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Susceptibility of Mammals to Highly Pathogenic Avian Influenza: A Qualitative Risk Assessment From the Belgian Perspective
No full texthe world experienced a huge number of outbreaks of highly pathogenic avian influenza (HPAI) in birds, which could represent one of the largest registered epidemics of infectious disease in food-producing animals. Therefore, mammals, including humans, are continuously exposed to HPAI viruses leading to sporadic and sometimes unusual mammal infections. The aim of this paper is to assess the risk of crossing the avian/mammalian species barrier by the currently circulating HPAI viruses, focusing on the epidemiological situation of Belgium, a representative country for Western Europe.</p
The burden of psoriasis in Belgium, 2021
No full textPsoriasis is a common, chronic, inflammatory skin disease with a great impact on healthcare systems. Given the limitations of the currently available burden estimates, estimates of the Belgian national burden of disease study are necessary in order to guide decision-making processes within the health sector. According to the Global Psoriasis Atlas, the prevalence of psoriasis is rising globally. The current study aims to estimate the burden of psoriasis in Belgium using national data. As there is no single comprehensive data source on prevalence of psoriasis in Belgium, a critical appraisal of existing local and national data sources was conducted. We estimated the non-fatal psoriasis burden in terms of years lived with disability (YLD). Estimated prevalence data were combined with disability weights to yield YLDs imposed by psoriasis. Mortality attributable to psoriasis was assumed to be zero, in line with the Global Burden of Disease study (GBD) 2019. We assessed three data sources containing information on existing cases with psoriasis in Belgium. Based on qualitative and quantitative appraisal, a widespread network of general practitioners was identified as the best available national data source. In 2021, the prevalence of psoriasis in Belgium was 2.1%, leading to 13084 DALYs (113 DALYs per 100 000). The burden of psoriasis was in line with national disease burden estimates for bipolar disorder, multiple myeloma, and hearing loss. Our prevalence, YLD, and DALY estimates for psoriasis in Belgium were however lower than those of the GBD study. Psoriasis imposes a non-negligible burden on population health in Belgium, despite it not being a cause of death. Along progression in psoriasis management, objective evaluation of psoriasis burden is critical to track the trends at the population level. Key messages • Psoriasis is a common skin disease with a relatively high morbidity burden. • Information on psoriasis prevalence and burden are crucial for disease management and appropriate health-care planning.</p
The promotion of ultra-processed foods in modern retail food outlets in rural and urban areas in Kenya.
No full textOBJECTIVE: To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.
DESIGN: This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.
SETTING: Three counties in Kenya (Nairobi — urban, Mombasa — coastal tourist and Baringo — rural). Each county was stratified into high and low SES using national poverty indices.
PARTICIPANTS: Food outlets that offered a self-service, had at least one checkout and had a minimum of two stocked aisles were assessed.
RESULTS: Of 115 outlets assessed, UPF occupied 33 % of the cumulative shelf space. UPF were the most advertised foods (60 %) and constituted 40 % of foods available for sale. The most commonly used promotional characters were cartoon characters (18 %). UPF were significantly more available for sale in Mombasa (urban) compared to Baringo (rural) (adjusted prevalence rate ratios (APRR): 1·13, 95 % CI 1·00, 1·26, = 0·005). UPF advertisements were significantly higher in Mombasa ((APRR): 2·18: 1·26, 3·79, = 0·005) compared to Baringo and Nairobi counties. There was a significantly higher rate of advertisement of UPF in larger outlets ((APRR): 1·68: 1·06, 2·67 = 0·001) compared to smaller outlets.
CONCLUSIONS: The high marketing and availability of UPF in modern retail outlets in Kenya calls for policies regulating unhealthy food advertisements in different settings in the country.</p
Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study
No full textBACKGROUND: While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets.
METHODS: Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios.
RESULTS: We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL1.5) than the CBD (BRL1.8) and the EAT-Lancet diet (BRL1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL0.33) and EAT-Lancet (CF: BRL0.18) was found, but with a less pronounced effect.
CONCLUSIONS: The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.</p
The Belgian Cancer Inventory: Co-creating a framework for monitoring the implementation of cancer policies and associated inequalities
No full textBackground: In 2021, the European Commission launched the policy-driven Europe’s Beating Cancer Plan1, and the research-focused Mission on Cancer2. These initiatives recognise the burden cancer poses on society, and offer opportunities to reduce this burden through targeted actions. However, the uptake of those actions is not systematically monitored in every Member State. In Belgium, a country lacking an up-to-date national cancer plan, a monitoring and evaluation framework for cancer care and control policies is currently under development at the request of the federal cabinet, covering both Belgian- and European-level measures. This framework, known as the Belgian Cancer Inventory, will also aim to identify inequalities in the implementation and outcomes of each policy it tracks.
Methods: To ensure the Inventory meets the needs and expectations of stakeholders in the Belgian cancer field, a participatory, co-creation approach was leveraged for its design. Through a Delphi exercise, experts from across the cancer care continuum were asked to assess over the course of three rounds the importance and actionability of a set of 259 indicators extracted from grey and scientific literature, as well as of seven inequality dimensions taken from the European Cancer Inequalities Registry3 by which these indicators could be disaggregated (e.g. age, income level, region). Based on pre-defined consensus criteria, advancement to the next round was determined.
Results: In total, the Delphi study featured contributions from 94 participants. Following the first round during which importance was the sole evaluation criterion, all indicators and dimensions were retained, barring one survivorship-related indicator. Furthermore, 74 indicators and 19 dimensions were added at the suggestion of the panellists. At the end of the second round in which both actionability and importance were evaluated, 72 indicators and five dimensions were eliminated. In the third round, contributors ranked the remaining Delphi items on the basis of priority for inclusion into the Inventory. Ultimately, the top-ranking indicators were matched to Belgian and European policy objectives, and six inequality dimensions were selected: age, sex, educational level, objective and self-reported income level, and region.
Conclusions: Using a co-creation method, an initial framework for the Belgian Cancer Inventory was developed, including indicators and integrating inequality dimensions. While this framework presents a promising start to the systematic monitoring of cancer policies and associated inequalities in Belgium, it will need to be further refined through a feasibility analysis and benchmarking exercise. Questions remain on the completeness of the data that would feed into the Inventory.
References
1European Commission. Europe’s Beating Cancer Plan — Communication from the Commission to the European Parliament and the Council (2021). Available from: https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf [accessed 31 August 2024].
2European Commission. Mission on Cancer Implementation Plan (2021). Available from: https://research-and-innovation.ec.europa.eu/document/download/2e87e31f-37f7-4892-ab4f-2fad7ee1fcc3_en?filename=cancer_implementation_plan_final.pdf [accessed 31 August 2024].
3European Commission. European Cancer Inequalities Registry. Available from: https://cancer-inequalities.jrc.ec.europa.eu/ [accessed 31 August 2024].</p
Risks associated with the presence of PFAS in FCM: An investigation of the Belgian market.
No full textPer- and polyfluoroalkyl substances (PFAS) are a group of chemicals that have been widely used by various industries, including the food contact material industry. These substances are favoured for their ability to repel oil and resist moisture. However, exposure to PFAS has been linked to several health problems, including effects on the immune system. According to the European Food Safety Authority (EFSA), food contact materials (FCM) are likely to contribute to human exposure to PFAS. Therefore, this study investigated the exposure to PFAS from FCM. One hundred and ten FCM made of paper and board (e.g. straws, cups, bowls, boxes etc.), sugar cane or wheat pulp-based FCM, called paper analogues (e.g., cup, bowls, plates, hamburger boxes etc.) were carefully selected on the Belgian market and investigated using liquid chromatography coupled with high-resolution mass spectrometery. Out of the 25 PFAS targeted, 11 were detected in the samples, mainly perfluoroalkyl carboxylic acids (PFBA, PFPeA, PFHxA, PFHpA, PFOA, PFNA, PFDA, PFUnDA, PFDoDA, PFTrDA) and PFOS. It was found that all of the paper analogue samples contained PFAS, while 43% of the paper and board samples showed the presence of these chemicals. Except for one sample, most detections suggest contamination rather than intentional use. Finally, a risk assessment was conducted, which revealed potential risks for consumers related to a coffee cup made of paper and board and a food tray made of sugar cane.</p