Habitual food consumption of the Belgian population in 2014-2015 and adherence to food-based dietary guidelines.

BACKGROUND: Between 2014 and 2015 a second National Food Consumption Survey was conducted in Belgium in order to evaluate the habitual food consumption in the general Belgian population and to compare it with food-based dietary guidelines (FBDG) and results of the 2004 Food Consumption Survey. METHODS: A representative sample of the Belgian population was randomly selected from the National Population Register following a multistage stratified sampling procedure. Information on dietary intake was collected from 3146 subjects between 3 and 64 year old through two non-consecutive 24-hour dietary recalls using GloboDiet®. In addition, a self-administered food frequency questionnaire was completed. The distribution of habitual food consumptions and proportion of persons who did not meet the recommendations were estimated with SPADE. RESULTS: For most of food groups analysed, the habitual consumption did not comply with FBDG. The consumption of nutrient-poor and energy-dense foods (e.g. alcohol, soft drinks and snacks) was excessive (35% of total energy intake), while the consumption of most other food groups was below the minimum recommended. A large majority of the population had an inadequate consumption of dairy products (98%), vegetables (95%), fruit (91%), potatoes, rice and pasta (88%) bread and cereals (83%) and water and sugar-free drinks (73%). Males had higher consumption of most food groups than females, thereby complying more often with FBDG. For all food groups, except dairy products and fruit, the consumption increased with age. The proportion of individuals meeting FBDG was the highest among young children (3-5 years) and the worst among adolescents aged 14-17 years old. Habitual consumption remained stable between 2004 and 2014 in the population aged 15-64 years old for all food groups except for increased consumption of water and sugar-free drinks (1180 to 1289 g/d) and decreased consumption of spreadable and cooking fat (27 to 19 g/d), red meat (34 to 25 g/d) and bread and cereals (173 to 142 g/d). CONCLUSIONS: The habitual food consumption of the Belgian population (3-64 years) in 2014-2015 deviates largely from FBDG, particularly among adolescents aged between 14 and 17 years old. Few improvements were observed between 2004 and 2014 in the population between 15 and 64 years old. Further efforts are therefore necessary to improve dietary habits in Belgium, in order to prevent and reduce diet-related diseases.

The added value of food frequency questionnaire (FFQ) information to estimate the usual food intake based on repeated 24-hour recalls.

BACKGROUND: Statistical methods to model the usual dietary intake of foods in a population generally ignore the additional information on the never-consumers. The objective of this study is to determine the added value of Food Frequency Questionnaire (FFQ) data allowing distinguishing the never-consumers from the non-consumers while modeling the usual intake distribution. METHODS: Three food items with a different proportion of never-consumers were selected from the database of the Belgian food consumption survey of 2004 (N = 3200). The usual intake distribution for these food items was modeled with the Statistical Program for Analysis of Dietary Exposure (SPADE) and modeling parameters were extracted. These parameters were used to simulate (a) a new database with two 24-h recalls per respondent and (b) a "true" usual intake distribution. The usual intake distribution from the new database was obtained by modeling the 24-h recalls with SPADE, once without and once with the inclusion of the FFQ data on the never-consumers. Ratios were calculated for the different percentiles of the usual intake distribution: the modeled usual intake (g/day) (for both SPADE with and without the inclusion of FFQ data on never-consumers) was divided by the corresponding percentile of the simulated "true" usual intake (g/day). The closer the ratio is to one, the better the model fits the data. RESULTS: Inclusion of the FFQ information to identify the never-consumers did not improve the estimation of the higher percentiles of the usual intake distribution. However, taking into account this FFQ information improved the estimation of the lower percentiles of the usual intake distribution even when the proportion of never-consumers was low. CONCLUSIONS: The inclusion of FFQ information to identify the never-consumers is beneficial when interested in the whole usual intake distribution or in the lower percentiles only, no matter how low the proportion of never-consumers for that food item may be. However, when interest is only in the higher percentiles of the usual intake distribution, inclusion of FFQ information to identify the never-consumers will have no benefit.

Results From Belgium's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: This 2016 Belgium Report Card on Physical Activity for Children and Youth is the first systematic evaluation of physical activity (PA) behaviors, related health behaviors, health outcomes, and influences thereon, using the Active Healthy Kids Canada grading framework. METHODS: A research working group consisting of PA experts from both Flanders and Wallonia collaborated to determine the indicators to be graded, data sources to be used, and factors to be taken into account during the grading process. Grades were finalized after consensus was reached among the research working group and 2 stakeholder groups consisting of academic and policy experts in the fields of PA, sedentary behavior, and dietary behavior. RESULTS: Eleven indicators were selected and assigned the following grades: Overall PA (F+), Organized Sport Participation (C-), Active Play (C+), Active Transportation (C-), Sedentary Behaviors (D-), School (B-), Government Strategies and Investment (C+), and Weight Status (D). Incomplete grades were assigned to Family and Peers, Community and the Built Environment, and Dietary Behaviors due to a lack of nationally representative data. CONCLUSIONS: Despite moderately positive social and environmental influences, PA levels of Belgian children and youth are low while levels of sedentary behaviors are high.

Physical activity and sedentary behavior in Belgium (BNFCS2014): design, methods and expected outcomes.

BACKGROUND: There is strong evidence to indicate that regular moderate intensity physical activity is associated with health benefits. Furthermore, sedentary behavior has been related with an increased risk for all-cause mortality. The accurate measurement of physical activity and sedentary behavior is therefore vital to evaluate their health impact and provide evidence for the development of public health recommendations. This paper describes the methodology used for assessing physical activity and sedentary behavior in the Belgian population in the context of the Belgian National Food Consumption Survey 2014 (BNFCS2014). RESULTS: Data about physical activity and sedentary behavior were collected as part of the cross-sectional BNFCS2014 between February 2014 and May 2015. A nationally-representative sample of children (3-9 years) and adolescents (10-17 years) were asked to wear an accelerometer (Actigraph® GT3X) during their waking hours for 7 consecutive days. Data were recorded in 15-second epochs and respondents with at least 2 valid week days (i.e., 10 h of wear-time) and 1 valid week-end day (i.e., 8 h of wear-time) were retained for the analyses. The Evenson cut points were used to assess the time spent in each physical activity intensity level: sedentary, low, moderate and vigorous. Complementary, diaries were provided to register the activities performed when the accelerometer was removed; these activities were added to the measures provided by the accelerometers. In addition, age-specific self-reported questionnaires (ToyBox and FPAQ) were completed to provide contextual information about the type of activities performed. Due to financial constraints, physical activity in adults (18-64 years) was assessed and described through the self-reported International Physical Activity Questionnaire (IPAQ long version) only. CONCLUSION: Data were collected in the context of the BNFCS2014 to provide a comprehensive picture of the physical activity and sedentary behavior in the Belgian population, with a special focus on children (3-9 years) and adolescents (10-17 years). Levels of physical activity and sedentary behavior can be compared to international guidelines and analyzed according to several background variables, such as age, gender, Body Mass Index, education level and region. Such results are aimed to underpin future policies in the field of physical activity.

High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study).

BACKGROUND: High school dropout and long-term sickness absence/disability pension in young adulthood are strongly associated. We investigated whether common risk factors in adolescence may confound this association. METHODS: Data from 6612 school-attending adolescents (13-20 years old) participating in the Norwegian Young-HUNT1 Survey (1995-1997) was linked to long-term sickness absence or disability pension from age 24-29 years old, recorded in the Norwegian Labour and Welfare Organisation registers (1998-2008). We used logistic regression to estimate risk differences of sickness or disability for school dropouts versus completers, adjusting for health, health-related behaviours, psychosocial factors, school problems, and parental socioeconomic position. In addition, we stratified the regression models of sickness and disability following dropout across the quintiles of the propensity score for high school dropout. RESULTS: The crude absolute risk difference for long-term sickness or disability for a school dropout compared to a completer was 0.21% or 21% points (95% confidence interval (CI), 17 to 24). The adjusted risk difference was reduced to 15% points (95% CI, 12 to 19). Overall, high school dropout increased the risk for sickness or disability regardless of the risk factor level present for high school dropout. CONCLUSION: High school dropouts have a strongly increased risk for sickness and disability in young adulthood across all quintiles of the propensity score for dropout, i.e. independent of own health, family and socioeconomic factors in adolescence. These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to labour market integration and targeted support for those who fail to complete school.

Adolescent health and high school dropout: a prospective cohort study of 9000 Norwegian adolescents (the Young-HUNT).

BACKGROUND: High school dropout is of major concern in the western world. Our aims were to estimate the risk of school dropout in adolescents following chronic somatic disease, somatic symptoms, psychological distress, concentration difficulties, insomnia or overweight and to assess to which extent the family contributes to the association between health and school dropout. METHODS: A population of 8950 school-attending adolescents (13-21 years) rated their health in the Young-HUNT 1 Study (90% response rate) in 1995-1997. High school dropout or completion, was defined with the Norwegian National Education Database in the calendar year the participant turned 24 years old. Parental socioeconomic status was defined by using linkages to the National Education Database, the National Insurance Administration and the HUNT2 Survey. We used logistic regression to estimate odds ratios and risk differences of high school dropout, both in the whole population and among siblings within families differentially exposed to health problems. RESULTS: All explored health dimensions were strongly associated with high school dropout. In models adjusted for parental socioeconomic status, the risk differences of school dropout according to health exposures varied between 3.6% (95% CI 1.7 to 5.5) for having ≥ 1 somatic disease versus none and 11.7% (6.3 to 17.0) for being obese versus normal weight. The results from the analyses comparing differentially exposed siblings, confirmed these results with the exception of weaker associations for somatic diseases and psychological distress. School dropout was strongly clustered within families (family level conditional intraclass correlation 0.42). CONCLUSIONS: Adolescent health problems are markers for high school dropout, independent of parental socioeconomic status. Although school dropout it strongly related to family-level factors, also siblings with poor health have reduced opportunity to complete high school compared to healthy siblings. Public health policy should focus on ensuring young people with poor health the best attainable education.

Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway.

AIMS: Family and intergenerational perspectives might contribute to a better understanding of why young people in many European countries experience work impairment and end up being dependent on public benefits for life sustenance. The aim of this cohort study was to explore the relationship between the receipt of medical benefits in parents and their young adult offspring and the contributions of family health and family socioeconomic status. METHODS: Baseline information on the health of 7597 adolescents and their parents who participated in the HUNT Study 1995-1997 was linked to national registers to identify long-term receipt of medical benefits for parents (1992-1997) and adolescents as they entered adulthood (1998-2008). We used logistic regression to explore the association between parent and offspring receipt of medical benefits, adjusting for family health and socioeconomic status. RESULTS: Among adolescents, 13% received medical benefits from age 20-29. Adolescents whose parents had received medical benefits (26%) were more likely to receive such benefits themselves from age 20-29 compared with adolescents without benefit-receiving parents (age- and sex-adjusted odds ratio (OR) 2.16, 95 % confidence interval (CI) 1.86-2.49). Adjustment for family health reduced this estimate considerably (to OR 1.66, 95% CI 1.38-1.99), whereas adjustment for family socioeconomic status had less impact. CONCLUSIONS: Adolescents whose parents receive medical benefits enter adult working life with an elevated risk of health-related work exclusion. Family health vulnerability appears to be a key to understanding this association, suggesting that more attention to intergenerational continuities of health could be a way to prevent welfare dependence in future generations.

School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway).

BACKGROUND: School and work participation in adolescence and young adulthood are important for future health and socioeconomic status. The authors studied the association between self-rated health in adolescents, high school dropout and long-term receipt of medical and non-medical social insurance benefits in young adulthood. METHODS: Self-rated health in adolescence was assessed in 8795 adolescents participating in the Norwegian Young-HUNT Study (1995-1997). Linkages to the National Education Database and the National Insurance Administration allowed identification of school dropout and receipt of long-term medical and non-medical benefits during a 10-year follow-up (1998-2007). The data were explored by descriptive statistics and by multinomial logistic regression. RESULTS: A total of 17% was registered as being high school dropouts at age 24. The predicted 5-year risk of receiving benefits between ages 24-28 was 21% (95% CI 20% to 23%). High school dropouts had a 5-year risk of receiving benefits of 44% (95% CI 41 to 48) compared with 16% (95% CI 15 to 17) in those who completed high school (adjusted for self-rated health, parental education and sex). There was a 27% school dropout rate in adolescents who reported poor health compared with 16% in those who reported good health. The predicted 5-year risk of receiving any long-term social insurance benefits in adolescents who reported poor health was 33% (95% CI 30 to 37) compared with 20% (95% CI 19 to 21) in those who reported good health. CONCLUSION: The strong association between poor self-rated health in adolescence, high school dropout and reduced work integration needs attention and suggests preventive measures on an individual as well as on a societal level.