BackgroundNegative trends in adolescent mental and subjective health are a challenge to public health work in Sweden and worldwide. Self-reported mental and subjective health complaints such as pain, sleeping problems, anxiety, and various stress-related problems seem to have increased over time among older adolescents, especially girls. The aim of this study has therefore been to investigate perceived stress, mental and subjective health complaints among older adolescents in Northern Sweden.MethodsData were derived from a cross-sectional school-based survey with a sample consisting of 16–18 year olds (n = 1027), boys and girls, in the first two years of upper secondary school, from different vocational and academic programmes in three public upper secondary schools in a university town in northern Sweden. Prevalence of perceived stress, subjective health complaints, general self-rated health, anxiety, and depression were measured using a questionnaire, including the Hospital Anxiety and Depression Scale (HADS).ResultsA large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference: two to three times as many girls as boys reported subjective health complaints, such as headache, tiredness and sleeping difficulties and musculoskeletal pain, as well as sadness and anxiety. High pressure and demands from school were experienced by 63.6% of girls and 38.5% of boys. Perceived stress in the form of pressure and demands correlated strongly with reported health complaints (r = 0.71) and anxiety (r = 0.71).ConclusionsThe results indicate that mental and subjective health complaints are prevalent during adolescence, especially in girls, and furthermore, that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in subjective adolescent health needs to be further explored.

Objective: To describe the diversity in dietary patterns existing across centres/regions participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Design and setting: Single 24-hour dietary recall measurements were obtained by means of standardised face-to-face interviews using the EPIC-SOFT software. These have been used to present a graphic multi-dimensional comparison of the adjusted mean consumption of 22 food groups. Subjects: In total, 35 955 men and women, aged 35-74 years, participating in the EPIC nested calibration study. Results: Although wide differences were observed across centres, the countries participating in EPIC are characterised by specific dietary patterns. Overall, Italy and Greece have a dietary pattern characterised by plant foods (except potatoes) and a lower consumption of animal and processed foods, compared with the other EPIC countries. France and particularly Spain have more heterogeneous dietary patterns, with a relatively high consumption of both plant foods and animal products. Apart from characteristics specific to vegetarian groups, the UK 'health-conscious' group shares with the UK general population a relatively high consumption of tea, sauces, cakes, soft drinks (women), margarine and butter. In contrast, the diet in the Nordic countries, The Netherlands, Germany and the UK general population is relatively high in potatoes and animal, processed and sweetened/refined foods, with proportions varying across countries/centres. In these countries, consumption of vegetables and fruit is similar to, or below, the overall EPIC means, and is low for legumes and vegetable oils. Overall, dietary patterns were similar for men and women, although there were large gender differences for certain food groups. Conclusions: There are considerable differences in food group consumption and dietary patterns among the EPIC study populations. This large heterogeneity should be an advantage when investigating the relationship between diet and cancer and formulating new aetiological hypotheses related to dietary patterns and disease. Of all the environmental exposures diet is a universal exposure, comprising a complex mixture of different compounds that varies over time, space and according to a number of historical, ethnic, religious, agricultural, socioeconomic and psychological factors, at the individual and population levels 1 . The lack of unbiased dietary methods and the difficulty of measuring long-term individual cumulative dietary exposure, when measurements are obtained at fixed point(s) in time of the subject's life, are important methodological limitations for estimating diet accurately as an exposure 2,3 . These drawbacks may partly explain the lack of consistency in estimates of the association between diet and disease, particularly with regard to cancer 4 , and the attenuation in relative risk estimates of the actual relationship between diet and the outcome diseases due to random errors in dietary measurements 5 -7 . Another emerging possible ...

Initial breastfeeding (particularly when exclusive) may be associated with lower blood cholesterol concentrations in later life. Moves to reduce the cholesterol content of formula feeds below those of breast milk should be treated with caution.

This study shows that tiredness, headache, stomach ache, and backache are common also among young schoolchildren. The results suggest a need of preventive efforts addressing these complaints at early age.

The Swedish PedsQL 4.0 generic core scales are a reliable and valid tool for health-related quality of life (HRQoL) assessment in Swedish child populations. The proxy full form, however, should be used with caution. The study also support continued use of the PedsQL as a four-factor model, capable of revealing meaningful HRQoL differences between boys and girls.

Different recurrent pain symptoms in children have mainly been investigated separately and comprehensive studies exploring the relationship between several of the most common recurrent pain symptoms simultaneously are few. The present study investigated frequency and co-occurrence of recurrent headache, stomach-ache, and backache in young schoolchildren (6-13 years of age). A randomized cluster sample of 1155 children from grades 0 to 6 completed a questionnaire; the youngest children helped by their parent. The results showed that 2/3 of the children reported having pain at least once every month, 1/3 at least once a week, and 6% reported experiencing pain symptoms every day. Half of the children with recurrent pain symptoms reported pain symptoms from several body locations, and, in children with weekly pain symptoms, two out of three reported multiple pain. Multiple, but not single, pain symptoms became more prevalent with age. The only difference between girls and boys was a higher prevalence of multiple weekly pain symptoms in girls. In conclusion, this study shows that a great number of young schoolchildren suffer from frequently recurring and co-occurring pain symptoms, indicating an urgent need for preventive and curative programs starting already in the first school years. Furthermore, the high prevalence of multiple symptoms indicates that recurrent pain symptoms in children, particularly frequent symptoms, should be regarded a potential general pain disorder rather than merely a localized body disorder.

Airway irritants such as ozone are known to impair lung function and induce airway inflammation. Clara cell protein (CC16) is a small anti-inflammatory protein secreted by the nonciliated bronchiolar Clara cells. CC16 in serum has been proposed as a noninvasive and sensitive marker of lung epithelial injury. In this study, we used lung function and serum CC16 concentration to examine the pulmonary responses to ambient O3 exposure and swimming pool attendance. The measurements were made on 57 children 10–11 years of age before and after outdoor exercise for 2 hr. Individual O3 exposure was estimated as the total exposure dose between 0700 hr until the second blood sample was obtained (mean O3 concentration/m3 × hours). The maximal 1-hr value was 118 μg/m3 (59 ppb), and the individual exposure dose ranged between 352 and 914 μg/m3hr. These O3 levels did not cause any significant changes in mean serum CC16 concentrations before or after outdoor exercise, nor was any decrease in lung function detected. However, children who regularly visited chlorinated indoor swimming pools had significantly lower CC16 levels in serum than did nonswimming children both before and after exercise (respectively, 57 ± 2.4 and 53 ± 1.7 μg/L vs. 8.2 ± 2.8 and 8.0 ± 2.6 μg/L; p < 0.002). These results indicate that repeated exposure to chlorination by-products in the air of indoor swimming pools has adverse effects on the Clara cell function in children. A possible relation between such damage to Clara cells and pulmonary morbidity (e.g., asthma) should be further investigated.

Aim: To investigate the current prevalence and trend of overweight in young schoolchildren in Umeå, Sweden. Methods: Two cross‐sectional samples of children were studied: 1115 randomly selected children from preschool class to grade 6 (aged 6–13 y) attending school in 2001 and a matched sample of 507 schoolchildren from grades 0, 1 and 4 (aged 6–11 y) attending school in 1986. Overweight was defined according to age‐ and gender‐specific body mass index (BMI) cutoff values, corresponding to BMI values of 25 kg/m2 (level 1) and 30 kg/m2 (level 2) at late adolescence. Results: In the population from 2001, the prevalence of overweight was 23% (18% at level 1, 5% at level 2). The prevalence differed with age, with a higher prevalence at the ages of 6 and 13 y. Comparing children from grades 0, 1 and 4, attending school in 1986 and 2001, respectively, the total prevalence of overweight was twice as high in 2001 as in 1986. Regarding severe overweight (level 2), the difference was even larger (five times). In the 1986 sample, the prevalence of overweight did not differ between girls and boys, while significantly more girls than boys were overweight in 2001. Conclusion: In this sample of young children from Sweden, the prevalence of overweight doubled over the past 15 y and severe overweight increased even more, suggesting a need for intensified preventive efforts in young schoolchildren.