Search

Additional file 2. Grey literature search and websites of targeted national public health agencies.

Additional file 5. Reference list of the included disease burden studies.

Additional file 4. Studycharacteristics, exposure assessment data sources and methodological choices ofthe 46 independent studies using a top-down approach.

Additional file 1. Search Strategy.

Additional file 6. Reference list of the excluded studies, including reason for exclusion.

Additional file 3. Definitions of the data extraction items.

Objectives Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. Results A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates.

The first step of the project involved reviewing and compiling information from various global sources (reports, papers, guidelines) on recommended food systems policy actions. These recommendations were then classified, which helped to define the different policy domains (food supply chains and food environments) and their respective subdomains. Afterwards, we defined the nutrition-related outcomes, nutrition-related inequalities and environmental sustainability outcomes impacted by the prior-identified recommended food system policies and interventions. Food policy actions are key to bringing about a sustainable food transition away from the current unsustainable practices. In order to develop an index (on the transition to more sustainable food systems for national and local governments) based on the aforementioned policy domains, the existing evidence on effectiveness of public policies on nutrition, inequalities and the environment will be examined, highlighting the existing evidence gaps. The types of evidence available (if any) for impact of actions on the outcomes defined for each identified policy domain and their subdomains will be explored through a scoping review.

Background: Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. Methods: NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. Results: A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies. Conclusion: The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe., peer-reviewed

Additional file 1.

Additional file 1. Search strategy and grey literature search and overview of studies.

Additional file 1: Table 6. Multinomial regression of body mass index classes (normal weight category as reference) in function of age, gender, educational level and lack of physical activity, Belgian population ≥ 18 years – underweight population was excluded, BHIS2013-IMA2013-2017 – the model includes the confounders that were significant after backwards stepwise elimination (N= 4,504). Table 7. Socio-demographic characteristics by body mass index category, Belgian population ≥18 years, health interview survey 2013 for population included in the multivariate regression (with no missing values in physical activity and educational level). Table 8. Chronic disease in function of available confounders – coefficient (standard error), Belgian population ≥ 18 years – underweight population was excluded, BHIS 2013-IMA2013-2017 – the model includes the confounders that were significant after backwards stepwise elimination. Table 9. Cost of absenteeism in function of body mass index classes adjusted for age, gender, educational level, nationality, lack of physical activity, tobacco use and daily intake of sugared drinks - Belgian population ≥ 18 years, BHIS 2013-IMA2013-2017 (N= 2,480). Table 10. Relative contribution of chronic disease to the direct and indirect costs (in percentage).

Adherence Barriers Questionnaire for HIV (English). (DOCX 89 kb)

Background Overweight and obesity are one of the most significant risk factors of the twenty-first century related to an increased risk in the occurrence of non-communicable diseases and associated increased healthcare costs. To estimate the future impact of overweight, the current study aimed to project the prevalence of overweight and obesity to the year 2030 in Belgium using a Bayesian age-period-cohort (APC) model, supporting policy planning. Methods Height and weight of 58,369 adults aged 18+ years, collected in six consecutive cross-sectional health interview surveys between 1997 and 2018, were evaluated. Criteria used for overweight and obesity were defined as body mass index (BMI) ≥ 25, and BMI ≥ 30. Past trends and projections were estimated with a Bayesian hierarchical APC model. Results The prevalence of overweight and obesity has increased between 1997 and 2018 in both men and women, whereby the highest prevalence was observed in the middle-aged group. It is likely that a further increase in the prevalence of obesity will be seen by 2030 with a probability of 84.1% for an increase in cases among men and 56.0% for an increase in cases among women. For overweight, it is likely to see an increase in cases in women (57.4%), while a steady state in cases among men is likely. A prevalence of 52.3% [21.2%; 83.2%] for overweight, and 27.6% [9.9%; 57.4%] for obesity will likely be achieved in 2030 among men. Among women, a prevalence of 49,1% [7,3%; 90,9%] for overweight, and 17,2% [2,5%; 61,8%] for obesity is most likely. Conclusions Our projections show that the WHO target to halt obesity by 2025 will most likely not be achieved. There is an urgent necessity for policy makers to implement effective prevent policies and other strategies in people who are at risk for developing overweight and/or obesity.