Policies and programs in nutrition and physical fitness in Greece

A 50-year follow-up of the Seven Countries Study: Prevalence of cardiovascular risk factors, food and nutrient intakes among Cretans

OBJECTIVE

To identify the cardiovascular disease (CVD) risk-factor status and dietary habits of the surviving elderly participants of the initial Seven Countries Study (SCS) cohort and newly recruited middle-aged men from the same villages.

DESIGN

Our total cohort of remaining survivors of the SCS consisted of 27 men aged 90 years old and over, while a younger cross-sectional study of 85 men between 53 and 73 years of age of the same catchment area were also examined. Biochemical, anthropometric, dietetic and lifestyle CVD risk factors information was obtained.

RESULTS

It was found that being overweight and having systolic blood pressure higher than the recommended were highly prevalent (>75%) among both age groups as well as abdominal obesity (about 50%). Hypercholesterolemia was highly prevalent in the younger population (68.8%), while smoking rates were relatively low among elderly. The daily meat consumption of SCS participants had doubled, from 35g in the 1960s to 76g among the SCS survivors in 2010 (p=0.002), while daily fruit and vegetable consumption had dropped from 656g to 266g (p<0.001). The younger participants also had increased dietary meat (130g/day) (p<0.001) and decreased fruits-vegetables intake (412g/day) (p<0.001) compared to 50 years ago. However, the younger population and elderly subjects showed higher fish intake (91g/day and 38g/day respectively, p<0.001) compared to 1960 and favorable olive oil consumption. In regard to nutrient intake, the majority of the subjects did not meet the recommendations for CVD prevention.

CONCLUSIONS

The study population is at increased risk for the development of CVD, while current dietary habits of the SCS survivors partially differed from those of 50 years ago.

School health education programs in Crete: evaluation of behavioural and health indices a decade after initiation

OBJECTIVE

To assess the long-term effectiveness of a school-based health education intervention program 10 years after its initiation.

METHOD

In 1992 the total population of first grade students from three counties of Crete participated in the study. Over 1000 students were randomly selected for initial and periodic evaluation. Biochemical and behavioural parameters (anthropometric, lipoproteins, blood pressure, physical activity, dietary record and health habits) were measured. Re-evaluation of the program was performed at 3, 6 and 10 years after its initiation.

RESULTS

Ten years after the initiation of the program, the results showed that BMI had increased significantly less (p<0.001) and performance in the shuttle run test was significantly better (p<0.001) in the intervention group as compared to the control group. The reduction in total cholesterol noted in both groups was significantly greater in the intervention group than in the control group (p<0.001). The incidence of smoking was also significantly lower in the intervention group (intervention group 7%, control group 13%, p<0.005).

CONCLUSION

This program appears to improve children's health and decrease risk factors for chronic diseases. If these positive effects are maintained in the forthcoming decades, the risk of chronic diseases may well be reduced.

Bayesian latent variable modelling of multivariate spatio-temporal variation in cancer mortality

In this article, three alternative Bayesian hierarchical latent factor models are described for spatially and temporally correlated multivariate health data. The fundamentals of factor analysis with ideas of space- time disease mapping to provide a flexible framework for the joint analysis of multiple-related diseases in space and time with a view to estimating common and disease-specific trends in cancer risk are combined. The models are applied to area-level mortality data on six diet-related cancers for Greece over the 20-year period from 1980 to 1999. The aim of this study is to uncover the spatial and temporal patterns of any latent factor(s) underlying the cancer data that could be interpreted as reflecting some aspects of the habitual diet of the Greek population.

Attitudes towards exercise and physical activity behaviours in Greek schoolchildren after a year long health education intervention

OBJECTIVE

To examine the short term effects of a health education programme on Greek primary schoolchildren

METHODS

The school based intervention programme was applied to 29 children in the 6th grade of the 2nd Primary School of Agios Stefanos (approximately 12,000 inhabitants); 49 pupils from the 1st Primary School constituted the control group. To assess the effectiveness of the intervention, attitude and behavioural variables were measured before and after the intervention.

RESULTS

After adjustment for initial differences in the assessed variables, pupils who took part in the intervention had more positive attitudes towards physical activity than the control group and scored significantly more highly on their intention to participate in physical activity. Moreover, pupils in the intervention group reported more hours/week spent in organised physical activities than pupils in the control group (mean (SD) 3.54 (0.32) v 2.54 (0.26), p<0.020). Finally, a higher proportion of pupils in the intervention classes matched the recommendations of 60 minutes of moderate to vigorous physical activity daily (77.4% v 55.1%, p<0.043).

CONCLUSIONS

Within the limitations of the study, the data show that school health education programmes have the potential to slow the age related decline in physical activity and help pupils establish lifelong, healthy physical activity patterns. Promoting healthy habits and physical activity behaviours during childhood may prevent some of the leading causes of morbidity and mortality in the Greek population, and also decrease direct healthcare costs and improve quality of life.

Regional, demographic and national influences on attitudes and beliefs with regard to physical activity, body weight and health in a nationally representative sample in the European Union

INTRODUCTION

Although the benefits of physical activity regarding body-weight gain and health in general are now widely accepted, physical activity levels remain low among citizens in the western world. This could be attributed to certain attitudes and beliefs about physical activity. Identifying and understanding these parameters would be the first step in an attempt to increase the levels of physical activity in populations generally characterized as having a sedentary lifestyle.

OBJECTIVE

The aim of the present study was to identify the attitudes and beliefs regarding physical activity, body weight and health in a nationally representative sample in the EU and in particular to explore the demographic and national (cultural) influences on attitudes towards physical activity.

DESIGN

In each member state of the EU, approximately 1000 adults aged 15 years and over, were selected to complete an interviewer-assisted face-to-face questionnaire. Overall, a sample of 15,239 individuals in the EU participated in the study. Subject selection was quota-controlled to ensure samples in each country were nationally representative.

RESULTS

On a European level wide variations were observed regarding the levels, beliefs and attitudes towards physical activity. More positive beliefs were observed among Finns, while less positive beliefs were observed among southern Europeans. A similar pattern was observed for attitudes, with the Portuguese having the highest percentage feeling that they do not need to be more physically active than they already are. However, most southern Europeans felt that a campaign would encourage them to become more active than they already are. On a demographic level, the youngest, more educated and most physically active subjects had more positive attitudes and beliefs towards physical activity and the health benefits derived from it; while for the overweight, beliefs and attitudes toward physical activity were related primarily to the benefits related to weight control.

CONCLUSIONS

Lower levels of physical activity, an unwillingness to become active among non-participants and confusion regarding the weight gain benefits and general health benefits of exercise were reported more frequently among southern Europeans and older and less educated subjects. The Finns scored highest in all these parameters, possibly due to the programmes implemented and the beliefs and behaviour changes observed in this country during the last few years. The actions taken in Finland and their benefits could be employed appropriately in the other European states.