Search

ObjectiveA low socio-economic status (SES) is related to less healthy dietary habits, but the reasons for this remain unclear. We examined whether the absolute or relative importance of various food choice motives contributed to SES disparities in vegetable/fruit and energy-dense food intake.DesignWe analysed cross-sectional data from the FINRISK Study 2007 by means of structural equation modelling and used a shortened version of the Food Choice Questionnaire to assess the absolute importance of health, pleasure, convenience, price, familiarity and ethicality motives. We calculated the relative importance of each motive by dividing the participant's rating of it by his/her mean score on all motives. Dietary intake was measured with an FFQ.SettingA population-based survey in Finland.SubjectsMen (n 1691) and women (n 2059) aged 25–64 years.ResultsHigher education and income were related to a greater vegetable/fruit intake (β = 0·12, P < 0·001), while education was associated negatively with the consumption of energy-dense foods (β = −0·09, P < 0·001). Socio-economically disadvantaged individuals considered price and/or familiarity more important in their food choices in both absolute and relative terms. A higher income was related to a greater relative importance of health considerations. Relative motives were more strongly associated with vegetable/fruit and energy-dense food consumption than absolute motives and the relative importance of price, familiarity and health partly mediated the effects of the SES indicators on the consumption of these food items.ConclusionsIndividual priorities in food choice motives, rather than the absolute importance of single motives, play a role in producing SES disparities in diet.

Background: There is increasing evidence that depressive symptoms and obesity are positively related, but the mechanisms that explain the association between them are unclear. Objective: We examined direct and indirect associations between depressive symptoms, emotional eating, physical activity (PA) selfefficacy (ie, an individual’s confidence in his or her ability to overcome barriers to maintain PA behaviors), and adiposity indicators. Design: Structural equation modeling was used to test the hypothesized mediation model in Finnish men (n = 2312) and women (n = 2674) aged 25‐74 y from the National Cardiovascular Risk Factor Survey conducted in 2007. The Center for Epidemiologic Studies‐ Depression Scale, the Three-Factor Eating Questionnaire-R18, and a PA barriers self-efficacy scale were used. Body mass index (BMI), waist circumference (WC), and percentage body fat of participants were measured in a health examination. Results: Depressive symptoms and emotional eating had positive correlations and PA self-efficacy had negative correlations with BMI, WC, and percentage body fat. Elevated depressive symptoms were related to higher emotional eating (b = 0.38 for men and 0.31 for women) and lower PA self-efficacy (b = 20.41 for men and 20.31 for women), whereas emotional eating and PA self-efficacy were inversely correlated (r = 20.12 and 20.18, respectively). The positive bivariate associations between depressive symptoms and adiposity indicators became nonsignificant in models that included emotional eating and PA self-efficacy, and both of these factors significantly mediated the effects of depressive symptoms on adiposity indicators. Conclusions: Psychological factors related to both eating and PA may be relevant in explaining the positive relation between depressive symptoms and adiposity. Interventions that target obesity should take into account the effects of these factors on weight regulation. Am J Clin Nutr 2010;92:1031‐9.

The present study describes the main actions in Finnish nutrition policy during the past decades. The main actor is the National Nutrition Council, which provides nutritional recommendations and action programmes, and sets up expert groups to solve nutritional problems in the population. The main fortification programmes have been the iodization of table salt, supplementation of selenium to fertilizers and the vitamin D fortification programme. As an example of national legislation, labelling the salt content of foods is described. Finnish nutrition policy is based on a good monitoring system of nutrition and risk factors of chronic diseases, as well as active epidemiological research. However, the authorities have not often taken proposed fiscal measures seriously but have instead considered agricultural and economic policies more important than health policy.

To examine 10-year changes in waist circumference (WC) and identify socio-economic groups having higher WC than expected by their body mass index (BMI). Population based cross-sectional surveys carried out in four regions of Finland in 1992, 1997 and 2002. A total of 9026 women and 8173 men, aged 25–64 years. Waist circumference, BMI, socio-economic indicators (education, household income, employment status, marital status) and health behaviors (smoking, alcohol use, physical activity). In 2002, women had about 2.7 cm and men about 1.0 cm higher WC than subjects 10 years previously. Waist circumference increased more than BMI among women, especially among unemployed women. Higher WC among non-employed women was not explained by socio-economic indicators or health behaviors. Among men, smaller WC was associated with lower socio-economic status. However, associations partly disappeared after adjustment for health behaviors including physical activity at work. Socio-economic patterning of WC is divergent and gender-specific. More attention should be paid to increasing waistlines among women.

OBJECTIVE This study aimed to examine whether psychosocial working conditions are associated with angina pectoris (AP) symptoms in women. METHODS Data were derived from postal questionnaires filled in by 40- to 60-year-old women employed by the City of Helsinki, Finland, in 2000 to 2002 (n = 7093, response rate 67%). AP symptoms were measured by the Rose Questionnaire. Logistic regression analyses were carried out to examine AP symptoms as outcome. Independent variables consisted of Karasek's job demands and job control, work fatigue, working overtime, work-related mental and physical strain, the work-home interface, and social support, adjusted for age. Confounding effects of socioeconomic status, health behaviors (smoking, binge drinking, body mass index), and menopause were also examined. Pregnant women were excluded. RESULTS AP symptoms were reported by 6% of participants. Work fatigue was strongly associated with AP. In addition, working overtime, low job control, and high physical strain at work were associated with AP. The associations between psychosocial working conditions and AP symptoms were unaffected by health behaviors, socioeconomic status, or menopause. CONCLUSIONS Working conditions were associated with the AP symptoms identified by the Rose Questionnaire. Longitudinal studies are needed to disentangle the causal relationships, i.e., whether psychosocial stress is a true risk factor/cause of angina symptoms and cardiovascular disease among women.

Udgivelsesdato: 2006-Feb BACKGROUND: Relative body weight is typically inversely associated with social status in affluent societies but studies comparing the social patterning of relative body weight and obesity in different countries have only seldom been conducted. The aim of this study was to analyse and compare the social patterning of relative weight and obesity by occupational status, educational attainment and marital status between Danish and Finnish women and men. METHODS: Data from the Finnish Survey on Living Conditions and the Danish Health and Morbidity Survey, both collected in 1994, were compared. Relative weight was studied by using body mass index (BMI), and those with BMI > or =30 kg/m(2) were regarded as obese. Logistic regression analysis was used to examine the social patterning of obesity in the pooled dataset. Two-variable interaction effects were tested separately. RESULTS: Compared with their Danish counterparts, Finnish women and men had higher average relative weight and they were more often obese. There were no country differences in the socio-economic patterning of obesity by educational attainment, but a stronger patterning of obesity by occupational status was found among Danish women. Moreover, non-married women in Denmark were more likely to be obese than their married counterparts. CONCLUSIONS: Finns have higher relative weight and they are more often obese than Danes. The social patterning of obesity was similar in both studied countries but stronger in Denmark.

Background: Disparities in body mass index (BMI) between persons with different educational levels in Western countries are well documented, but the background of these education-associated disparities remains poorly understood. Objective: The objective was to examine the influence of environmental and genetic factors on education-associated disparities in self-reported BMI and weight change. Design: Longitudinal postal surveys were performed in 1975, 1981, and 1990. The data were analyzed by using multivariate genetic models for twin data. The data derived from the Finnish Twin Cohort included 2482 monozygotic and 5113 dizygotic same-sex male and female twin pairs born between 1915 and 1957. Results: Education-associated differences in BMI and in weight change were clear in 1975 and 1981, respectively, whereas no differences were seen in weight change between 1981 and 1990 when age and baseline BMI were adjusted for. The trait correlation between baseline BMI and educational attainment (-0.15 in men and women) was mainly due to correlations between additive genetic factors that contributed to BMI and education in men (-0.20; 95% CI: -0.25, -0.14) and women (-0.32; 95% CI: -0.40, -0.25) when adjusted for age. Among women, a weaker positive correlation was found for the unshared environmental effects contributing to the 2 traits (0.06; 95% CI: 0.02,0.12). The same factors that affected the association between education and BMI in 1975 largely explained the association between education and weight change in 1981. Conclusion: The results suggest the possibility that common genetic factors affect educational attainment and body weight, which contribute to education-associated disparities in BMI in adulthood.

OBJECTIVE: To investigate whether current smoking and lifetime snuff use are associated with a lifetime history of major (≥5 kg) intentional weight loss in young adults, and to examine the dependence of this association on familial factors. DESIGN: Cross-sectional population-based questionnaire survey of young adult Finnish twins participating in the fourth wave of the longitudinal FinnTwin-16-study in 2000–2002. SUBJECTS: A total of 4521 young adult Finnish twins aged 23–27 y. MEASUREMENTS: Questionnaire data on the number of intentional weight-loss episodes and on body mass index (BMI), cigarette smoking and snuff use, educational level, and number of subjects' own children. RESULTS: Current daily smoking was strongly associated with a history of two or more intentional major weight-loss episodes (lost ≥5 kg twice or more lifetime) both in women odds ratio (OR 1.87; 95%; confidence interval (CI) 1.39–2.50) and in men (OR 2.00; 95% CI 1.37–2.90). Frequent lifetime snuff use was statistically significantly associated with recurrent intentional weight loss episodes in men (OR 1.51; 95% CI 1.08–2.13). Among the twin pairs discordant for daily smoking, the smoking twin was more likely than the nonsmoking co-twin to have recurrent intentional weight-loss episodes (OR 1.57; 95% CI 1.03–2.41). These episodes were also strongly associated with high BMI. Education was inversely related to recurrent intentional weight-loss episodes in men. CONCLUSION: Tobacco use is strongly associated with a lifetime history of recurrent intentional major weight-loss episodes in early adulthood. This represents a major challenge to existing attitudes on smoking prevention and the promotion of healthful weight control.

Objective:To describe the characteristics of employees having lunch at staff canteens and to examine the association between workplace lunch and recommended food habits.Design:A mailed questionnaire including data on lunch pattern, food habits, sociodemographic background, work-related factors and body weight. Logistic regression models including food habits as dependent variables and lunch pattern, sociodemographic factors, work-related factors and body mass index as independent variables.Setting:Helsinki Health Study survey data, collected in spring 2001.Subjects:Employees from the City of Helsinki reaching 40, 45, 50, 55 and 60 years. The data included 2474 women and 591 men; the response rate was 68%.Results:About half of those with a staff canteen at work had lunch there. Those with higher educational level were more likely to have lunch at the staff canteen, as also were women with pre-school children and normal-weight men. Those having lunch at staff canteens were more likely to follow recommended food habits, compared with other subjects. Having lunch at the staff canteen seemed to increase the consumption frequency of vegetables and fish.Conclusions:Having lunch at staff canteens is associated with the quality of the diet. To serve a cooked meal including vegetables during working time may be an efficient way to improve diet among adult employees. More emphasis should be put on increasing the possibility for employees to have lunch at staff canteens.

Background . Working conditions influence health, but previous studies on the associations between work-related factors and health behaviours are scarce. The aim of this study was to analyse whether unfavourable working conditions are associated with diet, physical activity, alcohol consumption, and smoking. Methods . The data derive from postal questionnaires collected in 2000–2001 from 40- to 60-year-old employees of the City of Helsinki ( n = 6243, response rate: 68%). Logistic regression analysis was used to examine health behaviours as outcomes. Job demands and job control, physically and mentally strenuous work, work fatigue, working overtime and satisfaction with work–home interface were independent variables, adjusted for age, education, occupational social class and marital status. Results . Most of the examined associations between working conditions and health behaviours were not statistically significant. Among women, mentally strenuous work and high job control were associated with a healthy diet. Work fatigue was associated with physical inactivity, whereas physically strenuous work and satisfaction with work–home interface were more often reported by physically active women. Work fatigue was associated with high drinking among men. Low job strain was reported by nonsmoking women, whereas working overtime was associated with nonsmoking among men. Conclusions . Working conditions were only weakly associated with health behaviours, and the associations varied for different health behaviours.

Obesity and poor long-term results of obesity treatment remain an interesting paradox in modern societies. Medical and social pressures to lose weight seem to be substantial, treatment is theoretically easy and many studies suggest that quality of life is improved among reduced-obese. Nevertheless, only few obese people lose weight permanently. The aim of my study was to explore the influence of obesity and weight loss on obese people's well-being and quality of life, to study success and failure to control weight and examine conditions associated with sustained weight loss. The study consisted of five sub-studies ranging from large population based surveys with record-based linkages to open interviews focusing on people's own descriptions of weight-related problems among obese and reduced-obese subjects. Results showed that gender-specific differences existed in weight-related problems. Excess body weight was associated with social and economic disadvantages, particularly among women. Weight loss maintenance required a constant battle against weight regain, and sustained weight loss was rare. In women, low initial well-being and health-compromising behaviour that improved after weight loss seemed to predict weight loss maintenance. In men, low level of stress, medical problems and health-related behaviour were associated with sustained weight loss. Permanent behavioural changes were required for sustainability of weight loss, and improvements in the quality of life were needed to compensate for sacrifices required by weight loss maintenance. Since adequate improvements in the well-being and quality of life were seldom experienced after weight loss, regain was understandable.

The aim of this study was to analyse accounts of successful weight loss maintenance. The data were gathered through open interviews of nine women who had kept 10–27 kg of weight off for at least seven years. Respondents were encouraged to discuss any topics they regarded as important. Interviews were tape-recorded, transcribed and analysed using qualitative methods influenced by grounded theory and narrative analysis. The core category or ‘main story’ centres around the construct of weight maintenance as an ongoing battle against weight regain. Women had to be reactive and proactive with constant monitoring, flexibility and specific strategies to deal with problematic situations. Despite rewards of weight loss maintenance (including improved self-esteem, better functional capacity and professional gains), these women felt different from other people and a tension between the obese past and the present day was evident.

OBJECTIVE: To describe factors associated with long-term maintenance of weight loss. DESIGN AND SUBJECTS: We identified initially overweight individuals (body mass index>27 kg/m2, n=911) from the nationwide Finnish Twin Cohort and studied those who lost at least 5% of their body weight between 1975 and 1981. Subjects who had maintained weight loss until 1990 (38 men, 17 women) were compared to both re-gainers (28 men, 26 women) and the other overweight subjects in the cohort. MEASUREMENTS: Self-report data on weight, height, health behaviours and perceived well-being; self-report and register-based data on health status and use of medication. RESULTS: Only 6% of all overweight individuals lost and maintained at least 5% weight loss. In men weight loss maintenance was associated with a low level of stress and health-promoting behaviours but also with medical problems. Failure to maintain weight loss seemed to be associated with stressful life and past high alcohol intake. In women weight loss maintenance was associated with low initial well-being and health-compromising behaviours that improved after weight loss. CONCLUSION: Long-term weight loss maintenance is rare. Predictors of weight loss maintenance are different between women and men.

Background Although an inverse relationship between socioeconomic status and body mass index (BMI) is well documented, broad population studies focusing on the association between BMI and various forms of disadvantage such as unemployment, low income or social isolation are rare. Methods A nationwide, representative sample of 25‐64-year-old Finnish subjects (n = 6016) was classified according to their BMI into four groups: ‘thin’ (BMI ,20), ‘normal’ (BMI 20‐24.9), ‘overweight’ (BMI 25‐29.9) and ‘obese’ (BMI >30). Multivariable analyses using logistic regression were conducted with this BMI-grouping as an independent variable to predict social and economic disadvantage, controlling simultaneously for age, educational attainment, region of residence, and limiting long-standing illness. Results In women, overweight was associated with current unemployment and obesity with long-term unemployment as well as absence of close friends outside the family circle. Both overweight and obesity were associated with low individual earnings. Obese women were also most likely to have low household disposable and individual incomes; a similar pattern was seen among thin women. A small subgroup of thin men were socially and economically disadvantaged with all our indicators whereas excess body weight was not problematic for men. Conclusions Deviant body weight is associated with social and economic disadvantage in a gender-specific and partly curvilinear way. In particular, obese women face multiple social and economic disadvantage.

The tendency for obese people to relapse and regain the weight they have lost constitutes a serious problem in obesity treatment. The present study is an attempt to analyse obesity narratives to characterize the complex interrelationship between relapses and sociocultural factors. In-depth interviews were obtained from 90 obese subjects who were applying for weight loss programmes or seeking help for obesity-related problems. The social constructionist version and application of grounded theory was used to analyse the stories told by the subjects about their obesity experiences. Three main strategies to explain weight gain and relapses after weight-loss periods were identified: deprivation of supervision, anti-dieting values and isolation and unfulfilled dreams. These strategies emphasize the impact of social control, weight-related values and attitudes as well as unrealistically high hopes connected to weight loss. The results indicate that the social environment plays an important role in weight-related issues and social reactions to weight changes are difficult to handle, irrespective of the nature of the reactions. Obesity narratives present the explanations and justifications for previous failures and reflect the obese persons' understanding of their experiences in diverse social contexts.

To analyse determinants of long-term weight maintenance we studied energy expenditure, dietary intake, eating behaviour and psychological symptoms of 9 women (SS, BMI = 26.6) who reached their ideal weight during 1985-86 and were still an average 16.2 kg below their original weight in 1993. Controls were 42 obese, non-reducing females (OC, BMI = 34.8). Dietary intake was calculated from four-day food records. Dietary restraint was assessed by the Three-Factor Eating Questionnaire (TFEQ) and symptoms of bulimia or binge eating by Bulimic Investigatory Test, Edinburgh (BITE). Physical exercise was estimated by open interviews, resting metabolic rate (RMR) by indirect calorimetry and body composition by bioelectrical impedance. Psychological characteristics were studied using the Defense Style Questionnaire (DSQ), Beck Depression Inventory (BDI) and Symptom Checklist (SCL-90). SS had lower RMR (1320 kcal vs. 1540 kcal, p = 0.004), lower daily energy intake (1208 kcal vs. 1525 kcal, p = 0.020) and higher scores for dietary restraint (14.6 vs. 8.4, p = 0.002) than OC. Restraint scores correlated negatively with energy intake and RMR in both groups, especially in SS (r = -0.75, p = 0.021 and r = -0.87, p = 0.002, respectively). Attempts to incorporate habitual physical activities to daily life (89% vs. 39%, p = 0.011) and weekly sports hobbies (67% vs. 13%, p = 0.002) were more often reported by SS. The scores of BITE, DSQ, BDI and SCL-90 were within normal range in both groups but SS had higher scores in most measures, especially for anxiety (16.4 vs. 14.3, p = 0.045). In conclusion, long-term maintenance of weight loss was associated with highly restrained eating, regular physical activity, and perhaps with increased anxiety.

Background: Due to vitamin D intake below recommendation (10 µg/day) and low (

We examined the associations of emotional eating and depressive symptoms with the consumption of sweet and non-sweet energy-dense foods and vegetables/fruit, also focusing on the possible interplay between emotional eating and depressive symptoms. The participants were 25–64-year-old Finnish men ( n = 1679) and women ( n = 2035) from the FINRISK 2007 Study (DILGOM substudy). The Three-Factor Eating Questionnaire-R18, Center for Epidemiological Studies Depression Scale, and a 132-item Food Frequency Questionnaire were used. Emotional eating and depressive symptoms correlated positively ( r = 0.31 among men and women), and both were related to a higher body mass. Emotional eating was related to a higher consumption of sweet foods in both genders and non-sweet foods in men independently of depressive symptoms and restrained eating. The positive associations of depressive symptoms with sweet foods became non-significant after adjustment for emotional eating, but this was not the case for non-sweet foods. Depressive symptoms, but not emotional eating, were related to a lower consumption of vegetables/fruit. These findings suggest that emotional eating and depressive symptoms both affect unhealthy food choices. Emotional eating could be one factor explaining the association between depressive symptoms and consumption of sweet foods, while other factors may be more important with respect to non-sweet foods and vegetables/fruit.

Objective: To examine the association of smoking with recurrent dieting and BMI among Finnish adults. Research Methods and Procedures: We used questionnaire data from 1990 on 11,055 subjects from the Finnish Twin Cohort who were 33 to 61 years of age. Multinomial logistic regression analysis was carried out using lifetime dieting as the outcome variable and smoking as the main explanatory variable, adjusted for BMI and age. Twin pairs discordant for dieting and smoking were studied to examine the effect of environmental and genetic factors. Results: Among women, current smokers [odds ratio (OR), 1.09 to 1.41 at different ages] and former smokers (OR, 1.52 to 2.82) were more likely to have dieted recurrently than never smokers. Among men, current smokers were less likely (OR, 0.69; 95% confidence interval, 0.55, 0.87) and former smokers were more likely (OR, 1.30; 95% confidence interval, 1.05, 1.61) to have dieted recurrently at different ages. The differences between the discordant pairs were consistent with this, although not statistically significant. Discussion: Recurrent dieting was associated with former smoking in both sexes and with current smoking in women.

Objectives: To examine whether high relative weight increases the risk of future sickness absence and to what extent any differences in short and long absence periods can be explained by specific obesity-related disorders, general health, and working conditions. Research Methods and Procedures: The study included 5386 female and 1452 male employees of the city of Helsinki surveyed in 2000 to 2002. Survey data were linked to sickness absence records until the end of 2004 (mean follow-up time 2.9 years). Results: Women and men with higher relative weight had clearly more short (1 to 3 days) and long (>3 days) periods of sickness absence during follow-up. The associations were rather monotonic and stronger for long periods. In women, adjusting for arthrosis and gout decreased the excess risk of long periods among those who were obese. In men, arthrosis, gout, and metabolic disease explained some of the excess risk for both short and long periods among the obese. Adjusting for physical functioning and self-rated health decreased the excess risk for short and long periods of sickness absence among obese women and men. Working conditions had almost no effect on the association between BMI and short or long periods of sickness absence. Discussion: Obesity increases the risk of having short and long periods of sickness absence. This finding can be partly explained by measures of general health and specific obesity-related disorders. Healthy weight maintenance is a crucial issue in promoting occupational functioning and minimizing the costs associated with sickness absence.

ObjectiveThis study examines the relationship between family–work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors.Design and settingCross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40–60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work–family conflicts and family–work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load.ResultsWomen reporting strong work–family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19–1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93–1.55)). Women and men with strong family–work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61–0.92), men OR 0.57 (0.34–0.96)). Women and men with strong work–family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60–0.96), men OR 0.54 (0.34–0.87)). Additionally, women with strong family–work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63–0.94)). Adjusting for family and work-related factors did not affect these associations.ConclusionsConflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.

Sirpa Sarlio-Lahteenkorva says that a specific tax on sugar would reduce consumption, but Jack Winkler thinks that such taxes are politically unpalatable and would have to be enormous to have any effect

Objective: To examine the association between relative body weight and health status and the potential modifying effects of socioeconomic position and working conditions on this association. Research Methods and Procedures: The data were derived from three identical cross-sectional surveys conducted in 2000, 2001, and 2002. Respondents to postal surveys were middle-aged employees of the City of Helsinki (7148 women and 1799 men, response rate 67%). BMI was based on self-reported weight and height. Health status was measured by the Short-Form 36 subscales and component summaries. Results: Body weight was inversely associated with physical health, but in mental health, differences between BMI categories were small and inconsistent. In women, physical health deteriorated monotonically with increasing BMI, whereas in men, poor physical health was found among the obese only. Socioeconomic position did not modify the association between BMI and health. In women, the association between body weight and physical health became stronger with decreasing job control and increasing physical work load, whereas in men, a similar modifying effect was found for high job demands. Discussion: Body weight was associated with physical health only. Lower levels of relative weight in women than in men may be associated with poor physical health. High body weight combined with adverse working conditions may impose a double burden on physical health.

Objective: To examine socioeconomic differences in obesity using several different socioeconomic indicators, ranging from childhood socioeconomic environment and adult socioeconomic status to material resources and economic satisfaction. Research Methods and Procedures: The data derived from the Helsinki Health Study baseline surveys in 2000 and 2001. Respondents to postal surveys were middle-aged employees of the City of Helsinki (4, 975 women and 1, 252 men, response rate 68%). Associations between eight socioeconomic indicators and obesity (BMI ≥ 30 kg/m2), calculated from self-reported data, were examined by fitting a series of logistic regression models. Results: In women, all socioeconomic indicators except household income and economic satisfaction were associated with obesity. Parental education and childhood economic difficulties, i.e., socioeconomic conditions in childhood, remained associated with obesity after adjusting for all indicators of current socioeconomic position. Indicators of adult socioeconomic status, own education and occupational class, were no longer associated with obesity when childhood socioeconomic conditions were adjusted for. Home ownership and economic difficulties were associated with obesity after full adjustments. In men, the findings paralleled those among women, but few associations reached statistical significance. Discussion: Obesity was associated with several dimensions of socioeconomic position. Childhood socioeconomic disadvantage was associated with obesity independently of the various indicators of current socioeconomic position. Associations between obesity and both educational level and occupational class disappeared after adjustment for other indicators of socioeconomic position. This suggests that the variation observed in the prevalence of obesity by these key socioeconomic indicators may reflect differences in the related material resources.

Objective: Information on weight satisfaction in Eastern Europe is limited. This study compares relative weight, weight satisfaction and self-esteem of teenagers living in two post-Soviet capitals, Moscow and Tallinn, and a western capital Helsinki. Method: Classroom surveys including data about weight and height, weight satisfaction and selfesteem among 15-18-year-old girls (n=911) and boys (n=650) collected in 1994-95. Results: Body mass index and self-esteem were highest in Helsinki. Nevertheless, feelings of overweight were most common among Tallinn girls and feelings of over- and underweight among Muscovite girls. Boys were mostly satisfied with their current weight with no differences between cities. Low self-esteem was associated with feelings of overweight among girls and underweight among boys. Discussion: Somewhat unexpectedly, girls grown in non-western cultures were more dissatisfied with their weight than girls in Helsinki. These findings may partly be attributable to rapid economic and cultural transformations that were occurring in these countries during the study period.

To examine how thinness is associated with indicators of socio-economic disadvantage, health-related behaviours, and health indicators including mortality.Independent risk factor surveys carried out in four geographic areas in Finland in 1982, 1987, 1992, and 1997, with mortality follow-up to the end of the year 2001.A total of 13 389 men and 14 770 women aged 25-64 y at baseline, and 2077 deaths during the follow-up when subjects who have died during the first 5 y were excluded.A self-administrative questionnaire data on socio-economic status, health behaviour, and perceived health, together with measured height, weight, and metabolic indicators using standardised protocol. Mortality data by Statistics Finland were linked to the baseline surveys.Thin men (BMI/=20 kg/m(2)) were the socio-economically disadvantaged group engaged in adverse health behaviours. They also reported poorer perceived health despite having better metabolic indicators. Thin women reported more adverse behaviours than other women and had better metabolic profile than their obese counterparts. Thin subjects had higher mortality, but results become nonsignificant among men when first 5 y of follow-up were excluded, and nonsignificant among women when health behaviours were adjusted for.Thinness is associated with good metabolic profile but increased mortality, explained partly by underlying diseases or adverse behaviours. Thinness in men is associated with socio-economic disadvantage.

The aim of this study was to examine the association between mental health and recommended food habits among employed middle-aged women and men. A mail survey including data on mental health and intake of food items was collected from 40 to 60-year-old women (n=4991) and men (n=1252) employed by the City of Helsinki. The participants' current mental health status was assessed by the General Health Questionnaire 12-item version and categorised into 'poor' (score 3-12) and 'normal' mental health (score 0-2). Multivariable logistic regression analyses were conducted using this categorisation as an independent variable to predict recommended food habits among women and men. All analyses first adjusted for age and lifetime mental diagnosis, secondly socio-economic status variables, and thirdly health behaviours. Women having poor mental health were less likely than their healthier counterparts to report consuming fresh vegetables, fresh fruits, low-fat milk and low-fat cheese on a daily basis, and cereals or porridge at least five times a week. Men having poor mental health reported consuming less frequently fresh fruits and dark bread. Except for cereals and dark bread, these results remained statistically significant in the fully adjusted model. The results suggest that poor mental health is associated with unhealthy food habits.

While serious mental disorders typically show socioeconomic differences similar to physical illness-that is, that lower positions imply poorer health-differences for common mental disorders have been inconsistent. We aim to clarify the associations and pathways between measures of socioeconomic circumstances and common mental disorders by simultaneously analysing several past and present socioeconomic measures. The data were derived from middle-aged women and men employed by the City of Helsinki. Cross-sectional surveys were conducted in 2000-2002 among employees who, during each year, reached 40, 45, 50, 55 or 60 years of age. The pooled data include 8970 respondents (80% women; response rate 67%). Common mental disorders were measured by GHQ-12 and the SF-36 mental component summary. Seven socioeconomic measures were included: parental education, childhood economic difficulties, own education, occupational class, household income, home ownership, and current economic difficulties. Logistic regression analysis was used to examine associations between the socioeconomic circumstances and common mental disorders. Past and present economic difficulties were strongly associated with common mental disorders, whereas conventional past and present socioeconomic status measures showed weak or slightly reverse associations. Adjusting for age and gradually for each socioeconomic measure did not affect the main findings, which were very similar for women and men, as well as for both measures of common mental disorders. While the associations of conventional socioeconomic status measures with common mental disorders were weak and inconsistent, our results highlight the importance of past and present economic difficulties to these disorders.

Fears and experiences of food restriction influence eating behavior but the association between past and present economic disadvantage, food insecurity and body size is poorly understood. Therefore, we examined these associations in a nationwide, representative sample of 25- to 64-y-old Finnish men and women (n = 6506). The respondents were classified by their body mass index (BMI) into four groups: thin, normal, overweight and obese. Economic disadvantage was assessed by three indicators including low household income, unemployment during past 5 y and long-term economic problems in childhood. Food insecurity was assessed by five separate items concerning economic fears and experiences related to sufficient supply of food during the past 12 mo, and a combined scale in which those with affirmative responses to four to five items were classified as hungry. Multivariable logistic regression analyses were conducted using both the BMI grouping and indicators of economic disadvantage as independent variables to predict food insecurity, controlling simultaneously for age, educational attainment and sex. The results showed that low household income, recent unemployment and economic problems in childhood were all predictors of food insecurity. Thin people were most likely to be hungry and showed most food insecurity in five separate items. In addition, obese people reported more buying cheaper food due to economic problems and fears or experiences of running out of money to buy food than did normal weight subjects. In conclusion, both past and present economic disadvantage is associated with various aspects of food insecurity. The association between food insecurity and BMI is curvilinear.