Associations between Changes in Health Behaviours and Body Weight during the COVID-19 Quarantine in Lithuania: The Lithuanian COVIDiet Study

The COVID-19 quarantine has caused significant changes in everyday life. This study aimed to evaluate the effect of the quarantine on dietary, physical activity and alcohol consumption habits of Lithuanians and the association between health behaviours and weight changes. An online cross-sectional survey was carried out among individuals older than 18 years in April 2020. The self-administered questionnaire included health behaviour and weight change data. Altogether 2447 subjects participated in the survey. Almost half of the respondents (49.4%) ate more than usual, 45.1% increased snacking, and 62.1% cooked at home more often. Intake of carbonated or sugary drinks, fast food and commercial pastries decreased, while consumption of homemade pastries and fried food increased. A decrease in physical activity was reported by 60.6% of respondents. Every third (31.5%) respondent, more often those already with overweight, gained weight. Multivariate logistic regression analysis showed that the higher odds of weight gain were associated with females, older age, increased consumption of sugary drinks, homemade pastries and fried food, eating more than usual, increased snacking, decreased physical activity and increased alcohol consumption. Our data highlighted the need for dietary and physical activity guidelines to prevent weight gain during the period of self-isolation, especially targeting those with overweight and obesit

Alcohol-attributable mortality and alcohol control policy in the Baltic Countries and Poland in 2001–2020 : an interrupted time-series analysis

Publisher Copyright: © 2023, The Author(s).Background: The Baltic countries–Lithuania, Latvia and Estonia–are characterized by a high rate of fully alcohol-attributable mortality, compared with Poland. Alcohol control policy measures implemented since 2001 in the Baltic countries included a restriction on availability and an increase in excise taxation, among others. The aim of the current study was to evaluate the relationship between alcohol control policy implementation and alcohol-attributable mortality in the Baltic countries and Poland. Methods: Alcohol-attributable mortality data for 2001–2020 was defined by codes 100% alcohol-attributable for persons aged 15 years and older in the Baltic countries and Poland. Alcohol control policies implemented between 2001 and 2020 were identified, and their impact on alcohol-attributable mortality was evaluated using an interrupted time-series methodology by employing a generalized additive model. Results: Alcohol-attributable mortality was significantly higher in the Baltic countries, compared with Poland, for both males and females. In the final reduced model, alcohol control policy significantly reduced male alcohol-attributable mortality by 7.60% in the 12 months post-policy implementation. For females, the alcohol control policy mean-shift effect was higher, resulting in a significant reduction of alcohol-attributable mortality by 10.77% in the 12 months post-policy implementation. The interaction effects of countries and policy tested in the full model were not statistically significant, which indicated that the impact of alcohol control policy on alcohol-attributable mortality did not differ across countries for both males and females. Conclusions: Based on the findings of the current study, alcohol control policy in the form of reduced availability and increased taxation was associated with a reduction in alcohol-attributable mortality among both males and females.Peer reviewe

Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020

Funding Information: Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA) (Award Number 1R01AA028224). Publisher Copyright: © 2023, The Author(s).Alcohol consumption in the Baltic countries and Poland is among the highest globally, causing high all-cause mortality rates. Contrary to Poland, the Baltic countries have adopted many alcohol control policies, including the World Health Organization (WHO) "best buys". The aim of this study was to evaluate the impact of these policies, which were implemented between 2001 and 2020, on all-cause mortality. Monthly mortality data for men and women aged 20+ years of age in Estonia, Latvia, Lithuania, and Poland were analysed for 2001 to 2020. A total of 19 alcohol control policies, fulfilling an a-priori defined definition, were implemented between 2001 and 2020 in the countries of interest, and 18 of them could be tested. Interrupted time-series analyses were conducted by employing a generalized additive mixed model (GAMM) for men and women separately. The age-standardized all-cause mortality rate was lowest in Poland and highest in Latvia and had decreased in all countries over the time period. Taxation increases and availability restrictions had short-term effects in all countries, on average reducing the age-standardized all-cause mortality rate among men significantly (a reduction of 2.31% (95% CI 0.71%, 3.93%; p = 0.0045)). All-cause mortality rates among women were not significantly reduced (a reduction of 1.09% (95% CI - 0.02%, 2.20%; p = 0.0554)). In conclusion, the alcohol control policies implemented between 2001 and 2020 reduced all-cause mortality among men 20+ years of age in Baltic countries and Poland, and thus, the practice should be continued.publishersversionPeer reviewe

Impact of the WHO “best buys” for alcohol policy on consumption and health in the Baltic countries and Poland 2000–2020

Funding Information: Funding: Research reported in this publication was in part supported by the (U.S.) National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH), grant number 1R01AA028224 . This research was conducted as part of the project ‘Evaluation of the impact of alcohol control policies on morbidity and mortality in Lithuania and other Baltic states’ and we would like to thank the whole team for their input to wider discussions in generating the research reported in this paper. Content is the responsibility of the authors and does not reflect official positions of the NIAAA or the NIH. Publisher Copyright: © 2023Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.Peer reviewe

Diet and Dyslipidemias in a Lithuanian Rural Population Aged 25-64: the CINDI Survey

The aim of the study was to evaluate the dietary intake of a Lithuanian rural population and to assess the relationship between diet and dyslipidemias. Material and Methods. A cross-sectional health survey was carried out in 5 municipalities of Lithuania in 2007. The random sample was obtained from lists of 25- to 64-year-old inhabitants registered at primary health care centers (n=1739). The food frequency questionnaire and 24-hour recall was used for the evaluation of nutrition habits. The levels of serum lipids were determined using enzymatic methods. Factor analysis was employed in order to reduce the number of food items. The scores of food factors were used in linear regression analysis of associations between nutrition and serum lipid levels. Results. The diet of the study population was very high in fat, especially in saturated fatty acids. The content of cholesterol in the diet of men was higher than recommended. The main sources of fat and protein were meat, milk, and their products. Cereals were the main source of carbohydrates. The major proportion of monosaccharide and disaccharides was derived from confectionary and fruits. The mean serum total cholesterol level was 5.60 mmol/L in men and 5.51 mmol/L in women. Conclusions. Healthier food patterns were associated with the lower levels of total, low-density lipoprotein cholesterol, and triglyceride

Predictors and trend in attendance for breast cancer screening in Lithuania, 2006-2014

In Lithuania, a Nationwide Breast Cancer (BC) Screening Program was launched in 2005, offering mammography for women aged 50 to 69 years, every other year. This study aimed to determine the trend in the attendance for mammography screening during 2006-2014 and to identify the factors that are predictive for participation in it. The study sample consisted of 1941 women aged 50-64 years, who participated in five cross-sectional biennial postal surveys of Lithuanian Health Behavior Monitoring, carried out in independent national random samples. The attendance for screening was identified if women reported having had a mammogram within the last two years. The proportion of women attending the screening was continuously increasing from 20.0% in 2006 up to 65.8% in 2014. The attendance for BC screening was associated with the participation in cervical cancer screening. A higher level of education, living in a city, frequent contact with a doctor, and healthy behaviors (fresh-vegetable consumption, physical activity, and absence of alcohol abuse) were associated with higher participation rates in BC screening. To increase BC screening uptake and to reduce inequalities in attendance, new strategies of organized BC screening program using systematic personal invitations are required in Lithuania

Dietary patterns and their association with lifestyle factors in Lithuanian adult population

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

Nutrition and physical activity counselling by general practitioners in Lithuania, 2000-2014

BACKGROUND: Primary health care plays a crucial role in providing recommendations on a healthy diet and physical activity to assist patients in weight management. The study aimed to evaluate health behaviour counselling provided by general practitioners (GPs) for adults with overweight and obesity in Lithuania between 2000 and 2014. METHODS: Eight biennial postal surveys to independent nationally representative random samples of Lithuanians aged 20-64 were conducted. Response rates varied from 41.1 to 74%, with a decreasing trend over time. The data of 5867 participants who visited a GP at least once during the last year and had BMI of >/=25.0 kg/m(2) were analysed. Respondents were asked about GP advice on nutrition and physical activity and changes in their health behaviour during the last year. RESULTS: The proportion of persons with overweight who reported GP advice on nutrition increased from 23.6% in 2000 to 37.5% in 2010 and advice on physical activity from 11.9 to 17.2% respectively; however, later both proportions decreased slightly. The likelihood of reporting was higher in respondents with higher BMI, more chronic conditions and frequent contact with a GP. Respondents who were living in cities, older and highly educated women were all more likely to report being advised on physical activity. Men and women who received advice from a GP more often reported changes in health behaviour as compared with non-advised individuals. CONCLUSIONS: Despite increasing trends, the rate of GP advice on nutrition and physical activity reported by patients with overweight and obesity remains low in Lithuania. GP advice appears to have a significant impact on attempts by patients to change behaviour related to weight control. Therefore, there is an obvious need to make additional efforts to increase the frequency of GP counselling and to identify and address barriers to advising patients with overweight

Epidemiological situation of overweight in Lithuania and the evaluation of overweight control possibilities in primary health care

The aim of this study to evaluate the possibilities of weight control in primary health care applying minimal intervention. The study was carried out in the primary health care centre 'Jūsų šeimos klinika'. The number of patients with overweight was 192 in intervention group and 130 in control group. After the year 180 patients from intervention group and 122 patients from control group were examined. Men lost 3.8 kg and women – 3.6 kg on average from intervention group. The mean reduction of BMI was 1.3 kg/m² in both sexes. The mean values of reduction of systolic blood pressure were 2.9 mmHg among men and 2.6 mmHg among women in intervention group. The reduction of body weight in intervention group was related to changes in eating and physical activity habits. The proportion of patients reading nutrition label information increased. The decline in frequency of sweet consumption was observed too. No changes in the levels of the risk factors of chronic diseases were found in the control group