A nationwide register-based cohort study from Finland including 48 124 incident benzodiazepines and related drug (BZDR) users aged 18–65 years who initiated use in 2006 and were not dispensed BZDRs during 2004–2005. The follow-up was 5 years or until death, whichever occurred first.

To investigate sociodemographic and clinical factors associated with high-dose use of BZDRs (i.e. Z-drugs) among new BZDR users.

The temporal BZDR dose was calculated as a point estimate every 6 months after initiation as defined daily doses (DDDs) per day, based on the PRE2DUP method (an approach based on mathematical modelling of personal drug purchasing behaviours). Sociodemographic and clinical factors associated with dose categories were studied using multinomial logistic regression.

During the 5-year follow-up, very high-dose BZDR use was observed in 7.4% (n = 3557) and medium high-dose use in 25.5% (n = 12 266) of the users (corresponding to ≥30 mg and 10–29 mg in diazepam equivalents, respectively). Very high-dose use was more common among men compared with women (10.9% versus 4.6%). Very high-dose use patterns were especially observed in younger age groups (18- to 25-year-olds). Compared with oxazepam, initiating BZDR use with clonazepam (adjusted odds ratio 3.86, 95% CI 3.24–4.60), diazepam (2.05, 1.78–2.36) or alprazolam (1.76, 1.52–2.03) was associated with increased odds for very high-dose use. Both medium high-dose and very high-dose BZDR use were associated with a lower level of education. In all, 58% of very high-dose use occurred in BZDR users who received their first prescription from general practitioners.

Clinicians should be aware of the dose escalation risk especially when prescribing diazepam, alprazolam or clonazepam for psychiatric indications. If BZDRs are needed, our findings suggest favouring oxazepam.

Bereaved youth are at greater risk for adverse mental health outcomes, yet less is known about how social context shapes health for bereaved children. Ecosocial theory is employed to conceptualize bereavement in the context of sociodemographic factors.

This longitudinal study used data from the Avon Longitudinal Study of Parents and Children. Of the 15,454 pregnancies enrolled, 5050 youth were still enrolled at age 16.5 and completed self-report questionnaires on life events and emotional/behavioral symptoms.

Sociodemographic precursors associated with parent, sibling, or close friend bereavement included maternal smoking, parental education levels, and financial difficulties. The significant yet small main effect of higher cognitive ability, assessed at age 8, on reduced emotional/behavioral symptoms at age 16.5 (β = −0.01, SE = 0.00, p < 0.001) did not interact with bereavement. Bereavement of a parent, sibling, or close friend was associated with a 0.19 point higher emotional/behavioral symptom log score compared to non-bereaved youth (95% CI: 0.10–0.28), across emotional, conduct, and hyperactivity subscales.

Descriptive findings suggest sociodemographic precursors are associated with bereavement. While there was an association between the bereavement of a parent, sibling, or close friend and elevated emotional/behavioral symptoms, cognitive ability did not moderate that effect.

Prehospital delays are a major obstacle to timely reperfusion therapy in acute ischemic stroke. Stroke sign recognition, however, remains poor in the community. We present an analysis of repeated surveys to assess the impact of Face, Arm, Speech, Time (FAST) public awareness campaigns on stroke knowledge.

Four cross-sectional surveys were conducted between July 2016 and January 2019 in the province of Quebec, Canada (n = 2,451). Knowledge of FAST stroke signs (face drooping, arm weakness and speech difficulties) was assessed with open-ended questions. A bilingual English/French FAST public awareness campaign preceded survey waves 1–3 and two campaigns preceded wave 4. We used multivariable ordinal regression models weighted for age and sex to assess FAST stroke sign knowledge.

We observed an overall significant improvement of 26% in FAST stroke sign knowledge between survey waves 1 and 4 (odds ratio [OR] = 1.26; 95% CI: 1.02, 1.55; p = 0.035). After the last campaign, however, 30.5% (95% CI: 27.5, 33.6) of people were still unable to name a single FAST sign. Factors associated with worse performance were male sex (OR = 0.68; 95% CI: 0.53, 0.86; p = 0.002) and retirement (OR = 0.54; 95% CI: 0.35, 0.83; p = 0.005). People with lower household income and education had a tendency towards worse stroke sign knowledge and were significantly less aware of the FAST campaigns.

Knowledge of FAST stroke signs in the general population improved after multiple public awareness campaigns, although it remained low overall. Future FAST campaigns should especially target men, retired people and individuals with a lower socioeconomic status.

The aims of the study were: (i) to estimate the frequency of legume consumption in a study sample from Poland; (ii) to assess relationships between frequency of legume consumption and sociodemographic factors, health status and health-related variables and (iii) to describe the sociodemographic and health-related profiles of ‘frequent’, ‘rare’ and ‘never legume consumers’.

A cross-sectional study with a self-administered questionnaire was conducted. χ2 test compared the distribution of sociodemographic, health status and health-related variables in accordance with frequency of legume consumption. Multiple correspondence analysis (MCA) revealed the sociodemographic and health-related profiles of ‘frequent’, ‘rare’ and ‘never legume consumers’.

Adult individuals from Poland.

The present study included 1135 adults aged 18–80 years.

Only 22·8 % of all participants declared frequent legume consumption. The prevalence of ‘rare’ and ‘never consumers’ was 72·1 and 5·1 %, respectively. The MCA highlighted strong correspondence of sociodemographic factors, health status and health-related variables with the frequency of legume consumption.

Low frequency of legume consumption in a study sample of adults from Poland was strongly associated with male sex, low educational level, physical work, living in villages and small cities, and living with more than one co-resident; low legume consumption was also associated with sedentary lifestyle, no disease prevalence and no dietary supplementation.

To determine the prevalence and sociodemographic factors associated with food insecurity in the state of New South Wales (NSW), Australia.

Cross-sectional analysis of food insecurity data collected by the NSW Population Health Survey between 2003 and 2014. Multiple logistic regression was used to examine associations with key sociodemographic variables.

NSW, Australia.

212 608 survey participants responded to the food insecurity survey question between 2003 and 2014. 150 767 of them were aged ≥16 years. The survey sample was randomly selected and weighted to be representative of the NSW population.

On average 6 % of adults aged ≥16 years experienced food insecurity in NSW. The odds of food insecurity appeared to increase from one survey year to the next by a factor of 1·05. Food insecurity was found to be independently associated with age, sex, marital status, household size, education, employment status, household income, smoking status, alcohol intake and self-rated health. The association with income, smoking status and self-rated health appeared to be the strongest among all covariates and showed a gradient effect. Food insecurity appeared to increase significantly between the age of 16 and 19 years.

The prevalence of food insecurity appears to be rising over time. Given the negative health consequences of food insecurity, more rigorous measurement and monitoring of food insecurity in NSW and nationally is strongly recommended. The findings provide support for interventions targeting low-income and younger population groups.

The objective of this study was to examine climate impact from diet across background and sociodemographic characteristics in a population-based cohort in northern Sweden.

A cross-sectional study within the Västerbotten Intervention Programme. Dietary data from a 64-item food frequency questionnaire collected during 1996–2016 were used. Energy-adjusted greenhouse gas emissions (GHGE) for all participants, expressed as kg carbon dioxide equivalents/day and 4184 kJ (1000 kcal), were estimated using data from life cycle analyses. Differences in background and sociodemographic characteristics were examined between participants with low and high GHGE from diet, respectively. The variables evaluated were age, BMI, physical activity, marital status, level of education, smoking, and residence.

Västerbotten county in northern Sweden.

In total, 46 893 women and 45 766 men aged 29–65 years.

Differences in GHGE from diet were found across the majority of examined variables. The strongest associations were found between GHGE from diet and age, BMI, education, and residence (all P < 0·001), with the highest GHGE from diet found among women and men who were younger, had a higher BMI, higher educational level, and lived in urban areas.

This study is one of the first to examine climate impact from diet across background and sociodemographic characteristics. The results show that climate impact from diet is associated with age, BMI, residence and educational level amongst men and women in Västerbotten, Sweden. These results define potential target populations where public health interventions addressing a move towards more climate-friendly food choices and reduced climate impact from diet could be most effective.

The present study aimed to identify nutrition transition (NT) profiles in Argentina (2005–2013) and assess their association with obesity in the adult population.

A large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence.

First, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.

Twenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people.

Three NT profiles were identified: ‘Socionutritional lag’ (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); ‘Double burden of malnutrition’ (undernutrition and overweight in highly urbanized scenarios; profile 2); and ‘Incipient socionutritional improvement’ (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3.

Argentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.

Childhood obesity has increased rapidly in Mexico, along with changes in the food environment. However, little is known about the dietary patterns (DP) of Mexican children. We aimed to characterize the DP of schoolchildren and to analyse their associations with sociodemographic factors.

Cross-sectional analysis. Dietary and sociodemographic information was obtained, including a single 24 h recall, socio-economic status (SES), geographic region, area of residence and ethnicity. DP were defined with cluster analysis (using k-means). Multinomial logistic regression models, adjusted for the survey design, were used to assess associations between DP and sociodemographic variables.

2012 Mexican National Health and Nutrition Survey (ENSANUT-2012).

Schoolchildren (n 2751) aged 5–11 years who participated in ENSANUT-2012.

Four DP were identified: ‘Traditional’, ‘Industrialized’, ‘Varied’ and ‘Modern’. Reported energy intake (mean (sd)) was lowest in the ‘Traditional’ and highest in the ‘Industrialized’ DP (7037 (3707) kJ/d (1682 (886) kcal/d) v. 8427 (3753) kJ/d (2014 (897) kcal/d), respectively, P<0·05). Significant differences in fat and fibre intakes were seen across DP. Non-indigenous v. indigenous children were 22·0 times (95 % CI 5·1, 93·6) more likely to have a ‘Modern’ rather than ‘Traditional’ DP. Relative likelihood of having an ‘Industrialized’ rather than ‘Traditional’ DP was 6·2 (95 % CI 3·9, 9·9) among schoolchildren from high SES v. low SES.

Among Mexican schoolchildren, DP were associated with sociodemographic variables. Non-indigenous children were significantly more likely to consume a ‘Modern’ than a ‘Traditional’ DP. Children with higher SES were more likely to have an ‘Industrialized’ pattern. It is necessary to consider dietary characteristics in the different sociodemographic strata when dietary interventions are designed.

To investigate (i) associations between adolescents’ frequency of breakfast and family functioning (close relations to parents, quality of family communication and family support) and (ii) if any observed associations between breakfast frequency and family functioning vary by sociodemographic factors.

School-based cross-sectional study. Students completed a web-based questionnaire. Associations were estimated by multilevel multivariate logistic regression.

Danish arm of the Health Behaviour in School-aged Children study, 2014.

Adolescents aged 13 and 15 years (n 3054) from a random sample of forty-one schools.

Nearly one-quarter of the adolescents had low breakfast frequency. Low breakfast frequency was associated with low family functioning measured by three dimensions. The OR (95 % CI) of low breakfast frequency was 1·81 (1·40, 2·33) for adolescents who reported no close relations to parents, 2·28 (1·61, 3·22) for adolescents who reported low level of quality of family communication and 2·09 (1·39, 3·15) for adolescents who reported low level of family support. Joint effect analyses suggested that the odds of low breakfast frequency among adolescents with low family functioning compared with high family functioning were highest among adolescents being girls, immigrants and living in other than a traditional family structure.

Low breakfast frequency was associated with low family functioning measured by close relations to parents, quality of family communication and family support. Further, analyses suggested that the associations were more pronounced among girls, immigrants and adolescents from other family structure than traditional. The study highlights the importance of the family setting in promoting regular breakfast frequency among adolescents.

To investigate: (i) how lunch frequency of adolescents varies between schools and between classes within schools; (ii) the associations between frequency of lunch and individual sociodemographic factors and school characteristics; and (iii) if any observed associations between lunch frequency and school characteristics vary by gender and age groups.

Cross-sectional study in which students and school headmasters completed self-administered questionnaires. Associations were estimated by multilevel multivariate logistic regression.

The Danish arm of the Health Behaviour in School-Aged Children study 2010.

Students (n 4922) aged 11, 13 and 15 years attending a random sample of seventy-three schools.

The school-level and class-level variations in low lunch frequency were small (intraclass correlation coefficient <2·1 %). At the individual level, low lunch frequency was most common among students who were boys, 13- and 15-year-olds, from medium and low family social class, descendants of immigrants, living in a single-parent family and in a reconstructed family. School-level analyses suggested that having access to a canteen at school was associated with low lunch frequency (OR=1·47; 95% CI 1·14, 1·89). Likewise not having an adult present during lunch breaks was associated with low lunch frequency (OR=1·44; 95% CI 1·18, 1·75). Cross-level interactions suggested that these associations differed by age group.

Lunch frequency among Danish students appears to be largely influenced by sociodemographic factors. Additionally, the presence of an adult during lunch breaks promotes frequent lunch consumption while availability of a canteen may discourage frequent lunch consumption. These findings vary between older and younger students.

The links between migrant status and psychosis have attracted considerable attention in recent decades. The aim of the study was to explore the demographic and clinical correlates of migrant v. Australia-born status in individuals with psychotic disorders using a large community-based sample.

Data were drawn from a population-based prevalence survey of adults with psychotic disorders. Known as the Survey of High Impact Psychosis (SHIP), it was conducted in seven Australian catchment areas in 2010. Logistic regression was used for the main analyses, examining associations of migrant status with sociodemographic and clinical variables.

Of the 1825 participants with psychotic disorders, 17.8% (n = 325) were migrants, of whom 55.7% (n = 181) were male. Compared to Australia-born individuals with psychosis, migrants were more likely to be currently married, to have completed a higher level at school, to have left school later, and to be employed with full-time jobs. Migrants with psychosis were either no different from or less impaired or disadvantaged compared to their Australian-born counterparts on a range of clinical and demographic variables.

In a sample of individuals with psychotic disorders, there was no evidence to suggest that migrant status was associated with worse clinical or socio-economic outcomes compared to their native-born counterparts.

The increasing prevalence of childhood overweight is an important health issue. There is a need for longitudinal research among children in order to identify risk factors for childhood overweight. The objective of the present research was to identify potential sociodemographic and behavioural risk factors for development of childhood overweight among 3- to 6-year-old children.

Longitudinal study.

Sixteen pre-primary and primary schools.

BMI Z-scores at baseline and two follow-up measurements were calculated for 568 children. Sociodemographic, parental adiposity, familial composition, child's diet, physical activity and sedentary behavioural data were collected through questionnaires.

Several risk factors for the development of childhood overweight were found. Being an only child, lower maternal educational level, maternal and paternal overweight, more than 1 h screen time on weekdays and high soft drinks consumption were shown to be positively associated with the development of childhood overweight.

Although behavioural factors are important, our findings support the thesis that interventions on the prevention of childhood overweight should focus on high-risk groups, i.e. children from low socio-economic background or with high parental BMI. Interventions should address the whole family and take into account their lifestyle and structure.

The prevalence of obesity has increased in the last decades in the Western world. The aim of the present study was to examine the association between risk-taking behaviour in adolescence and adult obesity in men and women. Furthermore, we wished to describe social differences in obesity in Denmark.

Two population-based questionnaire studies (2004–2005 and 2006–2007) were used to collect information on weight and height, sociodemographic factors and factors regarding risk-taking behaviour during adolescence. Data were analysed using multivariate logistic regression.

Denmark.

Individuals aged 18–45 years (men: n 22 827, participation rate 71·0 %; women: n 20 870, participation rate 81·4 %).

The prevalence of overweight and obesity was respectively 37·8 % and 10·6 % in men and 20·1 % and 9·7 % in women. In both sexes, obesity was found to be associated with older age, low level of schooling and living outside the capital centre. In relation to risk-taking behaviour, young age (≤13 years) at first intercourse significantly increased the odds of being obese in adulthood (men: OR = 1·34, 95 % CI 1·04, 1·71; women: OR = 1·66, 95 % CI 1·27, 1·99). In women specifically, young age at start drinking alcohol (≤12 years) was associated with obesity.

Sociodemographic factors, in particular age, level of schooling and area of residence, are associated with obesity in both men and women. Risk-taking behaviour during adolescence seems to cluster in both obese men and obese women, however most convincingly in women.

To determine the prevalence of metabolic syndrome (MetS) and its components and to evaluate the relationship between this diagnosis and cardiovascular risk factors, demographic and socio-economic variables.

A cross-sectional study using a questionnaire including information on sociodemographic and CVD risk factors. Blood pressure, anthropometric indices, fasting glucose and lipid profile were measured. MetS was defined according to the criteria of the National Cholesterol Education Program, Adult Treatment Panel III.

The whole Tunisian territory; Transition and Health Impact in North Africa (TAHINA) project.

A total of 4654 individuals (1840 men and 2814 women), aged 35 to 74 years, who participated in the Tunisian national survey.

The overall prevalence of MetS was 30·0 %, higher in women (36·1 %) than in men (20·6 %; P < 0·001). In both genders MetS prevalence increased significantly with age (P < 0·001), but this increase was more important in women. Multiple regression analyses showed that the odds for MetS increased significantly with urban area for both men and women (P < 0·05 and P < 0·001, respectively). The multivariate models showed also that the odds for MetS increased significantly with increasing level of education and in those with a family history of CVD for men (both P < 0·05) and after the menopausal transition for women (P < 0·05).

The study highlights the MetS problem in a middle-income developing country. There is an urgent need for a comprehensive, integrated, population-based intervention programme to ameliorate the growing problem of MetS in Tunisians.

In Morocco, the association between obesity/overweight and socio-demographic and lifestyle factors is poorly understood. The present study aimed to investigate this association in a representative sample of the Moroccan population aged 18 years and above.

This is a cross-sectional study using a questionnaire including demographic, socio-economic and physical activity items. Height and weight were measured and BMI was computed. The association between obesity (BMI ≥ 30·0 kg/m2) or overweight (25·0 ≤ BMI < 29·9 kg/m2) and the other variables was analysed using multiple binomial logistic regression, separately in men and women.

The whole Moroccan territory.

A total of 2891 subjects took part in the survey (1430 men and 1461 women).

The prevalence of obesity was 20·9 % in women and 6·0 % in men (P < 0·0001). The prevalence of overweight was 32·9 % in women v. 26·8 % in men (P < 0·0001). In women, the risk of obesity and overweight increased with age, with the highest risk being in individuals aged 45–54 years (OR = 3·02, 95 % CI 2·06, 4·44) compared to individuals <35 years old. Married women were more prone to obesity and overweight (OR = 2·42, 95 % CI 1·50, 3·91) than single women. In men, the risk of obesity and overweight increased with average family income (OR = 2·62, 95 % CI 1·40, 4·87 for family income ≥5000 MAD/month compared to <2000 MAD/month) and in married persons (OR = 3·75, 95 % CI 1·78, 7·81) compared to single individuals.

These results contribute to target groups in whom prevention programmes could be implemented.

To describe food habits and associated sociodemographic factors.

Cross-sectional survey in 2005.

Ninety-six school classes in Ramallah, Nablus and Hebron governorates, Occupied Palestinian Territory.

Grade 8 and 9 students aged 13–15 years (n 2952).

Self-administered student and parent questionnaires.

High standard of living (STL) index and residence in Ramallah were positively associated with intake of animal foods, Western-style foods, dairy products, fruits and vegetables, sweets and salty snacks. Only 26·1 % of the students ate three main meals daily; 26·2 % of the boys and 51·0 % of the girls had breakfast one to two times per week or less often (P < 0·001). Only one-quarter of students drank milk daily (32·9 % of boys and 18·3 % of girls, P < 0·001). The majority of students, boys and girls in similar proportions, consumed vegetables daily (72·8 % v. 73·8 %, respectively). Daily fruit consumption was also equally common among boys and girls (58·9 % v. 55·2 %, respectively), but with clear differences by STL, region and parents’ education. Daily intake of sweets and salty snacks was common among girls, and daily intake of soft drinks was common among boys.

Irregular meal patterns were common among Palestinian adolescents. High STL and residence in Ramallah were associated with frequent intake of foods high in sugar and fat, but also with frequent intake of fruits and vegetables. Effective interventions are needed to establish healthy dietary habits.