Perceived general health and mortality

Many international studies underline the importance of the health indicator "perceived general health" (PGH). For Germany, only few Longitudinal studies are available from recent years, dealing with the question whether PGH is a predictor for overall mortality. Based on a Mortality-Follow-up Study (n = 7212) under the auspices of the Federal Institute for Population Research the importance of the indicator PGH for the prediction of the mortality experience in the general population has been analysed for the period 1984 - 1998. The age-adjusted relative risk of "less than good health" for overall mortality is 2.11 (p <0.001) for males and 2.05 (p <0.001) for females (reference category: "good/very good health"). The relative risks for "poor health" are 4.32 (p <0,001) in males and 3.07 (p <0.001) in females. An inclusion of several control variables remarkably reduces these relative risks. The results indicate that the indicator "perceived general health" is an important predictor of overall mortality in Germany.     

Food and nutrient intake in East and West Germany, 8 years after the reunification--The German Nutrition Survey 1998

OBJECTIVE: To explore differences in food and nutrient intake as well as cardiovascular risk factors between the eastern and western parts of Germany in 1998 and to compare food consumption information between 1991 and 1998. DESIGN AND SUBJECTS: In all, 4030 people, aged 18-79 y, sampled from the East and West parts of Germany participated in the German Nutrition Survey (1998) by completing dietary histories and being assessed for cardiovascular risk factors. In a separate analysis, two food frequency data sets were compared from National Health Surveys conducted in 1991 (n = 7466) and in 1998 (n = 4556). RESULTS: In 1998, East Germans consumed more bread, fruit, fish, sausage, offal, and men additionally more cakes/cookies, beer and soft drinks than West Germans. They consumed less cereals, pasta, sweets, leafy vegetables, tea and drinking water, and men less vegetables and wine and women less pastry/crackers, potatoes and animal fat compared with their counterparts in West Germany. East Germans had a higher intake of total vitamin A, retinol, vitamin D, vitamin B12 and chloride, and in addition men of alcohol, and women of monosaccharides. They had a lower intake of total water, vitamin K, calcium, magnesium and manganese, and men of linoleic acid, and women of vitamin E than their West German counterparts. In East Germany, higher mean systolic blood pressure, and total and high-density lipoprotein cholesterol concentrations were found in men, and a lower mean total serum cholesterol concentration found in women compared with West Germany. CONCLUSION: Differences in food intake between the eastern and western parts of Germany still existed in 1998, although these differences were smaller than those observed 1 y after the reunification.     

Violence and fear of violence in East and West Germany

The purpose of this research was to assess the effect of major social changes in Germany since 1989 on mortality due to intentional injury. Mechanisms and types of fatal intentional injury in East and West Germany between 1970 and 1995 were determined from death certificates and compared with judicial data on violent crime convictions and recent public survey data on citizen fear of crime. The number of homicides among East German males increased between 1989 and 1991, and the homicide rate remains high when compared with West German males (although lower than that of American males). Homicide among German females is less common, presently about equally likely in East and West. Violent crime in general has become more frequent in Germany, and citizen fear of crime has increased markedly, especially in the East. Non-citizens are convicted for an increasing number of homicides and assaults. Rates of suicide were declining in East and West before reunification, and these rates have continued to decline. Social changes in Europe since 1989 have led to noticeable increases in violence and homicide in Germany, which in turn have reduced feelings of security among German citizens, especially in the East. Suicide rates have not been affected.     

Weight gain in two adult cohorts in East and West Germany reunification

BACKGROUND: Several epidemiological studies have shown consistently higher prevalence rates of obesity and overweight in East German adults compared to West German adults before German reunification in 1990. If different lifestyle factors after German division contribute to these differences, one might speculate that trends of obesity and overweight in the East and West after German reunification in 1990 would be similar. OBJECTIVE: To examine weight gain in East and West German adult cohorts in the decade after German reunification. METHODS: The study population includes 554 individuals with complete data aged 20 - 47 years in 1990-92 participating in the ten year follow-up of the European Community Respiratory Health Survey (ECRHS) in the German centres Hamburg (West) and Erfurt (East). Age and occupation-adjusted prevalence and incidence rates, stratified for gender and centre, were calculated for the Erfurt and Hamburg cohorts. RESULTS: The prevalence of overweight increased in males and females in both cities, and was statistically significant for Hamburg males (32.7% to 44.9%), Hamburg females (12.3% to 25.4%) and Erfurt females (18.5% to 31.2%). The increase in the prevalence of obesity was statistically significant for males (Hamburg: 3.7% to 7.9%; Erfurt: 5.2% to 10.8%) and for females only in Hamburg (6.4% to 14.2%). The increase in the prevalence of overweight and obesity were larger in Hamburg than in Erfurt. Moreover, the incidence rates of obesity were higher in Hamburg for both sexes, but were not statistically significant CONCLUSION: Our findings indicate different patterns of weight gain in 2 study sites in East- and West-Germany. These results might reflect a convergence of initially higher prevalences of overweight and obesity in the East with initially lower prevalences in the West.     

Injury mortality in East Germany

OBJECTIVES: This study determined the effects of social changes in East Germany since 1989 on patterns of injury mortality. METHODS: Death certificate data regarding injuries from 1980 through 1995 and police data regarding traffic injuries in East Germany from 1980 through 1998 were compared with similar data from West Germany. RESULTS: The number of motor vehicle-related injuries and deaths in East Germany increased dramatically between 1989 and 1991, whereas those in West Germany declined slightly. The increased mortality in the more rural East has especially involved young men driving automobiles on rural roads and has persisted since reunification of East and West Germany. Falls, other accidents, and suicides have shown no such effect. Homicide among East German men has increased but remains uncommon. CONCLUSIONS: Recent social changes in East Germany, including increased access to motor vehicles and decreased restrictions on personal freedom, have been associated with increased motor vehicle crashes and mortality, especially among young men and on rural roads.     

Serum leptin and lipid profiles in Thai obese and overweight subjects

The weight, height, body mass index (BMI), waist/hip ratio, serum leptin and lipid profiles of 48 overweight (BMI > or = 25.00). Thai males and 166 overweight Thai females, compared with 26 males and 81 females in a control group (BMI = 18.5-24.9 kg/m2), were investigated. Subjects for the study were those persons who turned up regularly for physical check-ups at the out-patient department, general practice section of the Rajvithi Hospital, Bangkok. The study was conducted between March-October, 1998. Statistically significantly higher levels of serum leptin, cholesterol, LDL-C, LDL-C/HDL-C ratio and triglyceride were found in the overweight compared with the control subjects. The median serum leptin concentration in overweight subjects was 19.6 (2.0-60.0 ng/ml) compared with 9.0 (range 1.0-30.0 ng/ml) in the control subjects (p < 0.001). The median values of leptin serum concentrations in the overweight and obese males were significantly higher than those of the overweight and obese females. A total of 66.7% (32 out of 48) of the overweight and obese males had elevated leptin levels, while elevated leptin levels were found in 87.3% (145 out of 166) of the overweight and obese females. A total of 18.8% and 21.1% of the overweight and obese males and females respectively had cholesterol concentrations of > or = 6.48 mmol/l. However, the prevalence of low HDL-C (HDL-C < or = 0.91 mmol/l) was found to be 41.7% in the overweight and obese males and 4.2% in the overweight and obese females. Statistically significant associations were found between weight, height, BMI, waist, hip, waist/hip ratio, HDL-C, and serum leptin in both overweight male and female subjects. A negative correlation was found between serum leptin and LDL-C/HDL-C ratio in both the overweight and obese subjects.     

Regional variation and time trends in mortality from ischaemic heart disease: East and West Germany 10 years after reunification

STUDY OBJECTIVE: Within Europe, a pronounced geographical gradient of mortality from ischaemic heart disease has been observed with the highest burden in the north east and the lowest in the south west. The study objective was to compare mortality from ischaemic heart disease between former East and West Germany since reunification. DESIGN: Analyses of age standardised mortality rates from ischaemic heart disease (ICD-9 410-414, ICD-10 I20-I25) between 1990-1991 and 2000. SETTING: Former East and West Germany. MAIN RESULTS: After a peak in the early 1990s, mortality from ischaemic heart disease has substantially declined in both parts of Germany (from 222 to 169 per 100 000 in the East and from 150 to 116 per 100 000 in the West). The regional difference, however, remained rather constant: the rate ratio between the pooled mortality in the East compared with the West was 1.51 (95% CI 1.46 to 1.56) in 1991 and 1.45 (95% CI 1.39 to 1.50) in 2000. These rate ratios were higher in women (1.63 in 1991 and 1.52 in 2000) compared with men (1.45 and 1.44, respectively). CONCLUSIONS: Within Germany, there has been a pronounced east-west gradient of mortality from ischaemic heart disease since reunification. Further insight into possible underlying reasons may lead to improved preventive strategies.     

A combination of serum low albumin and above-average cholesterol level was associated with excess mortality

BACKGROUND: There is no population-based prospective study concerning the relation between serum albumin and mortality in a non-Western population, and few previous studies included the subgroup analysis stratified by serum cholesterol level. METHODS: A 13.7-year cohort study was conducted on 6,957 males and females aged 30-59 years from 300 randomly selected areas throughout Japan, who participated in the National Survey on Circulatory Disorders in 1980. RESULTS: In the group with median and above of total cholesterol, one standard deviation (SD) increment of serum albumin (2.6 g/L for males and 2.4 g/L for females) was inversely associated with all-cause mortality for both males and females (relative risk RR = 0.68 and 0.81: 95% confidence interval CI = 0.53-0.87 and 0.68-0.98), and with cancer mortality for females (RR = 0.74; 95% Cl = 0.57-0.96);and the lowest category of serum albumin (< or = 43 g/L) showed the highest cardiovascular mortality for males (RR = 5.04; 95% CI = 1.04-24.5) among the three albumin categories. These relationships were not evident in the group with total cholesterol level below median. CONCLUSION: A combination of a low albumin level and above average cholesterol level, even both within the clinical normal range,is associated with excess mortality in the Japanese general population.     

Social inequities in cardiovascular disease risk factors in East and West Germany.

Social class related differences in prevalence of cardiovascular disease risk factors in Germany were investigated with special emphasis on comparisons between East and West Germany and on time trends. Databases for West Germany are the first and second National Health Survey (survey 1: N = 4794, survey 2: N = 5315), carried out in the framework of the German Cardiovascular Prevention Study, and for East Germany the first GDR-MONICA project (N = 6125). Different social class indices were applied to evaluate social inequities for hypertension, hypercholesterolemia, cigarette smoking, obesity and predicted cardiovascular disease mortality. As a main result, it was found that very similar patterns in the relation between social class characteristics and cardiovascular disease risk factor prevalence occurred for both parts of Germany. Social class gradients were strongest for obesity and weakest for hypercholesterolemia. Analysis of time trends for the period from 1984 to 1988 (for West Germany only) revealed an increase in social inequalities for hypertension in males and cigarette smoking in females. These findings point to the need to focus more on social disadvantaged segments in the population when community based health promotion and disease prevention programs are brought into action.     

Marital status and mortality: the national longitudinal mortality study

PURPOSE: To examine the effect of marital status (married, widowed, divorced/separated, and never-married) on mortality in a cohort of 281,460 men and women, ages 45 years and older, of black and white races, who were part of the National Longitudinal Mortality Study (NLMS). METHODS: Major findings are based on assessments of estimated relative risk (RR) from Cox proportional hazards models. Duration of bereavement for the widowed is also estimated using the Cox model. RESULTS: For persons aged 45-64, each of the non-married groups generally showed statistically significant increased risk compared to their married counterparts (RR for white males, 1.24-1.39; white females, 1.46-1.49; black males, 1.27-1.57; and black females, 1. 10-1.36). Older age groups tended to have smaller RRs than their younger counterparts. Elevated risk for non-married females was comparable to that of non-married males. For cardiovascular disease mortality, widowed and never-married white males ages 45-64 showed statistically significant increased RRs of 1.25 and 1.32, respectively, whereas each non-married group of white females showed statistically significant increased RRs from 1.50 to 1.60. RRs for causes other than cardiovascular diseases or cancers were high (for white males ages 45-64: widowed, 1.85; divorced/separated, 2.15; and never-married, 1.48). The importance of labor force status in determining the elevated risk of non-married males compared to non-married females by race is shown. CONCLUSIONS: Each of the non-married categories show elevated RR of death compared to married persons, and these effects continue to be strong after adjustment for other socioeconomic factors.     

Visual disturbances in a population-based survey of 6962 subjects: the German National Health Examination Survey 1998

BACKGROUND: Available prevalence estimates of visual disturbances (excluding blindness) in Germany are based on data from highly selective populations. This report describes the prevalence of visual disturbances and potential determinants based on the German National Health Examination Survey from 1998. METHODS: A population-based cross-sectional study of the non-institutionalized population in unified Germany. People aged 18-79 years were eligible and were contacted by a multi-mode approach. The response proportion was 61%, resulting in a sample of 7124 subjects who participated in the study. Visual disturbances were assessed by a self-administered questionnaire. RESULTS: Prevalance rates are higher among women in unified as well as in East- and West Germany. The higher overall prevalence rates among women is mostly driven by higher prevalance rates at ages 18-49 years, especially for shortsightedness. The prevalence rates are higher in West Germany than East Germany. Visual disturbances are more prevalent among the middle and upper social class than the lower social class. Above the age group 40-44, the prevalence of visual disturbances considerably increases, to approximately 100% in the age group 55 years or older for both sexes and in both parts of Germany. CONCLUSIONS: Nearly 100% of German adults aged 50-79 years have some degree of visual disturbance that requires refractive correction. Prevalence rates of visual disturbances are higher among people from West Germany, people of higher social status and among women. Uncorrected visual disturbances are most prevalent in the age group 18-34 years and more often among males and subjects of lower social status.     

A comparison of the alcohol-attributable mortality in four European countries

Background: Deaths due to alcohol consumption are an important component of all-cause mortality, particularly premature mortality. However, there are considerable regional variations, the reasons for which are unclear. Methods: Estimates were made as reliably as possibly using vital statistics and best estimates of risk of the alcohol-attributable mortality, by age, sex and cause for four European countries (England and Wales, Germany, Denmark and Italy). Twenty-seven alcohol-related conditions were considered including the possible cardio-protective effects of alcohol. Results: It was estimated that there are approximately 2% fewer deaths annually in England and Wales than would be expected in a non-drinking population and 0.3% fewer deaths among East German females. In West Germany, Denmark, Italy and among East German males there are more deaths caused by alcohol than are prevented (between 0.7 and 2.6% of all deaths). The highest age-specific proportion of alcohol-attributable deaths is found in East Germany where around 30% of deaths among males aged 25–44 years are due to drinking. Among young men in all four countries the largest contributor to alcohol-related deaths is road traffic accidents involving alcohol. Conclusions: Possible explanations for the variation in alcohol-attributable deaths between countries include different underlying heart disease rates, different patterns of alcohol consumption and beverage preferences, and different use of mortality classification. Differences in the reported alcohol consumption levels explain little of the variation in alcohol-attributable deaths. Estimating alcohol-attributable mortality by age and sex across countries may be a useful indicator for developing alcohol strategies and exploring ways of preventing premature mortality.     

Leisure time sports activity and all-cause mortality in West Germany (1984–1998)

Background Current data and available studies suggest that regular physical activity decreases overall mortality. In Germany corresponding findings are scarce. The aim of this data analysis was to clarify this issue for a German sample in men and women.Methods A total of 3,742 males and 3,445 females aged 30–69, who participated in a baseline questionnaire in 1984–1986, were followed-up to the year 1998.Results During the follow-up period, 300 women and 643 men died. The multivariate rate ratios (RR) for accumulated hours of leisure time sports activities (LTSA) per week and with an LTSA-index based on METs per week with the reference of sedentary lifestyle, showed a clearly protective impact in a dose-response relationship (p for trend <0.05). Similar trends were observed in women and men. More than 2 hours of LTSA per week produced a RR of 0.70 (95% confidence interval [CI]: 0.54–0.91) in men and 0.57 (95% CI: 0.35–0.94) in women. In the group with the highest LTSA-index, the RR was 0.61 (95% CI: 0.44–0.84) in men and 0.46 (95% CI: 0.25–0.85) in women.Conclusion LTSA is inversely associated with all-cause mortality in females and males.     

Gender-specific risk factors for mortality associated with incident coronary heart disease--a prospective community-based study

BACKGROUND: Risk factors for mortality in community-residing persons developing congestive heart failure (CHF) and acute myocardial infarction (AMI) may differ for males and females. METHOD: Persons from the Groningen Longitudinal Aging Study with incident CHF (N=274) or AMI (N=198) were identified between 1993 and 1998 and their survival status was collected in 2001. Risk factors are assessed prior to the cardiac diagnosis. RESULTS: The 1-, 5-, 7-year survival rates were 65, 53, 50% for AMI and 74, 45, 32% for CHF. Multivariate analyses showed that male gender, high age, smoking, diabetes and low physical function were risk factors for mortality among persons with CHF. For AMI, 1 month mortality was related to high age and baseline low body mass index, while longer term mortality was related to male gender and high age. In addition, diabetes increased longer term mortality among females but not among males with AMI. Depression was not a risk factor for mortality for either condition in either gender. CONCLUSION: Males with CHF or AMI have worse survival rates compared to females. Risk factors for mortality are predominantly similar for males and females, except for diabetes which is a risk factor among females, but not males with AMI.     

Pilot study of risk behaviour, voluntary HIV counselling and HIV antibody testing from saliva among inmates of prisons in Slovakia

OBJECTIVE: To implement a pilot study of risk behaviour and HIV infection using HIV antibody testing from saliva to improve the situation as regards HIV/AIDS infection in prison institutions in the Slovak Republic. MATERIAL AND METHODS: The study comprised adult and juvenile males of grade one correction categories and prisoners from the prison for juveniles in Martin, as well as females prisoners in Nitra. Preventive activities were implemented in May 1998 in the form of discussions concerning topics related to HIV/AIDS infection. Saliva was collected for the presence of HIV antibodies and a questionnaire regarding sexual practice was completed. RESULTS: 32 persons [8 adult males (25%), 6 juvenile males (18.7%) and 18 females (56%)] were voluntarily tested for the presence of HIV antibodies in saliva. Nobody was HIV-positive. 75 persons (20 adult males, 30 juvenile males and 25 females) were involved in the study of risk behaviour. 40.8% participants had primary education, 28.2% secondary education, 2.8% were students of universities and 28.2% were apprenticies. 60% inmates (mostly females) were religious. Juvenile males reported the highest number of partners while females the smallest (p < 0.001). The more partners were reported by respondents, the lower was condom usage (p < 0.07). 47.6% females relied on credibility of partners, while 75% adult males and 50% adolescent males did not use protection. 0% females, 5% adult males and 10.3% juvenile males reported to have homosexual contacts outside prison while 19%, 5.6% and 8.3% in the prison, respectively. Paid sexual services were offered by 9.1% females, 15.8% adult males and 25% juvenile males. Outside prison adult and juvenile males used non-sterile used syringes as well as tattooing more often than females (p < 0.07 and p < 0.04, respectively). CONCLUSION: The present study provides information on the results of HIV-antibody testing in saliva. The results are based on a study of risk behaviour and difficulties linked with HIV/AIDS prevention among prisoners.     

Thyroid cancer incidence among adolescents and adults in the Bryansk region of Russia following the Chernobyl accident

Thyroid cancer incidence in the Bryansk region, the most contaminated area of Russia after the Chernobyl accident, is analyzed for the residents aged 15-69 y at the time of the accident (about 1 million persons according to the 1989 census) for the period from 1986 to 1998. Sex and age standardized incidence rates are presented and compared to the whole Russian population rates (SIR analysis). Also, a geographical correlation analysis is performed for incidence rates and mean thyroid doses at the district level, which provides a basis for preliminary estimation of radiation associated risks for the period 1991-1998 (to allow for a potential five year latent period). Thyroid doses were estimated based on the State official document "Methodology for reconstruction of dose from iodine radioisotopes in residents of the Russian Federation exposed to radioactive contamination as a result of the Chernobyl accident in 1986" (2000). Altogether, 1,051 thyroid cancer cases were detected in the Bryansk oncological dispensary from 1986 to 1998 and 769 from 1991 to 1998. Histological confirmation was available for 87% and 95% of these cases, respectively. Standardized incidence ratios (SIR) were 1.27 (95% CI = 0.92, 1.73) for the period 1986-1990 and 1.45 (95% CI = 1.20, 1.73) for the period 1991-1998 for males and 1.94 (95% CI = 1.70, 2.20) and 1.96 (95% CI = 1.82, 2.1) for females. The excess relative risk per 1 Gy (using external control) estimate for the period 1991-1998 was -0.4 (95% CI = -3.5, 2.7), -1.3 (95% CI = -2.8, 0.1) for males and females, respectively, and -0.6 (95% CI = -2.1, 0.8) for both sexes. Using internal controls, the excess relative risk (ERR(1Gy)) per unit dose of 1 Gy was found to be 0.7 with 95% CI (-2.3, 5.2) for males, -0.9 with 95% CI (-2.4, 0.8) for females and 0.0 with 95% CI (-1.4, 1.7) for males and females together. These results are discussed in the light of the quality of information available on thyroid cancer cases and screening campaigns carried out after the Chernobyl accident.     

Trends in risk factor control in Germany 1984-1998: high blood pressure and total cholesterol

BACKGROUND: Diagnosis and treatment of the two primary cardiovascular risk factors, hypertension and hypercholesterolaemia, are well established. Nevertheless, according to earlier analyses of representative health questionnaire and examination surveys in 1984, 1988 and 1991, control of risk factors in the sense of normalized values through drug therapy did not improve to any relevant degree in former West Germany. The National Health Survey of 1998 now allows the reconsideration of the hypothesis that medical treatment has been improving and lead to a reduction of risk factor values measured in the population. METHODS: Datasets of independent cross-sectional studies in 1984, 1988, 1991 and 1998 with net random sample sizes between 3,458 and 5,335 were analysed for actual (persons with elevated values and persons successfully treated) and population (persons with elevated values) prevalence, awareness of the risk factors under question, treatment coverage (risk factor aware and treated) and effectiveness (risk factor aware, treated and normalized), and the resulting parameters of controlled (successfully treated persons among actual prevalence) and uncontrolled prevalence (persons with elevated values among actual prevalence), respectively. Thresholds chosen were blood pressure values >or=160/95 mmHg for hypertension and values >or=250 mg/dl for hypercholesterolaemia. Regarding medication, the answer of 'one to two times weekly' or more was considered to indicate a relevant drug intake. RESULTS: For hypertension the population prevalence (population 30-69 years old) increased significantly (P < 0.0001) from 19.6% to 24.0% between 1984 and 1998, whereas the actual prevalence rose less steeply but still significantly (P < 0.0002) from 32.5% to 34.4%. For hypercholesterolaemia the population prevalence stagnated at 37.0% (1998), whereas the actual prevalence was 47.5% in 1998 (39.1% in 1984; P < 0.0001). For hypertension treatment, coverage improved from 45.4% to 63.0%, but treatment effectiveness decreased from 51.7% to 41.3%, both trends being highly significant. For hypercholesterolaemia, awareness increased from 18.3% to 57.6%, but treatment coverage decreased from 33.5% to 15.5%, whereas treatment effectiveness improved from 23.8% to 47.7%, all trends being highly significant (P < 0.0001). CONCLUSIONS: The results do not support the hypothesis that medical care for the large population at cardiovascular risk in (Western) Germany was adequate and successful in the 1980s and 1990s.     

AIDS – Wie leben schwule Männer heute? Kurzfassung der Ergebnisse der Befragung November 1999

A four page questionnaire was included in the November 1999 edition of 10 monthly German magazines for gay men to investigate how this population responds to risks posed by HIV/AIDS. This was the sixth time the questionnaire was administered in the former West Germany since 1987 and the fourth time in the former East Germany since 1991. A total of 2995 men responded (16% from the former East Germany, and 84% from the former West Germany). In 1999, 72% of respondents from both the western and eastern parts of the country did not engage in risk contacts in the twelve months preceding the survey, where risk contact was defined as unprotected anal intercourse with partners whose serostatus was unknown or whose status differed from that of the subject. In 1996, this percentage was 72% for East Germans and 76% for West Germans. The occurrence of protective behaviour in East and West has become increasingly similar over time; whereas, the proportion of men in the West German samle taking risks has increased since 1996. Whether the increased risk-taking in the West can be attributed to the introduction of combination therapy is a question which cannot be answered on the basis of the data gathered.     

A longitudinal study through adolescence to adulthood: the Young Hearts Project,Northern Ireland

The Young Hearts (YH) Project is an ongoing study of biological and behavioural risk factors for cardiovascular disease in a representative sample of young people from Northern Ireland, a region of high coronary mortality. This article describes the cross-sectional clinical, dietary and lifestyle data obtained from individuals (aged 20-25 y) who participated in phase 3 of the project (YH3). A total of 489 individuals (251 males, 238 females) participated in YH3 (48.2% response rate). Some 31.1% of participants at YH3 were overweight (BMI >25 kg/m(2)) with 4.4% of males and 8.0% of females were obese (BMI >30 kg/m(2)). More females than males had a very poor fitness (55.0 vs 22.1%, chi-squared 51.70, d.f. 1, P<0.001) and did not participate in any sporting or exercise activity (38.4 vs 24.9%, chi-squared 10.26, d.f. 1, P=0.001). Over 20% of participants had a raised total serum cholesterol (>5.2 mmol/l). More females had a raised serum LDL-cholesterol (>3.0 mmol/l) than males (44.6 vs 34.6%, chi-squared 4.39, d.f. 1, P<0.05). Over 46% of participants reported energy intakes from fat above recommended levels, and 68.5% of participants had saturated fat intakes above those recommended (Dietary reference values for food energy and nutrients for the United Kingdom. HMSO: London, 1991). Just over half of the study population reported alcohol intakes in excess of recommended sensible limits set by the Royal College of Physicians (A great and growing evil: the medical consequences of alcohol abuse. Tavistock: London, 1987), with 36.7% of males and 13.4% of females reporting intakes over twice these recommended limits. A total of 37% of the study population smoked. During young adulthood, individuals may be less amenable to attend a health-related study and recruitment of participants to the current phase of the study proved a major problem. However, these data constitute a unique developmental record from adolescence to young adulthood in a cohort from Northern Ireland and provide additional information on the impact of early life, childhood and young adulthood on the development of risk for chronic disease.