title: Trends in cardiovascular risk factors in Greece before and during the financial crisis: the impact of social disparities.
abstract: BACKGROUND
  Economic crises may have a significant impact on public health. The objective of this study was to assess trends in health-related behaviours and cardiovascular risk factors within Greece before, at the beginning and during the current financial crisis by comparing data from three waves of the Greek cross-sectional household 'Hellas Health' surveys.
  
  
  METHODS
  Data from three waves were analysed. The first wave was conducted in 2006 (n = 1005), the second in 2008 (n = 1490) and the third in 2011 (n = 1008). Samples were representative of the Greek adult population in terms of age and residency. Smoking status, height, weight and fruit and vegetable consumption were self-reported. Physical activity levels were assessed with the International Physical Activity Questionnaire.
  
  
  RESULTS
  The prevalence of smoking in Greece decreased from 42.6 to 38.1% during the crisis period 2008-11 (P = 0.026), but not during 2006-8. The prevalence of high levels of physical activity increased among Greek adults (from 21.9 to 31.7%, P < 0.001) in all socio-economic and demographic groups, with the exception of the highest socio-economic status (SES) group. On the contrary, the consumption of at least five portions of fruit and vegetables per day significantly decreased during the crisis among those of lower SES (from 9.0 to 4.1%, P = 0.006). Prevalence of obesity did not show significant trends.
  
  
  CONCLUSIONS
  During the economic crisis, fruit and vegetable consumption alarmingly decreased, especially among those of lower SES, whereas trends in smoking prevalence and physical activity levels seem favourable. These results indicate that the economic crisis may unequally impact cardiovascular risk factors among different socio-economic groups.
authors.affiliation: 1 Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece f.filippidis@mail.harvard.edu.
authors.forename: Filippos T
authors.initials: FT
authors.lastname: Filippidis
authors.affiliation: 1 Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Sotiria
authors.initials: S
authors.lastname: Schoretsaniti
authors.affiliation: 1 Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Christine
authors.initials: C
authors.lastname: Dimitrakaki
authors.affiliation: 2 Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA 3 Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece.
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
authors.affiliation: 3 Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece 4 Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Behrakis
authors.affiliation: 2 Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Connolly
authors.affiliation: 1 Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004032:Diet; D057172:Economic Recession; D005260:Female; D006115:Greece / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class