Consumption of Dietary Supplements among Working-Age Residents of Lithuania in the Period from 2021 to 2023

Background and Objectives: The aim of this study was to assess the consumption of dietary supplements (DS) among working-age residents of Lithuania from 2021 to 2023 with respect to social and demographic factors and an assessment of personal health. Materials and Methods: Using stratified sampling techniques, this study included three samples of working-age residents (1600 each year, 4800 total). Three surveys were conducted, the distribution of the respondents between groups was compared using the χ2 test. Results: The consumption of DS significantly differed each year and accounted for 78.1%, 71.6%, and 72.7% of the respondents, respectively (p < 0.05). In 2022, the prevalence of the consumption of DS was lower in the majority of social and demographic groups (p < 0.05). In 2023, it was higher among females, younger residents, and those from larger families, who suffered from COVID-19 (p < 0.05). Despite similar changes found in the consumption of DS among those who negatively assessed their health, this group showed more prevalent consumption of DS among residents with non-university education, unemployed respondents, and those with lower income (p < 0.05). Conclusions: Despite a significantly lower prevalence in the consumption of DS in 2022, it was higher again in 2023. The assessment of personal health shows different habits in the consumption of DS.

Trends in Pancreatic Cancer Incidence and Mortality in Lithuania, 1998-2015

BACKGROUND

Pancreatic cancer is one of the deadliest cancers worldwide, and its incidence is increasing. The aim of this study was to examine the time trends in the incidence and mortality rates of pancreatic cancer for the period of 1998-2015 for the first time in Lithuania by sex, age, subsite, and stage.

METHODS

This study was based on all cases (deaths) of pancreatic cancer diagnosed between 1998 and 2015. Age-standardized incidence (mortality) rates and group-specific rates were calculated for each sex using the direct method (European Standard). TNM classification-based information reported to the cancer registry was grouped into three categories: (1) localized cancer: T1-3/N0/M0; (2) cancer with regional metastasis: any 1-3/N+/M0; (3) advanced cancer: any T/any N/M+. Joinpoint regression was used to provide annual percentage changes (APCs) and to detect points in time where statistically significant changes in the trends occurred.

RESULTS

Overall, 8514 pancreatic cancer cases (4364 in men and 3150 in women) were diagnosed and 7684 persons died from cancer of the pancreas. Pancreatic cancer incidence rates were considerably lower for women than for men, with a female:male ratio of 1:2. Incidence rates changed during the study period from 14.2 in 1998 to 15.0/100,000 in the year 2015 in men, and from 6.7 to 9.8/100,000 in women. Incidence rates over the study period were stable for men (APC = 0.1%) and increasing for women by 1.1% per year. Similarly, mortality rates increased in women by 0.9% per year, and were stable in men. During the study period, incidence and mortality rates of pancreatic cancer were close. For the entire study period, rates increased significantly in the 50-74 years age group; only cancer of the head of pancreas showed a decline by 0.9%, while tail and not-specified pancreatic cancer incidence increased by 11.4% and 4.51%, respectively.

CONCLUSIONS

The increasing pancreatic cancer incidence trend in the Lithuanian population may be related to the prevalence of its main risk factors (smoking, obesity, physical inactivity, diet, and diabetes).

The impact of the COVID-19 on the consumption of food supplements in the Lithuanian population

Background

The COVID-19 pandemic affected the dietary changes of the population. The aim - to evaluate the changes in the consumption of food supplements in the Lithuanian population over 1997-2020, and the impact of the COVID-19 pandemic on the consumption of food supplements.

Methods

A representative sample of the Lithuanian adult population was formed by sex, age and the number of residents in each county. A total of 2573 adult respondents were surveyed using questionnaires on their consumption of food supplements and the results were compared to previous studies. SPSS, 20.0 for Windows version was used for the statistical analysis of the data. The reliability of the differences was found by the chi-squared (χ2) test with statistical significance of p ≤ 0.05.

Results

Between 1997 and 2017, food supplements were never taken by an average of 37-47 % of the Lithuanian population. In 2020, the number of never users dropped to 17.6 % and 82.4 % of the Lithuanian population started taking food supplements, mostly to strengthen the body and boost the immune system. The number of daily consumers more than doubled - from 8.9 % in 2017 to 18.6 % in 2020. In recent years the number of consumers of food supplements for 3-4 months per year has doubled and reached 15.5%. The percentage of users for 1-2 months per year (13%) has been almost stable in recent years and only a slight change occurred in the number of occasional users of food supplements - from 30.3% in 2017 up to 34.4 % in 2020.

Conclusions

The COVID-19 pandemic has provoked the consumption of food supplements by the Lithuanian population - the number of users has increased from 59 % to 82.4 %, and the number of daily users doubled to 18.6 %. The population mainly consumes food supplements mainly to strengthen the body and boost the immune system.

Key messages

The COVID-19 pandemic has had a significant impact on the increase of food supplement consumption.

The population mainly consumes food supplements mainly to strengthen the body and boost the immune system.

The need for information on nutrition among adolescents and adult knowledge regarding food consumption recommendations

OBJECTIVES

The eating habits of most Lithuanian people do not adhere to the recommendations for a healthy diet. If children and adolescents were provided with the relevant information, it would not only improve their nutritional knowledge, but also their eating habits in adulthood and the subsequent health of their children. The objective of this study was to determine the need for information on nutrition among Lithuanian adolescents, the current knowledge of adults regarding recommendations for the consumption of various food groups, and the factors that influence both the need for information and the current knowledge.

METHODS

Two cross-sectional studies were conducted, consisting of 3,574 adolescents aged 14-18 years and 1,007 adults aged 18-75 years. Logistic regression models with confidence intervals of 95% were used to determine the influence of various socio-demographic factors on the adolescent need for information on nutrition and the adult knowledge of nutrition.

RESULTS

A total of 66.7% of adolescents stated that they need information regarding nutrition, whereas 29.8% indicated that they lack such information. Significantly more girls than boys, and more students from schools in urban areas than students from schools in rural areas, expressed their need for information on nutrition. Lithuanian adults lacked knowledge of recommendations for the consumption of various food groups. Women and respondents with higher education degrees were found to have more knowledge on recommendations of the consumption of various food groups compared to men and respondents of other levels of education respectively.

CONCLUSIONS

The results of this study demonstrate that the required information on nutrition must be continuously provided via various channels to both adolescents and adults, and socio-demographic factors must be taken into account when planning public health intervention measures.

Risk of Endometrial Cancer in Women with Diabetes: A Population-Based Retrospective Cohort Study

The aim of this study was to examine the association between type 2 diabetes (T2DM), use of glucose-lowering medications and endometrial cancer (EC) risk.

METHODS

The risk of EC incidence among women with T2DM in Lithuania was assessed using a retrospective cohort study design. Female patients who were registered with T2DM between 1 January 2000 and 31 December 2012 were identified in the National Health Insurance Fund database. EC cases (ICD-10 code C54) were identified from the Lithuanian Cancer Registry. Standardized incidence ratios (SIRs) were calculated by dividing the observed numbers of EC among patients with T2DM by the expected number of EC, calculated using national rates.

RESULTS

A total of 77,708 diabetic women were included in the analysis, and 995 cases of EC were identified. A significantly increased EC risk in diabetic women was found as compared to the general population (SIR = 1.69, 95% CI 1.59-1.80). The greatest EC risk was found among younger patients at T2DM diagnosis, and the risk declined gradually with increasing age but persisted in being significantly increased among all age groups. The risk for EC increased with increasing duration of diabetes, and the highest EC risk was observed more than 10 years after T2DM diagnosis. A significantly higher EC risk than expected from the general population was found in all patient groups by glucose-lowering medication combinations. The lowest EC risk was observed in diabetic women who were users of "oral only" (without metformin) (SIR = 1.42, 95% CI 1.10-1.83) and "metformin only" (SIR = 1.69, 95% CI 1.49-1.92) medications. A two times greater EC risk was observed among the remaining glucose-lowering medication categories. In contrast, use of insulin only was not related to a higher EC incidence risk (SIR = 0.45, 95% CI 0.23-0.86); however, the risk estimation was based on nine cases.

CONCLUSIONS

Our study shows a significantly increased EC risk in diabetic women as compared to the general population. In this study, a significantly higher EC risk was found in all patient groups by glucose-lowering medication combinations, except for insulin only users.

Evaluation of public knowledge and beliefs of adverse health effects of unhealthy food and knowledge and beliefs based inequalities among various socio-demographic groups in Lithuania

OBJECTIVES

The availability of information on healthy products does not ensure the empowerment of people with the knowledge on how to choose or avoid food products or dishes depending on unhealthy factors. Public knowledge and beliefs of unhealthy food effects on health needs to be evaluated so that appropriate measures can be taken to properly inform people and relevant socio-demographic groups.

METHODS

The original survey questionnaire containing questions about specific food groups and various health effects was compiled. A total of 1,007 respondents, Lithuanian residents aged 18-75 years, were surveyed in March 2019. Multilevel stratified probability sampling method was used for data representativeness.

RESULTS

Almost half of respondents (46.2%) knew that deep-fried food could cause cancer. The majority of respondents (68.4%) were aware that sugar causes obesity and 61.7% were aware that sugar increases the risk of diabetes mellitus; 41.6% (more often those living in non-rural areas) know that grilled meat may cause cancer. More than half of respondents (57.2%) (more likely those living in non-rural areas and those with a university degree) were aware that smoked meat products may cause cancer. Only 46.4% were aware of the fact that salt raises blood pressure and the risk of cardiovascular diseases.

CONCLUSION

Only about half of Lithuanian residents aged 18-75 were aware of the scientifically proven harmful effects of unhealthy food groups. Socio-demographic factors influence the knowledge and beliefs of the population.

Differences in consumption of sugar and sweeteners in two neighbor countries: Lithuania and Poland

Background

In connection with attempts to reduce consumption of added sugar, consumption of non-nutritive (or low caloric) sweeteners (NNS) is likely to increse in many countries. In addition to variety of NNS, limited evidence on public health effects related to NNS exist. Thus, it remains important to monitor consumption of added sugar and sweeteners in our societies. As Lithuania and Poland are neighbor countries with similar culture and nutritional habits, the objective of this study was to compare consumption of sweeteners among adults in Lithuania and Poland.

Methods

A representative sample of Lithuanian population of adults aged 18 to 75 years was formed. A total number of 1008 residents from Lithuania participated. Distribution of them by answers about consumption of added sugar and sweeteners was assessed with respect to results of the survey conducted in central part of Poland where a group of 2000 adult respondents was investigated.

Results

Majority of respondents in both countries declared consumption of added sugar: 79.3% and 87.4% of Lithuanian and Polish respondents, respectively (p-value less than 0.05). Apart from sugar, majority of the respondents in Lithuania declared consumption of honey or fructose (respectively, 78.1% and 43.4%), consumption of other sweeteners such as saccharin, stevia, corn syrup, aspartame and sucralose were less prevalent (respectively, 30.9%, 18.2%, 9.5%, 9.0%, 3.4%). In Poland, 41.8% of respondents declared consumption of products containing stevia. Distribution of Poles by answers to the question which sweetener they used most often was 26.6%, 23.6%, 15.6%, 12.3% for stevia, xylitol, aspartame and fructose, respectively. Honey, acesulfame K, thaumatin and other substances were used by a lower percentage of Polish respondents.

Conclusions

Despite cultural similarities consumption of added sugar and sweeteners among adults differed significantly in two neighbor counties: Lithuania and Poland.

Key messages

In comparison to Lithuania, consumption of added sugar, xylitol and natural non-nutritive but intense sweetener stevia was more prevalent in Poland. In comparison to Poland, consumption of added sugar was less prevalent, but non-intense and high in calories sweeteners were more prevalent in Lithuania.

Well-being of families of people with psychosocial disabilites in context of deinstitutionalization

Background

A large part of disabled people have psychosocial disabilities. Importance of their inclusion is stated in many strategic documents. However, this group of people still faces many barriers in societies. Currently, deinstitutionalization is carried out in Lithuania. Well-being of people with psychosocial disabilities and their family members is affected by this process. Thus, we aimed to assess changes in well-being of family members of people with psychosocial disabilities during deinstitutionalization in Lithuania.

Methods

Data was collected during two stages of deinstitutionalization, in 2016 and 2019. Family members living with people with psychosocial disabilities answered anonymously to questions of Lithuanian psychological well-being scale. Respectively, 334 and 391 adults participated (13.8% of males and 86.2% of females each time). T scores and levels of well-being were calculated and compared according to socio-demographics of respondents and stage of deinstitutionalization.

Results

Generally, distribution of the participants did not differ by level of overall well-being between the stages of deinstitutionalization (p-value more than 0.05). Differently, place of residence, younger age, higher income and employment were associated with higher well-being. In the second phase, rural, younger, employed and full-time employed respondents had higher estimates of overall well-being (p-value less than 0.05). Also, younger and employed population had higher satisfaction with physical health, income, employment and life in Lithuania (p-value less than 0.05). In most counties of Lithuania, overall well-being of family members of people with psychosocial disabilities was in line with the average level.

Conclusions

Although distribution of family members of people with psychosocial disabilities by level of overall well-being had not changed from 2016 to 2019, an increase in well-being among rural, younger, employed and those with higher income was observed.

Key messages

Generally, overal well-being of family members of people with psychosocial disabilities had not changed during the process of deinstitutionalization in Lithuania from 2016 to 2019. Living in rural areas, younger age, higher income and employment were associated with an increase in well-being of family members of people with psychosocial disabilities.

Personal cell phones among children: attitudes of parents of primary school pupils

Background

A large number of primary school children have personal smartphones which enable them to communicate with lots of people and use social networks. However, social networking should not be accessible to primary school pupils due to existing age restrictions. Studies show that cell phones can be used to send offensive or sexual content to children or by them. This might have long-term effects on child's mental health and even provoke suicidal thoughts. While parents are able to control many aspects of children's life, we aimed to disclose parental attitudes towards use of mobile phones among children.

Methods

A total number of 619 parents of primary school children from middle-sized town of Lithuania participated in this study. Parents anonymously expressed their opinion to questions about personal cell phones usage among children. Distribution of participants was assessed according to social and demographic characteristics.

Results

Most of the respondents (79.8%) indicated that use of mobile phones might be harmful to children's health, 56.0% indicated that their children use social networks and every second child was registered by their parents (49.5%). Minority of the respondents (8.1%) thought that children (including children from other families) receive messages from strangers and communicate with them (2.1%). Similarly, very few of the respondents thought that children receive offensive (15.0%) or sexual (4.8%) content. Younger and lower educated parents registered their children to social networks more frequently (p-value less than 0.05). Lower educated parents more frequently indicated that offensive or sexual content can reach children via smartphones (p-value less than 0.05).

Conclusions

Majority of parents of primary school children thought that cell phones might be harmful to children's health but most of them did not pay attention to threats such as communication with strangers or transmission of sexual content.

Key messages

Only minority of parents of primary school children indicated communication with strangers or transmission of sexual content as threats induced by use of smartphones among children. Regardless that lower educated parents indicated awareness of content-related threats to children more frequently they registered their children to social networks more frequently as well.

Phospholipids as Emulsion Stabilizers

The equilibrium phase behavior and the macroemulsion type and stability of oil-water-lecithin mixtures was studied. For dioleyl phosphatidylcholine (DOPC) and n-alkanes as the oil component, the phase equilibrium is characterized by an extended inverse micellar region in equilibrium with water (Winsor II). On the other hand, n-C8F18-DOPC-water and soybean oil-DOPC-water mixtures show a three phase equilibrium of almost pure water, almost pure oil, and lamellar phase Lalpha (Winsor III). Equilibrium phases of DOPC systems can be emulsified in each other. Inverse W/O macroemulsions are favored for all the n-alkanes (C6-C14) studied; O/W emulsions are rather unstable. On the other hand, n-perfluorooctane and soybean oil produced very stable O/W emulsions. The phase behavior and emulsion stabilizing properties of an egg yolk phospholipid mixture is similar to those of DOPC. The phase equilibrium of the saturated analogue of DOPC: distearoyl phosphatidylcholine (DSPC) in mixtures with alkanes and water at room temperature is different and characterized by a Winsor III equilibrium of a Lbeta lamellar phase in a gel state, oil and water. Accordingly, the O/W emulsions are strongly favored to inverse systems. The pattern of the phase equilibrium and macroemulsion stability becomes similar to that of DOPC at elevated temperatures. The macroemulsion stability pattern versus the phospholipid packing type is discussed in relation to the recently proposed theory of emulsion stability to coalescence (Kabalnov, A. and Wennerstrom, H., Langmuir 12, 276 (1996)).