Future trends of overweight and obesity in Belgium using Bayesian age-period-cohort models

Abstract Background Considering the current overweight and obesity epidemic and its associated increase in non-communicable diseases and healthcare costs, the current study aimed to project the trends in prevalence of overweight and obesity in Belgium using a Bayesian age-period-cohort (APC) model to support 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. A Bayesian APC model was applied to evaluate past trends and associated socio-demographic risk factors, and to forecast trends to 2019-2029. All analyses were performed based on integrated nested Laplace approximation (INLA) and took the complex survey design into account. Results The prevalence of overweight and obesity has increased between 1997 and 2018. If current trends continue, it is likely to that a further increase in the prevalence of overweight and obesity in the population will be seen by 2029 with a probability of growth of 51.2% and 73.3%, respectively. Forecasts indicated a potential prevalence of 50.1% [16.2%; 84.4%] in 2029 for overweight, and 21.4% [9.0%; 43.4%] for obesity. Among survey participants, middle-aged men with no higher education and a middle income showed the highest risk of overweight and obesity. Conclusions We projected an alarming increase in the prevalence of overweight and obesity. A decrease in cases seems very unlikely. There is an urgent need to target younger age groups for prevention and implementation of public educational programs to limit the increasing trend in overweight and obesity. Key messages • The occurence of obesity is likely to increase in the following 10 years. • Projection of trends can serve as a useful tool for policy planning on the mid- and longer term.


Introduction:
Italy was one of the first EU countries hit by the COVID-19 pandemic. Currently, Italy has reported 15.5 million cases of COVID-19 and 161000 deaths. Meanwhile, the vaccination campaign against COVID-19 began in Italy at the end of 2020, using mRNA and viral vector vaccines (immunizing people against Spike protein of SARS-CoV-2. The purpose of this study was to estimate, in a representative sample of the Italian population, the prevalence of antibodies against SARS-CoV2 in 2019 (before case zero, identified in Italy in February 2020) and in 2021, after 3 pandemic waves and a vaccination campaign.

Methods:
During October / November 2019: 365 participants were selected in the Piedmontese population among those who went to a hospital for routine blood tests. The population was selected on the basis of age and gender to be representative of the Italian population. The same number of patients was selected in the first quarter of 2021, the inclusion and exclusion criteria remained the same. Sera were searched for spike protein of SARS-CoV-2 and, if positive, tested for antinucleocapsid antibodies.

Results:
Our preliminary data show that half of the sample for both years is female. In the 2019 sample, i.e. before case zero was identified in Italy (Lombardy), five of the sera (4 males and one female) tested positive for anti-Spike,indicating a previous infection (vaccine didn't exist). In the 2021 sample, 152 males and 139 females tested positive for IgG anti-spike, for a total of 291. The prevalence therefore passed from 1.37% to 79.73%. As regards the search for ANti-Nantibodies, one male and one female tested positive in 2019; in 2021 9 males and 13 females.

Conclusions:
The results of our study show that in 2019, before the first official case in Italy was highlighted, coronavirus was already circulating. The prevalence has risen exponentially, going from less than 2% to around 80%. Key messages: Covid-19 was circulating in Italy in 2019.
Seroprevalence of anti-S in 2021 was about 20%.

Background:
Breast cancer is a heterogeneous disease with distinct molecular signatures of disease etiology, evidenced by the joint expression of molecular tumor markers. Differential effects of oral contraceptive use on breast cancer risk by molecular subtypes have been reported. This is the first metaanalysis to investigate associations between oral contraceptive use and subsequent breast cancer risk stratified by combined estrogen receptor (ER) and progesterone receptor (PR) status alongside the Luminal A and B subtypes, which additionally consider the human epidermal growth factor receptor 2 (HER2) status.

Methods:
A systematic review and meta-analysis of case-control and cohort studies was conducted in PubMed and Web of Science. The odds ratios (ORs) were summarized using a randomeffects model.

Results:
Eleven studies met the inclusion criteria for qualitative and quantitative analysis. Random effects meta-analyses revealed significant risk increasing effects for ever-users of oral contraception on ER-PR-breast cancer compared to never-users (OR = 1.30, 95% CI; 1.07 to 1.56, p < 0.01). Ever-use of oral contraception was not associated with breast cancer risk when stratified by the ER+PR+ breast cancer subtype (OR = 1.00, 95% CI; 0.86 to 1.16, p = 0.99). Data on Luminal A and B subtypes was limited and not suggestive for associations with breast cancer risk in ever-users of OCs compared to neverusers. Furthermore, a significant increased risk of ER-PRbreast cancer was observed for OC use duration of > 4 years compared to never-users (OR = 1.74, 95% CI: 1.15 to 2.63, p < 0.01).

Conclusions:
The current state of the evidence suggests that OC use longer than 4 years is associated with an increased breast cancer risk, pertaining to the estrogen and progesterone double negative breast cancer subtype. Large-scale prospective observational studies including more comprehensive molecular signature of breast cancer aetiology, including HER2 status, are needed.

Key messages:
The use of oral contraception was associated with estrogen and progesterone receptor double negative breast cancer, but not hormone receptive positive cancer. This is the first meta-analysis to investigate oral contraceptive use and associations with breast cancer risk by combined estrogen and progesterone receptor status.

Background:
Considering the current overweight and obesity epidemic and its associated increase in non-communicable diseases and healthcare costs, the current study aimed to project the trends in prevalence of overweight and obesity in Belgium using a Bayesian age-period-cohort (APC) model to support 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. A Bayesian APC model was applied to evaluate past trends and associated socio-demographic risk factors, and to forecast trends to 2019-2029. All analyses were performed based on integrated nested Laplace approximation (INLA) and took the complex survey design into account.

Results:
The prevalence of overweight and obesity has increased between 1997 and 2018. If current trends continue, it is likely to that a further increase in the prevalence of overweight and obesity in the population will be seen by 2029 with a probability of growth of 51.2% and 73.3%, respectively. Forecasts indicated a potential prevalence of 50.1% [16.2%; 84.4%] in 2029 for overweight, and 21.4% [9.0%; 43.4%] for obesity. Among survey participants, middle-aged men with no higher education and a middle income showed the highest risk of overweight and obesity.

Conclusions:
We projected an alarming increase in the prevalence of overweight and obesity. A decrease in cases seems very unlikely. There is an urgent need to target younger age groups for prevention and implementation of public educational programs to limit the increasing trend in overweight and obesity.

Key messages:
The occurence of obesity is likely to increase in the following 10 years. Projection of trends can serve as a useful tool for policy planning on the mid-and longer term.
Abstract citation ID: ckac131.210 The contribution of health behaviours to waist circumference change following employment transitions