Correction: Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents.

[This corrects the article DOI: 10.1371/journal.pone.0295384.].

Interventions targeting young people not in employment, education or training (NEET) for increased likelihood of return to school or employment-A systematic review.

The present systematic review aims to identify, synthesize, and evaluate evidence of effects from interventions targeting youth not in education, employment, or training (NEET). We searched relevant multidisciplinary databases to identify randomized controlled trials (RCTs) and quasi-randomized re-engagement trials. Primary outcomes were participation in education and employment, and training status. Secondary outcomes included changes in financial status, quality of life and well-being, social functioning, and physical, psychological, and behavioral outcomes. The Joanna Briggs Institute methodology and PRISMA guidelines were applied. Eligible studies were screened, included, and extracted for data. Nine trials were included (eight RCTs and one quasi-experimental study), in which samples ranged from 96 to 7346 participants. Results on primary outcomes showed that five studies found an effect of interventions on employment outcomes, while three studies indicated an effect on education or training. Results on secondary outcomes included effects on mental health, subjective health complaints, drug use, self-esteem, and self-efficacy. Studies with other main outcomes than re-engagement showed an effect of interventions on pass rates for the driving test, independent housing, and increased job-seeking activities. Limitations and future directions are discussed, including the lack of rigorous studies, theoretical underpinnings, and standardized measures for re-engagement outcomes. Systematic review registration: registered in PROSPERO, CRD42023463837.

Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach.

BACKGROUND: More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence. METHODS: A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. RESULTS: Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females. CONCLUSION: Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors.

Background: Sexual harassment is common in most countries and cultures. Less is known about sexual harassment, its risk factors, and psychosocial outcomes among young adolescents. The aim of the study was to examine the 12-month prevalence of sexual harassment exposure, and sociodemographic and psychosocial factors associated with exposure among junior high school students in Norway. Methods: A comprehensive cross-sectional study was completed by 83,297 Norwegian adolescents in junior high school in 2021. Data on exposure to sexual harassment were used in combination with sociodemographic measures and psychosocial outcomes: depressive symptoms, loneliness, self-esteem, and well-being. Group differences were analyzed with Chi Square tests, and sociodemographic risk factors were analyzed with logistic regression. Psychosocial outcomes were assessed with multivariate and univariate ANOVAs, and dose-response relationships were assessed with linear regression. Results: Among the adolescents, 32.6% had experienced sexual harassment during the past year. Girls had higher odds of exposure (OR: 1.90, 95% CI: 1.84-1.96), whereas adolescents whose parents had higher education had lower odds (OR: 0.95, 95% CI: 0.90-0.99). Exposure was associated with higher levels of depressive symptoms (partial η2 [ES] = 0.11) and loneliness (ES = 0.07), and with lower self-esteem (ES = 0.06) and well-being (ES = 0.06). Among exposed adolescents, more frequent exposure was associated with poorer outcomes. Conclusion: Exposure to sexual harassment affects one third of junior high school students in Norway. Those who are exposed have poorer psychosocial outcomes, and there is a dose-response relationship between exposure and outcomes. Awareness of sexual harassment among young adolescents, and interventions to prevent and reduce it, are needed.

Changes in health-related quality of life and sleep habits after a 6-month non-randomised cluster-controlled trial among children with overweight or obesity.

Being overweight or obese can have severe negative psychological impacts and reduce health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight or obesity, it is important to design and implement effective interventions. The aim of this study was to evaluate the effects of a 6-month family-based lifestyle intervention on HRQoL and sleep habits in Norwegian children with overweight or obesity in a primary-care setting. This 6-month, non-randomised, cluster-controlled trial included Norwegian children aged 5-13 years with overweight or obesity and their parents. A questionnaire was filled out by the parents. A total of 33 and 52 children in the control group and 41 and 78 children in the intervention group answered the HRQoL and sleep habits questions, respectively, and were included. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. The Children's Sleep Habits Questionnaire (CSHQ) and Kidscreen-10 index were used to assess sleep habits and HRQoL. At baseline, the mean average scores for HRQoL were 50.0 [standard deviation (SD) 8.1] for the intervention group and 49.0 (SD 10.1) for the control group. For sleep habits at baseline, the mean average scores were 45.2 (SD 11.8) for the intervention group and 46.0 (SD 11.9) for the control group. No significant changes in HRQoL and sleep habits after the intervention were revealed. Overall, the family-based lifestyle intervention targeting overweight and obese children in a primary-care setting showed no significant effect on HRQoL or sleep quality.

The use of youth healthcare services and its association with health-related quality of life, physical and mental health and over-the-counter analgesics use in 13-19-year-old adolescents: a cross-sectional study.

BACKGROUND: Youth healthcare services in Norway include a public health nurse (PHN) at school and local youth health centres (YHCs). They provide health services for all adolescents free of charge, focusing on health promotion and disease prevention. The present study aimed to assess possible associations between health-related quality of life (HRQoL), physical and mental health, over-the-counter analgesics (OTCA) use and use of youth healthcare services among 13-19-year-old adolescents. METHODS: This study was based on national, cross-sectional data from the Ungdata Survey conducted in 2022. The sample was comprised of 16 482 adolescents. Multiple logistic regression was used to analyse the associations between HRQoL, headaches, selected physical symptoms, psychological distress, use of OTCA, PHN availability, sociodemographic variables, and use of the PHN at school or at a YHC. The KIDSCREEN-10 was used to measure HRQoL, and the Hopkins Symptoms Checklist 10 was used to measure symptoms of psychological distress. RESULTS: Girls used the youth healthcare services more frequently than boys. Better HRQoL was significantly associated with fewer visits to the PHN at school. Girls reported lower HRQoL and mental health, and more pain and frequent OTCA use than boys. When having symptoms of psychological distress, boys had greater odds of visiting the PHN at school than girls. For girls in senior high school, headaches and OTCA use were strongly associated with visiting the PHN at school and the YHC. In senior high school, boys with an immigration background had greater odds of visiting the YHC than native Norwegian boys, while girls with an immigration background were less likely to visit the YHC than native Norwegian girls. CONCLUSIONS: Our results show that more girls than boys use youth healthcare services. When adolescents experience pain, have mental problems, use OTCA, or report low levels of HRQoL, they have greater odds of using youth healthcare services. Youth healthcare services offer excellent opportunities to support and follow up with adolescents. The findings provide important insights into youth healthcare services used by adolescents for various stakeholders, including PHNs and policy makers, with potential implications for future public health efforts.

Consumption of meat and dairy substitute products amongst vegans, vegetarians and pescatarians.

Background: An increasing number of people adhere to plant-based diets, and the market for plant-based meat and dairy substitute products has been expanding rapidly. Objective: To examine total intake of macronutrients and salt in a sample of Norwegian vegans, vegetarians and pescatarians; the consumption frequency of plant-based meat and dairy substitutes and raw ingredients used in these products; and the contribution to total macronutrient and salt intake from these products. Design: A cross-sectional design using single 24-h dietary recall to assess the intake of macronutrients, salt and substitute products that the participants (n = 158 Norway residents [age 18-60 years]: vegans [n = 83]; vegetarians [n = 47]; pescatarians [n = 28]) consumed. The chi-square test with pairwise comparisons and the Kruskal-Wallis test with post hoc test were used to compare differences between diet groups. Macronutrient and salt intake were assessed relative to the Nordic Nutrition Recommendations (NNR). Results: Dietary macronutrient intake fell within NNR recommendations, with a favourable distribution of fatty acids and high levels of dietary fibre. Most of the vegans (90%), vegetarians (68%) and pescatarians (64%) consumed meat or dairy substitutes. The main raw ingredient in the substitute products was soy, followed by oats and peas. Overall, substitute products contributed to 12% of total energy and 16% of total salt intake. The substitute products contributed to higher saturated fatty acid (SFA) intake amongst vegans (27% of total SFA intake) compared with vegetarians (10%) and pescatarians (8%). Moreover, substitute products contributed to higher protein intake in vegans (19%) compared with pescatarians (7%). Conclusion: Most participants consumed meat or dairy substitute products, suggesting that these products are included regularly in Norwegian plant-based diets. Furthermore, substitute products may contribute to dietary fat, SFA and protein intake amongst vegans.

Effect of Ending the Nationwide Free School Fruit Scheme on the Intake of Fruits, Vegetables, and Unhealthy Snacks in Norwegian School Children Aged 10-12 Years.

The Norwegian authorities started a nationwide free school fruit program in 2007, implemented in all secondary schools (grades 8-10) and combined schools (grades 1-10) in Norway. The program ended in 2014. This study evaluates the effect of ending the nationwide free school fruit program on the consumption of fruit, vegetables, and unhealthy snacks among Norwegian sixth and seventh graders. The study sample consists of pupils at 18 schools that participated in all data collections in the Fruits and Vegetables Make the Marks project (FVMM), initiated in 2001, with new data collections in 2008 and 2018. Four of the schools were combined schools, therefore children in sixth and seventh grade at these schools received free fruit in 2008 (intervention schools), and fourteen schools did not (control schools). Between 2008 and 2018, pupils at the intervention schools ate a lower proportion of fruits and vegetables per school week, and the consumption of unhealthy snacks increased compared to the control schools. Completion of the free fruit program was not significantly different for boys and girls, or low and high parental education. The results indicate that the end of the free school fruit program resulted in less healthy eating habits among children.

Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries.

BACKGROUND: There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood. METHODS: This prospective study consisted of 13-19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006-2008 (n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017-2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008-2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure. RESULTS: Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively). CONCLUSIONS: Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.

Changes in dietary habits and BMI z-score after a 6-month non-randomized cluster-controlled trial among 6-12 years old overweight and obese Norwegian children.

Background: Effective prevention programs to address the high prevalence of childhood overweight and obesity and the concomitant health consequences have been warranted. Objective: To improve dietary habits and weight status among Norwegian children with overweight/obesity in the primary care setting. Design: A 6-month non-randomized cluster-controlled intervention among 137 children, aged 6-12 years, with overweight/obesity and their parents. Intervention and control groups were recruited by public health nurses and followed-up by 12 Healthy Life Centers across Norway. The intervention group received individual family counseling and participated in nutrition courses and physical activity groups. A frequency questionnaire assessing sociodemographic characteristics and dietary habits was completed by the parents. Trained public health nurses measured height and weight using standardized methods to calculate body mass index (BMI) and BMI z-scores. Results: The intervention resulted in an increased odds of consuming evening meals (OR: 3.42), a decreased availability of salty snacks (ß = -0.17), a decreased intake of salty snacks (-0.18), an increased consumption of water (ß = 0.20), and a decreased estimated total intake of energy (ß = -0.17), carbohydrates (ß = -0.17), mono- and disaccharides (ß = -0.21), sucrose (ß = -0.24), and saturated fatty acids (ß = -0.17). The intervention directly predicted lower BMI z-score (ß = -0.17), and post-treatment levels of energy (ß = -0.65), saturated fat (ß = 0.43), and total carbohydrates (ß = 0.41) were directly linked to BMI z-score after intervention. Age and sex were indirectly associated with BMI after intervention through energy and saturated fat intake. Conclusions: The intervention had a beneficial impact on nutrient intake and weight status among children with overweight/obesity. These findings provide support for implementing complex intervention programs tailored to local primary care settings. Trial registration: Clinicaltrials.gov, NCT02290171. Registered 13. November 2014, https://clinicaltrials.gov/ct2/show/NCT02290171.

Risky Lives? Self-Directed Violence and Violence From Others Among Young People Not in Education, Employment, or Training (NEET).

Self-directed violence and violence from others comprise a major public health concern in youth. However, we lack knowledge about the prevalence of violent experiences among young people that are not in education, employment, or training (NEET), whether violent occurrences are similar among girls and boys, and whether violence differs between NEET youths and young students. This cross-sectional study compared the occurrences of self-directed violence (suicide attempts and self-harm) and exposure to violence from others (violent threats, beaten without visible marks, or injured due to violent events) between 96 NEET youth and 384 age- and sex-matched upper secondary school students (16-21 years). Suicide attempts were reported by 45.2% of NEET girls and 18.8% of schoolgirls (p < 0.001), but no significant difference was found between NEET boys (17.6%) and schoolboys (13.1%). Self-harm was reported by 78.9% of NEET girls and 33.9% of schoolgirls (p < 0.001). Self-harm was less prevalent among boys; it was reported by 34.6% of NEET boys and 21.8% of schoolboys (p = 0.056). A multivariable logistic regression analysis, adjusted for parental education, showed that, compared to schoolgirls, NEET girls had much higher odds ratios (ORs) for both self-directed violence and violence from others with OR ranging from 4.39; CI 1.96-9.85 to 7.68; CI 3.20-18.41. The risk of injury due to violent events was higher among NEET boys (OR: 3.23, 95%CI: 1.21-8.62) compared to schoolboys. Our findings highlighted the importance of including NEET individuals in studies on violence and emphasized the importance of psychosocial health services for young people marginalized from education and the labor market.

Creatine as a Promising Component of Paternal Preconception Diet.

Male fertility has been declining globally over the past several decades, advancing from a personal issue to a public health problem. Beyond any doubt, a reduction in fertility (often characterized by low sperm count or motility) can severely threaten reproductive health and lifecourse framework in a long-term fashion. Aside from uncovering the currently unknown etiology of modern-day male infertility, the scientific and medical community faces a double burden: finding an efficient biomarker of impaired fertility and exploring any intervention that can act to enhance fertility. A plethora of nutritional compounds have been recognized as possible modulators of semen quality, and specific dietary patterns and nutrients appear to be accompanied by a lower risk of male infertility. Creatine, a conditionally essential nutrient, has caught attention as a male fertility-promoting candidate due to its role in sperm energy metabolism. This mini-review describes the creatine-related bioenergetics of spermatozoa, explores a connection between creatine levels and sperm quality in men, and critically examines available evidence for interventional studies with creatine to affect sperm viability.

Association between physical activity, sedentary time, participation in organized activities, social support, sleep problems and mental distress among adults in Southern Norway: a cross-sectional study among 28,047 adults from the general population.

BACKGROUND: Identification of modifiable factors associated with poor mental health is crucial to develop targeted and effective intervention strategies for prevention of mental distress and illness in the general population. Thus, the aim of the present study was to examine the association between low level of leisure-time physical activity, high sedentary time, low participation in organized activities, low social support, sleep problems, and mental distress in a large sample of Norwegian adults. METHODS: A cross-sectional study was completed by 28,047 adults (≥18 years old) in southern Norway by filling out an online self-report questionnaire. Multivariable binary logistic regression models, stratified according to gender and adjusted for age and perceived financial situation, were used to examine possible associations between unhealthy lifestyle behaviors, participation in organized activities, social support, and mental distress. RESULTS: Our results showed an increased odds of having mental distress among men reporting low leisure-time physical activity (OR: 1.18; 95%CI: 1.03-1.37), high sedentary time (1.32; 1.16-1.51), low involvement in organized activities (1.43; 1.25-1.64), low social support (2.55; 2.18-2.99), and sleep problems (7.29; 6.35-8.37) compared to the rest of the male population. For women, the results showed increased odds of mental distress among those reporting high sedentary time (1.25; 1.11-1.39), low involvement in organized activities (1.60; 1.42-1.80), low social support (2.71; 2.39-3.06), and sleep problems (5.78; 5.15-6.50) compared to the rest of the female population. For both men and women, results also indicated that mental distress was increased among younger adults and among those reporting financial difficulties compared to the rest of the population. CONCLUSION: Our results showed an association between unhealthy lifestyle behaviors, low participation in organized activities, low social support and mental distress, and that the strength of the association varied substantially. These findings provide increased knowledge about the relationship between modifiable lifestyle factors and mental health which should have implications for future public health efforts.

Association between Self-Reported Childhood Difficulties and Obesity and Health-Related Behaviors in Adulthood-A Cross-Sectional Study among 28,047 Adults from the General Population.

The aim of the present study was to examine the associations between self-reported childhood difficulties, weight status, and lifestyle behaviors among a representative sample of Norwegian adults. This cross-sectional study included 28,047 adults (>18 years old) living in southern Norway. A self-report questionnaire was used to assess information about the overall quality of the respondents' childhood retrospectively in addition to current weight status and current lifestyle behaviors. Multivariable logistic regression models adjusted for gender, age, and educational level showed that evaluating childhood as difficult was associated with increased odds of obesity (OR: 1.29; 95% CI; 1.16-1.44) in adulthood. Moreover, a difficult childhood was associated with increased odds of unhealthy lifestyle behaviors in adulthood, including low consumption of fruit and berries (1.21; 1.09-1.34) and fish (1.43; 1.30-1.57), high consumption of sugar-sweetened beverages (1.30; 1.14-1.48), low level of physical activity (1.10; 1.01-1.21), smoking cigarettes (1.78; 1.61-1.97), and using smokeless tobacco (1.20; 1.07-1.36). Overall, results from the present study suggest that experiencing childhood as difficult is associated with an increased risk of obesity and a range of unhealthy lifestyle behaviors in adulthood. Thus, our findings highlight the importance of identifying and providing support to children in difficult life circumstances in addition to customized and targeted public health efforts in adulthood.

Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents.

Social media are an integral part of adolescents' daily lives, and reviews have suggested an overall small association between more social media use and mental health problems. However, researchers have commonly investigated social media use in a time use perspective, rendering nuances in adolescents' social media experience less well explored. Thus, studies of relationships between social media use and mental health problems need also examine the nature of the events taking place on social media. This study aimed to examine depressive symptoms in adolescents in relationship to time spent on social media, negative social media-related experiences, and general self-efficacy. Data collected in a national survey, Ungdata 2021 (n = 139,841), was used. Multivariate linear regression analyses showed that time spent on social media was associated with depressive symptoms (ß = 0.09, p < 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (ß ranging 0.09-0.22, all p < 0.001), and their inclusion weakened the initial association between time on social media and depressive symptoms. General self-efficacy was directly associated with lower symptom levels (ß = -0.29, p < 0.001) but did not change the associations between social media use and depressive symptoms. The findings imply that not only time spent on social media, but in particular negative social media-related experiences, are related to depressive symptoms in Norwegian adolescents. General self-efficacy is an important resource for adolescents' mental health.

Physical activity, sugar-sweetened beverages, whole grain bread and insomnia among adolescents and psychological distress in adulthood: prospective data from the population-based HUNT study.

BACKGROUND: In this study, we examined the relationship between low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and experiencing insomnia in adolescence and psychological distress in young adults. METHODS: This prospective study was based on information retrieved from the Trøndelag Health Study (HUNT) in Norway and included adolescents (age 13-19) participating in Young-HUNT3 (2006-2008) and in HUNT4 (2017-2019) 11 years later (age 23-31). The study sample consisted of 2,230 participants (1,287 females and 943 males). The exposure variables collected in adolescence included self-reported physical activity, consumption of sugar-sweetened beverages and whole grain bread and insomnia, and psychological distress in young adulthood was used as an outcome variable. The relationship between lifestyle behaviours in adolescence and psychological distress in young adulthood was examined using multivariable logistic regression, adjusted for gender, age and psychological distress in adolescence and educational level in young adulthood. RESULTS: An increased odds of psychological distress was shown among young adults who reported low levels of physical activity (OR: 1.44, 95 % CI: 1.10-2.89), high consumption of sugar-sweetened beverages (OR: 1.49, 95 % CI: 1.12-1.98), low consumption of whole grain bread (OR: 1.35, 95 % CI: 1.04-1.77) and insomnia (OR: 1.69, 95 % CI: 1.23-2.33) in adolescence. In terms of absolute differences, unhealthy lifestyle behaviours increased the risk of psychological distress in young adulthood between 3.18 (95 % CI: 0.29-6.07) (low whole grain bread consumption) and 6.01 (95 % CI: 1.95-10.07) (insomnia) percentage points. CONCLUSIONS: Low levels of physical activity, high consumption of sugar-sweetened beverages and low consumption of whole grain bread and insomnia during adolescence were associated with psychological distress in young adulthood.

The Association between Dietary Habits, Substance Use, and Mental Distress among Adults in Southern Norway: A Cross-Sectional Study among 28,047 Adults from the General Population.

The aim of the present study was to examine associations between dietary habits, substance use, and mental distress among adults. This cross-sectional study was conducted in 2019 using an online questionnaire and included 28,047 adults (≥18 years) from Southern Norway. Multivariable logistic regression models stratified by gender were used to examine the associations between different lifestyle behaviors and mental distress. The results showed increased odds of mental distress among males and females with low consumption of vegetables (OR:1.26; 95% CI:1.08-1.47 and 1.14; 1.02-1.28) and fish (1.28; 1.12-1.46 and 1.36; 1.22-1.52), and among females, but not males, with high consumption of sugar-sweetened beverages (1.25; 1.06-1.48) compared to those with a healthier consumption of these foods and beverages. The results also showed increased odds of mental distress among male and female smokers (1.38; 1.19-1.60 and 1.44; 1.26-1.64), and among females, but not males, reporting current use of smokeless tobacco (1.20; 1.03-1.40), compared to male and female non-smokers and female non-users of smokeless tobacco. Overall, unhealthy dietary habits, smoking and the use of smokeless tobacco was associated with increased odds of mental distress, but the relationship varied according to gender. Future studies are needed to confirm any possible causal relationships.

Associations between pain, self-efficacy, sleep duration, and symptoms of depression in adolescents: a cross-sectional survey.

BACKGROUND: Although pain has been identified as an important public health problem among adolescents, few studies have investigated possible protective and risk factors for pain. The main aim of the present study was to investigate associations between prevalence of daily pain, self-efficacy, sleep duration, and symptoms of depression in a representative sample of Norwegian adolescents. METHODS: A comprehensive cross-sectional survey was completed by 12,867 junior high school students and high school students (response rate: 90%) aged 14-19 years. Logistic regression models were adjusted for age, gender, and parental educational level. RESULTS: We found a high prevalence of daily pain among adolescents, especially among girls (19%) compared with boys (7%). Short sleep duration was associated with increased odds ratios (ORs) of pain in the shoulders/neck (OR 1.3; 95% CI 1.3-2.0) and stomach (1.7; 1.2-2.4). Symptoms of depression were associated with increased ORs for all measured types of daily pain, including head (3.7; 3.0-4.6), shoulders/neck (3.9; 3.1-4.8), joints/muscles (4.3; 3.3-5.6), and stomach (5.5; 4.1-7.4). By contrast, self-efficacy was not associated with any form of daily pain. CONCLUSION: Given the burden of pain, high incidence of pain problems, and strong association between pain and depression and, to some degree, short sleep duration, co-occurring symptoms may be an important area for research in the public health field. The results highlight the importance of early identification and prevention. Longitudinal studies are needed to understand better pain problems and their underlying mechanisms with the aim of developing targeted interventions.

Associations between parental alcohol problems in childhood and adversities during childhood and later adulthood: a cross-sectional study of 28047 adults from the general population.

BACKGROUND: Adverse childhood experiences (ACE) are related to adverse physical and mental health outcomes. However, few larger studies based on a general population sample with age groups ranging from young adults to elderly have investigated whether parental alcohol problems increase the risk of offspring subjective reports of ACE both during childhood and current adult adversities. The purpose of this study was to examine the associations between parental alcohol problems and adversities during childhood and later in adulthood. METHODS: The 28,047 respondents were adults (> 18 years old) from the general population who participated in the Norwegian Counties Public Health Survey. The study had a cross-sectional design and included respondents' evaluations of childhood experiences and current adult adversities. The short version of the Children of Alcoholics Screening Test (CAST-6, cut-off ≥3) measured parental alcohol problems. Multivariable logistic regression was adjusted for gender, age, and education. RESULTS: Growing up with parental alcohol problems strongly increased the risk of experiencing a dysfunctional family environment during childhood (odds ratio [OR] 6.84; 95% confidence interval [CI] 6.36-7.36), perceiving childhood as difficult (OR 5.01; 95% CI 4.58-5.49), and reporting a lack of support from a trusted adult (OR 3.07; 95% CI 2.86-3.29). Parental alcohol problems were associated with a modestly increased risk of harmful alcohol use (OR 1.38; 95% CI 1.29-1.48), but the association with struggling with bad memories was strong (OR 4.56; 95% CI 4.17-4.98). CONCLUSIONS: Parental alcohol problems increased the risk of offspring experiencing adversities during both childhood and adulthood. Providing supportive services to these children and their families and addressing this issue as part of treatment is important to prevent alcohol related harm.

Iron Status of Vegans, Vegetarians and Pescatarians in Norway.

Although plant-based diets provide well-established physical and environmental health benefits, omitting meat or meat products has also been associated with a risk of being deficient in specific nutrients, such as iron. As data on the iron status among Norwegian vegans, vegetarians and pescatarians are lacking, the present study aimed to assess iron status in these groups of healthy adults. Blood markers for iron status were measured in 191 participants (18-60 years old) comprising 106 vegans, 54 vegetarians and 31 pescatarians: serum-ferritin (S-Fe), serum-iron (S-Iron) and serum-total iron binding capacity (S-TIBC). Serum-transferrin-saturation (S-TSAT) was estimated (S-Iron/S-TIBC × 100). The median concentration of blood markers for iron status were within the normal range with no difference between the different dietary practices. In total, 9% reported iron supplement use the last 24 h. S-Fe concentrations below reference (<15 µg/L) were found in 8% of the participating women, of which one participant reported iron supplement use. In multiple regression analysis, duration of adherence to dietary practices and the female gender were found to be the strongest predictors for decreased S-Fe concentration. In conclusion, although the participants were eating a plant-based diet, the majority had sufficient iron status. Female vegans and vegetarians of reproductive age are at risk of low iron status and should have their iron status monitored.