Tobacco use in students of the Third Faculty of Medicine of Charles University in the Czech Republic.

OBJECTIVES: This study assessed trends in tobacco use in students of the Third Faculty of Medicine of Charles University in the Czech Republic between academic years 2012/13 and 2019/2020. METHODS: Two cross-sectional surveys designed to obtain information on smoking history, smoking status, tobacco products use, and cessation were conducted among 382 students of the 6-year Master's Study Programme (General Medicine) and the 3-year Bachelor's Study Programme (Public Health) in 2012/2013; and among 580 students of General Medicine and of the Bachelor's Study Programmes (Public Health, Dental Hygiene and Nursing) in 2019/2020. RESULTS: Regular/daily smoking was reported by 4.4 ± 2.4% (with 95% CI) of General Medicine students and 4.8 ± 4.1% of Public Health students in 2012/2013, and 1.3 ± 1.1% of General Medicine students and 14.4 ± 4.8% of students of bachelor studies in 2019/2020. The share of regular and occasional smokers was higher among junior students in both academic years (23.9 ± 5.1% and 20.1 ± 4.7%, respectively) compared to senior students (23.6 ± 9.8% and 9.6 ± 5.7%). Cigarettes were the most common products used in both academic years (67.0 ± 4.7% and 45.5 ± 4.0%). There was a significant increase in proportion of students using more tobacco products in the course of the time (from 12.1 ± 3.1% to 53.7 ± 4.1%). The proportion of students who quitted smoking has risen from 11.4 ± 3.2% to 16.1 ± 3.0%. On the contrary, the proportion of students who started smoking has dropped from 15.9 ± 3.7% to 2.9 ± 1.4%. The proportion of non-smokers has risen from 57.6 ± 5.0% to 65.3 ± 3.9%. CONCLUSIONS: The study revealed some positive trends concerning tobacco use in students (decline in regular smokers among students of General Medicine, senior students, cigarette smokers, water pipe smokers; rise in non-smokers), but also negative ones (rise in regular smokers among students of Public Health, students who used more tobacco products).

The Low Prevalence of Overweight and Obesity in Czech Breastfed Infants and Young Children: An Anthropological Survey.

The aim of this study is to evaluate the prevalence of overweight and obesity in a sample of children who were exclusively or predominantly breastfed for at least 6 months compared to Czech references that were constructed based on a representative sample of children, regardless of their mode of feeding. Between 2008 and 2011, a longitudinal study on the growth of breastfed infants was carried out in the Czech Republic. Forty-three GP pediatricians addressed parents at 18-month preventive examinations and collected data on the families' socio-economic conditions and the infants' feeding conditions. The children were measured (length, weight, and head circumference), and anthropometric measurements from 10 previous preventive examinations were obtained from the health records. Out of the collected 1775 questionnaires, 960 children were selected according to the criteria of the WHO Multicentre Growth Reference Study. For the purpose of this study, 799 children who were exclusively or predominantly breastfed for at least 6 months were selected. We found that the proportions of children who were classified as overweight (>90th percentile) or obese (>97th percentile) at 6, 12, and 18-month examinations were far below the proportions of the Czech references. An update of the Czech references and growth charts is highly recommended by GP pediatricians for the valid assessment of growth and nutritional status, including a screening of overweight and obesity in primary preventive health care.

Body parameters of Czech breastfed children compared to the Czech references and WHO growth standards.

BACKGROUND: The study concerns the comparison of percentile curves of Czech breastfed children with Czech national references from 1991 and 2001 and WHO growth standards. Growth charts of breastfed children demonstrate different curve shapes, especially in the first months of life. Incorrect interpretation of the growth curve could lead to premature introduction of complementary foods or infant formula. AIM: The comparison of four body parameters of Czech breastfed children with currently used Czech national references and WHO standards in order to recommend that Czech paediatricians use either Czech references or WHO standards in their practice. SUBJECTS AND METHODS: Nine hundred and sixty breastfed children were included in the study of length-for-age, head circumference-for-age, weight-for-age and weight-for-length parameters. All percentile curves were compared. Values of the 50th percentile expressed in z-scores based on both Czech references and WHO standards were tested. RESULTS: The study confirmed results of previous surveys documenting that growth of breastfed children is specific. Nevertheless, percentile curves of growth parameters of Czech breastfed children are closer to Czech references than WHO standards. CONCLUSIONS: The Czech national references fulfil the needs of Czech paediatricians (with pointing to specifics of breastfed child growth) and WHO standards are suitable, especially for international comparison.

Smoking Habits and Attitudes in Students of the Third Faculty of Medicine of Charles University in Prague.

AIM: This study seeks to assess smoking habits, attitudes and intention to quit in students of the Third Faculty of Medicine of Charles University in Prague, Czech Republic. METHODS: A cross-sectional survey designed to obtain information on smoking history, current smoking status, cessation attempts, and attitudes towards smoking among health professionals was conducted in 452 students of the first and last years of a 6-year Master's Study Programme (General Medicine) and a 3-year Bachelor's Study Programme (Public Health). An anonymous questionnaire was administered during the classes in the course of academic years 2011-12 and 2012-13. RESULTS: 5.7% of the Master's Study Programme students (3.3% women and 9.0% men ) and 4.8% of the Bachelor's Study Programme students reported that they are regular smokers. The share of regular smokers was almost twice as big in students of the English Curriculum of the Master's Programme (10.7%) in comparison with the students of the Czech Curriculum (4.5%), and more than twice as big in students of the last years of both study programmes (3.9% in students of the 1st year and 10.8% in students of the 6th year of the Master's Programme; 3.2% in students of the 1st year and 7.0% in students of the 3rd year of the Bachelor's Study Programme). At the time of the research, 18.9% of students of the Master's Programme and 17.1% of students of the Bachelor's Programme were occasional smokers. 5.9% of students of the Master's Programme and 19.0% of students of the Bachelor's Programme reported that they quit smoking during their studies at the medical faculty; on the contrary, 9.8% of students of the Master's Programme and 14.3% of students of the Bachelor's Programme started smoking during that time. CONCLUSIONS: Smoking in health professionals undermines their significant role in health promotion and prevention of chronic diseases in their patients. Therefore, education at the medical faculty should focus on motivation of future health professionals towards non-smoking except providing knowledge on current research and guidance on early identification and further intervention in smokers.

Growth of Czech breastfed infants in comparison with the World Health Organization standards.

Growth references are important for paediatric health monitoring. It is critical to understand differences in growth interpretation and potential consequences when using available growth references. This study compares the growth of Czech breastfed children with the current WHO growth standards 2006 and the Czech references 1991, 2001. A total of 960 infant/parent pairs in the Czech Republic were recruited through paediatric practices. Anthropometric data were collected during infants' first 12 months of life and parent questionnaires were gathered during a preventive visit at 18 months. Czech breastfed infants were longer with a greater head circumference at all percentiles compared to the WHO standards and were similar to the national references. The percentile weight-for-age and weight-for-length values of infants (: 6 months) were lower, and higher (6-12 months) compared to the WHO standards. The infant growth in the sample differed from both the WHO standards as well as the national references. Our findings indicate that the growth of Czech breastfed children differs from the current national references. These discrepancies were smaller compared to the WHO standards. The results of the study were used for new growth assessment guidelines to optimize feeding recommendations for Czech infants. The adoption of the WHO standards in the Czech Republic is not recommended.

Dietary patterns and their changes in early childhood.

BACKGROUND: Early childhood is a critical period for shaping and influencing feeding behaviours which have implications for future health. Understanding the food consumption patterns and their shifts over time can provide guidance to health care providers and nutrition specialists who provide nutrition counselling and develop nutrition messages. OBJECTIVES: To examine feeding patterns of 1-5 year old children and their changes with age. METHODS: Across-sectional questionnaire study designed to obtain information on basic demographic indicators and feeding habits was conducted in Prague and all 13 regions of the Czech Republic. The carers of 1,130 children aged 1 to 5 years were approached in public places. Obtained data were computerized, descriptive statistics and t-tests for food intake frequency by age, breast-feeding status, sex, maternal education, and domicile were calculated. The difference was considered significant when P value was < 0.05. RESULTS: The median duration of breast-feeding of children not breast-fed at the time of the interview was 9 months; 29.5% one-year olds were still breast-fed at the time of the interview. Median number of meals per day was 4 in 1 and 5 year olds and 5 in children 2 to 4 years old. The diet of one-year-olds, albeit with lower fruit and vegetable consumption and low fish consumption, was close to recommendations. The milk and milk products, fruit, vegetable, and poultry intake frequency significantly decreased with age. The meat and grains groups, smoked meat and meat products, sweets, and fried food intake frequency significantly increased with age. Fish consumption remained low. Higher vegetable intake frequency was associated with breast-feeding, maternal education, and female sex. Higher fruit consumption was associated with breast-feeding and living in Prague. Higher meat group intake frequency was associated with male sex. CONCLUSIONS: Our data confirm that the dietary habits are formed early in the life. Enhancement of multi-channel delivery of nutrition messages for feeding of toddlers and pre-schoolers and for the improvement of family eating habits are needed.

The prevalence of wasting in Czech infants: a comparison of the WHO child growth standards and the Czech growth references.

The objective of this descriptive study was to evaluate the performance of the international World Health Organization (WHO) child growth standards in the Czech Republic and determine the prevalence of wasting among children using the 1991 Czech growth reference and the WHO growth standards. The study utilized the 2006 WHO Child Growth Standards and the 1991 Czech growth references. The WHO standards were based on a longitudinal study of 882 children aged 0-24 months and on cross-sectional studies of 6669 children aged 18-71 months. The 1991 Czech growth references were based on a cross-sectional survey including 90 910 children aged 0-18 years (34 164 were children aged < 5 years). The prevalence of wasting was significantly higher among Czech children when using the WHO growth standards compared with the Czech references. The prevalence of wasting among 0-5-month-old children was 15.5% among boys and 12.9% among girls compared with the expected 2.3% of the WHO standards. In the length category of 50 cm, 9.0% of boys and 9.9% of girls fell under the WHO wasting cut-off compared with the 3% from the Czech growth reference. The application of the WHO growth standards may results in a significant increase of Czech children classified in the category of wasting, especially among infants aged 0-5 months. The performance and potential impacts of the WHO growth standards should be evaluated further before their adoption in the Czech Republic and other countries with local growth references.

Impact of breast-feeding promotion on infant feeding in the Czech Republic.

OBJECTIVES: To assess infant feeding practices, identify factors that influence the duration of exclusive breast-feeding, and evaluate the impact of the National Breastfeeding Promotion Programme in the Czech Republic. HYPOTHESIS: We predicted the positive effect of the program in terms of increased prevalence of breast-feeding at discharge from the hospital and 6 months later. DESIGN: Multicenter cross-sectional survey. Mothers were randomly selected and interviewed in maternity hospitals in 1998 and were reinterviewed 6 months later. SETTINGS: Nine maternity hospitals in 6 cities across the country and households. PARTICIPANTS: 1104 mothers who gave birth within the 38th to the 42nd week of pregnancy to a healthy child with a minimum birthweight 2500 g; 1019 mothers were reinterviewed 6 months later. INTERVENTION: The National Breastfeeding Promotion Programme implemented since 1991. VARIABLES MEASURED: Breast-feeding rates at discharge from the hospital and 6 months later, participation in prenatal classes, strategies related to breast-feeding promotion in the hospital, and support following discharge. ANALYSIS: Epi Info 6, SPSS (analysis of variance, F test), chi2. RESULTS: On leaving the hospital, 93.5% of newborns were exclusively breast-fed. Six months later, 23.1% of infants were breast-fed exclusively and 29.9% of infants were breast-fed while receiving complementary food. Participation in prenatal classes, first suckling within 2 hours of birth, breast-feeding on demand in the hospital, exclusive breast-feeding on leaving the hospital, and the duration of breast-feeding recommended by a pediatrician were positively related to the duration of exclusive breast-feeding (P <.001). CONCLUSIONS AND IMPLICATIONS: Compared with national data from the last 2 decades, the data from this study proved the increasing rates of breast-feeding at discharge from the hospital and 6 months later. The findings indicate the effectiveness of the National Breastfeeding Promotion Programme. However, further implementation of breast-feeding promotion strategies in health facilities coordinated by the Ministry of Health is needed.