Sociodemographic and lifestyle determinants of non-attendance for cervical cancer screening in Lithuania, 2006-2014.

OBJECTIVES: In 2004, Lithuania started the Nationwide Cervical Cancer Screening Programme. The aim of the study was to estimate the trend in the uptake of cervical cancer (CC) screening in Lithuania during 2006-2014 and to identify sociodemographic and lifestyle factors associated with non-attendance for screening. STUDY DESIGN: Cross-sectional studies. METHODS: The data of 4248 women aged 25-60 years who participated in population-based cross-sectional surveys of Lithuanian Health Behaviour Monitoring were analysed. The postal surveys of independent random samples were conducted every second year. Participation in screening was determined by asking women whether they have had a Pap smear test within the last 3 years. Associations of non-attendance with sociodemographic characteristics and lifestyle factors were assessed by multivariate logistic regression analysis. RESULTS: The proportion of women who reported taking a test for CC within 3 years was continuously increasing from 60.0% in 2006 to 74.2% in 2014. The likelihood of not being screened was lower among older as compared to younger women (odds ratio=0.70; 95% confidence interval = 0.61-0.82). Non-attendance was associated with lower education, being single, having rare contacts with a doctor, low physical activity, and obesity. In addition, older women who smoked and consumed alcohol at least once a week were more likely to have never been screened. CONCLUSIONS: Established social and behavioural determinants of non-attendance for CC screening should be used for optimising CC prevention in Lithuania. The implementation of organised screening programme using innovative screening methods might increase attendance and reduce inequalities.

Physical activity, but not dietary intake, attenuates the effect of the FTO rs9939609 polymorphism on obesity and metabolic syndrome in Lithuanian adult population.

OBJECTIVES: This study aimed to examine the associations between the fat mass and obesity associated (FTO) gene rs9939609 variant with obesity and metabolic syndrome and interactions between FTO alleles, dietary intake and physical activity in Lithuanian adult population. STUDY DESIGN: Cross-sectional study. METHODS: A health survey was carried out in randomly selected municipalities of Lithuania. The random sample was obtained from the lists of 25-64 year-old inhabitants. The data from 1020 individuals were analyzed. The single-nucleotide polymorphism, rs9939609, in the FTO gene was assessed using a real-time polymerase chain reaction. 24-hour recall was used for evaluation of dietary habits. Information on physical activity at work, traveling to and from work and at leisure time was gathered by a standard questionnaire. RESULTS: The carriers of the AA genotype had the highest mean values of body mass index (BMI) and waist circumference (WC). They had 1.72 time higher odds of obesity (P = 0.009) and 1.67 time higher odds of increased WC (P = 0.013) than those with the TT genotype. Carriers of the T allele had lower prevalence of metabolic syndrome compared to carriers of the AA genotype (33.8% and 42.5% respectively; P = 0.018). No interaction between the rs9939609 variant and energy or dietary intakes on weight status was found. Significant effect of the interactions 'genotype×age' and 'genotype×physical activity' on BMI was demonstrated. The FTO rs9939609 polymorphism was associated with anthropometric parameters and metabolic syndrome in the younger age group (25-44 years) and in individuals having low level of physical activity. CONCLUSIONS: Age and physical activity modulated the effect of the FTO polymorphism on weight status and metabolic syndrome in Lithuanian adult population.

The prevalence and trends of overweight and obesity among Lithuanian adults, 1994-2012.

OBJECTIVES: The aim of this study was to assess trends in body mass index (BMI) and in the prevalence of overweight and obesity among Lithuanian adults between 1994 and 2012. STUDY DESIGN: The data were obtained from ten biennial cross-sectional surveys of Lithuanian Health Behaviour Monitoring. For every survey, a nationally representative random sample aged 20-64 was drawn from the National Population Register. Response rates ranged from 51% to 74%. In total, 7968 men and 10,695 women reported their weight and height. METHODS: All surveys used the same methodology and questionnaires, which were sent by mail. Self-reported weight and height were used to calculate body mass index (BMI). Overweight was defined as BMI ≥ 25 kg/m(2) and obesity--as BMI ≥ 30 kg/m(2). RESULTS: The most prominent increase in mean BMI was observed in the oldest age group (55-64 years) of men. A decrease in mean BMI occurred in the youngest age groups (20-34 and 35-44 years) of women. The proportion of overweight men increased from 47.0% to 62.5%, and the proportion of obese men--from 10.6% to 19.0%. In women, the prevalence of obesity was similar in the first and in the last survey (19.0% and 20.5% respectively). CONCLUSIONS: Over the study period, the difference in the prevalence of overweight and obesity increased between the age groups, because of age-related trends. Our data emphasize the need for a national strategy for obesity prevention and control targeting the whole population, particularly men and older women.

Alcohol consumption and attitudes towards banning alcohol sales on campus among European university students.

OBJECTIVES: The European Commission's new health strategy for improving health at the European Union (EU) level includes tackling alcohol consumption. This study aimed to assess the prevalence of alcohol consumption and problem drinking, as well as students' attitudes towards banning the sale of alcohol on campus. STUDY DESIGN: In total, 5826 students from universities in seven European countries (Denmark, Germany, Spain, Lithuania, Poland, Bulgaria and Turkey) took part in this cross-sectional study. METHODS: A self-administered questionnaire assessed sociodemographic information, frequency of alcohol consumption, problem drinking and attitudes towards banning the sale of alcohol on campus. RESULTS: The highest prevalence of drinking alcohol more than once per week was reported in Bulgarian (males 46%, females 64%) and Spanish students (males 59%, females 64%). Among those students who drank alcohol (n=3170), problem drinking (CAGE score >1) was found in 24% of males and 13% of females. Male gender, depressive moods and a low importance of good grades at university were risk factors for drinking alcohol more than once per week as well as for problem drinking. There were substantial country differences in the proportion of students who would support a ban of alcohol sales on campus (23% in Denmark, 88% in Poland). Support for a ban was higher among female students and among students who drank alcohol once or less per week. CONCLUSIONS: Problem drinking is a concern among students in many European countries, especially among males. Students' support for banning the sale of alcohol on campus varies between countries and should be considered in developing EU policy.

Validity and reproducibility of the NORBAGREEN food frequency questionnaire.

OBJECTIVE: To measure the validity and reproducibility of the NORBAGREEN food frequency questionnaire (FFQ). SUBJECTS/METHODS: In Finland, 125 subjects aged 25-64 years sampled from the five main regions of the FINDIET 2002 Study and in Lithuania, 99 citizens of Kaunas aged 19-75 years participated in the study. Reference methods for the FFQ were two 3-day FFQs in Finland and four 24-h recalls in Lithuania. The FFQ was repeated after 6-8 months in both countries. The outcome of the FFQ1 was correlated with the outcome of the reference methods and with the outcome of repeated FFQ2. Cross-classification of food intakes by FFQ1 and the reference methods was examined in tertiles. RESULTS: Validity correlations (FFQ vs the reference method, Spearman's correlation) were for vegetables, fruit and bread 0.50 (P<0.01), 0.53 (P<0.01) and 0.54 (P<0.01) in Finland; and 0.55 (P<0.01), 0.31 (P<0.01) and 0.51 (P<0.01) in Lithuania, respectively. Correlations were smaller for potatoes and fish. The overall proportion categorized in the same or adjacent intake tertiles with the two instruments was over 83% in both countries. Reproducibility correlations varied between 0.51 and 0.75 in the Finnish study, and between 0.51 and 0.83 in the Lithuanian study. CONCLUSIONS: The NORBAGREEN FFQ can be used to rank subjects according to vegetable, fruit and bread consumption. Questions on fish and potato consumption need to be developed further.

Differences in health complaints among university students from three European countries.

BACKGROUND: The purpose of this research was to assess the prevalence of somatic and psychosomatic health complaints in a cross-national population of university students and to study risk factors associated with health complaints. METHODS: The analysis was based on samples of first-year students from Pamplona (Spain), Bielefeld (Germany), and Kaunas (Lithuania). The total sample included 2343 students. Ten health complaints were measured by a symptom checklist with a self-administered questionnaire. Sociodemographic and lifestyle data were also collected. Factor analysis was employed to develop three complaint scores. RESULTS: Multifactorial logistic regression analysis revealed substantial associations between the factors female gender and psychosocial stress and high levels (>median) of complaint scores. Furthermore, after adjustment for age, sex, and lifestyle variables Lithuanian students were less likely to report gastrointestinal complaints (OR 0.62, CI 0.43-0.90) and neck ache/backache (OR 0.41, CI 0.28-0.61) compared to Spanish students. In addition, German students were less likely to report psychosomatic (OR 0.49, CI 0.35-0.69) and gastrointestinal complaints (OR 0.47, CI 0.34-0.65) than their Spanish peers. CONCLUSIONS: Although the results cannot be generalized to the general population of the respective countries, the different profiles of reported complaints should give rise to special interventions in this young population.

Disparities in food habits in Europe: systematic review of educational and occupational differences in the intake of fat.

BACKGROUND: A higher socio-economic level is associated with healthier dietary habits. Nevertheless, socio-economic differences in the intake of fat have not consistently been reported in Europe. The objective of our study was to systematically assess differences in total fat (TF) intake and saturated fat (SF) intake across social groups. METHODS: Representative samples from nine European countries were used to perform a meta-analysis of surveys between 1985-1999, including both published and nonpublished results. RESULTS: Because important heterogeneity was found and the estimates for TF from Spain and Estonia were different from all others, we calculated the differences in intake excluding these two countries. We found a lower TF intake in the highest (versus the lowest) occupational level both for men (difference: -1.1% of total energy intake; 95% CI: -1.3 to -0.8%) and women (difference: -0.9%; 95% CI: -1.2 to -0.6%) when Estonia and Spain were excluded. CONCLUSION: European surveys indicate that people in the lowest category of occupation consume more fat and SF than people in the highest category.

Smoking and passive smoking in Estonia, Lithuania and Finland. Identifying target groups of tobacco policy.

BACKGROUND: The aim of this study was to identify population groups which are the most crucial as targets for anti-tobacco action. METHODS: A comparison was made of the prevalence and patterns of smoking and passive smoking in Estonia, Finland and Lithuania. RESULTS: Total exposure to smoking, both one's own and passive smoking, was more common in two Baltic countries than in Finland. In these Baltic countries passive smoking was notably common among women. In all countries the exposure was more prevalent among the younger and less educated, but no difference emerged between urban and rural areas. CONCLUSIONS: The following target groups were identified as priorities for anti-tobacco actions: i) men of all ages in Estonia and Lithuania to stop their already established tobacco use, ii) young women in all three countries to prevent their starting a career of tobacco use and iii) young and less educated women in Estonia and Lithuania to prevent passive smoking, i.e. their exposure to environmental tobacco smoke.