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We examined whether bone health is related to protein intake from different sources by utilising a distinct, rare dietary pattern: avoidance of animal foods for approximately half of the year according to Christian Orthodox Church fasting. Four-hundred adults, of whom 200 had been following religious fasting for a median of 15 years and 200 were non-fasters, underwent anthropometry, measurements of bone mineral density (BMD) and bone mineral content (BMC), and completed a food frequency questionnaire. Groups did not differ significantly in anthropometric measures, BMD, or BMC. Fasters had higher consumption of seafood and lower consumption of red meat, poultry-eggs, dairy products, and grains-cereals than non-fasters. Protein intake from these food groups exhibited similar differences; overall, fasters had lower protein intake than non-fasters. BMD and BMC were positively, though weakly, correlated with red meat and poultry-egg consumption. Thus, protein intake seems to play a minor (if any) role in bone health. [ABSTRACT FROM AUTHOR]

Abstract Background Exposure to environmental tobacco smoke is a major threat to public health. Greece, having the highest smoking prevalence in the European Union is seriously affected by passive smoking. The purpose of this study was to measure environmental tobacco smoke (ETS) exposure in the non smoking areas of hospitality venues and offices in Greece and to compare the levels of exposure to levels in the US, UK and Ireland before and after the implementation of a smoking ban. Methods Experimental measurements of particulate matter 2.5 μm (PM2.5), performed during a cross sectional study of 49 hospitality venues and offices in Athens and Crete, Greece during February – March 2006. Results Levels of ETS ranged from 19 μg/m3 to 612 μg/m3, differing according to the place of measurement. The average exposure in hospitality venues was 268 μg/m3 with ETS levels found to be highest in restaurants with a mean value of 298 μg/m3 followed by bars and cafes with 271 μg/m3. ETS levels were 76% lower in venues in which smoking was not observed compared to all other venues (p < 0.001). ETS levels in Greek designated non-smoking areas are similar to those found in the smoking sections of UK hospitality venues while levels in Ireland with a total smoking ban are 89% lower and smoke-free communities in the US are 91 – 96% lower than levels in Greece. Conclusion Designated non-smoking areas of hospitality venues in Greece are significantly more polluted with ETS than outdoor air and similar venues in Europe and the United States. The implementation of a total indoor smoking ban in hospitality venues has been shown to have a positive effect on workers and patrons' health. The necessity of such legislation in Greece is thus warranted.

Abstract Background Smoking is Greece's largest public health threat. Greece has the highest adult smoking prevalence among all E.U countries, which in turn possibly predisposes Greek children and adolescents to smoke. The purpose of our study was to research into the smoking habits of preschool children's parents since children of that age could be vulnerable to parental negative role modeling and to investigate into the necessity of conducting a public health awareness programme aimed at the general population. Methods A cross-sectional study was performed on the parents of children enrolled in kindergarten in western Crete-Greece (2809 parents), and interviewed during the 2004–2005 Cretan school health promotion programme. Results 63% of households had at least one parent a current smoker and in 26% both parents were found to be current smokers. Smoking prevalence among adults with preschool children was estimated at 44% (52% of fathers and 36% of mothers). Paternal education and nationality were statistically significantly related to smoking (p < 0.001), unlike place of residence (p = 0.862) and level of maternal education (p = 0.132). Conclusion Smoking prevalence is high even among parents with preschool children. Taking into account the parents' significant primary role in the children's upbringing and the effect that parental induced passive smoking has on children's health and health attitude; one can deduce that the health of Greek children is under threat. It is of major importance that educational and policy intervention measures are implemented to reduce such a situation that could contribute to promoting the initiation of smoking among Greek adolescents.

Abstract Background Folate has emerged as a key nutrient for optimising health. Impaired folate status has been identified as a risk factor for cardiovascular disease, various types of cancers, and neurocognitive disorders. The study aimed at examining the distribution and determinants of serum folate concentrations in a healthy adult population in Crete, Greece. Methods A cross-sectional sample of 486 healthy adults (250 men, 236 women) aged 39 ± 14 years, personnel of the Medical School and the University Hospital of Crete in Greece, was examined. Serum folate and vitamin B12 concentrations were measured by microbiological assay, and total homocysteine was determined fluorometrically and by high-pressure liquid chromatography. Lifestyle questionnaires were completed, and nutrient intakes and food consumption were assessed by 24-h dietary recalls. Multivariate analyses were performed using SPSS v10.1. Results The geometric mean (95% confidence interval) concentrations of serum folate were 15.6 μmol/l (14.6–16.8) in men and 19.2 μmol/l (17.9–20.7) in women (p < 0.001). Inadequate folate levels (≤7 nmol/l) were present in 6.8% of men and 2.1% of women (p < 0.001). Approximately 76% of men and 87% of women did not meet the reference dietary intake for folate (400 μg/day). Serum folate was inversely related to total homocysteine levels (p < 0.001). Increased tobacco and coffee consumption were associated with lower folate concentrations (p < 0.05 for both) but these associations disappeared after controlling for nutrient intakes. In multivariate analysis, intakes of MUFA, fibre, calcium, magnesium, folate, and vitamins A, E, C, B1, and B6 were positively associated with serum folate. Consumption of potatoes, legumes, fruits, and vegetables were favourably related to the serum folate status. Conclusion Serum folate concentrations were associated with various demographic, lifestyle and dietary factors in healthy Cretan adults. Large-scale epidemiological studies should be conducted within the general Greek adult population to assess the prevalence of impaired folate status and further examine associations with dietary patterns and chronic disease risk. Considering the importance of folate in health maintenance, it is important to increase the public's awareness of modifiable lifestyle patterns and diet and tobacco use in particular, which may be associated with improved folate status.

Abstract Background No study to date has focused on the impact of Greek Orthodox Christian fasting on serum lipoproteins and obesity yet. Methods 120 Greek adults were followed longitudinally for one year. Sixty fasted regularly in all fasting periods (fasters) and 60 did not fast at all (controls). The three major fasting periods under study were: Christmas (40 days), Lent (48 days) and Assumption (August, 15 days). A total of 6 measurements were made during one year including pre- and end-fasting blood collection, serum lipoprotein analyses and anthropometric measurements. Results Statistically significant end-fasting total and LDL cholesterol differences were found in fasters. Fasters compared to controls presented 12.5% lower end-total cholesterol (p < 0.001), 15.9% lower end-LDL cholesterol (p < 0.001) and 1.5% lower end-BMI (p < 0.001). The end- LDL/HDL ratio was lower in fasters (6.5%, p < 0.05) while the change in end- HDL cholesterol in fasters (4.6% decline) was not significant. Similar results were found when the pre- and end-fasting values of fasters were compared. No change was found in control subjects. Conclusions Adherence to Greek Orthodox fasting periods contributes to a reduction in the blood lipid profile including a non-significant reduction in HDL cholesterol and possible impact on obesity.

Objective: To analyse the gluteal adipose-tissue fatty-acid profiles from Cretan cohort survivors of the Seven Countries Study (SCS) at 2010 and to compare them with those of survivors assessed in 2000, as well as with literature data on male Cretans at 1965.Design: We analysed data concerning the gluteal adipose-tissue fatty acids (analysed by GC) from three studies.Setting: The island of Crete (rural areas and the city of Heraklion).Subjects: Twenty-two of the 2010 SCS survivors aged 90 years and over; seventy-eight men aged 80 years of the 2000 SCS survivors; and 280 men assessed in 1965.Results: In comparison to 1965 and 2000, the SCS survivors in 2010 had a higher amount of 18:1n-9 (P<0·05) in their gluteal adipose tissue and a lower amount of PUFA (P<0·05). On the other hand, a constant decrease in adipose-tissue 14:1n-5 and 16:1n-7 was recorded between 1965 and 2010 (P<0·001), and between 2000 and 2010 (P<0·05), while 18:2n-6 appeared to decrease between the 1965 and 2010 assessments (P<0·001).Conclusions: Comparison with a 1965 representative Cretan sample and 2000 SCS survivors indicated an increased concentration of oleic acid (known for its protective role against mortality) and a decreased concentration of PUFA (known for their susceptibility to oxidation) in our surviving sample at 2010. These changes may reflect internal physiological processes due to diet change within these years and/or ageing. [ABSTRACT FROM AUTHOR]