Subjective social status and its relationship to health and health behavior: comparing two different scales in university students.

Background Little is known about the relationship between socioeconomic status (SES) and health in late adolescence. As it is difficult to measure SES in this age group directly, we used two subjective social status (SSS) scales with different reference groups for social comparison in the relatively homogeneous group of university students and analyzed the relationship with health and health behaviors. Methods We used two 10-rung ladders, a societal and a university one, to measure SSS in students (n = 689, 16-29 years). We compared the scales' ratings and analyzed relationships with sociodemographic factors, health outcomes and behaviors. Results On average, students rated their individual SSS higher on the university scale (6.87) than on the societal one (6.41). Regarding health outcomes and behaviors, we found similar results for both scales, while sociodemographic variables were more likely to be associated with the societal scale. Conclusion SSS seems to be a useful measure besides the objective SES. Our data suggest that both SSS scales are helpful in the framework of health inequality but differ slightly in what they measure. More detailed research may help to determine which scale is appropriate for individual study context.

Eating behaviour of university students in Germany: Dietary intake, barriers to healthy eating and changes in eating behaviour since the time of matriculation.

A healthy diet plays a key role in preventing obesity and non-communicable diseases such as type 2 diabetes. This is true for all age groups, including young adults. While unhealthy eating habits among young adults, in particular university students, have been identified in former studies, this group has been neglected in existing health promotion strategies. Our aim was to explore baseline dietary intake, common barriers to healthy eating, and changes in eating behaviour among university students since the time of matriculation. We used data from the quantitative part of the Nutrition and Physical Activity Study (NuPhA), a cross-sectional online survey (data collection: 2014/10/31-2015/01/15). Students were recruited from all over Germany. Overall, 689 university students (30.5% male; mean age: 22.69) from more than 40 universities across Germany participated. We found that there is room for improvement with regard to the consumption of specific food groups, for example, fruits and vegetables. The main barriers to healthy eating were lack of time due to studies, lack of healthy meals at the university canteen, and high prices of healthy foods. Cluster analysis revealed that barriers to healthy eating might affect only specific subgroups, for instance freshmen. Changes in eating behaviour since matriculation were found in the consumption of meat, fish, and regular meals. Future qualitative studies may help to explore why university students change their eating behaviour since the time of matriculation. Such knowledge is necessary to inform health promotion strategies in the university setting.

Micronutrient Intake in Healthy Toddlers: A Multinational Perspective.

Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world's most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.

Nutrition and physical activity during the transition from adolescence to adulthood: further research is warranted.

The transition from adolescence to adulthood is associated with many physical, social, and psychological changes. In addition, adolescents also have to deal with structural changes. An example of one such structural change is the transition from school to university or to other vocational establishments. Structural changes can also entail changes in overall framework conditions and daily life patterns and thus also in dietary habits and physical activity levels. The aim of the present paper was to draw attention to the research deficit in this area with the help of the results of our analyses. The results show that significant changes take place as a consequence of the transition from school to a vocational establishment. However, our analyses could not identify the exact catalysts and the time framework of these changes. In this respect, further research is urgently warranted.

Dietary counselling for cardiovascular disease prevention in primary care settings: results from a German physician survey.

BACKGROUND: Primary care physicians (PCPs) play an important role in the promotion of healthy dietary behaviour. However, little is known about the practice of and factors associated with the provision of dietary counselling in primary health care in Germany. OBJECTIVES: To explore the attitudes towards and factors associated with the routine provision of dietary counselling in Germany using data from the nationwide, representative sample of the Physician Survey on Cardiovascular Disease Prevention. METHODS: A total of 4074 randomly selected PCPs (response rate: 33.9%) provided data on dietary counselling for prevention of cardiovascular disease (CVD) based on the 5 A's (Assess, Advise, Agree, Assist, Arrange), attitudes towards dietary counselling and patients' and practice characteristics. RESULTS: While the majority of PCPs (86%) reported having high levels of competence in providing dietary advice, only 49% felt they had been successful in counselling their patients on nutrition. PCPs routinely asked (68%) and advised patients to change their dietary habits more frequently (77%) compared to other counselling techniques based on the 5 A's. Female physicians and those with a higher percentage of privately insured patients and patients at higher risk of CVD were more likely to use the 5 A's to routinely counsel their patients on nutrition. CONCLUSIONS: The data showed high levels of involvement by German PCPs in CVD prevention and dietary counselling. The rather low perceived success of dietary intervention and differences with respect to patients' health insurance status indicate a need to address both communication skills in medical training and appropriate reimbursement of preventive services.

A systematic review of vitamin D status in populations worldwide.

Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status.