Abstract Background Food insecurity is a substantial and growing concern in many high-income countries. Yet, representative data on the extent of the issue in the general Belgian population is lacking. This study aims to assess the extent of food insecurity in Belgium, identify those at risk of food insecurity, and explore the relationship between food insecurity and fruit and vegetable consumption. Methods We used data from the Belgian National Food Consumption Survey 2022-2023, a representative sample of the Belgian population aged 3 years and older (n = 2,800). Food insecurity was assessed using the 3 screening questions derived from the USDA Household Food Security Survey Module. Frequencies of fruit and vegetable consumption were obtained from a food propensity questionnaire. Prevalence of food insecurity was estimated using post-stratification weights. Logistic regression models were used to determine the association between frequency of fruit and vegetable consumption and food insecurity, adjusting for gender, household composition, educational attainment, and income. Results Preliminary results indicate that 12.6% of population experienced some form of food insecurity. Those who experienced food insecurity consumed fruit and vegetables less frequently than others, after adjustment for other socio-economic variables (ORs>4.00, p-values>0.05). Conclusions This study confirms that food insecurity is a substantial concern in Belgium. Food insecurity should be routinely monitored at the national level. Experiencing food insecurity appears to be negatively associated with the consumption of healthy foods such as fruits and vegetables and thus with the overall quality of the diet. Further research should be supported to identify effective strategies to reduce food insecurity in Belgium. Policy attention should be given to ensure financial accessibility to healthy foods and their attractiveness, especially for people experiencing food insecurity. Key messages • Food insecurity is an major concern in Belgium and should be routinely monitored. • Financial accessibility to healthy foods should be improved, especially for those facing food insecurity.

Recently, presence of mineral oil in numerous foods has been detected. The analysis of mineral oil in food is convoluted since it comprises MOSH (saturated hydrocarbons) and variable amounts of mainly alkylated MOAH (aromatic hydrocarbons). Both fractions have a different toxicological profile and therefore they need to be assessed separately. For Belgium, occurrence data are available comprising concentrations of 217 food samples. These data were used, in combination with the 2014/15 Belgian Food Consumption Survey data, in a lower bound scenario to evaluate the dietary exposure of the Belgian population. Exposure to mineral oil was much lower compared to the results previously reported by EFSA and RIVM. The main contributors in Belgium were similar to previous studies (i.e. cereal products and oils), but an important additional contribution of non-alcoholic drinks was identified due to the presence of mineral oil in coffee. However, the concentration of mineral oil was determined from the dry product by applying a dilution factor with transfer rate of 100%, and not in the prepared coffee.This study gives an account of the dietary exposure of the Belgian population to mineral oil for the first time and reports the associated uncertainties.

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.

A dietary exposure assessment of food emulsifiers E481 (sodium stearoyl-2-lactylate) and E482 (calcium stearoyl-2-lactylate) in the Belgian population was performed. Nationally representative food consumption data from the Belgian National Food Consumption Surveys 2004 (BNFCS2004) and 2014 (BNFCS2014) were used for calculations. A conservative approach (combining individual food consumption data with the maximum permitted level (MPL) of foods (tier 2), was compared with more refined estimates (combining individual food consumption data with actual concentrations measured in food products available on the Belgian market (tier 3)). Estimated daily intakes were compared to the acceptable daily intake (ADI) of the stearoyl-2-lactylates. The results of tier 2 demonstrated that 92% of the children (3-9 years), 53% of the adolescents (10-17 years), 15% of the adults (18-64 years) and 26% of the elderly (64-98 years) had a potential intake higher than the ADI. When replacing the MPL with maximum analysed concentration levels in foods, daily intake estimates decreased dramatically. The estimated daily intake of the food emulsifiers was below the ADI for all age groups, except for a small percentage of children (1.9%) for which the intake exceeded the ADI. The main contributors to the exposure of E481 and E482 were bread, rolls and fine bakery wares.

Regular consumption of fruit and vegetables is a protective factor for chronic diseases. Adolescence is a crucial period for acquiring healthy dietary habits. Some socioeconomic and cultural disparities have been observed in fruit and vegetable consumption in adolescents living in high-income countries. The aim of this research was to examine how the daily consumption of fruit and vegetables differs according to socioeconomic and cultural characteristics of adolescents living in Belgium, a country characterized by a very diverse population. Data of the 2014 Belgian National Food Consumption Survey, a nationally representative cross-sectional study conducted in the general population were used. Persons aged 3 to 64-years-old were randomly selected from the National Population Register, following a multistage stratified sampling procedure. Overall, 917 adolescents between 10 and 17-years-old completed two non-consecutive 24-hour dietary recalls, a food frequency questionnaire (FFQ) and a face-to-face interview with a trained dietician. The mean daily consumption of fruit and vegetables (together and separately) was examined according to the household structure, siblings, highest education level in the household, parental occupations, country of birth, language spoken at home, and region of residency. A weighting factor calculated according to age, gender, day of the first dietary recall (weekday or weekend), season, and province of residency was applied. Univariable and multivariable linear regressions analyses were performed with STATA Version 14. Including potential under-reporters, 98% of the adolescents consumed fruits or vegetables during both study days. The mean daily fruit and vegetable consumption was 193.5 g (SEM: 5.1), mean daily fruit consumption was 82.8 g (4.0), and mean daily vegetable consumption was 110.7 g (2.7). Adjusted for the total energy consumption and for all variables included in the multivariable model [R2 = 12.4%; constant: 125.3 g/day (ES: 41.4)], boys [b = −28.3 (11.2)], adolescents living in less-educated households [vs. university: b = −39.2 (11.8)], those with a manual worker mother [vs. managerial or academic occupation: b = −63.2 (27.9)], those born in Belgium [vs. born outside the EU: b = −101.9 (28.9)], and those living in Wallonia [vs. Flanders: b = −34.8 (10.7)] significantly consumed lower fruit and vegetable amounts. Differences in fruit and vegetable consumption across education categories were more pronounced in girls than in boys (p for interaction = 0.04). Consuming less fruit was significantly associated with being male [b = −25.7 (8.8)], living in a less-educated household [vs. university: b = −22.8 (9.3)], having a manual worker mother [vs. managerial or academic occupation: b = −47.8 (23.0)], and living in Wallonia [vs. Flanders: b = −21.0 (8.6)]. Consuming less vegetables was associated with living in a household having completed a secondary education [vs. university: b = −18.6 (6.2)], being born in Belgium [vs. born outside the EU: b = −38.4 (16.2)], living in Wallonia [vs. Flanders: b = −15.0 (5.9)], and was nearly significantly associated with being the second in the siblings [vs. the eldest: b = −13.4 (5.6); p = 0.06]. Living with one or both parents, number of the siblings, paternal occupation, and language spoken at home were not associated with differences in fruit and vegetable consumption. Despite elevated overall amounts consumed, our results confirm disparities in fruit and vegetable consumption observed in other high-income countries, particularly in favor of higher socioeconomic status. We observed different socioeconomic inequities for fruit and vegetables separately, like maternal occupational disparities specific to fruit consumption and differences according to the country of birth specific to vegetable consumption. Cultural differences also need to be further explored in such a multiregional and multilinguistic country like Belgium.

The Belgian national food consumption data collection in children was a part of the second Belgian general national food consumption survey, BNFCS2014, in 2014-2015 (3-64 years). In addition to food consumption data, information concerning eating habits, food safety, physical activity, sedentary behaviour and health was collected. As the project was included in the EU Menu Project, the methodology of the survey followed to a large extent the EFSA guidance on the EU Menu methodology.A representative sample of the Belgian population aged three to nine years old was randomly selected from the National Population Register following a multistage stratified sampling procedure. The participation rate to the general survey, BNFCS2014, was 37%. Ultimately, 1000 children were included in the survey. Data collection was divided equally over the four seasons and all days of the week in order to incorporate seasonal effects and day-to-day variation in food intake.Information on food intake for the children population was collected with two non-consecutive one-day food diaries followed by a GloboDiet completion interview with the parent or guardian. This was complemented with a food propensity questionnaire. Body weight and height were measured. In addition, children wore an accelerometer and kept a logbook for seven consecutive days to objectively measure physical activity and sedentary behaviour.Data from the survey will be very valuable for national risk assessments, nutritional studies and the development and evaluation of nutrition or health policies. The food consumption data was also coded according to the FoodEx2 classification and will be included in the EFSA Comprehensive European Food Consumption database.

To assess the dietary share of ultra-processed foods (UPF) among Belgian children, adolescents and adults and associations with diet quality.

Based on successive Health Interview Surveys (HIS), it has been demonstrated that also in Belgium obesity, measured by means of a self-reported body mass index (BMI in kg/m2), is a growing public health problem that needs to be monitored as accurately as possible. Studies have shown that a self-reported BMI can be biased. Consequently, if the aim is to rely on a self-reported BMI, adjustment is recommended. Data on measured and self-reported BMI, derived from the Belgian Food Consumption Survey (FCS) 2014 offers the opportunity to do so.

Dietary patterns are one of the major determinants as far as health and burden of disease is concerned. Food consumption data are essential to evaluate and develop nutrition and food safety policies. The last national food consumption survey in Belgium took place in 2004 among the Belgian population aged 15 years and older. Since dietary habits are prone to change over time a new Belgian National Food Consumption Survey (BNFCS2014) was conducted in 2014–2015.

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).

The expansion of the obesity epidemic is accompanied with an increase in bariatric procedures, in particular in women of reproductive age. The weight loss induced by the surgery is believed to reverse the negative impact of overweight and obesity on female reproduction, however, research is limited to in particular retrospective cohort studies and a growing number of small case-series and case-(control) studies.

This systematic review investigates the relationship between maternal obesity and breastfeeding intention, initiation, intensity, duration and milk supply. A comprehensive search was performed through three major databases, including Medline, Cochrane Library and Cumulative Index For Nursing and Allied Health Literature, and by screening reference lists of the relevant publications. Selection criteria were: report of original research, studies on low-risk obese mothers and the comparison with normal weight mothers which met at least two of the following primary outcomes: breastfeeding intention; initiation; intensity; duration and/or milk supply. Furthermore, the included reports had to contain a clear definition of pre-pregnant obesity, use compensation mechanisms for potential confounding factors, have a prospective cohort design and had to have been published between 1997 and 2011 and in English, French or Dutch. Effects of obesity on breastfeeding intention, initiation, intensity, duration and milk supply were analysed, tabulated and summarised in this review. Studies have found that obese women are less likely to intend to breastfeed and that maternal obesity seems to be associated with a decreased initiation of breastfeeding, a shortened duration of breastfeeding, a less adequate milk supply and delayed onset of lactogenesis II, compared with their normal weight counterparts. This systematic review indicates therefore that maternal obesity is an adverse determinant for breastfeeding success.

Evidence has grown supporting the role for short sleep duration as an independent risk factor for weight gain and obesity. The purpose of the present study was to examine the relationship between sleep duration and dietary quality in European adolescents. The sample consisted of 1522 adolescents (aged 12.5-17.5 years) participating in the European multi-centre cross-sectional ‘Healthy Lifestyle in Europe by Nutrition in Adolescence’ study. Sleep duration was estimated by a self-reported questionnaire. Dietary intake was assessed by two 24 h recalls. The Diet Quality Index for Adolescents with Meal index (DQI-AM) was used to calculate overall dietary quality, considering the components dietary equilibrium, dietary diversity, dietary quality and a meal index. An average sleep duration of ≥ 9 h was classified as optimal, between 8 and 9 h as borderline insufficient and < 8 h as insufficient. Sleep duration and the DQI-AM score were positively associated (β = 0.027, r 0.130, P< 0.001). Adolescents with insufficient (62.05 (sd 14.18)) and borderline insufficient sleep (64.25 (sd 12.87)) scored lower on the DQI-AM than adolescents with an optimal sleep duration (64.57 (sd 12.39)) (P< 0.001; P= 0.018). The present study demonstrated in European adolescents that short sleep duration was associated with a lower dietary quality. This supports the hypothesis that the health consequences of insufficient sleep may be mediated by the relationship of insufficient sleep to poor dietary quality.

The number of women of reproductive age undergoing bariatric surgery, including laparoscopic adjustable gastric banding (LAGB), has increased in recent years. The objective of this study was to list both maternal and neonatal outcomes in pregnancies in obese women (BMI ≥ 30 kg/m2) after LAGB and compare them with pregnancies in obese or normal weight women without LAGB. Studies showed a lower incidence of gestational diabetes, pregnancy-induced hypertension (PIH), pre-eclampsia, caesarean section (CS), macrosomia, and low birth weight babies in post-LAGB pregnancies compared to pregnancies in obese women without LAGB. Gestational weight gain was also lower in post-LAGB pregnancies. However, the incidence of PIH, pre-eclampsia, CS, preterm birth, large for gestational age, spontaneous abortion, and NICU admission was higher in post-LAGB pregnancies than in normal weight pregnancies. In conclusion, LAGB seems to improve pregnancy outcomes in obese women, even when obesity is still present at the onset of pregnancy. However, further research is needed and pregnant women with a gastric band should always be closely monitored by a multidisciplinary team.

To ensure a good pregnancy outcome after bariatric surgery, a healthy life-style and a multidisciplinary prenatal follow-up is recommended. The aim of this prospective multicenter trial was to compare diet quality and physical activity (PA) of pregnant women with bariatric surgery with current lifestyle recommendations.