Qorbani, Rute Santos, Marika Ferrari, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Abu Am Hanif, Balkish M. Naidu, Maria Wany Louzada Strufaldi, Moesijanti Soekatri, Marcia Scazufca, Katharina Maruszczak, Jacqueline Ramke, Elvis Oa Wambiya, Kairit Mikkel, Napoleón Pérez-Farinós, Natalia Nowak-Szczepanska, Miao Li Chee, Jose Sanchez-Abanto, Rajaa Al-Raddadi, Michel Joffres, Vayia Rarra, Ningli Wang, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Manoli Garcia-de-la-Hera, Weili Yan, Dong Wook Shin, Rômulo Araújo Fernandes, Ilona Nenko, Sanjib Kumar Sharma, Alfonso Siani, Indrapal I. Meshram, Imelda A. Agdeppa, Ei Ei K. Nang, Ian Rouse, Avula Laxmaiah, Ana M. B. Menezes, Yih Chung Tham, Ebrahim Eftekhar, María José Tormo, Felicia Cañete, Marie Eliasen, Lutgart Braeckman, Dirk Vanderschueren, Genc Burazeri, Kari Kuulasmaa, Jesús Vioque, Marisa K. Sophiea, Agneta Sjöberg, Katarzyna Dereń, Albertino Damasceno, Jochanan Stessman, Stig E. Bojesen, Aline Meirhaeghe, Else Karin Grøholt, Flávio Danni Fuchs, Robert Lundqvist, Frédéric Gottrand, Jeongseon Kim, Helmut Schröder, Joanna Baran, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Aneta Weres, Hans Concin, Damaskini Valvi, Sari Hantunen, Machi Suka, Elena Sacchini, Norbert Amougou, Ursula Kiechl-Kohlendorfer, Edwige Landais, Viktoria Anna Kovacs, Rosemarie Martin, Kenneth James, Amaneh Shayanrad, Grethe S. Tell, Norazizah Ibrahim Wong, Vedrana Sember, Anelise Reis Gaya, Konrad Jamrozik, Thorkild I. A. Sørensen, Martin Neovius, Urho M. Kujala, Nathalie Michels, Marcel Goldberg, Alexandra Cucu, Liliana Dacica, Adelheid Weber, Hermann Pohlabeln, Sandjaja, Jukka T. Salonen, Patricia Varona-Pérez, Tiina Laatikainen, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Julie Taylor, Anabela Mota-Pinto, Cora L. Craig, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Dominique Cottel, Charumathi Sabanayagam, Andrea Gazzinelli, Mieczysław Litwin, Sadaf G. Sepanlou, Adolfo Rubinstein, Abbas Dehghan, Rildo de Souza Wanderley Júnior, Wenhua Zhao, Aleksandra Piwońska, Yong Tao, Bontha V. Babu, Marc J. Gunter, Harunobu Nakamura, Wojciech Drygas, Eiji Oda, Jia Li Duan, Stefan Söderberg, Anthony Kafatos, Lynell V Maniego, Els Clays, Wei-Yen Lim, Marshall K. Tulloch-Reid, Mariachiara Di Cesare, Mattias Johansson, Simona Costanzo, Margot González-León, Matthias Nauck, Henry Völzke, George Luiz Lins Machado-Coelho, Annette Peters, Rajiv T Erasmus, Juan Francisco Miquel, Andrea Gualtieri, Abdul Hamid Zargar, Kaare Christensen, Peter Willeit, Tanja Stocks, Christine Cameron, Samuel C. Dumith, Janina Petkeviciene, Boyd Swinburn, Magdalena Muc, Sabine Schipf, Tajana Zeljkovic Vrkic, Martin Bobak, Damian K Francis, Veronica Mocanu, Karien Stronks, Antonisamy Belavendra, Artur Mazur, Nagalla Balakrishna, Jardena J. Puder, Mehrdad Azmin, Shelly R. McFarlane, Sara Santos Sanz, Yang Yang, Anneke Blokstra, Rafel Ramos, Ertugrul Celikcan, Jody C Miller, Jesús Ibarluzea, Svetlana A. Shalnova, Maria Elisa Zapata, Guansheng Ma, Fereidoun Azizi, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Ana B. Crujeiras, Zhenyu Zhang, Naser Ahmadi, Abdullatif Husseini, Alun Evans, Jiang He, Edyta Łuszczki, Maria G. Stathopoulou, Alibek Mereke, Mari-Liis Tammesoo, Axel C. Carlsson, Helen Gonçalves, Idowu O Senbanjo, Jim Mann, Rajendra Pradeepa, Juel Jarani, Eva Martos, Eugene Sobngwi, Themistoklis Tzotzas, Vassilis Zafiropulos, Reina Engle-Stone, Atul Trivedi, Hui Cai, Sarah Filippi, Georg Posch, Galina Obreja, Cecily Kelleher, Sareh Eghtesad, Chung T Nguyen, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Yi-Ting Lin, Anil Poudyal, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Annamari Lundqvist, Thor Aspelund, Caroline H.D. Fall, Philippe Amouyel, Kristyna Zejglicova, Argyro Karakosta, Piotr Bandosz, Juvenal Soares Dias-da-Costa, Maria Lazo-Porras, Maung Maung Than Htike, Dalia Luksiene, Jutta Stieber, Augusto Di Castelnuovo, Aryeh D. Stein, Lechaba Tshepo, Judith Benedics, Aletta E. Schutte, Jürgen König, Magdalena Korzycka, Grzegorz Sobek, Dimitrios Trichopoulos, Tai Hing Lam, Yn-Tz Sung, Masanori Iwasaki, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Nimmathota Arlappa, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Shoichiro Tsugane, Kaosar Afsana, Alireza Sadjadi, Myriam Galfo, Jean Claude Mbanya, Bernardo L. Horta, Marleen E. Hendriks, M. Arfan Ikram, Fadia AlBuhairan, Huashuai Chen, Marzieh Katibeh, Sidsel Graff-Iversen, Sahar Saeedi Moghaddam, Larissa Pruner Marques, Louise Eriksen, Aleksandra Gomula, Ricky Eddie, Maciej Banach, Jost B. Jonas, Andrea R. V. R. Horimoto, Slavica Sović, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Aye Aye Sein, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Cecilia Björkelund, Luigi Palmieri, Roya Kelishadi, Jie Mi, Nahla Hwalla, Jing Liu, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, Judith Simons, Sofia Malyutina, Michele Monroy-Valle, Andres Metspalu, Lariane M Ono, Rafaela Rosário, Flora A. Ukoli, Efthymios Kapantais, Enzo Manzato, S. Goya Wannamethee, Alison J Price, Gregorio Varela-Moreiras, Ali Reza Safarpour, Erfan Ghasemi, Janine Clarke, René Charles Sylva, Wan Nazaimoon Wan Mohamud, Zhamyila Usupova, Chaoqiang Jiang, Julio Zuñiga Cisneros, Freja B Kampmann, Wei Cheng Lo, Reza Mohammadpourhodki, Kaspar Staub, Mojtaba Farjam, Vincenzo Solfrizzi, Garry L. Jennings, Fabio Galvano, Monika Zuziak, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Emmanuel Cohen, Snehalatha Chamukuttan, Maria Ruiz-Castell, Karen Sparrenberger, Pedro Plans-Rubio, Wei Zheng, Eldridge Ferrer, Martijn Huisman, Maria Hassapidou, Iris Pigeot, Jakub Stokwiszewski, Domenico Palli, Ewelina Czenczek-Lewandowska, Ramiro Guerrero, Farzad Hadaegh, Han Cg Kemper, Saeid Safiri, Ivan Pećin, Arnaud Chiolero, Niels Møller, Jorge Bezerra, Ulrike Gehring, Iná S. Santos, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Marie Moitry, Nizal Sarrafzadegan, Jacqueline F. Price, Ranko Stevanovic, Sai Yin Ho, Georg Lappas, Alberto Palloni, Malay K. Mridha, Elaine M. Dennison, Jeonghee Lee, Saeid Eslami, Rahman Shiri, Japhet Killewo, Juergen Breckenkamp, Mathilde Kersting, Y Nikitin, Iqbal Bata, Geetha R Menon, Maria Avdicova, Sanjay Rampal, Antônio Augusto Moura da Silva, Kirsten Mehlig, Chien-An Sun, Ramin Heshmat, Violeta Iotova, Stefaan Demarest, Mette Rasmussen, Dirk De Bacquer, San-Lin You, Suzanne N Morin, Martin Gulliford, Maties Torrent, Luc Dauchet, Fred Paccaud, Paibul Suriyawongpaisal, Sherali Rakhmatulloev, Hyeon Chang Kim, Markku Peltonen, Ruth Frikke-Schmidt, Vera Musil, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Gowri Mahasampath, Ulrich Keil, Sérgio Viana Peixoto, Haiquan Xu, Helle-Mai Loit, Valérie Deschamps, Ilpo Huhtaniemi, Lijuan Liu, Marialaura Bonaccio, Altan Onat, Rody G. Sy, José María Huerta, Ko Ko Zaw, Akihiro Yoshihara, Peter Ueda, Belgin Ünal, Rachel Dankner, Andrzej Wiecek, Eman Aly, Ruzena Kubinova, Justina Vaitkeviciute, Hanna Tolonen, Priscilla Duboz, Orn Olafsson, Yin Guo, Chiara Donfrancesco, Salim Mohanna, Dusan Grafnetter, Daniel Weghuber, Ali Ahmadi, Rosemary B. Duda, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Liis Nelis, Badreya Al-Lahou, J. Jaime Miranda, Lèlita Santos, Aroor Bhagyalaxmi, Mohamed Bamoshmoosh, Børge G. Nordestgaard, Jeannette Lee, Ahmad Reza Dorosty, Alain Morejon, Ying-Wei Wang, Jakob Tarp, Rosalba Rojas-Martínez, Luxia Zhang, Bahram Mohajer, Maja Bæksgaard Jørgensen, Jurate Klumbiene, Zhengming Chen, Ambady Ramachandran, Andrea Rodriguez-Martinez, Alisha N. Wade, Suyeon Park, Janne Schurmann Tolstrup, Lucjan Szponar, Krishna Kumar Aryal, Tahir Aris, Mahfuzar Rahman, Dorja Vočanec, Juan P. 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Pizarro, Jin Soo Moon, Frank Claessens, Zulfiqar A Bhutta, Frank Tanser, Nor Azwany Yaacob, Vanina Bongard, Gregor Jurak, Johan G. Eriksson, Christina-Paulina Lambrinou, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Thomas Meinertz Dantoft, Wichai Aekplakorn, Anwar Batieha, Eduardo Capuano, Teresa Haugsgjerd, Jeremy M. Jacobs, Paola Russo, Nguyen D Nguyen, Luis Revilla, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Wan Mohamad Wan Bebakar, Paul Elliott, Denise Eldemire-Shearer, Angela Döring, Giovanni Viegi, Xiaoguang Yang, María-Elena González-Villalpando, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Tomasz Zdrojewski, Carlos P. Boissonnet, Mohamad Hasnan Ahmad, Mahmudur Rahman, Günther Fink, Marcia Makdisse, Dragana P Jovic, Aline Wagner, Coimbatore Subramaniam Shanthirani, Pascal Bovet, Dong Wook Kim, Tom Wilsgaard, Anders Grøntved, Thirunavukkarasu Sathish, Antonia Trichopoulou, Noushin Mohammadifard, Igor Spiroski, Natasja M. van Schoor, Cláudia S. Minderico, Betina H. Thuesen, Queenie Chan, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Line Lund Kårhus, Cihangir Erem, Amina Barkat, Maria Paula Santos, Fernanda Cunha Soares, Constanta Huidumac Petrescu, Allan G. Hill, Honor Bixby, Benoît Salanave, Joana Carvalho, Maigeng Zhou, Ofra Kalter-Leibovici, Roy A Wong-McClure, Kim F. Michaelsen, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, José R. Banegas, Quang Ngoc La, Uruwan Yamborisut, Parinaz Mehdipour, Farhad Pourfarzi, Sudha Ramachandra Rao, Katsuyasu Kouda, Chien-Jen Chen, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Ronald D. Gregor, Rudolf Kaaks, Maria do Carmo Franco, Marta García-Solano, Beata Gurzkowska, Bahman Cheraghian, Stefaan De Henauw, Daniel Ferrante, Johanna A. 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Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020

29. Difficulties in getting to sleep, late bedtime and sleep duration among adolescents in Latvia

Author: Daiga Grinberga, B Velika, S Klavina-Makrecka, Iveta Pudule, Anita Villerusa, and Inese Gobina
Subjects: medicine.medical_specialty, business.industry, Public Health, Environmental and Occupational Health, Medicine, business, Psychiatry, Sleep in non-human animals, Bedtime, Sleep duration
Abstract: Background Sleep is important for adolescent general wellbeing and different sleep domains like difficulties in getting to sleep, bedtime resistance and sleep duration can be studied. This study investigates the prevalence of weekly difficulties in getting to sleep in association with bedtime and sleep duration on schooldays and weekends among adolescents in Latvia. Methods Data from the HBSC Survey 2017/2018 of Latvia with 4412 respondents aged 11, 13 and 15 years were used for statistical analysis. Sleep duration less than 7h was classified as insufficient and bedtime at 0:00 or later as delayed bedtime. Age-adjusted logistic regression and adolescents without weekly difficulties in getting to sleep as a reference was used for studying the associations. Results On average, 43.6% of adolescents (38.0% boys and 49.1% girls) reported weekly difficulties in getting to sleep. Of those, 26.5% reported sleep duration Conclusions Difficulties in getting to sleep among adolescents are highly prevalent and increases the odds of insufficient sleep duration, especially in girls. Delayed bedtime seems to modify the association between the difficulties in getting to sleep and sleep duration. Key messages Adolescents with difficulties in getting to sleep are at risk of delayed bedtimes and insufficient sleep duration. Further studies to explore the underlying mechanisms linking difficulties in getting to sleep and delayed bedtime are required.
Published: 2020

30. Insufficient sleep duration in association with self-reported pain and corresponding medicine use among adolescents: a cross-sectional population-based study in Latvia

Author: Iveta Pudule, Toms Pulmanis, Solvita Klavina-Makrecka, Inese Gobina, and Anita Villerusa
Subjects: Male, medicine.medical_specialty, Health (social science), Adolescent, Affect (psychology), Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Humans, 030212 general & internal medicine, Association (psychology), Medicine use, Child, Analgesics, 030505 public health, business.industry, Public health, Public Health, Environmental and Occupational Health, Headache, Moderation, Latvia, Abdominal Pain, Cross-Sectional Studies, Logistic Models, Adolescent Behavior, Back Pain, Sleep Deprivation, Female, Self Report, 0305 other medical science, business, Clinical psychology, Sleep duration
Abstract: Pain among adolescents is prevalent that may negatively affect adolescents’ general well-being of which sleep is an important domain. This study aims to explore the associations between weekly pain and medicine use for relevant pain and insufficient sleep duration among 11-, 13- and 15-year-old adolescents in Latvia by assessing the moderation effect of gender and age. Data from the Health Behaviour in School-aged Children Study on 2017/2018 of Latvia (n = 4412; 49.6% boys) were used. Logistic regression was applied to analyse the odds of insufficient sleep (
Published: 2020

31. The sociodemographic profile and characteristics of self-reported suicidal attempters in Latvia: a population-based study

Author: Krista Mieze, Anda Kivite-Urtane, Daiga Grinberga, Biruta Velika, Iveta Pudule, and Elmars Rancans
Subjects: Psychiatry and Mental health
Published: 2021

32. Preventable premature deaths (PYLL) in Northern Dimension partnership countries 2003-13

Author: Ulla-Karin Nurm, Pekka Jousilahti, Iveta Pudule, Ilkka Vohlonen, Mikko A. Vienonen, Marita I. Friberg, Gleb R. Denissov, Igor A. Krasilnikov, Vital M. Pisaryk, Veli Koistinen, Karolina Mackiewicz, Bartosz M. Zablocki, Rafael G. Oganov, and Romualdas J. Gurevicius
Subjects: Adult, Estonia, Male, medicine.medical_specialty, Republic of Belarus, Population, 030204 cardiovascular system & hematology, Human capital, 03 medical and health sciences, 0302 clinical medicine, Life Expectancy, Sex Factors, Cause of Death, Germany, Medicine, Humans, 030212 general & internal medicine, education, Finland, Aged, Aged, 80 and over, Sweden, education.field_of_study, business.industry, Mortality, Premature, Public health, Public Health, Environmental and Occupational Health, Age Factors, Northern Dimension, Lithuania, Middle Aged, Latvia, Years of potential life lost, Health promotion, Social history (medicine), General partnership, Female, Poland, Preventive Medicine, business, Demography, Forecasting
Abstract: Background Objective was to measure preventable premature loss of life in countries from same geographical area but with considerable differences in social and economic development. By comparing inter-country differences and similarities in premature mortality, acceleration of health-in-all-policies is enhanced. Methods Preventable premature deaths were described by Potential Years of Life Lost (PYLL). Data consisted of death registers for 2003, 2009 and 2013. PYLL-rates were age-standardized by using standard OECD population from 1980 and expressed as sum of lost life years per 100 000 citizens. Results In Northern Dimension area, PYLL-rates had declined from 2003 to 2013. In 2013, worst PYLL-rate was in Belarus 9851 and best in Sweden 2511. PYLL-rates among men were twice as high as among women. Most premature losses (1023) were due to external causes. Malignant neoplasms came second (921) and vascular diseases third (816). Alcohol was also an important cause (270) and country differences were over 10-fold. Conclusions In ND-area, the overall development of public health has been good during 2003–13. Nevertheless, for all countries foci for public health improvement and learning from each other could be identified. Examining the health of populations in countries from relatively similar geographical area with different social history and cultures can provide them with evidence-based tools for health-in-all-policies to advocate health promotion and disease prevention. Gender differences due to preventable premature deaths are striking. The higher the national PYLL-rate, the bigger the PYLL-rate difference between men and women and the loss of human capital.
Published: 2019

33. Comparison between the risks in road safety behaviour in urban and rural areas in Latvia in 2016

Author: Aija Bukova-Zideluna, Anita Villerusa, and Iveta Pudule
Subjects: education.field_of_study, alcohol, differences between urban and rural areas, 05 social sciences, Population, Adult population, Health behaviour, 050301 education, smoking, Odds, lcsh:Social Sciences, lcsh:H, Geography, Safety behaviour, Environmental health, 0502 economics and business, Rural area, education, road safety, 0503 education, Road traffic, Rural population, human activities, 050203 business & management, use of seat-belt
Abstract: The study examined the differences between respondents in urban and rural areas in respect of their self-reported attitudes and behaviour regarding taking risks in road traffic. Data of Health Behaviour among Latvian Adult Population 2016 survey was used for analysis. Results: 83.7% (N=1605) of urban respondents and 86.7% (N = 1456) of rural respondents always used seatbelts in the front seat. Only 55.3% (N = 1605) of urban respondents and 52.1% (N = 875) of rural respondents always used seatbelts in the back seat. Odds to use seatbelts in the front seat were higher for rural population (OR = 1.27; 95% CI: 1.05–1.53). Odds to use seatbelts in the back seat were higher for urban population (OR=1.14; 95% CI: 1.01–1.30). Rural residents agreed more often with suggestion that it is not necessary to fasten the seatbelt on short journeys (OR = 1.42; 95% CI: 1.15–1.75) and that it is not necessary to fasten the seatbelt travelling at speed less than 40 km/h (OR=1.22; 95% CI: 1.01–1.56). Rural respondents agreed more often than urban respondents that that driving a car under alcohol influence increases a chance of being involved in an accident (OR = 1.45; 95% CI: 1.10–1.90).
Published: 2019

34. WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old Children

Author: Marie Kunešová, Iveta Pudule, Lauren Lissner, Agneta Yngve, Ana Isabel Rito, Ausra Petrauskiene, Joop M A van Raaij, Trudy M. A. Wijnhoven, Pieter van 't Veer, Ragnhild Hovengen, Eva Martos, Angela Spinelli, Vesselka Duleva, Maria Hassapidou, Gregor Starc, Lien Braeckevelt, Igor Spiroski, João Breda, Napoleón Pérez-Farinós, Victoria Farrugia Sant'Angelo, and Mirjam M. Heinen
Subjects: Gerontology, Nutrition and Disease, Article Subject, Epidemiology, 030209 endocrinology & metabolism, Overweight, Childhood obesity, 03 medical and health sciences, 0302 clinical medicine, Childhood Obesity Surveillance Initiative, Voeding en Ziekte, medicine, Life Science, Obesity, 030212 general & internal medicine, VLAG, Global Nutrition, Wereldvoeding, Data collection, business.industry, Anthropometry, Clothing, medicine.disease, Childhood, Europe, COSI, medicine.symptom, business, Body mass index, Weight gain, Estilos de Vida e Impacto na Saúde, Demography
Abstract: Background. The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible protocol for anthropometric procedures. Objectives. (1) Review intercountry variation in types of clothing worn by children during weight and height measurements, clothes weight adjustments applied, timing of the survey, and duration of data collection; (2) assess the impact of the observed variation in these practices on the children’s weight or body mass index (BMI) outcome measures. Results. The relative difference between countries’ unadjusted and clothes-adjusted prevalence estimates for overweight was 0.3–11.5%; this figure was 1.4–33.3% for BMI-for-age Z-score values. Monthly fluctuations in mean BMI-for-age Z-score values did not show a systematic seasonal effect. The majority of the monthly BMI-for-age Z-score values did not differ statistically within a country; only 1–3 monthly values were statistically different within some countries. Conclusions. The findings of the present study suggest that the built-in flexibility in the COSI protocol concerning the data collection practices addressed in the paper can be kept and thus do not necessitate a revision of the COSI protocol.
Published: 2016

35. PW 2206 The relationship between smoking habits and unsafe behaviour on the roads

Author: Aija Bukova-Zideluna, Iveta Pudule, and Anita Villerusa
Subjects: Smoking habit, business.industry, 030503 health policy & services, Health behaviour, Crash, Pedestrian, Logistic regression, law.invention, 03 medical and health sciences, 0302 clinical medicine, Safety behaviour, law, Environmental health, Seat belt, Medicine, 030212 general & internal medicine, 0305 other medical science, business, Road traffic
Abstract: From the review of literature it is widely accepted that the use of a seat belt reduces the risk of death in road traffic by up to 65% and the use of reflectors reduces pedestrian accidents and death by 75%–85%. Careless behaviour on roads can increase the risk of a crash and serious injury. As smoking has been linked to risky behaviour, the aim of the study was to examine the relationship between self-reported smoking and road safety behaviour in Latvia. Methods The data of ‘Health behaviour among the Latvian adult population’ for four consecutive surveys for the years 2010–2016 were selected for analysis. T-test and logistic regression analyses were conducted to compare the unsafe behaviour of road users with others in terms of sociodemographic, health-related and behavioural outcomes. Results 85.0% (95% CI: 84.4% to 85.6%) of 12 619 respondents used a seat belt in the front seat and 45.3% (95% CI: 44.4% to 46.1%) in the back seat; the overall use of reflectors was 44.3% (95% CI: 43.4% to 45.1%). 33.2% of respondents reported that they smoked every day; 66.5% of them placed no smoking restrictions in their car. Worse road safety behaviour was attributed to men, 15–24 (p The study indicates that not using seat belts can be consistent with other risk-taking behaviour such us smoking. Standard policies and campaigns may not be effective for individuals who do not use seat belts and a targeted approach may be more effective. Campaigns for using seat belts could be combined with anti-smoking campaigns.
Published: 2018

36. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries

Author: Adriana Baban, Betül Ulukol, Mark A Bellis, Natasa Terzic, Lisa Jones, Robertas Povilaitis, Gentiana Qirjako, Marija Raleva, Nicola Leckenby, Margarita Kachaeva, Karen Hughes, and Iveta Pudule
Subjects: Adult, Male, Child abuse, Adolescent, media_common.quotation_subject, Health Behavior, Albanija, Poison control, Suicide prevention, Occupational safety and health, Neglect, Lietuva (Lithuania), Surveys and Questionnaires, Environmental health, Latvija (Latvia), Injury prevention, Humans, Medicine, Turkija (Turkey), media_common, Family Characteristics, Psichikos sveikata / Mental health, business.industry, Research, Adult Survivors of Child Abuse, Rusija (Rossija, Rusijos Federacija, Rossijskaja Federacija, Rusijos imperija, Carinė Rusija, Russia), Public Health, Environmental and Occupational Health, Šiaurės Makedonija, Vaikai / Children, Europe, Psichologija / Psychology, Eastern european, Juodkalnija, Domestic violence, Female, Rumunija (Romania), business, Self-Injurious Behavior
Abstract: To evaluate the association between adverse childhood experiences - e.g. abuse, neglect, domestic violence and parental separation, substance use, mental illness or incarceration - and the health of young adults in eight eastern European countries.Between 2010 and 2013, adverse childhood experience surveys were undertaken in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, The former Yugoslav Republic of Macedonia and Turkey. There were 10,696 respondents - 59.7% female - aged 18-25 years. Multivariate modelling was used to investigate the relationships between adverse childhood experiences and health-harming behaviours in early adulthood including substance use, physical inactivity and attempted suicide.Over half of the respondents reported at least one adverse childhood experience. Having one adverse childhood experience increased the probability of having other adverse childhood experiences. The number of adverse childhood experiences was positively correlated with subsequent reports of health-harming behaviours. Compared with those who reported no adverse experiences, respondents who reported at least four adverse childhood experiences were at significantly increased risk of many health-harming behaviours, with odds ratios varying from 1.68 (95% confidence interval, CI: 1.32-2.15) - for physical inactivity - to 48.53 (95% CI: 31.98-76.65) - for attempted suicide. Modelling indicated that prevention of adverse childhood experiences would substantially reduce the occurrence of many health-harming behaviours within the study population.Our results indicate that individuals who do not develop health-harming behaviours are more likely to have experienced safe, nurturing childhoods. Evidence-based programmes to improve parenting and support child development need large-scale deployment in eastern European.Évaluer l'association entre des expériences négatives vécues pendant l'enfance (comme des abus, des négligences, des violences domestiques, la séparation des parents, l'usage de substances illicites, des maladies mentales ou l'incarcération) et la santé des jeunes adultes dans huit pays de l'Europe de l'Est.Entre 2010 et 2013, des enquêtes sur des expériences négatives vécues pendant l'enfance ont été menées en Albanie, en Lettonie, en Lituanie, au Monténégro, en Roumanie, en Fédération de Russie, dans l'ex-République yougoslave de Macédoine et en Turquie. On a compté 10 696 répondants, dont 59,7% de femmes, âgés de 18 à 25 ans. Une modélisation à variables multiples a été utilisée pour étudier les relations entre des expériences négatives vécues pendant l'enfance et les comportements mettant la santé en danger au début de l'âge adulte, notamment l'usage de substances illicites, l'inactivité physique et les tentatives de suicide.Plus de la moitié des répondants ont déclaré au moins une expérience négative vécue pendant l'enfance. Le fait d'avoir vécu une expérience négative pendant l'enfance augmentait la probabilité de vivre d'autres expériences négatives pendant l'enfance. Le nombre d'expériences négatives vécues pendant l'enfance était positivement corrélé avec les signalements ultérieurs de comportements mettant la santé en danger. Par rapport aux personnes qui n'ont déclaré aucune expérience négative, les répondants qui ont déclaré au moins 4 expériences négatives vécues pendant l'enfance présentaient un risque significativement augmenté de nombreux comportements mettant leur santé en danger, avec des rapports de cotes variant de 1,68 (intervalle de confiance de 95%, IC: 1,32–2,15) pour l'inactivité physique, à 48,53 (IC de 95%: 31,98–76,65) pour les tentatives de suicide. La modélisation a indiqué que la prévention des expériences négatives vécues pendant l'enfance réduirait considérablement l'occurrence de nombreux comportements mettant la santé en danger au sein de la population étudiée.Nos résultats indiquent que les individus qui ne développent pas de comportements mettant leur santé en danger sont plus susceptibles d'avoir été protégés et éduqués pendant leur enfance. Les programmes fondés sur les faits visant à améliorer l'éducation des enfants et à soutenir leur développement nécessitent un déploiement à grande échelle en Europe de l'Est.Evaluar la relación entre las experiencias adversas en la infancia, por ejemplo, abusos, abandono, violencia doméstica y separación de los padres, consumo de sustancias, enfermedad mental o encarcelamiento, y la salud de los adultos jóvenes en ocho países orientales de Europa.Entre 2010 y 2013 se llevaron a cabo encuestas sobre experiencias infantiles adversas en Albania, Letonia, Lituania, Montenegro, Rumania, la Federación de Rusia, la antigua República Yugoslava de Macedonia y Turquía. El número de encuestados fue de 10 696 - 59,7 % mujeres - de entre 18 y 25 años. Se empleó un modelo multivariado para examinar las relaciones entre las experiencias infantiles adversas y los comportamientos dañinos para la salud en las primeras etapas de la vida adulta, incluido el consumo de sustancias, la inactividad física y el intento de suicidio.Más de la mitad de los encuestados informó de al menos una experiencia adversa en la infancia. Haber sufrido una experiencia adversa en la infancia aumentó la probabilidad de tener otras experiencias adversas en la infancia. El número de experiencias adversas en la infancia se correlacionó positivamente con los informes posteriores acerca de comportamientos dañinos para la salud. En comparación con aquellos que no comunicaron experiencias adversas, los encuestados que informaron de al menos cuatro experiencias adversas en la infancia presentaban un riesgo significativamente mayor de muchas conductas dañinas para la salud, con un cociente de posibilidades que variaba de 1,68 (intervalo de confianza del 95 %, IC: 1,32–2,15) para la inactividad física a 48,53 (IC del 95 %: 31,98–76,65) para el intento de suicidio. El modelado indicó que la prevención de experiencias adversas en la infancia podría reducir sustancialmente la incidencia de muchos de los comportamientos dañinos para la salud en la población de estudio.Nuestros resultados indican que los individuos que no desarrollan comportamientos dañinos para la salud tienen más probabilidades de haber tenido una infancia segura y educativa. Los programas basados en la evidencia para mejorar la crianza de los hijos y apoyar el desarrollo infantil necesitan un despliegue a gran escala en la región oriental de Europa.تقييم الارتباط بين خبرات الطفولة السيئة – مثل سوء المعاملة أو الإهمال أو العنف المنزلي أو انفصال الأبوين أو تعاطي المخدرات أو الاعتلال النفسي أو الحبس – وصحة صغار البالغين في ثمانية بلدان أوروبية شرقية.أجريت بين عامي 2010 و2013 مسوح حول خبرات الطفولة السيئة في ألبانيا ولاتفيا وليتوانيا والجبل الأسود ورومانيا والاتحاد الروسي وجمهورية مقدونيا اليوغوسلافية السابقة وتركيا. وشارك في المسح 10696 شخصاً – 59.7 % منهم من الإناث – اللاتي تتراوح أعمارهن من 18 إلى 25 سنة. وتم استخدام النمذجة متعددة المتغيرات لتحري الارتباط بين خبرات الطفولة السيئة والسلوكيات الضارة بالصحة في البلوغ المبكر بما في ذلك تعاطي المخدرات والخمول البدني ومحاولة الانتحار.أبلغ ما يزيد عن نصف المشاركين عن خبرة واحدة على الأقل من خبرات الطفولة السيئة. وازدادت مع التعرض لخبرة واحدة من خبرات الطفولة السيئة احتمالية التعرض لخبرات الطفولة السيئة الأخرى. وارتبط عدد خبرات الطفولة السيئة إيجابياً بالتقارير اللاحقة حول السلوكيات الضارة بالصحة. وتزايدت على نحو كبير خطورة اكتساب العديد من السلوكيات الضارة بالصحة لدى المشاركين الذين أبلغوا عن أربع خبرات على الأقل من خبرات الطفولة السيئة مقارنة بالذين لم يبلغوا عن خبرات سيئة، وتراوحت نسب الاحتمال من 1.68 (فاصل الثقة 95 %: 1.32 - 2.15) – فيما يخص الخمول البدني – إلى 48.53 (فاصل الثقة 95 %: 31.98 - 76.65) – فيما يخص محاولة الانتحار. وأشارت النمذجة إلى أن توقي خبرات الطفولة السيئة قد يحد بدرجة كبيرة من وقوع العديد من السلوكيات الضارة بالصحة داخل فئة الدراسة.تشير نتائجنا إلى أنه من الأرجح أن يتمتع الأشخاص الذين لا يكتسبون سلوكيات ضارة بالصحة بطفولة تتميز بالأمان والرعاية. ويتعين نشر البرامج المستندة إلى البيّنات على نطاق واسع في أوروبا الشرقية بغية تحسين إعداد الآباء لرعاية الأبناء ودعم نمو الأطفال.评价八个东欧国家虐待、忽视、家庭暴力和父母分离、吸毒、精神疾病或监禁等儿童期不良经历与年轻人健康之间的联系。在2010年至2013年之间，在阿尔巴尼亚、拉脱维亚、立陶宛、黑山共和国、罗马尼亚、俄罗斯联邦、前南斯拉夫马其顿共和国和土耳其展开儿童期不良经历调查。共有10696名18-25岁之间的受访者，其中女性占59.7%。使用多变量模型来研究儿童期不良经历与成年早期危害健康的行为的关系，包括吸毒、缺少运动和自杀企图。超过半数的受访者表示至少有一次儿童期不良经历。有一次儿童期不良经历增加遭受其他儿童期不良经历的概率。儿童期不良经历数量与危害健康行为的后续报告呈正相关。较之没有报告不良经历的受访者，报告至少有四个儿童期不良经历的受访者其许多危害行为的风险显著增加，优势比从缺乏锻炼的1.68（95%置信区间（CI）：1.32–2.15）到自杀企图的48.53（95% CI：31.98–76.65）。模型表明，预防儿童期不良经历将会大幅度减少研究人群中许多危害健康行为的发生。我们的结果表明，没有养成危害健康行为的个体更可能是渡过安全、受到关爱的童年。需要在东欧大规模部署以证据为基础的项目，以改善教育和支持孩子发展。Оценить связь негативных впечатлений в детстве — например, плохое обращение, пренебрежение, насилие в семье, расставание родителей, употребление психоактивных веществ, психические заболевания или лишение свободы — со здоровьем молодых людей в восьми восточноевропейских странах.В 2010-2013 гг. в таких странах, как Албания, Латвия, Литва, Черногория, Румыния, Российская Федерация, бывшая югославская Республика Македония и Турция были проведены опросы среди молодежи, посвященные негативным впечатлениям в детстве. В опросах принимали участие 10 696 респондентов, включая 59,7% девушек в возрасте 18–25 лет. Исследование взаимосвязи между негативными впечатлениями в детстве и вредным для здоровья поведением в старшем подростковом возрасте, в том числе употребление психоактивных веществ, отсутствие физической активности и попытки самоубийства, проводилось методом многомерного моделирования.Более половины респондентов сообщили по меньшей мере об одном негативном впечатлении в детстве. Наличие одного негативного впечатления увеличивало вероятность наличия и последующих негативных впечатлений в детстве. Число негативных впечатлений в детстве положительно коррелирует с последующими сообщениями о вредном для здоровья поведении. По сравнению с теми, кто не переживал негативных впечатлений в детстве, у респондентов, указавших по меньшей мере четыре случая негативных впечатлений, имелся значительно больший риск вредного для здоровья поведения с отношением рисков от 1,68 (95%-й доверительный интервал, ДИ: 1,32–2,15) для физической неактивности и до 48,53 (95% ДИ: 31,98–76,65) для попыток самоубийства. Моделирование показало, что предотвращение негативных впечатлений в детстве существенно уменьшает возникновение многих случаев пагубного поведения внутри исследуемой популяции.Результаты показывают, что лица, у которых не развивается вредное для здоровья поведение, скорее всего имели благополучное детство и родительскую заботу. В восточноевропейских странах требуется масштабное развертывание доказательно обоснованных программ по улучшению семейного воспитания и поддержке развития детей.
Published: 2014

37. The 12-month prevalence of depression and health care utilization in the general population of Latvia

Author: J. Vrublevska, Daiga Grinberga, Iveta Pudule, M. Trapencieris, Biruta Velika, S. Snikere, and Elmars Rancans
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Health Status, Population, Logistic regression, Sampling Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Sex Factors, Health care, Epidemiology, Odds Ratio, Prevalence, Medicine, Humans, Disabled Persons, 030212 general & internal medicine, education, Psychiatry, Depression (differential diagnoses), Mini-international neuropsychiatric interview, education.field_of_study, Depressive Disorder, business.industry, Depression, Age Factors, Health Services, Middle Aged, Patient Acceptance of Health Care, Disability pension, Latvia, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Cross-Sectional Studies, Logistic Models, Relative risk, Female, Self Report, business, Demography
Abstract: Background This cross-sectional study aims to assess the 12-month prevalence of major and minor depression in the Latvian population, and to evaluate associated health care utilization. Methods Trained interviewers conducted face-to-face interviews with a multistage stratified probability sample of the Latvian general population, ages 15–64 (n=3003). Participants were interviewed using the depression module of the Mini International Neuropsychiatric Interview. Self-reported health care utilization and somatic illness were also assessed. Multinomial logistic regressions were applied. Results The 12-month prevalence of major depression was 7.9% (95%CI 7.0–8.9), while for minor depression it was 7.7% (95%CI 6.8–8.7). We did not find a substantial difference in the relative risk ratio (RRR 1.7 for female) for having major depression by gender. RRR of having major depression was higher for those who had used healthcare services six or more times (RRR 2.0), those who had three or more somatic disorders during the past 12 months (RRR 2.3), those who perceived their health status as being below average (RRR 8.3), and those who were occasional smokers (RRR 3.0). RRR of having minor depression was increased for those who had at least three somatic disorders (RRR 2.3), those who received disability pension (RRR 1.9), and those who perceived their health status to be below average (RRR 3.0). Limitations The study was cross-sectional. Other psychiatric comorbidity was not assessed. Conclusions This is the first population based study reporting the 12-month prevalence of depression in Latvia. Certain factors associated with depression have been found.
Published: 2016

38. Self-reported suicide attempts and exposure to different types of violence and neglect during childhood: Findings from a young adult population survey in Latvia

Author: Toms Pulmanis, Iveta Pudule, Anita Villerusa, Lauma Springe, Daiga Grīnberga, and Biruta Velika
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, media_common.quotation_subject, Population, Poison control, Suicide, Attempted, Suicide prevention, Occupational safety and health, Neglect, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Injury prevention, medicine, Prevalence, Humans, 030212 general & internal medicine, Young adult, education, Psychiatry, media_common, Exposure to Violence, education.field_of_study, business.industry, Adult Survivors of Child Abuse, Public Health, Environmental and Occupational Health, General Medicine, Latvia, 030227 psychiatry, Cross-Sectional Studies, Attributable risk, Female, Self Report, business, Demography
Abstract: Aims: Suicide rates in Latvia are among the highest in the EU. Among 18–25 year-old young adults, it is the second leading cause of death. This study investigates the prevalence of self-reported suicide attempts in young adults and examines its association with neglect or violence of a physical, emotional or sexual nature. Methods: A questionnaire was administered to 1259 young adults 18–25 years of age, selected by targeted quota sampling from secondary and vocational schools. Results: The prevalence of self-reported suicide attempts was 6.1%. Physical and emotional adverse experiences showed clear associations with attempted suicide. Although prevalence of reported physical neglect was higher than for physical violence (27.0% versus 16.3%, respectively) the latter posed a higher risk for attempted suicide (OR = 4.0; 95% CI, 2.4–6.6). Conversely, emotional violence had a higher prevalence than emotional neglect (31.5% vs. 23.6%, respectively), but neglect showed a stronger association with attempted suicide (OR = 4.4; 95% CI, 2.6–7.3). Conclusions: The high OR for attempted suicide associated with emotional neglect, together with findings that emotional violence had the highest prevalence, and that emotional neglect and emotional violence showed the highest population attributable risk fraction (PopAR%) of 46.8 and 40.4, respectively, suggested that emotional factors merit special attention in further investigations of attempted suicide among young adults in Latvia. The targeted quota sampling method from five cities representing all regions of Latvia and 43.8% of its population, ensure national relevance of our findings for policy and program development by legislative, educational and public health institutions.
Published: 2016

39. Soft drinks and obesity in Latvia: a stakeholder analysis

Author: Martin McKee, Iveta Pudule, and Cécile Knai
Subjects: Consumption (economics), Government, Economic growth, Schools, Health Personnel, Public Health, Environmental and Occupational Health, Carbonated Beverages, Context (language use), medicine.disease, Faculty, Latvia, Childhood obesity, Nutrition Policy, Risk Factors, Political agenda, Economic cost, Political science, medicine, Humans, media_common.cataloged_instance, Stakeholder analysis, Obesity, European union, media_common
Abstract: Background: Childhood obesity is now firmly on the political agenda in western Europe but has received rather less attention in the eastern region of the European Union. This is a situation that cannot continue forever, especially in the light of evidence of the future social and economic cost of failure to act. Methods: Semi-structured interviews with key stakeholders in Latvia were conducted in October 2004 to understand the Latvian response to childhood obesity and, specifically, to soft drink consumption as one of its key risk factors. Analysis was undertaken using the established principles of stakeholder analysis to assess the position and influence of the stakeholders on consumption of soft drink consumption within broader efforts to curb obesity in children. Results: Twenty interviews were conducted and no one refused to be interviewed. Most stakeholders were concerned or convinced of the importance of restricting soft drinks consumption as part of initiatives to prevent childhood obesity. The most influential and supportive stakeholders were high school and primary school directors and parent groups. Conclusion: These findings help elucidate the actions of the Latvian government in November 2006 when it moved to ban certain foods and drinks from schools based on a concern for the adverse impact of additives on child health. The rapidity with which this poorly evidenced decision took place may have been supported by the unique context of an unstable government, nutrition leadership in dissolution, relatively weak industry influence and a surprisingly strong movement of teachers and parents.
Published: 2010

40. Bullying and subjective health among adolescents at schools in Latvia and Lithuania

Author: Apolinaras Zaborskis, Ilze Kalnins, Inese Gobina, Iveta Pudule, and Anita Villerusa
Subjects: Male, medicine.medical_specialty, Health (social science), Adolescent, Health Behavior, Poison control, Suicide prevention, Occupational safety and health, Quality of life (healthcare), Surveys and Questionnaires, Environmental health, Injury prevention, medicine, Health Status Indicators, Humans, Child, Crime Victims, business.industry, Public health, Public Health, Environmental and Occupational Health, Human factors and ergonomics, Life satisfaction, Lithuania, Latvia, Aggression, Cross-Sectional Studies, Quality of Life, Female, business
Abstract: To investigate the prevalence of bullying among adolescents in Latvia and Lithuania and to study its association with self-rated health, health complaints, and life satisfaction.A total of 3417 students in Latvia and 5626 in Lithuania were surveyed using the Health Behaviour Study among School-aged Children 2001/2002 (HBSC) questionnaire and research protocol.Being a victim, bully, or bully/victim was reported by 30.1% adolescents in Latvia and 52.3% in Lithuania with the highest proportion reporting being a victim. Bullying was associated with poor subjective health and low life satisfaction.The factors explaining the difference of bullying prevalence between both countries should be studied to develop effective anti-bullying interventions relevant to local conditions.
Published: 2008

41. Educational variations in the consumption of foods containing fat in Finland and the Baltic countries

Author: Janina Petkeviciene, Ritva Prättälä, Jurate Klumbiene, Laura Paalanen, Iveta Pudule, and Anu Kasmel
Subjects: Adult, Baltic States, Male, Health Knowledge, Attitudes, Practice, Nutritional Sciences, Low education, Population, Medicine (miscellaneous), Food habits, Diet Surveys, Environmental health, Humans, Nutritional Physiological Phenomena, education, Finland, Dietary fat, Consumption (economics), education.field_of_study, Nutrition and Dietetics, Public Health, Environmental and Occupational Health, Middle Aged, Dietary Fats, Cross-Sectional Studies, Geography, Educational Status, Female, Food preparation, Disease prevention, Educational patterns
Abstract: ObjectiveTo examine educational differences among people who consume foods containing fat in Finland and the Baltic countries.DesignData were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002.SettingEstonia, Finland, Latvia and Lithuania.SubjectsFor each survey, nationally representative random samples of adults aged 20–64 years were drawn from population registers (Estonia,n = 3656; Finland,n = 9354, Latvia,n = 6015; Lithuania,n = 5944).ResultsDifferences were revealed between the countries in the consumption of foods that contain fat. Finnish people consumed butter on bread, high-fat milk, meat and meat products, and vegetable oil for cooking less frequently than people in the Baltic countries. Cheese was most popular in Finland. Educational differences in fat-related food habits were examined by applying logistic regression analysis. A positive association was found between level of education and consumption of vegetable oil used in food preparation. Drinking high-fat milk was associated with low education in all countries. People with higher education tended to consume cheese more often. Educational patterns in the consumption of butter on bread and in the consumption of meat and meat products differed between countries.ConclusionsThe consumption of foods containing fat was related to educational levels in all four countries. The diet of better-educated people was closer to recommendations for the consumption of saturated and unsaturated fats than the diet of people with lower level of education. The educational gradient was more consistent in Finland than in the Baltic countries. These existing educational differences in sources of fat consumed should be taken into account in the development of national cardiovascular disease prevention programmes.
Published: 2007

42. Prevalence and sociodemographic characteristics of self-reported suicidal behaviours in Latvia in 2010: A population-based study

Author: Lauma Spriņǵe, Māris Taube, Daiga Grīnberga, Biruta Velika, Toms Pulmanis, Iveta Pudule, and Elmārs Rancāns
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Population, Poison control, Suicide, Attempted, Suicide prevention, Suicidal Ideation, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Injury prevention, Prevalence, Medicine, media_common.cataloged_instance, Humans, 030212 general & internal medicine, European union, Psychiatry, education, Suicidal ideation, media_common, education.field_of_study, business.industry, Middle Aged, Latvia, Middle age, 030227 psychiatry, Stratified sampling, Psychiatry and Mental health, Female, Self Report, medicine.symptom, business
Abstract: The fact that Latvia is among the countries with the highest suicide mortality rates in the European Union highlights the importance of research in this field.The aims of the study were to determine the 2010 prevalence of self-reported suicidal behaviours in Latvia, to identify sociodemographic risk factors and to examine sequences for reporting of suicidal behaviours.Computer assisted personal interviews were carried out to gather information on a representative sample of the Latvian population aged 18 to 64 (n = 2816). The study sample was selected using a combination of stratified random sampling and quota methods.Last year prevalence of any type of suicidal behaviour was 18.5% - nearly threefold lower than observed in 2000 (52.6%). Middle age, non-cohabitation status and lower level of education were significant risk factors for serious types of suicidal behaviour (suicidal ideation, suicidal plans, suicide attempts) among men, but only lower level of education was for women. Risk factors regarding mild types of suicidal behaviour (life-weariness, death wishes) were the same for men and women: older and middle aged, non-cohabitation status, and lower level of education. A total of 79.6% reported a continuous pattern of suicidal behaviours.Several sociodemographic risk factors for suicidal behaviours have been found. Further research is needed to clarify additional risk factors, especially in the high-risk groups studied and specific determinants contributing to reduction in prevalence of suicidal behaviours and suicide mortality in Latvia.
Published: 2015

43. Determinants of daily smoking in Estonia, Latvia, Lithuania, and Finland in 1994—2002

Author: Eero Lahelma, Iveta Pudule, Ville Helasoja, Jurate Klumbiene, Ritva Prättälä, Kristiina Patja, and Anu Kasmel
Subjects: Adult, Estonia, Male, medicine.medical_specialty, Cross-sectional study, 050109 social psychology, 03 medical and health sciences, Sex Factors, Surveys and Questionnaires, Epidemiology, Prevalence, Humans, Medicine, 0501 psychology and cognitive sciences, Finland, 030505 public health, business.industry, Public health, Smoking, 05 social sciences, Public Health, Environmental and Occupational Health, Lithuania, General Medicine, Odds ratio, Lithuanian, Middle Aged, Latvia, Estonian, language.human_language, 3. Good health, Distress, Cross-Sectional Studies, Socioeconomic Factors, language, Educational Status, Female, 0305 other medical science, business, Psychosocial, Stress, Psychological, Demography
Abstract: Aims: To investigate time trends in the smoking prevalence and the sociodemographic and psychosocial background of smoking in the Baltic countries in comparison with Finland during 1994—2002. Methods: Differences in daily smoking according to age, education, urbanization, and psychological distress in the Baltic countries and Finland were studied using postal surveys in 1994, 1996, 1998, 2000, and 2002 among adults (20—64 years old) in Estonia (n=6,271), Latvia (n=6,106), Lithuania (n=9,824), and Finland (n=15,764). Results: In 1994, 1996, 1998, 2000, and 2002 the prevalence of smoking in Estonia, Latvia, Lithuania, and Finland was 47%, 54%, 46%, and 29% among men, and 21%, 19%, 11%, and 19% among women, respectively. Smoking increased among Lithuanian women from 6% in 1994 to 13% in 2002, but decreased among Estonian men and women. Smoking was generally more common among younger individuals, the less educated, and people with distress in all four countries. The odds ratios for smoking for those with low education compared with those with high education were 2.18 (1.69—2.81), 3.32 (2.55—4.31), 2.20 (1.79—2.70) and 2.80 (2.40—3.27) in men, and 1.90 (1.42—2.52). 3.09 (2.28—4.18), 0.86 (0.59—1.26), and 3.00 (2.53—3.55) in women, in Estonia, Latvia, Lithuania, and Finland, respectively. There were indications of increasing educational differences in Latvian men. Smoking was less common among rural women in all countries except Estonia. Conclusions: Estonia, Latvia, and Finland show characteristics of the ``mature'' phase of a smoking epidemic, and smoking may not increase in these countries. In Lithuanian women smoking may increase. Smoking may be increasingly unequally distributed in the future in all the studied countries.
Published: 2006

44. Comparison of the Micro-Nutrica Nutritional Analysis program and the Russian Food Composition Database using data from the Baltic Nutrition Surveys

Author: Iveta Pudule, Aileen Robertson, Daiga Grinberga, Algis Abaravicius, Martin McKee, Sirje Vaask, and Joceline Pomerleau
Subjects: Baltic States, Vitamin, Databases, Factual, Medicine (miscellaneous), Russia, Food composition database, chemistry.chemical_compound, Nutrient, Environmental protection, Environmental health, Dietary Carbohydrates, Humans, Nutritional analysis, Nutrition and Dietetics, Dietary intake, Latvian, Nutrition Surveys, Ascorbic acid, Dietary Fats, Food Analysis, language.human_language, Diet, Geography, chemistry, language, Dietary Proteins, Energy Intake
Abstract: Objective: The objective of this study was to compare the nutrient content of foods and diets based on data from two food composition databases used in the Baltic Nutrition Surveys (conducted in Estonia, Latvia and Lithuania in 1997): an adapted version of the Finnish Micro-Nutrica Nutritional Analysis program (used in Estonia) and the Russian Institute of Nutrition Food Composition Database (used in Latvia and Lithuania). Design: The adapted Micro-Nutrica and Russian databases were used to estimate the energy and nutrient (protein, fat, carbohydrate, vitamin C, calcium and iron) content of 15 common foodstuffs in the region and the nutrient intakes of 32 Latvian respondents (based on 24-h recalls). Differences between databases were estimated. Results: There were discrepancies in the energy and nutrient content of the 15 selected foods using the two databases. The adapted Micro-Nutrica database generally gave a lower energy content than the Russian database (median: −6%), and a lower fat content for typically fat-rich foods. Intakes of energy, fat, carbohydrate and calcium by the 32 selected respondents were significantly lower when the Micro-Nutrica database was used. Differences were particularly high for fat (difference=−23.5%, 95% confidence interval=−31.1 to −15.8%, P
Published: 2004

45. Poster session: Track 4, Management

Author: Jūratė Klumbienė, Anu Kasmel, Iveta Pudule, Kati Vähäsarja, Janina Petkevičienė, and Ville Helasoja
Subjects: medicine.medical_specialty, Nutrition and Dietetics, Health professionals, business.industry, Endocrinology, Diabetes and Metabolism, Family medicine, medicine, Medicine (miscellaneous), Overweight, medicine.symptom, business
Published: 2003

46. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

Author: Gregor Starc, Agneta Yngve, Iveta Pudule, Ausra Petrauskiene, Trudy M. A. Wijnhoven, Vesselka Duleva, Ana Isabel Rito, Marie Kunešová, Maria Hassapidou, Agneta Sjöberg, Joop M A van Raaij, Eva Martos, Victoria Farrugia Sant'Angelo, Nazih Eldin, João Breda, and Ragnhild Hovengen
Subjects: Male, Gerontology, Pediatric Obesity, behaviors, Health, Toxicology and Mutagenesis, Psychological intervention, School Policy, lcsh:Medicine, physical activity, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, Obesity -- Europe, Overweight, Body Mass Index, Nutrition -- Europe, Promotion (rank), prevention, healthy school environment, school policy, Child, media_common, Human Nutrition & Health, Schools, Humane Voeding & Gezondheid, Obesity in children -- Europe, Europe, nutrition, Female, Exercise -- Health aspects, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, medicine.symptom, associations, policy, medicine.medical_specialty, Monitoring, media_common.quotation_subject, education, Physical activity, Nutritional Status, World Health Organization, Article, World health, Childhood obesity, primary schools, children, Environmental health, medicine, Humans, overweight, consumption, food environment, interventions, Nutrition, VLAG, Global Nutrition, Wereldvoeding, business.industry, Public health, lcsh:R, Public Health, Environmental and Occupational Health, secondary-schools, Physical Activity, medicine.disease, weight status, monitoring, School environment, Primary Schools, business, Body mass index, Healthy School Environment, Estilos de Vida e Impacto na Saúde
Abstract: Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical ctivity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%95% of schools) and school nutrition environment scores (range: 0.300.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.201.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z-score was not observed. Conclusions: Some European countries have implemented more school policies that are supportive to a healthy nutrition environment than others. However, most countries with low school nutrition environment scores also host schools with supportive school environment policies, suggesting that a uniform school policy to tackle the “unhealthy” school nutrition environment has not been implemented at the same level throughout a country and may underline the need for harmonized school policies., peer-reviewed
Published: 2014
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47. WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010

Author: Ausra Petrauskiene, Maria Hassapidou, Ana Isabel Rito, Nazih Eldin, João Breda, Napoleón Pérez-Farinós, Igor Spiroski, Ragnhild Hovengen, Marie Kunešová, Angela Spinelli, Iveta Pudule, Gregor Starc, Harry Rutter, Trudy M. A. Wijnhoven, Lien Braeckevelt, Joop M A van Raaij, and Eva Martos
Subjects: Gerontology, Male, medicine.medical_specialty, Pediatric Obesity, Cross-sectional study, Child Welfare, Overweight, World Health Organization, Childhood obesity, Body Mass Index, Epidemiology, medicine, Prevalence, Life Science, Humans, VDP::Medisinske fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Child, Obesidade Infantil, School Health Services, VLAG, Human Nutrition & Health, Global Nutrition, VDP::Midical sciences: 700::Health sciences: 800::Community medicine, social medicine: 801, Wereldvoeding, Nutrição Aplicada, Schools, Anthropometry, business.industry, Humane Voeding & Gezondheid, Public Health, Environmental and Occupational Health, nutritional and metabolic diseases, medicine.disease, Obesity, Europe, Cross-Sectional Studies, European Childhood Obesity Surveillance Initiative, Female, COSI, Biostatistics, medicine.symptom, business, Body mass index, Estilos de Vida e Impacto na Saúde, Demography, Research Article
Abstract: Background The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010) and to explore changes in body mass index (BMI) and overweight among children within and across nine countries from school years 2007/2008 to 2009/2010. Methods Using cross-sectional nationally representative samples of 6−9-year-olds, BMI, anthropometric Z-scores and overweight prevalence were derived from measured weight and height. Significant changes between rounds were assessed using variance and t-tests analyses. Results At Round 2, the prevalence of overweight (including obesity; WHO definitions) ranged from 18% to 57% among boys and from 18% to 50% among girls; 6 − 31% of boys and 5 − 21% of girls were obese. Southern European countries had the highest overweight prevalence. Between rounds, the absolute change in mean BMI (range: from −0.4 to +0.3) and BMI-for-age Z-scores (range: from −0.21 to +0.14) varied statistically significantly across countries. The highest significant decrease in BMI-for-age Z-scores was found in countries with higher absolute BMI values and the highest significant increase in countries with lower BMI values. The highest significant decrease in overweight prevalence was observed in Italy, Portugal and Slovenia and the highest significant increase in Latvia and Norway. Conclusions Changes in BMI and prevalence of overweight over a two-year period varied significantly among European countries. It may be that countries with higher prevalence of overweight in COSI Round 1 have implemented interventions to try to remedy this situation. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-806) contains supplementary material, which is available to authorized users.
Published: 2014

48. Dietary beliefs in the Baltic republics

Author: Iveta Pudule, Algis Abaravicius, Martin McKee, Daiga Grinberga, Roma Bartkeviciute, Aileen Robertson, Sirje Vaask, Kamelija Kadziauskiene, and Joceline Pomerleau
Subjects: Adult, Baltic States, Male, Health Knowledge, Attitudes, Practice, Adolescent, Cross-sectional study, Population, Medicine (miscellaneous), Logistic regression, Diet Surveys, Healthy food, Environmental health, Humans, Nutritional Physiological Phenomena, Sodium Chloride, Dietary, Salt intake, education, education.field_of_study, Nutrition and Dietetics, Public Health, Environmental and Occupational Health, Feeding Behavior, Middle Aged, Dietary Fats, humanities, Frequent use, Cross-Sectional Studies, Educational Status, Female, Psychology, Dietary salt
Abstract: ObjectivesAs beliefs and knowledge about the possible effects of foods on health can influence food behaviours, this study examined selected dietary beliefs in the Baltic countries and the association of beliefs related to salt intake and to types of fat with food behaviours.DesignA cross-sectional study.SettingData from three surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used to describe the prevalence of dietary beliefs in these countries and to investigate the association between beliefs and behaviours (using logistic regression).SubjectsRepresentative national samples of adults were selected in each country (Estonia,n=2018; Latvia,n=2308; Lithuania,n=2153).ResultsMisunderstood concepts (myths) related to dietary salt, types of fat, meat consumption and bread and potatoes were observed in high proportions of the population. Education level was an important correlate of beliefs related to salt intake and types of fat, people with a higher education level being more likely to be familiar with these issues. Correct beliefs were not consistently associated with healthier behaviours (e.g. less frequent use of salt at the table and use of non-animal fats for cooking), except for salt intake in Estonia.ConclusionsSeveral misunderstood dietary concepts (myths) are still prevalent in the Baltic countries. Correct beliefs related to salt intake and types of fat were not consistent predictors of healthier food behaviours. In-depth qualitative investigations are needed to better describe and understand dietary beliefs and attitudes in the Baltic countries, and to identify barriers to the adoption of healthy food habits.
Published: 2001

49. Physical Inactivity in the Baltic Countries

Author: Sirje Vaasc, Kamelija Kadziauskiene, Roma Bartkeviciute, Daiga Grinberga, Martin McKee, Iveta Pudule, Joceline Pomerleau, Aileen Robertson, and Algis Abaravicius
Subjects: Adult, Estonia, Male, medicine.medical_specialty, Adolescent, Epidemiology, Health Behavior, Population, Risk Assessment, Age Distribution, Risk Factors, Environmental health, Humans, Medicine, Sex Distribution, Risk factor, education, Exercise, Life Style, Socioeconomic status, Probability, education.field_of_study, business.industry, Public health, Public Health, Environmental and Occupational Health, Lithuania, Middle Aged, medicine.disease, Health Surveys, Latvia, Obesity, Physical activity level, Health promotion, Female, business, Risk assessment
Abstract: Background. Physical inactivity is a known risk factor for heart disease and obesity, two major health problems in the Baltic Republics. This study examined patterns of physical activity level in these countries, and correlates of leisure-time sedentary behavior. Methods. Data from three national surveys of adults conducted in Estonia, Latvia, and Lithuania in 1997 were used. Respondents who provided information on their activity level were included in this study (Estonia: n = 2,018; Latvia: n = 2,303; Lithuania: n = 2,140). Results. One in three Estonians and one in five Latvians and Lithuanians had a low physical activity level at work. Half the respondents (Lithuania: 60%, Latvia: 52%, Estonia: 43%) participated only in sedentary activities during their leisure time. Leisure-time sedentarity was inversely related to education level in men and women and with income in men. It was also associated with smoking in men and with inadequate vegetable intake in men and women. Conclusions. Sedentary behavior during leisure time should be a public health issue in the Baltic Republics. Health promotion strategies aiming at increasing leisure-time physical activity level will need to target the general population, but particularly individuals from lower socioeconomic strata.
Published: 2000

50. Alcohol consumption in the Baltic Republics

Author: Iveta Pudule, Daiga Grinberga, Aileen Robertson, Kamelija Kadziauskiene, Algis Abaravicius, Martin McKee, Sirje Vaask, and Joceline Pomerleau
Subjects: Adult, Estonia, Male, Research Report, Alcohol Drinking, Epidemiology, Cross-sectional study, Ethnic group, Poison control, Wine, Logistic regression, Russia, Odds, Humans, Medicine, Socioeconomic status, business.industry, Public Health, Environmental and Occupational Health, Beer, Lithuania, Odds ratio, Middle Aged, Latvia, Cross-Sectional Studies, Social Class, Socioeconomic Factors, Female, Health education, business, human activities, Demography
Abstract: STUDY OBJECTIVES—Premature mortality associated with alcohol intake is of particular concern in several countries of the former Soviet Union. This study explored self reported alcohol consumption (beer, wine, spirits) and its determinants in the Baltic Republics. DESIGN—Cross sectional surveys conducted in 1997. SETTINGS—Estonia, Latvia and Lithuania. PARTICIPANTS—Representative samples of adults age 19-64 (Estonia n=2010; Latvia n=2258; Lithuania n=2139). METHODS—Between country differences in the frequency of alcohol intake were estimated. The odds of consuming alcohol weekly according to socioeconomic characteristics (age, ethnicity, rural/urban area, education, income) were calculated using multiple logistic regression analyses, adjusting for all variables simultaneously. MAIN RESULTS—The proportion of respondents consuming alcohol weekly varied by country (p
Published: 2000

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