Factors Associated with the Prevalence of Thyroid Nodules and Goiter in Middle-Aged Euthyroid Subjects.

The aim of the present study was to determine associations of thyroid hormone levels and different metabolic parameters and anthropometric measurements with volume of nodular and nonnodular thyroid as well as with prevalence of goiter and thyroid nodules in middle-aged euthyroid subjects. Methods. The study consisted of 317 euthyroid subjects aged 48-49 from the Kaunas Cardiovascular Risk Cohort study. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and antithyroid peroxidase antibody (ATPO) levels, as well as anthropometric and metabolic parameters and smoking information, were evaluated. Results. In subjects with and without thyroid nodules, thyroid volume correlated with components of metabolic syndrome, body mass index (BMI), smoking, and TSH levels. In the nonnodular thyroid group, thyroid volume was also positively related to serum insulin and HOMA-IR, whereas a negative correlation between thyroid volume and leptin was identified in the nodular thyroid group. The goiter was identified in 12.3% of subjects. Female gender, thyroid nodules, smoking, BMI, and levels of TSH were independent predictors for goiter. Thyroid nodules were found in 31.2% of participants. Female gender, higher TSH levels, and thyroid volume were independent risk factors for thyroid nodules. Conclusions. Female gender, thyroid nodules, smoking, BMI, and TSH levels were identified as potential predictors of goiter. Female gender, TSH levels, and thyroid volume predicted the presence of thyroid nodules.

Trends in major risk factors and mortality from main non-communicable diseases in Lithuania, 1985-2013.

BACKGROUND: This study aimed to assess the trends in the prevalence and levels of risk factors and mortality from main non-communicable diseases in the Lithuanian population aged 45-64 years during 1985 to 2013. METHODS: Data from four general population surveys conducted between 1985 and 2008 were used. All these surveys were carried out in Kaunas city and five randomly selected municipalities of Lithuania. Risk factors measured at each survey included regular smoking, overweight, obesity, arterial hypertension, and high levels of blood lipids. In total, data of 10,719 subjects (4,965 men and 5,754 women) aged 45-64 were analysed. Trends in standardized all-cause mortality and mortality from cardiovascular disease (CVD), coronary heart disease (CHD), and malignant neoplasms were estimated for both sexes by joinpoint regression analysis. RESULTS: In 1985-2013, some favourable trends were observed in the age-standardized mean levels and prevalence of risk factors and mortality from main non-communicable diseases in the Lithuanian middle-aged population. The mean values of blood lipids (with the exception of triglycerides) and the prevalence of dyslipidemias declined. In women, mean levels of systolic blood pressure and body mass index decreased, while in men, the levels of these factors increased. The prevalence of arterial hypertension and obesity increased in men. The proportion of obese women decreased. Smoking prevalence increased in both men and women. From 2007 to 2008, significant downward trends, which were steeper in women than in men, were observed in all-cause, CVD, and CHD mortality. CONCLUSIONS: Despite the favourable changes in some risk factors and mortality rates, the prevalence of risk factors and mortality from main non-communicable diseases in Lithuania are still high. This indicates the importance of the ongoing primary and secondary prevention and optimal treatment of these diseases.

Associations between risk factors in childhood (12-13 years) and adulthood (48-49 years) and subclinical atherosclerosis: the Kaunas Cardiovascular Risk Cohort Study.

BACKGROUND: The data on the childhood determinants of adult cardiovascular disease (CVD) are lacking in populations of Eastern Europe that are characterised by substantially high CVD mortality. From a public health perspective, it is important to identify high-risk individuals as early as possible in order to have the greatest benefit of preventive interventions. The aim of this study was to evaluate the associations of childhood and adulthood traditional risk factors with subclinical atherosclerosis and arterial stiffness in a Lithuanian cohort followed up for 35 years. METHODS: The study cohort consisted of 380 adults aged 48-49 from Kaunas Cardiovascular Risk Cohort study, who were followed up since childhood (12-13 years). The baseline survey (1977) included blood pressure (BP) and anthropometric measurements and sexual maturity scale. In the follow-up survey (2012), BP, anthropometric and lipids measurements, interview about smoking, measurement of carotid intima-media thickness (IMT) and determination of pulse wave velocity (PWV) were performed. Two types of general linear models were applied to test the associations of childhood and adulthood risk factors with IMT and PWV. Model 1 included only childhood variables. In model 2, adulthood variables were added to childhood variables. RESULTS: In linear regression model with childhood variables childhood systolic BP (ß = 0.014; p = 0.016) and BMI (ß = 0.006; p = 0.003) were directly associated with IMT only in women. When adulthood variables were included into regression model, the association between childhood systolic BP and IMT remained significant (ß = 0.013; p = 0.021), while childhood BMI was not associated with IMT (ß = 0.003; p = 0.143). Additionally, association of adult smoking and IMT was found in women (ß = 0.033; p = 0.018). IMT of men was directly related to adult systolic BP (ß = 0.022; p = 0.018) and inversely to HDL cholesterol level (ß = -0.044; p = 0.021). PWV was directly associated only with adult systolic BP in both genders (ß = 0.729 for men and ß = 0.476 for women; p = 0.001). CONCLUSIONS: Sex differences in the associations between childhood and adulthood risk factors and subclinical atherosclerosis were found. The results of the study support efforts to reduce conventional risk factors both in childhood and adulthood for the primary prevention of atherosclerosis.

The effect of tobacco control policy on smoking cessation in relation to gender, age and education in Lithuania, 1994-2010.

BACKGROUND: This study aimed to evaluate the association between tobacco control policies and trends in smoking cessation according to gender, age and educational level in Lithuania in 1994-2010. METHODS: The data were obtained from nine cross-sectional postal surveys conducted biennially within the framework of Finbalt Health Monitor project during 1994-2010. Each survey was based on a nationally representative random sample drawn from the National population register. The sample consisted of 3000 citizens aged 20-64 in 1994-2008 surveys and 4000 in the 2010 survey. In total, 17161 individuals participated in all surveys. The development of tobacco control policy in Lithuania was assessed using the Tobacco Control Scale (TCS). The association of the TCS scores with short-term and long-term quitting according to gender, age and education was examined using logistic regression analysis with control for secular trends. RESULTS: Over the last two decades, a large improvement in the development of tobacco control policy has been achieved in Lithuania. At the same time, this progress was associated with the increase in smoking cessation. A significant increase in both short-term and long-term quit ratios was found among people aged 20-44. An increase by 10 points on the TCS was associated with 17% increase in the odds of short-term quitting and with 15% increase in the odds of long-term quitting. The association between tobacco control policies and long-term quitting was stronger among younger than older people. No differential effect of tobacco control policies on smoking cessation was found in relation to gender and educational level. CONCLUSIONS: The improvement in Lithuanian tobacco control policies was associated with an increase in smoking cessation in long-term perspective. These policies have not only benefitted highly educated groups, but lower educated groups as well. Nonetheless, further development of comprehensive tobacco control policies is needed in order to decrease social inequalities in smoking cessation.

Anthropometric measurements in childhood and prediction of cardiovascular risk factors in adulthood: Kaunas cardiovascular risk cohort study.

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

[Dietary patterns and their association with lifestyle factors in Lithuanian adult population]. / Lietuvos gyventoju mitybos iprociu ir gyvensenos veiksniu sasajos.

The aim of this study was to determine the association between dietary patterns and others lifestyle factors. In 1998-2004, four cross-sectional surveys were carried out within the FINBALT HEALTH MONITOR project. For every survey, a random sample of 3000 Lithuanians, aged 20-64 years, was taken from the National Population Register. The response rates varied from 61.7% to 74.4%. The study material was collected by mailed questionnaires. The 20 food groups were included into food frequency questionnaire. Factor analysis was employed in order to reduce the number of food items. Four main factors were identified: "Light food," "Sweets," "Heavy food," and "Cereals." They accounted for 46% of total variance in food intake in men and women. The associations between dietary patterns and lifestyle factors were examined by applying logistic regression analysis. Nonsmokers, physical active people, wine drinkers, and men consuming beer were more likely to follow the "Light food" pattern (consumption of fresh vegetables, fruits, chicken, and fish). People having positive values of the "Cereals" pattern smoked and drank alcohol less often and were more physical active than those with negative values of the factor. "Heavy food" factor was associated with daily smoking and drinking of strong alcohol in men and drinking of beer in women. The consumers of strong alcohol and people less physically active in leisure time were more likely to follow "Sweets" pattern. CONCLUSIONS. Nutrition habits were related to lifestyle factors. Men and women who followed the "Cereals" pattern have the healthiest lifestyle.

Association between educational level and vegetable use in nine European countries.

OBJECTIVE: The relationship of socio-economic status and vegetable consumption is examined in nine European countries. The aim is to analyse whether the pattern of socio-economic variation with regard to vegetable consumption is similar in all studied countries with high v. low vegetable availability and affordability, and whether education has an independent effect on vegetable consumption once the effects of other socio-economic factors have been taken into account. DESIGN: The data for the study were obtained from national surveys conducted in Finland, Denmark, Germany, Estonia, Latvia, Lithuania, France, Italy and Spain, in 1998 or later. These surveys included data on the frequency of use of vegetables. Food Balance Sheets indicated that the availability of vegetables was best in the Mediterranean countries. The prices of vegetables were lowest in the Mediterranean countries and Germany. RESULTS: Educational level was positively associated with vegetable consumption in the Nordic and Baltic countries. In the Mediterranean countries, education was not directly associated with the use of vegetables but, after adjusting for place of residence and occupation, it was found that those with a lower educational level consumed vegetables slightly more often. Manual workers consumed vegetables less often than non-manual workers, but otherwise there was no systematic association with occupation. CONCLUSIONS: The Mediterranean countries did not show a positive association between educational level and vegetable consumption. The positive association found in the Northern European countries is linked to the lower availability and affordability of vegetables there and their everyday cooking habits with no long-standing cultural tradition of using vegetables.

Female ever-smoking, education, emancipation and economic development in 19 European countries.

Large differences in ever-smoking rates among women are found between countries and socio-economic groups. This study examined the socio-economic inequalities in female ever-smoking rates in 19 European countries, and explored the association between cross-national differences in these inequalities and economic development and women's emancipation. Data on smoking were derived from national health interview surveys from 19 European countries. For each country, age group (25-39, 40-59 and 60+ years), educational level (4 standard levels), and cumulative ever-smoking rates were calculated as the proportion of current and former smokers of the total survey population. A Relative Index of Inequality was estimated for women in the three age groups to measure the magnitude of educational differences. In regression analyses the association of ever-smoking rates of women age 25-39 years with the gross domestic product (GDP) and the Gender Empowerment Measure (GEM) was explored. Less educated women aged 25-39 years were more likely to have ever smoked than more educated women in all countries, except Portugal. In the age groups 40-59 years the educational pattern differed between countries. Women aged 60+ years who were less educated were less likely to have ever smoked in all countries, except Norway and England. The size of inequalities varied considerably between countries and reversed within three age groups. For women 25-39 years, the association of ever-smoking rates with GDP was positive, especially for more educated women. The association of ever-smoking rates with GEM was positive for less educated women, but negative for more educated women. The results are consistent with the idea that economic development and social-cultural processes related to gender empowerment have affected the diffusion of smoking in different ways for more and less educated women.

Dietary patterns and their association with sociodemographic factors in Lithuanian adult population.

SUMMARY: The aim of the study was to determine the association between dietary patterns and sociodemographic factors using the data of Lithuanian health behavior monitoring. MATERIAL AND METHODS: In 1998-2004, four cross-sectional surveys were carried out within the Finbalt Health Monitor project. For every survey, a random sample of 3000 Lithuanians aged 20-64 years was taken from the National Population Register by mailed questionnaires. The response rates varied from 61.7% to 74.4%. Factor analysis was employed in order to reduce the number of food items. Four main factors were defined: "light food," "sweets," "heavy food," and "cereals" factors. The associations between dietary patterns and sociodemographic factors were examined by applying a logistic regression analysis. RESULTS: Four major factors accounted for 45.9% of the total variance in food intake in men and 46.5% in women. The "sweets" factor was inversely associated with age both in men and women. A strong positive association was found between age and the "cereals" factor. Men and women with a higher level of education were more likely to follow "light food" and "sweets" pattern and less likely "heavy food" if compared with people with a lower level of education. The odds of consuming "light food" were higher in cities than in rural areas. Married men and women were more likely to follow "heavy food" pattern compared to unmarried. CONCLUSION: This study identified four main dietary patterns in Lithuanian population. Dietary patterns of people with a higher level of education and inhabitants of cities are closer to the recommendations on healthy nutrition.

Risk factors for noncommunicable diseases in Lithuanian rural population: CINDI survey 2007.

UNLABELLED: The aim of the study was to assess the risk profile for noncommunicable diseases in Lithuanian rural population. MATERIAL AND METHODS: Within CINDI program, the risk factor survey was carried out in five rural regions of Lithuania in random sample of population aged 25-64 years in 2007. The risk factors were defined according to the WHO criteria. A total of 1739 participants were enrolled in the study. RESULTS: The prevalence of hypertension was considerably higher among men than among women (60.3% and 44.6%, respectively). Hypercholesterolemia was identified in half of examined persons with no gender difference. The proportion of obese female persons was greater than male. Metabolic syndrome was diagnosed in 15.1% of men and in 21.5% of women. The significant gender difference was observed in the prevalence of regular smoking (47.5% in men and 18.1% in women) as well as risky alcohol consumption (26.7% of men and 3.1% of women). The majority of rural population was lacking leisure-time physical activity. The prevalence of hypertension, hypercholesterolemia, obesity, and metabolic syndrome was increasing with age in both men and women. Regular smoking and risky alcohol consumption were more common among younger than older population. Leisure-time physical activity tended to increase with age. CONCLUSIONS: The prevalence of risk factors for noncommunicable diseases in Lithuanian rural population is high. The obtained data prove that comprehensive and intersectorial preventive actions aimed at the reduction in the risk of noncommunicable diseases are urgently needed in Lithuania.

Matrix metalloproteinase-3 gene polymorphism and dilatative pathology of ascending thoracic aorta.

Matrix metalloproteinase-3 (MMP-3) degrades extracellular matrix and may lead to development of dilatative pathology of ascending thoracic aorta. Expression of MMP-3 depends upon the 5A/6A polymorphism in the promoter region. An increased number of 5A alleles leads to high expression of MMP-3. Thus, objective of the study was to determine whether the 5A/6A polymorphism in the promoter region of MMP-3 gene is associated with the development of dilatative pathology of ascending thoracic aorta. We studied 76 patients (age ranged from 31 to 81 years; median age, 64 years) who underwent aortic reconstruction surgery due to dilatative pathology of ascending thoracic aorta and a random sample of the population (n=604) aged 25-64 years, all from Lithuania. DNA was analyzed by using real-time polymerase chain reaction to genotype polymorphism 5A/6A at a position -1171 of the MMP3 gene promoter. The prevalence of MMP-3 genotypes was similar in the group of dilatative pathology of ascending thoracic aorta and random sample of population. The frequency of 5A allele did not differ significantly between both groups and was 0.506 and 0.514, respectively. Male carriers of 5A/5A genotype were significantly younger compared with those with the 6A/6A genotype. In conclusion, the frequency of MMP-3 promoter 5A/6A genotypes did not differ between the group of patients with dilatative pathology of ascending thoracic aorta and the random sample of population, but the males with dilatative pathology of ascending thoracic aorta and 5A/5A genotype required aortic reconstruction surgery at the younger age than the males carrying 6A/6A genotype in the MMP-3 promoter region.

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

OBJECTIVE: To examine educational differences among people who consume foods containing fat in Finland and the Baltic countries. DESIGN: Data were collected from cross-sectional postal Finbalt Health Monitor surveys that were carried out in 1998, 2000 and 2002. SETTING: Estonia, Finland, Latvia and Lithuania. SUBJECTS: For 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). RESULTS: Differences 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. CONCLUSIONS: The 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.

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

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.

Sociodemographic and health behaviour factors associated with obesity in adult populations in Estonia, Finland and Lithuania.

BACKGROUND: The aim of this study was to analyse the pattern of sociodemographic variations in the prevalence of obesity in Estonia, Finland and Lithuania. In addition, the association between obesity and selected health behaviours was examined. METHODS: Cross-sectional surveys were conducted among representative national samples of adult populations in 1994, 1996 and 1998. The number of participants aged 20-64 was 3759 in Estonia, 9488 in Finland and 5635 in Lithuania. The data were obtained from mailed questionnaires (covering sociodemographic characteristics, health behaviour indicators, and self-reported height and weight). Obesity was defined as BMI > or = 30 kg/m2. RESULTS: The prevalence of obesity among men and women was 10% and 15% in Estonia, 11% and 10% in Finland, and 10% and 18% in Lithuania respectively. The prevalence of obesity increased only among Estonian men. Obesity was more prevalent among those aged over 50 in all three countries. It was also more prevalent among the less educated women in all countries and among the less educated men in Finland. Obesity was less prevalent among daily smokers among Estonian men and women and Lithuanian men. Physically inactive Estonian women and Finnish men and women were more likely to be obese. CONCLUSIONS: A significant association was found between low educational level and obesity in women in all the countries, but this association was found for men only in Finland. In Finland obesity was also more consistently associated with indicators of unhealthy behaviour than in Estonia and Lithuania. Thus, even though the social gradient of obesity was broadly similar in all the countries studied, differences emerged with regard to the behavioural correlates of obesity.

Health inequalities in Lithuania: education and nutrition habits.

The aim of the study was to evaluate the associations between food behavior and educational level among Lithuanian adult population. Five health behavior surveys were carried out within the international Finbalt Health Monitor project in 1994-2002. For every survey the national random sample of 3000 inhabitants aged 20-64 was taken from the National Population Register. The study material was collected through mailed questionnaires covering sociodemographic characteristics and some nutrition habits. The respondents were categorized according to the level of education into three groups: persons having incomplete secondary, secondary and university education. Multiple regression analysis was used for evaluation of associations between level of education and nutrition habits. The persons with university education have a healthier diet than those with incomplete secondary education. The consumption of fish, vegetables and fruit, use of vegetable oil for cooking, was substantially higher in those with university education as compared to persons with incomplete secondary education. The proportion of persons drinking whole milk was the highest among the low educated men and women. The high-educated women consumed meat less often than those with incomplete secondary education did. However, persons with university education preferred butter on bread. The high-educated men consumed cheese daily more often than those with low education. The positive trends in nutrition habits of Lithuanians were observed between 1994 and 2002. However, educational differences in nutrition habits still remain significant. In conclusion, alongside with other health interventions, the programs aimed at reducing inequalities in health should consider the educational differences in nutrition habits of Lithuanians paying more attention to less educated persons.

Changes in health behavior of Lithuanian adolescents and adults over 1994-2002.

UNLABELLED: The aim of the study was to investigate the time trends in health behavior during the period 1994-2002 in Lithuanian schoolchildren and adult population. The data on smoking, alcohol drinking, consumption of fresh vegetables and fruits, physical activity habits are presented in the article. The study material was collected in 1994, 1998 and 2002 within the framework of two international projects: Health Behavior in School-aged children coordinated by WHO and Finbalt Health Monitor assessing health behavior among adults in Finland and Baltic countries. The data of our study showed that since 1994 prevalence of smoking substantially increased among Lithuanian teenagers aged 11-15 years and adult women. The increase in alcohol consumption was recorded in schoolchildren as well as in adult population. The adults started eating fresh vegetables and fruits more frequently while the usage of fresh fruits among teenagers declined. In 2002 70% of schoolboys and 45% of schoolgirls were physically active. There were no changes in physical activity among teenagers over the period of the study. The proportion of physically active persons in adult population has increased since 1994. CONCLUSION: The health behavior is unhealthy in large proportion of Lithuanian teenagers and adults. The negative trends in health behavior especially among teenagers may increase the risk of noncommunicable diseases in Lithuanian population. Therefore the elaboration and implementation of effective health promotion programs, which should start in early childhood and would be adopted to the needs of different age groups, is urgently needed.

Association between health behaviour and self-reported health in Estonia, Finland, Latvia and Lithuania.

BACKGROUND: The aim of the present study is to examine the associations of the selected health behaviours (daily smoking, frequent strong alcohol use, consumption of fresh vegetables less than 3 days a week and leisure time physical activity less than two/three times a week) to the self-assessed health after adjustment to the age and education in Estonia, Finland, Latvia and Lithuania. METHODS: Data from cross-sectional surveys carried out in all the above-mentioned countries were used. The methodology and questionnaires of the surveys were standardized between the participating countries within the Finbalt Health Monitor System. Logistic regression was used to assess the effect of self-perceived health status on prevalence of health behaviours. RESULTS: In Finland both women and men rated their health better than both genders in all the Baltic countries. In Finland self-assessment of health is significantly associated with most health behaviours, but in the Baltic counties the associations are weak or unstable. CONCLUSION: The results suggest that in Finland as in many other stable countries self-assessed health status was related to health behaviours and can be used as an indicator of health behaviours. In the Baltic countries, factors other than health behaviours may be more relevant to the self assessment of health status.

Health behaviour in Estonia, Finland and Lithuania 1994-1998. Standardized comparison.

BACKGROUND: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. METHODS: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. RESULTS: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. CONCLUSIONS: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.

Prevalence of dyslipidemias among Lithuanian rural population (CINDI program).

The aim of this study is to describe trends in serum total, low and high density lipoprotein cholesterol, triglycerides and nutrition habits in Lithuanian rural population between 1987 and 1999. The article presents the data of three screenings of random samples of the population aged 25-64 of five Lithuanian rural regions. Since 1987 the prevalence of hypercholesterolemia has decreased. The greatest decrease was observed in the proportion of persons with elevated level of low-density lipoprotein cholesterol. The prevalence of low level of high-density lipoprotein cholesterol decreased more significantly among women compared to men. The most remarkable changes in the prevalence of dyslipidemias were observed between 1993 and 1999. The increasing age was strongly correlated with higher prevalence of hypercholesterolemia in both genders. The prevalence of hypercholesterolemia was higher among men with higher education, overweight, hypertension and smokers than among those with low education, normal weight, normal level of blood pressure and nonsmokers. In women hypercholesterolemia was associated only with hypertension. The nutrition habits of Lithuanian rural population have changed, especially over the last five years. The consumption of animal fat has decreased and the usage of vegetable oil and margarine has increased. Women increased consumption of vegetables and fruits. The strengthening of favorable trends in nutrition habits in Lithuanian population should be one of the most important strategies in the implementation of cardiovascular disease prevention programs.

[Trends in the prevalence of risk factors of noncommunicable diseases during 1987-1999]. / Letiniu neinfekciniu ligu rizikos veiksniu paplitimo pokyciai 1987-1999 metais.

The trends in the prevalence of hypertension, hypercholesterolemia, overweight and smoking among Lithuanian rural population were assessed from 1987 to 1999. Three independent surveys in 1987, 1993 and 1999 were carried out in five rural regions of Lithuania in random samples of men and women aged 25-64 involving 2695, 1550 and 1838 persons respectively. The risk factors were defined according to the WHO criteria. During the 13 years the prevalence of hypercholesterolemia and overweight has significantly decreased among men (by 23.2% and 4.9% respectively) as well as among women (by 19.9% and 10.7% respectively). The prevalence of hypertension among women has decreased by 9.1%, with no significant changes among men. The prevalence of smoking has increased by 8.9% among women and has not changed among men. Age was positively correlated with the prevalence of all risk factors, except smoking. Younger persons smoked more often than elderly did. Prevalence of risk factors varied by educational level. Hypertension and overweight have been more prevalent among women with incomplete secondary education, than among those with university education. The prevalence of overweight and hypercholesterolaemia has been higher among highly educated men compared to low educated. The inverse relationship between smoking and education has been observed in men. In conclusion, the decreasing trends in the prevalence of some risk factors have been estimated in Lithuania within last decade. Sociodemographic differences in the prevalence of risk factors should be taken into account while developing health promotion and diseases prevention programmes.