(J Epidemiol Community Health 1999;53:277-282)

ObjectivesThe population of Estonia has one of the lowest life expectancies and health statuses in Europe. This is reflected in a lower perception of health among older adults. This study focuses on the role of health behaviour (smoking, alcohol consumption, physical activity and nutrition) in self-rated health, accounting for sociodemographic characteristics, activity limitations and long-term illnesses as well as satisfaction with life of older Estonian men and women.DesignWe use representative cross-sectional data from Wave 4 of the Estonian Survey of Health, Ageing and Retirement in Europe, conducted mainly in 2011.ParticipantsFrequencies, χ2 tests and logistic regression models include respondents aged 50 years and older, with no upper age limit (n=6660).ResultsMen have 20% higher odds (CI 1.02 to 1.43) of poor self-rated health. Being of foreign origin (OR 1.48; CI 1.24 to 1.77), having a basic (2.50; CI 2.06 to 3.00) or secondary (1.71; CI 1.43 to 2.04) education, being retired (2.00; CI 1.65 to 2.44) or staying at home (1.49; CI 1.16 to 1.93) and having activity limitations (3.25; CI 2.77 to 3.80) or long-term illnesses (4.78; CI 4.08 to 5.60) are related to poor self-rated health. Never being involved in vigorous (2.30; CI 1.90 to 2.79) or moderate physical activity (1.41; CI 1.02 to 1.94), and consuming legumes and eggs less frequently (1.25; CI 1.08 to 1.45) is associated with poorer self-rated health. Lower satisfaction with life accounts for some of the variation (2.28; CI 1.92 to 2.71).ConclusionsThere is a strong cumulative effect of one’s previous life course on the self-rated health of older adults in Estonia, suggesting that public health policies have long-term consequences rather than immediate consequences. Health services supporting health behaviours and targeting vulnerable population groups with specific sociodemographic characteristics and health problems may influence self-rated health for some. Public health services emphasising social activities or psychological aspects may be most successful in improving self-rated health of older Estonians through satisfaction with life.

Objective: The objective of this study was to describe mean macronutrient and food intakes in the Baltic republics, with a particular focus on fat, vegetable and fruit consumption. Design: Cross-sectional study. Setting: Data from surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used. Information was collected using a 24 h recall of dietary intake and an interviewer-administered questionnaire. Subjects: Representative national samples of adults were selected. All those with information from the dietary recall were included in the study (Estonia: n 2015; Latvia: n 2300; Lithuania: n 2094). Results: The mean proportion of energy from fat was high in each country, but particularly in Lithuania (44%) and Latvia (42%) compared with Estonia (36%). In contrast, percentage energy from carbohydrate, protein and alcohol was higher in Estonia. Mean protein intake was generally suf®cient if not high in some population sub-groups. Median vegetable intakes were very low (`200 gaday) in each country, particularly in Latvia. While 78% of the Lithuanian respondents consumed vegetables daily, this was the case in only 60% of the Latvian and 48% of the Estonian respondents. Conclusions: This study suggests that there is a pressing need to replace high-fat energy dense foods by foods rich in complex carbohydrates and dietary ®bre, such as vegetables and fruits, in the Baltic republics. This could provide the populations with a reduced risk and increased protection against non-communicable diseases. These issues will need to be tackled through comprehensive food and nutrition policies and health promotion campaigns.

Objectives: As beliefs and knowledge about the possible effects of foods on health can influence food behaviours, this study examined selected dietary beliefs in the Baltic countries and the association of beliefs related to salt intake and to types of fat with food behaviours. Design: A cross-sectional study. Setting: Data from three surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used to describe the prevalence of dietary beliefs in these countries and to investigate the association between beliefs and behaviours (using logistic regression). Subjects: Representative national samples of adults were selected in each country (Estonia, n 2018; Latvia, n 2308; Lithuania, n 2153X Results: Misunderstood concepts (myths) related to dietary salt, types of fat, meat consumption and bread and potatoes were observed in high proportions of the population. Education level was an important correlate of beliefs related to salt intake and types of fat, people with a higher education level being more likely to be familiar with these issues. Correct beliefs were not consistently associated with healthier behaviours (e.g. less frequent use of salt at the table and use of non-animal fats for cooking), except for salt intake in Estonia. Conclusions: Several misunderstood dietary concepts (myths) are still prevalent in the Baltic countries. Correct beliefs related to salt intake and types of fat were not consistent predictors of healthier food behaviours. In-depth qualitative investigations are needed to better describe and understand dietary beliefs and attitudes in the Baltic countries, and to identify barriers to the adoption of healthy food habits.

Objective: The objective of this study was to compare the nutrient content of foods and diets based on data from two food composition databases used in the Baltic Nutrition Surveys (conducted in Estonia, Latvia and Lithuania in 1997): an adapted version of the Finnish Micro-Nutrica Nutritional Analysis program (used in Estonia) and the Russian Institute of Nutrition Food Composition Database (used in Latvia and Lithuania). Design: The adapted Micro-Nutrica and Russian databases were used to estimate the energy and nutrient (protein, fat, carbohydrate, vitamin C, calcium and iron) content of 15 common foodstuffs in the region and the nutrient intakes of 32 Latvian respondents (based on 24-h recalls). Differences between databases were estimated. Results: There were discrepancies in the energy and nutrient content of the 15 selected foods using the two databases. The adapted Micro-Nutrica database generally gave a lower energy content than the Russian database (median: À6%), and a lower fat content for typically fat-rich foods. Intakes of energy, fat, carbohydrate and calcium by the 32 selected respondents were significantly lower when the Micro-Nutrica database was used. Differences were particularly high for fat (difference ¼ À23.5%, 95% confidence interval ¼ À31.1 to À15.8%, Po0.0001). Conclusions:The results suggest that reported comparisons of nutrient intakes in the Baltic countries should be treated with caution and that more research is needed for the development of comparable national databases in the region. Potential differences between databases should be investigated early when international surveys of dietary intake are being planned.