Belgian Adult Population Research Articles

Gender and Education Differences in Mental Health in Belgium: a Bayesian Age-Period-Cohort Analysis

Abstract Background Mental illnesses (MI) constitute a growing public health problem, with reports of a higher prevalence among middle-aged adults (age effect), during specific periods such as economic crisis (period effect) and in recent birth cohorts (cohort effect). However, few studies have assessed whether these age-period-cohort (APC) effects were related to general population trends or if they are driven by changes in the mental health status of more vulnerable groups. Therefore, this study aimed to assess gender and educational differences underlying observed APC effects in the prevalence of MI in the Belgian adult population. Methods This study used data from six cross-sectional waves of the Belgian Health Interview Survey (1997-2018, ∼ 10,000 respondents per wave). Mental health was assessed using the 12-item General Health Questionnaire. Bayesian hierarchical APC models were applied on the prevalence of MI, taking into account gender and educational differences, as well as some potential confounding factors. Results Overall, this study confirmed the higher prevalence of MI in middle-aged adult, in 2013, and in more recent birth cohorts (1980-2000). Accounting for the interaction between gender and education, we found that the MI educational gradient was more pronounced for women than men. Finally, we found that APC trends were different between gender. The odds of having MI tended to be stable across age groups for women, while men showed an increased odds between 50-60 years and a decrease between 60-65 years. Regarding period and cohort effects, the increase odds in 2013 was mainly present in men, while the increase in recent birth cohorts was mainly present in women. Conclusions This study emphasizes that the age-period-cohort effects on mental health are different depending on gender and education, thus enriching our understanding on the underlying mechanisms to better guide future public (mental) health policies. Key messages • This study shows the importance of studying not only the overall trends in mental illness, but also the underlying differences in its distribution. • Insights into gender and educational differences in Age-Period-Cohort effects on mental health is crucial for the development of timely and efficient public health interventions.

Unravelling COVID-19 social mortality patterns using conditional inference tree algorithm

Abstract Background The COVID-19 pandemic led to significant excess mortality in 2020 in Belgium. By using microlevel cause-specific mortality data for the total Belgian adult population in 2020, three outcomes were considered in this study aiming at predicting sociodemographic (SD) and socioeconomic (SE) patterns of 1) COVID-19 specific death compared to survival; 2) all other causes of death (OCOD) compared to survival; 3) COVID-19 specific deaths compared to all OCOD. Methods Multivariable logistic regression models were fitted for the three outcomes. In addition, we computed conditional inference tree (CIT) algorithms, complementing regression models, to identify and rank the strongest SD and SE predictors of the three outcomes. Results Older people, males, people living in collectivities, first-generation migrants, and deprived SE groups experienced higher odds of dying from COVID-19 compared to survival; living in collectivities was identified by the CIT as the strongest predictor followed by age and sex. Education emerged as one of the strongest predictors for people not living in collectivities. Overall, similar patterns were observed for all OCOD except for first- and second-generation migrants having lower odds of all OCOD compared to survival; age group was identified by the CIT as the strongest predictor. Older people, males, people living in collectivities, first- and second-generation migrants, and people with lower levels of education had higher odds of COVID-19 death compared to all OCOD; living in collectivities was identified by the CIT as the strongest predictor followed by age, sex, and migration status. Education and income emerged as the strongest predictors among people not living in collectivities. Conclusions This study identified important SD and SE disparities in COVID-19 mortality underlying the importance of implementing preventive measures, particularly within the most vulnerable populations, in infectious disease pandemic preparedness. Key messages • Living in collectivities appeared to be the strongest predictor of COVID-19 death across all age groups, highlighting the importance of preventive measures in reducing the transmission of the virus. • Poor education plays a crucial role in predicting COVID-19 death among people not living in collectivities, highlighting the importance of targeting preventive measures towards low educated groups.

Fermentable oligo-di-mono-saccharides and polyols (FODMAPs) and fibre intake in a Belgian adult population

Fermentable oligo-di-mono-saccharides and polyols (FODMAPs) and fibre intake in a Belgian adult population

Anxiety and depression in people with post-COVID condition: a Belgian population-based cohort study three months after SARS-CoV-2 infection.

Since the onset of the COVID-19 pandemic, most research has focused on the management of the acute symptoms of the disease. Yet some people tend to experience symptoms beyond the acute phase, defined as Post-COVID-19 Condition (PCC). This study aims to assess the impact of COVID-19 and PCC on anxiety and depression. This is a prospective longitudinal cohort study among the Belgian adult population with recent SARS-CoV-2 infection for which contact tracing was initiated. A total of 3127 people were followed-up just after their infection and three months later (from April 2021 to January 2022). Anxiety and depression were assessed at the two stages using the GAD-7 (Generalized Anxiety Disorder) and the PHQ-9 (Patient Health Questionnaire). Three months after infection, participants with PCC (50%) had an increased probability of having both anxiety and depressive symptoms (p < 0.001). The proportion with anxiety and depressive symptoms at three months were significantly higher in people with PCC (11% and 19%) compared to people without persistent COVID symptoms (3.8% and 4.2%) and to a matched sub-sample not infected with SARS-CoV-2 (6.5% and 4.3%). Having at least one acute COVID-19 symptom (p < 0.001), experiencing financial loss following the infection (p < 0.001), and different PCC symptoms were associated with anxiety and depressive symptoms worsening over time. This study showed that three months after a SARS-CoV-2 infection, one in two people suffer from PCC with significant consequences for their mental health. Follow-up on mental health must therefore have an important place in people suffering from PCC.

Prevalence of SARS-CoV-2 antibodies and associated factors in the adult population of Belgium: a general population cohort study between March 2021 and April 2022

BackgroundThis study assessed seroprevalence trends of SARS-CoV-2 antibodies in the Belgian adult population between March 2021 and April 2022, and explored factors associated with seropositivity and seroreversion among the vaccinated and unvaccinated population.MethodsA prospective longitudinal surveillance study was conducted within a random sample of the general population (18 + years) in Belgium, selected from the national register through a multistage sampling design. Participants provided a saliva sample and completed a survey questionnaire on three occasions: at baseline and in two follow-up waves. Outcome variables included (1) seropositivity, defined as the presence of SARS-CoV-2 antibodies, assessed with a semi-quantitative measure of anti-RBD (Receptor Binding Domain) IgG ELISA and (2) seroreversion, defined as passing from a positive to a negative antibody test between two measurements. Trends in SARS-CoV-2 antibody prevalence were assessed using binary logistic regression with contrasts applying post-stratification. Potential determinants of seropositivity were assessed through multilevel logistic regressions.ResultsIn total 6,178 valid observations were obtained from 2,768 individuals. SARS-CoV-2 antibody prevalence increased from 25.1% in the beginning of the study period to 92.3% at the end. Among the vaccinated population, factors significantly associated with higher seropositivity rates were being younger, having a bachelor diploma, living with others, having had a vaccine in the last 3 months and having received a nucleic-acid vaccine or a combination. Lower seropositivity rates were observed among vaccinated people with a neurological disease and transplant patients. Factors significantly associated with higher seropositivity rates among the unvaccinated population were having non-O blood type and being non-smoker. Among vaccinated people, the seroreversion rate was much lower (0.3%) in those who had received their latest vaccine in the last 3 months compared to those who had received their latest vaccine more than 3 months ago (2.7%) (OR 0.13; 95%CI 0.04–0.42).ConclusionsThe rapid increase in antibody seropositivity in the general adult population in Belgium during the study period was driven by the vaccination campaign which ran at full speed during this period. Among vaccinated people, seropositivity varied in function of the time since last vaccine, the type of vaccine, sociodemographic features and health status.

Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population?

BackgroundHealth literacy (HL) has been put forward as a potential mediator through which socioeconomic status (SES) affects health. This study explores whether HL mediates the relation between SES and a selection of health or health-related outcomes.MethodsData from the participants of the Belgian health interview survey 2018 aged 18 years or older were individually linked with data from the Belgian compulsory health insurance (n = 8080). HL was assessed with the HLS-EU-Q6. Mediation analyses were performed with health behaviour (physical activity, diet, alcohol and tobacco consumption), health status (perceived health status, mental health status), use of medicine (purchase of antibiotics), and use of preventive care (preventive dental care, influenza vaccination, breast cancer screening) as dependent outcome variables, educational attainment and income as independent variables of interest, age and sex as potential confounders and HL as mediating variable.ResultsThe study showed that unhealthy behaviours (except alcohol consumption), poorer health status, higher use of medicine and lower use of preventive care (except flu vaccination) were associated with low SES (i.e., low education and low income) and with insufficient HL. HL partially mediated the relationship between education and health behaviour, perceived health status and mental health status, accounting for 3.8–16.0% of the total effect. HL also constituted a pathway by which income influences health behaviour, perceived health status, mental health status and preventive dental care, with the mediation effects accounting for 2.1–10.8% of the total effect.ConclusionsAlthough the influence of HL in the pathway is limited, our findings suggest that strategies for improving various health-related outcomes among low SES groups should include initiatives to enhance HL in these population groups. Further research is needed to confirm our results and to better explore the mediating effects of HL.

Sociodemographic and socioeconomic disparities in COVID-19 vaccine uptake in Belgium: a nationwide record linkage study

BackgroundRecent studies have identified important social inequalities in SARS-CoV-2 infections and related COVID-19 outcomes in the Belgian population. The aim of our study was to investigate the sociodemographic and socioeconomic...

The evolution of the subjective well-being of the general population during the COVID-19 pandemic period: the case of Belgium

The consequences of the COVID-19 pandemic period on a nation’s well-being remain inadequately understood, especially over time. Therefore, this research aims to map the changes in the subjective well-being (SWB) of the general Belgian adult population during the COVID-19 pandemic. Analyses of variances (ANOVA) were performed to evaluate the changes in SWB during the pandemic at five different time points during the period from February 2020 until December 2022 using repeated cross-sectional representative samples of the Belgian population. The differences over time in subjective well-being were investigated in terms of life evaluation, positive affect, and negative affect. The changes in autonomy, competence, relatedness, loneliness and peace of mind were also explored as explanatory variables. Moderation analyses were performed to investigate the differential changes in well-being for different age groups. Our results show the subjective well-being of the Belgian population decreased during the COVID-19 pandemic, notably during the second lockdown and the fifth wave. Furthermore, younger individuals are significantly more susceptible to negative changes in well-being during the pandemic period. Finally, our results show that peace of mind is an important predictor of all SWB components during the pandemic. Based on these results several policy recommendations are formulated.

Association between SARS-CoV-2 variants and post COVID-19 condition: findings from a longitudinal cohort study in the Belgian adult population

BackgroundWhile many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection.MethodsThis study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression.ResultsThe proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33–1.96 and OR = 1.73, 95%CI = 1.54–1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC.ConclusionsPeople infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.

Post COVID-19 condition and health-related quality of life: a longitudinal cohort study in the Belgian adult population

BackgroundSince the onset of the COVID-19 pandemic, most research has focused on the acute phase of COVID-19, yet some people experience symptoms beyond, referred to as post COVID-19 conditions (PCC). However, evidence on PCC and its impacts on health-related quality of life (HRQoL) is still scarce. This study aimed to assess the impact of COVID-19 and PCC on HRQoL.MethodsThis is a longitudinal cohort study of the Belgian adult population with recent SARS-CoV-2 infection. In total, 5,727 people were followed up between the time of their infection and three months later. HRQoL was measured with the EQ-5D-5L questionnaire before and during the infection and three months later. Linear mixed regression models were built to assess the longitudinal association between participants’ characteristics and the evolution of their HRQoL.ResultsThis study found a significant decline in HRQoL during the SARS-CoV-2 infection in comparison to the situation before (β=-9.91, 95%CI=-10.13;-9.85), but no clinically important difference three months after the infection compared to the situation before, except among people reporting PCC (β=-11.15, 95%CI=-11.72;-10.51). The main symptoms of PCC with a significant negative impact on the different dimensions of HRQoL were fatigue/exhaustion (21%), headache (11%), memory problems (10%), shortness of breath (9%), and joint (7%) or muscle pain (6%). The dimension of HRQoL most negatively affected by several PCC symptoms was pain/discomfort.ConclusionsWith the growing number of people infected with SARS-CoV-2, PCC and its impact on HRQoL are becoming important public health issues. To allow people with PCC to recover and to limit its detrimental impact on HRQoL, it is essential to manage its various heterogeneous symptoms using a multidisciplinary approach.

Classification and risk factors of Post COVID-19 condition: a longitudinal study in the Belgian population

Abstract Background Since the onset of the COVID-19 pandemic, most research has focused on the pathophysiology and management of the acute symptoms of COVID-19, yet some people tend to experience symptoms beyond the acute phase of infection, that is, Post COVID-19 condition (PCC). However, evidence on the prevalence of PCC, its symptoms, and mechanisms are still scarce. This study aimed to assess the distribution, patterns of symptoms, and associated factors of PCC in adult with confirmed COVID-19 infection in Belgium. Methods This is a longitudinal cohort study of Belgian adult population with recent COVID-19 infection confirmed via a molecular test and systematically recruited via national tracing call centers. A total of 5181 people were followed-up using online questionnaires at the time of their infection and 3 months later (from April 2021 to February 2022). Their physical, social and mental health was evaluated as well as their acute COVID-19 symptoms and persistent PCC symptoms. These different variables were self-reported. Results Half of the participants reported PCC (49.6%). The most frequent persistent symptoms 3 months after infection were fatigue (28%), headache (18%), and memory problems (12%). Women (OR = 1.67,CI95%=1.40-1.99), people with a lower level of education (OR = 1.23,CI95%=1.02-1.48), obese people (OR = 1.23,CI95%=1.02-1.48), people with chronic disease (OR = 1.97,CI95%=1.40-2.77), and people with a higher number of acute COVID-19 symptoms (OR = 2.56, CI95%=1.83-3.58) or hospitalised (OR = 2.19,CI95%=1.25-3.82) were more likely to report PCC. Finally, a latent class analysis on the 29 PCC symptoms highlighted 3 different classes of symptoms. Conclusions With the growing number of people infected with COVID-19, PCC is becoming an important public health issue. To allow people with PCC to recover, it is essential to have a multidisciplinary approach and to provide early post-acute physical and psychological rehabilitation interventions according to symptom patterns.

Health care costs and lost productivity costs related to excess weight in Belgium

BackgroundThis study aimed to estimate annual health care and lost productivity costs associated with excess weight among the adult population in Belgium, using national health data.MethodsHealth care costs and costs of absenteeism were estimated using data from the Belgian national health interview survey (BHIS) 2013 linked with individual health insurance data (2013–2017). Average yearly health care costs and costs of absenteeism were assessed by body mass index (BMI) categories – i.e., underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2). Health care costs were also analysed by type of cost (i.e. ambulatory, hospital, reimbursed medication). The cost attributable to excess weight and the contribution of various other chronic conditions to the incremental cost of excess weight were estimated using the method of recycled prediction (a.k.a. standardisation).ResultsAccording to BHIS 2013, 34.7% and 13.9% of the Belgian adult population were respectively affected by overweight or obesity. They were mostly concentrated in the age-group 35–65 years and had significantly more chronic conditions compared to the normal weight population. Average total healthcare expenses for people with overweight and obesity were significantly higher than those observed in the normal weight population.The adjusted incremental annual health care cost of excess weight in Belgium was estimated at €3,329,206,657 (€651 [95% CI: €144-€1,084] and €1,015 [95% CI: €343–€1,697] per capita for individuals with overweight and obesity respectively). The comorbidities identified to be the main drivers for these incremental health care costs were hypertension, high cholesterol, serious gloom and depression. Mean annual incremental cost of absenteeism for overweight accounted for €242 per capita but was not statistically significant, people with obesity showed a significantly higher cost (p < 0.001) compared to the normal weight population: €2,015 [95% CI: €179–€4,336] per capita. The annual total incremental costs due to absenteeism of the population affected by overweight and obesity was estimated at €1,209,552,137. Arthritis, including rheumatoid arthritis and osteoarthritis, was the most important driver of the incremental cost of absenteeism in individuals with overweight and obesity, followed by hypertension and low back pain.ConclusionsThe mean annual incremental cost of excess weight in Belgium is of concern and stresses the need for policy actions aiming to reduce excess body weight. This study can be used as a baseline to evaluate the potential savings and health benefits of obesity prevention interventions.

An EQ-5D-5L Value Set for Belgium.

ObjectiveThis study aimed to establish a Belgian EQ-5D-5L value set based on the preferences of the adult Belgian general population.MethodsThe most recent EuroQol Valuation Technology (EQ-VT 2.1) protocol for EQ-5D-5L valuation studies was followed. Computer-assisted personal interviews were carried out in a representative sample of the adult Belgian population. Potential respondents were randomly selected from the National Register using a multistage, stratified, cluster sampling with unequal probability design. Each respondent valued 10 or 11 health states using composite time trade-off (cTTO) and 14 health states in seven paired choice tasks using a discrete choice experiment (DCE). Different model specifications were explored and assessed based on logical consistency, goodness of fit, predictive accuracy and theoretical considerations.ResultsA total of 892 respondents were included in the analyses. The sample was representative of the Belgian adult population in terms of age, sex, region of residence, educational attainment, labour market status, self-assessed health status and health-related quality of life (HRQoL). The preferred model specification was a hybrid (DCE and cTTO data combined) multiplicative eight-coefficient model with intercept random effects and correction for heteroskedasticity. Values range from − 0.532 to 1. Loss of HRQoL is highest in the dimension pain/discomfort, closely followed by anxiety/depression.ConclusionsThis study developed a Belgian EQ-5D-5L value set, based on the preferences of the Belgian adult general population. It provides opportunities for future clinical and economic evaluations in healthcare, for the measurement of patient-reported outcomes and for population health assessments.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-022-00353-3.

Post COVID-19 condition and its physical, mental and social implications: protocol of a 2-year longitudinal cohort study in the Belgian adult population

BackgroundSince the onset of the COVID-19 pandemic, most research has focused on the pathophysiology and management of the acute symptoms of COVID-19, yet some people tend to experience symptoms beyond the acute phase of infection, that is, Post COVID-19 condition (PCC). However, evidence on the long-term health impacts of a COVID-19 infection are still scarce. The purpose of this paper is to describe the COVIMPACT study, which aims to set up a cohort of people who have been tested positive for COVID-19 and study the evolution of their physical, mental and social health over the medium (3 months) and long term (two years), and the factors associated with an (un)favorable evolution.MethodsCOVIMPACT is a longitudinal cohort study organised over a two-years period between April 2021 and April 2023. The eligible population is all people aged 18 years and older, living in Belgium, with a recent COVID-19 infection and contacted by the health authorities for contact tracing. Two questionnaires are used: a baseline questionnaire that aims to assess the initial health status of the participants and their status during the acute phase of the illness, and a follow-up questionnaire that is sent every three months after participants enter into the cohort. A matched non-COVID-19 control group was also selected. As of November 1, 2021, 10,708 people completed the baseline questionnaire (5% of the eligible population) and the follow-up participation rate was 79%. In total, 48% of the cohort participants appeared to fit the proposed case definition of PCC (i.e. report at least one symptom related to their COVID-19 infection three months afterwards).DiscussionThis study was designed to provide timely information on the short and long term impact of a COVID-19 infection, to stakeholders such as policymakers, health practitioners and people with PCC. Although the follow-up participation rate was good (79%), the participation rate of the eligible population was low (5%). Compared to other studies, this study has a large sample, of non-hospitalised and hospitalised people, who will be followed over a long period of 3 months to two years post infection, and with a global approach to their health.

Anxiety and Depression in Belgium during the First 15 Months of the COVID-19 Pandemic: A Longitudinal Study.

The COVID-19 pandemic and policy measures enacted to contain the spread of the coronavirus have had nationwide psychological effects. This study aimed to assess the impact of the first 15 months of the COVID-19 pandemic on the level of anxiety (GAD-7 scale) and depression (PHQ-9 scale) of the Belgian adult population. A longitudinal study was conducted from April 2020 to June 2021, with 1838 respondents participating in 6 online surveys. Linear mixed models were used to model the associations between the predictor variables and the mental health outcomes. Results showed that the prevalence of symptoms of anxiety and depression was higher in times of stricter policy measures. Furthermore, after the initial stress from the outbreak, coping and adjustment were observed in participants, as symptoms of anxiety and depression decreased during times of lower policy restrictions to almost the same level as in pre-COVID times (2018). Though time trends were similar for all population subgroups, higher levels of both anxiety and depression were generally found among women, young people, people with poor social support, extraverts, people having pre-existing psychological problems, and people who were infected/exposed to the COVID-19 virus. Therefore, investment in mental health treatment programs and supports, especially for those risk groups, is crucial.

Welcome in my back yard? Explaining cross-municipal opposition to refugees through outgroup size, outgroup proximity, and economic conditions

AbstractThis study explores contextual sources of attitudes towards refugees by investigating the impact of outgroup size, outgroup proximity (or the presence of an asylum seekers centre), economic conditions, and their interaction on individuals’ attitudes. We analyse data from a cross-sectional survey of the Belgian adult population in October 2017, enriched with municipality-level indicators of intergroup context and economic conditions. Drawing on multilevel regression analyses, our findings show that proximity to an asylum seekers centre and a higher average taxable income of residents are associated with positive individual attitudes towards refugees, while (changes in) outgroup size are not linked with attitudes among this sample. Additionally, our findings indicate that the positive impact of educational attainment on attitudes is amplified (weakened) in municipalities with a larger (smaller) refugee and asylum seeker group size. In summary, these results highlight the relevance of including outgroup proximity at the local level and interactive relations in contextual studies of outgroup attitudes.

Prevalence of Anti-SARS-CoV-2 Antibodies and Potential Determinants among the Belgian Adult Population: Baseline Results of a Prospective Cohort Study.

The prevalence of anti-SARS-CoV-2 antibodies and potential determinants were assessed in a random sample representative of the Belgian adult population. In total, 14,201 individuals (≥18 years) were invited by mail to provide saliva via an Oracol® swab. Survey weights were applied, and potential determinants were estimated using multivariable logistic regressions. Between March and August 2021, 2767 individuals participated in the first data collection. During this period, which coincided with the onset of the vaccination campaign, the seroprevalence in the population increased from 25.2% in March/April to 78.1% in July. Among the vaccinated there was an increase from 74,2% to 98.8%; among the unvaccinated, the seroprevalence remained stable (around 17%). Among the vaccinated, factors significantly associated with the presence of antibodies were: having at least one chronic disease (ORa 0.22 (95% CI 0.08–0.62)), having received an mRNA-type vaccine (ORa 5.38 (95% CI 1.72–16.80)), and having received an influenza vaccine in 2020–2021 (ORa 3.79 (95% CI 1.30–11.07)). Among the unvaccinated, having a non-O blood type (ORa 2.00 (95% CI 1.09–3.67)) and having one or more positive COVID-19 tests (ORa 11.04 (95% CI 4.69–26.02)) were significantly associated. This study provides a better understanding of vaccine- and/or natural-induced presence of anti-SARS-CoV-2 antibodies and factors that are associated with this presence.

Prevalence of metabolic syndrome and its risk factors among Belgian adults

Abstract Background Metabolic syndrome (MetS) is a growing public health concern. It is characterized by the presence of at least three of these five risk factors including abdominal obesity, high triglycerides, hypertension, high blood sugar, and low HDL-cholesterol. Individuals with MetS are at increased risk to develop cardiovascular diseases and type 2 diabetes. A better understanding of this syndrome is essential to implement public health prevention actions. The aim of this study is to investigate the prevalence of MetS and its association with risk factors in the Belgian adult population. Methods This study was conducted on the first Belgium Health Examination Survey of 2018 among adults aged 18-90 (n = 1184). MetS was defined based on the Revised-Adult Treatment Panel III (R-ATP III) criteria. Association between risk factors (i.e. socio-demographic and health behavior determinants) and MetS was investigated through a multiple logistic regression (adjusted odds ratio (OR) and 95%CI). Results Among the 963 participants with complete data (49 ±15yrs, 51.3% men), we observed an overall prevalence of MetS of 30.9% (95%CI: 27%-35%). MetS is significantly associated with older age (OR 10.2; 95%CI 3.6-28.9), low education (OR 2.6; 95%CI 1.2-5.7), an increasing number of chronic diseases (OR 1.3; 95%CI 1.1-1.5) and BMI. ORs for overweight (BMI &amp;gt; 25 kg/m2), obesity (BMI &amp;gt; 30 kg/m2), and severe obesity (BMI &amp;gt; 35 kg/m2) are respectively 3.8 (95%CI 1.9-7.3), 22.6 (95%CI 9.3-54.8) and 65.9 (95%CI 15.9-271.9). No significant associations were found with gender, region, smoking status, alcohol consumption and physical activity. Conclusions Our results showed a high prevalence of MetS in the Belgian population. Identifying MetS high risk groups based on the socio-demographic and behavioral determinants is of major importance to establish preventive measures for cardiovascular diseases and diabetes of the Belgian population. Key messages The overall prevalence of MetS is almost 31% in the Belgian population. Age, education, overweight, obesity and chronic diseases are factors associated with the presence of MetS.

Organophosphate esters (OPEs) in Chinese foodstuffs: Dietary intake estimation via a market basket method, and suspect screening using high-resolution mass spectrometry

Despite of the ubiquity of organophosphate esters (OPEs) in various environmental matrices, information regarding the dietary intakes of OPEs is currently limited. To better understand dietary exposure and intake, the present study investigated 11 OPE flame retardants (FRs) in 105 composite food samples divided into 9 food categories, collected in 2018 and based on the contents of a typical Chinese food market basket. Nine OPEs, including triethyl phosphate (TEP), tributyl phosphate (TNBP), tris(2-chloroethyl) phosphate (TCEP), tris(2-chloroisopropyl) phosphate (TCIPP), triphenyl phosphate (TPHP), 2-ethylhexyl-diphenyl phosphate (EHDPP), tris(2-butoxyethyl) phosphate (TBOEP), tris(2-ethylhexyl) phosphate (TEHP) and tris(methyl-phenyl) phosphate (TMPP), were measurable above the method limits of quantifications (MLOQs) in at least one of the analyzed samples. Among the 9 food categories, sweets were contaminated most severely with a mean sum (Σ) OPE concentration of 10.34 ng/g wet weight (ww). Regardless the food categories, EHDPP and TEP were the predominant OPEs with mean concentrations of 1.12 and 0.95 ng/g ww, respectively. In addition, the levels of OPEs in “processed foods” were significantly (unpaired t-test, p < 0.01) higher than those in “non-processed foods”. Based on the measured OPE concentrations, we estimated daily per capita dietary intakes of ΣOPEs for Chinese adult population to be 44.3 ng/kg bw/day, that was mainly contributed by TCEP (14.3 ng/kg bw/day), TEP (12.7 ng/kg bw/day) and EHDPP (8.4 ng/kg bw/day). In addition to these 9 detected OPEs, further suspect screening in the combined extracts of foodstuffs by use of high-resolution spectrometry revealed a novel OP-FR, triphenyl phosphine oxide (TPPO). The highlight findings in this study were: 1) the amount of OPE via dietary intakes for the Chinese population is generally in the same order of magnitude as for other countries, i.e. the Swedish, Belgian and Australian adult population, and far less than the reference dosage value of each OPE (hazard index ≪ 1); 2) the total dietary intakes of OPEs were dominated by cereals, approximately accounting for 52.2%; and 3) the first reported detection of the novel OP-FR, TPPO, in foodstuff samples.

The relationship between media use and public opinion on immigrants and refugees: A Belgian perspective

AbstractBelgium, and Europe in general, has seen a strong increase in the number of refugees arriving over the past three years. At the same time we also note an increasing polarization of Belgian public opinion on this subject. Among the main actors to shape this public opinion are news media, as they contribute to or combat stereotyping of (sub)groups in the population. The purpose of the current study is to analyze to which extent media consumption and trust have an impact on public opinion on two minority groups – immigrants and refugees – in a representative sample of the Belgian adult population (n = 1500). We gathered data on Belgian news media consumption and trust, and attitudes on immigrants and refugees through an online questionnaire. The results indicate that Belgian adults hold more positive attitudes on immigrants than on refugees. The reading of quality online newspapers as well as high levels of trust in television and radio are correlated with a positive attitude towards both groups, whereas the consumption of commercial television and popular newspapers go along with a negative attitude. Fear of terrorism (negative relation) and a negative evaluation of media coverage of refugees (positive relation) also have a sizeable influence. In terms of regional differences within Belgium, we find that citizens in the Brussels Capital Region hold more positive attitudes towards both groups than those in Flanders and Wallonia.