The prevalence of adolescent idiopathic scoliosis (AIS) is increasing, partly due to a lack of physical activity. In a cross-sectional study with 18,216 pupils (5th, 6th, and 8th grades) from four Croatian counties using the forward bend test (FBT; presumed AIS), the prevalence of AIS and its correlation with physical activity were evaluated. Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). Abnormal FBT was more prevalent among girls than boys (8.3% vs. 3.2%). Boys were more physically active than girls (p < 0.001). Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). A higher prevalence of presumed AIS was found among inactive or just recreationally active schoolchildren than among those engaged in organized sports (p = 0.001), girls especially. Pupils with presumed AIS were less active and had fewer weekly sports sessions than their peers without scoliosis (p < 0.001). Notably low prevalence of AIS was detected among pupils engaged in soccer (2.8%, p < 0.001), handball (3.4%, p = 0.002), and martial arts (3.9%, p = 0.006), while it was higher than expected in swimming (8.6%, p = 0.012), dancing (7.7%, p = 0.024), and volleyball (8.2%, p = 0.001) participants. No difference was detected for other sports. A positive correlation was found between time spent using handheld electronic devices and the prevalence of scoliosis (r_s = 0.06, p < 0.01). This study confirms the increasing prevalence of AIS, particularly among less athletic girls. Further, prospective studies in this field are required to explain whether the higher prevalence of AIS in these sports is due to referral or other aspects.

Adolescence is a critical period during which alcohol is the most commonly used substance worldwide, and such use has detrimental effects on neurobiological, psychosocial, and physiological development. Despite substantial international evidence, little is known about the concurrent influence of drinking motives and internalizing symptoms on adolescent alcohol use, particularly in the Croatian context, where adolescent drinking rates remain high. A cross-sectional study using a survey questionnaire was conducted in 2024 in Split-Dalmatia County, Croatia. The final stratified cluster sample comprised 925 students (58.8% of the planned sample), with a mean age of 15.41 years. Using hierarchical regression analysis, the results showed that the final model, which included both drinking motives and mental health indicators, explained 39.6% of the variance in alcohol use, 37.2% of the variance in binge drinking, and 31.8% of the variance in alcohol intoxication. Male sex was consistently associated with all three outcomes, whereas age was positively associated with alcohol use and binge drinking. Drinking motives contributed the largest proportion of the explained variance. Furthermore, lower levels of loneliness and higher levels of anxiety were associated with more frequent alcohol use, while lower stress and higher anxiety were associated with more frequent intoxication. Drinking motives are stronger predictors of adolescent alcohol use and risky drinking patterns than internalizing symptoms whose predictive strength was generally small. Prevention programs should address aspects of drinking motives in addition to promoting mental health.

Background/Objectives: Adolescent idiopathic scoliosis (AIS) is a multifactorial condition with an unclear etiology. Previous studies have reported associations of scoliosis with female sex, lower body mass index (BMI), and lower physical activity levels. This study examined factors associated with suspected scoliosis identified through school screening, with emphasis on BMI and sports participation. Methods: A cross-sectional study was conducted during the 2019/2020 school year and included 18,216 adolescents. Suspected scoliosis was identified using the forward bend test (FBT). Logistic regression analysis assessed associations between suspected scoliosis and sex, grade, BMI, participation in the seven most frequently reported sports, and training frequency. Results: Higher BMI (odds ratio (OR) = 0.91, p < 0.001), participation in soccer (OR = 0.64, p < 0.001), gymnastics (OR = 0.58, p = 0.05), martial arts (OR = 0.66, p = 0.02), and higher recreational training frequency (OR = 0.92, p < 0.001) were associated with lower odds of suspected scoliosis. Female sex (OR = 2.49, p < 0.001) and higher grade level (6th: OR = 1.54; 8th: OR = 2.98; p < 0.001) were associated with increased odds of suspected scoliosis. Conclusions: Suspected scoliosis identified through school screening was more frequently observed among females and adolescents with lower BMI. Participation in certain sports and greater recreational physical activity were associated with lower prevalence and odds of suspected scoliosis. These findings reflect screening-based associations and do not imply causal relationships. The results support the importance of school-based screening and consideration of body composition and physical activity patterns in the early identification of adolescents with suspected scoliosis.

Background: This randomized controlled trial aimed to evaluate the effects of a school physician-led counseling intervention on total cholesterol (TC) levels, adherence to the Mediterranean diet, physical activity, and sedentary behavior in children aged 6–7 years with elevated cholesterol levels in a Mediterranean setting. Methods: A one-year randomized controlled study was conducted among children aged 6–7 years with elevated TC levels, excluding those with familial hypercholesterolemia (FH). Participants were randomly assigned to either a control group (n = 38) or an intervention group (n = 39). All participants received standard care consisting of educational materials and baseline counseling, while the intervention group additionally participated in three structured follow-up counseling sessions conducted by school physicians during the one-year study period. Counseling focused on Mediterranean dietary habits, implementation of basic dietary principles in cases of elevated TC levels, promotion of physical activity, and reduction in sedentary behavior. TC levels were measured at baseline and at the end of the study. Dietary habits, physical activity, and sedentary behavior were assessed using validated questionnaires. For the primary outcome, a descriptive change-from-baseline analysis, unadjusted mean difference, the approximate 95% confidence interval, and Cohen’s d effect size were calculated. Results: At baseline, no significant differences in TC levels were observed between groups (p = 0.852). After the intervention, mean TC levels were lower in the intervention group than in the control group (4.977 ± 0.414 mmol/L vs. 5.137 ± 0.410 mmol/L); however, the between-group difference did not reach statistical significance (p = 0.089). The unadjusted mean difference at follow-up was −0.160 mmol/L, with an approximate 95% confidence interval from −0.35 to 0.03 and a small-to-moderate effect size in favor of the intervention group (Cohen’s d = −0.39). Descriptive change-from-baseline analysis showed a greater mean reduction in TC in the intervention group than in the control group (−0.364 mmol/L vs. −0.195 mmol/L). A statistically significant improvement in adherence to the Mediterranean diet was observed in the intervention group compared with the control group (p < 0.001). Favorable changes were also observed in several physical activity and sedentary behavior variables, including participation in organized physical activity, walking and running activities, and reduced television viewing and video gaming time. Given the exploratory nature of behavioral analyses and the number of physical activity and sedentary behavior outcomes examined, these findings should be interpreted cautiously. Conclusions: The school physician-led counseling intervention did not result in a statistically significant between-group difference in TC levels after one year, although the direction and magnitude of change favored the intervention group. The intervention was associated with improved adherence to the Mediterranean diet and favorable exploratory lifestyle-related behavioral changes. Nevertheless, the findings should be interpreted cautiously in light of the relatively small sample size, non-significant primary outcome, and exploratory nature of behavioral analyses.