Nutrition

1. Key messages

The Belgian diet is characterized by excessive consumption of red meat, processed meat and sugar sweetened beverages on one side and by insufficient consumption of fruits, vegetables, nuts and seeds, milk, eggs and fish. Over time, these patterns have only slightly improved.
In 2014, the mean usual fruit and vegetable consumption was 255 grams/day. Only 14% of the population met the WHO dietary guidelines of 400 grams per day. The consumption of fruit and vegetables has slightly increased over the past years. It was higher in women than in men and increased with educational level.
In 2014, 97% of the Belgian population consumed sugar sweetened beverages. The mean usual consumption was 151 ml/day. The consumption was highest in adolescence and higher in men than in women. The consumption decreased in 2014 compared to 2004. The consumption is decreasing with increasing educational level.
The consumption of ultra-processed foods (UPF) in Belgium represented 30% of the total energy consumed. This proportion was higher among children (33% of the total energy consumed). No difference could be observed between men and women in the consumption of UPF. In 2014 the consumption of UPF did not significantly differ compared to 2004. In Wallonia the consumption of UPF was higher than in Flanders. It did not vary with the education levels.

2. Background

Dietary quality is an important factor in health and disease burden. A healthy diet helps protect against non-communicable diseases (NCDs) including diabetes, cancer, heart disease and stroke [1]. Recommendations have been established at international [2] and national [3-4] levels.

In Belgium, information on dietary consumption patterns are available from two national Food Consumption Surveys (FCS), conducted in 2004 and 2014 [5-7]. The focus in this report has been put on:

  1. Consumption patterns for 9 food groups compared against international recommendations [2].
  2. A more detailed analysis of three indicators related to the diet quality, i.e. fruit and vegetable consumption, consumption of sugar-sweetened beverages and consumption of ultra-processed foods.

Fruit and vegetables are low-energy density foods and are important sources of dietary fiber, vitamins and minerals. A high consumption of fruit and vegetables has been significantly associated with a decrease in the risk of coronary heart disease, stroke and obesity [8]. The WHO recommends a daily consumption of 400 grams of fruit and vegetables [9].

Contrarily, a high intake of free sugars, particularly in the form of sugar-sweetened beverages, is associated with poor dietary habits, unhealthy weight gains, risk of dental carries and other NCDs [1;8]. The WHO strongly recommends restricting the intake of free sugars to less than 10% of the total energy consumption, throughout the life course [10]. With respect to this guideline the consumption of sugar-sweetened beverages should be avoided.

Ultra-processed foods (UPF) are food products formulated from industrial ingredients with little or no content of intact foods. Such foods are often characterised by lower nutritional quality. They have been associated with a higher incidence of dyslipidaemia and a higher risk of overweight, obesity and hypertension. The consumption of UPF should thus be avoided as far as possible [11-12]. For the analysis of the Belgian data performed here, the food items have been classified by the NOVA classification based on the extent and purpose of industrialised processing. The results are presented as dietary share of the proportion of daily energy consumed [13].

3. Overall consumption patterns

Overall, the Belgian diet is characterized by excessive consumption of red meat, processed meat and sugar sweetened beverages and by insufficient consumption of fruits, vegetables, nuts and seeds, milk, eggs and fish. Overall, these patterns have only slightly improved between 2004 and 2014. For red meat consumption, however, an improvement was observed, with the proportion of excessive consumptions dropping from 59% to 36%.

Proportion of the Belgian population (15-64) above or below international dietary recommendations, by food group, 2004-2014
Source: Food Consumption Survey, Sciensano, 2004-2014 [7]
hsr en nutrition overview

4. Consumption of fruits and vegetables

Belgium

In 2014, the usual fruit and vegetable consumption was 255 grams per day. Only 14% of the population met the WHO guidelines of 400 grams per day.

Fruit and vegetable consumption in children was similar as in adolescents (206 grams/day and 210 grams/day respectively). In adults the consumption was 269 grams/day. There were no difference in fruit and vegetable consumption between boys and girls during childhood and adolescence. Conversely, in adults (18-64 years), men eat less fruit and vegetables than women (258 grams/day versus 284 grams/day).

Consumption of fruit and vegetables (in grams per day) in the population aged 3-64 years, by age group and sex, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Time trends

The mean usual consumption of fruit and vegetables, slightly increased from 243 grams/day in 2004 to 269 grams/day in 2014. The increase over time was similar in adolescents and adults. The proportion of the population that meets the recommendations increased from 7.5% to 16%. Consumption data of children (3-14 years) could not be compared with 2004 since the food consumption survey of 2004 did not comprise children.

Average usual consumption of fruit and vegetables (in grams per day) in the population aged 15-64 years, by age by year, Belgium, 2004-2014
Source: Food Consumption Survey, Sciensano, 2004-2014 [7]

Differences by region

In all age groups the mean usual consumption of fruit and vegetables was higher in Flanders than in Wallonia (275 grams/day versus 212 grams/day). In total, 16% of people living in Flanders met the recommendations for fruit and vegetable consumption compared to 8% in Wallonia.

Mean usual consumption of fruit and vegetables (in grams per day) in the population aged 3-64 years, by age and by region of residence, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Differences by educational level

Fruit and vegetable consumption increased with the educational level with a mean usual consumption of 211 grams/day for individuals in the lowest educational level and on average 300 grams/day for individuals in the highest educational level. Only 6% of the lower educated population meets the recommendations for fruit and vegetable consumption compared to 22% for the higher educated population.

Consumption of fruit and vegetables (in grams per day) in the population aged 3-64 years, by educational level, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

International comparison

In all age groups, the mean fruit and vegetable consumption in Belgium was below the EU-15 average. However, the difference with the EU-15 average was smaller in children 3-9 years (206 grams/day versus 210 grams/day) than in adolescents (210 grams/day versus 226 grams/day) and adults 269 grams/day versus 307 grams/day).

  • Children
  • Adolescents
  • Adults

Mean usual fruit and vegetable consumption (in grams per day) in children (3-9 years), by country of residence, EU-15, EFSA food consumption surveys
Source: EFSA comprehensive food consumption survey, chronic intake from 12 countries; data from Luxembourg and Ireland are missing [14]. Usual fruit and vegetables consumption calculated as the sum of the average chronic food consumption and the average chronic vegetable consumption

Mean usual fruit and vegetable consumption (in grams per day) in adolescents (10-17 years), by country of residence, EU-15, EFSA food consumption surveys
Source: EFSA comprehensive food consumption survey, chronic intake from 12 countries; data from Greece, Luxembourg and Ireland are missing [14]. Average usual fruit and vegetables consumption calculated as the sum of the average chronic fruit consumption and the average chronic vegetable consumption

Fruit and vegetable consumption (in grams per day) in adults 18-64 years), by country of residence, EU-15, last food consumption surveys
Source: EFSA comprehensive food consumption survey, chronic intake from 12 countries; data from Luxembourg and Greece are missing [14]. Average usual fruit and vegetables consumption calculated as the sum of the average chronic fruit consumption and the average chronic vegetable consumption

5. Consumption of sugar sweetened beverages

Belgium

In 2014, the usual consumption of sugar sweetened beverages was 151 ml/day, and 97% of the population consumed sugar-sweetened beverages. The consumption was highest in adolescents (220 ml/day); it was also higher in men than in women (196 ml/day and 112 ml/day respectively).

Consumption of sugar sweetened beverages (in ml per day) in the population aged 3-64 years, by age and sex, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Time trends

In 2014 compared to 2004, the consumption of sugar-sweetened beverages decreased from 387 ml/day to 298 ml/day in adolescents (15-17 years) and from 250 ml/day to 211 ml/day in young adults (18-39 years). In the older adult population (40-64 years) the consumption did not change in 2014 (89 ml/day). Consumption data of children (3-14 years) could not be compared with 2004 since the food consumption survey of 2004 did not comprise children.

Mean usual consumption of sugar sweetened beverages (in ml per day) in the population aged 15-64 years, by age and year, Belgium, 2004-2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Differences by region

The consumption of sugar sweetened beverages was slightly higher in Flanders (167 ml/day) than in Wallonia (148 ml/day), but this difference was not significant.

Consumption of sugar sweetened beverages (in ml per day) in the population aged 3-64 years, by age and region, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Differences by educational level

The proportion of the population that consumes sugar sweetened beverages is equally high in all educational groups. However, there is a socio-economic gradient for the amount of sugar sweetened beverages consumed, i.e., 227 ml in people with the lowest educational level versus 89 ml/day in people with the highest educational level.

Consumption of sugar sweetened beverages (in ml per day) in the population aged 3-64 years, by education level, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

6. Consumption of ultra-processed foods

In 2014, the mean proportion of daily energy intake from ultra-processed foods (UPF) was 29.9%. This proportion was slightly higher in young children (33.3%) compared to adolescents (29.2%) and adults (29.6%.) The daily energy intake from UPF was not significantly different between women and men.

Consumption of ultra-processed foods (in% of the total energy intake) in the population aged 3-64 years, by age and sex, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Time trends

The daily energy intake of UPF did not change in 2014 (29.9% of the total energy intake) compared to 2004 (29.8%).

Mean usual consumption of ultra-processed foods (in % of the total energy intake) in the population aged 15-64 years, by age and year, Belgium, 2004-2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Differences by region

The proportion of the usual daily energy intake from UPF was higher in Wallonia (36.8%) compared to Flanders (28.7%). This difference was more pronounced in children compared to adults.

Mean usual consumption of ultra-processed foods (in% of the total energy intake) in the population aged 3-64 years, by age and region, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

Differences by educational level

Within all age groups there was no significant difference in the proportion of energy intake from UPF between the different educational levels.

Mean usual consumption of ultra-processed foods (in% of the total energy intake) in the population aged 3-64 years, by age and education level, Belgium, 2014
Source: Food Consumption Survey, Sciensano, 2014 [7]

7. Read more

FCS: Food consumption survey

Definitions

NOVA classification
NOVA is a food classification tool that groups foods according to the extent and purpose of food processing. Food products are divided in four distinct food groups, i.e. ‘ultra-processed’, ‘processed’, ‘unprocessed or minimally processed’ or ‘processed culinary ingredient’ [10].
Ultra-processed foods
Ultra-processed foods (UPF) are foods formulated from industrial ingredients with little or no content of intact foods. UPFs are often characterised by lower nutritional quality and have been associated with a higher incidence of dyslipidaemia and a higher risk of overweight, obesity and hypertension. The consumption of UPF should be avoided [9].
Usual intake
Usual intake is the average daily intake over a long period of time.

References

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  2. GBD 2017 Risk Factor Collaborators (2017) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392 (10159): 1923-1994.
  3. Vanhauwaert E. De actieve voedingsdriehoek: een praktische voedings- en beweeggids. Brussel; 2012.
  4. Lebacq T, Ost C. Recommandations alimentaires. In: Tafforeau J, editor. Enquête de consommation alimentaire 2014-2015. 2016.
  5. De Ridder K, Bel S, Brocatus L, Lebacq T, Ost C, et al. (2016) Résumé des résultats 2014-2015. In: Tafforeau J, editors. Enquête de consommation alimentaire. Bruxelles: WIV-ISP.
  6. Debacker, N, Cox, Bianca, Temme, Liesbeth, Huybrechts, Inge, and Van Oyen, Herman (2007) De Belgische voedselconsumptiepeiling 2004: voedingsgewoonten van de Belgische bevolking ouder dan 15 jaar. Wetenschappelijk Instituut Volksgezondheid.
  7. Sciensano (2019) Website of the Belgian National Food Consumption survey 2014. https://fcs.wiv-isp.be/SitePages/Home.aspx.
  8. EFSA Panel on Dietetic Products, Nutrition, and Allergies (2010) Scientific opinion on principles for deriving and applying dietary reference values. EFSA Journal 8 (3):1458.
  9. World Health Organization (1990) Diet, nutrition, and the prevention of chronic diseases. Report of a WHO Study Group. 
  10. World Health Organization (2015) Guideline: sugars intake for adults and children. 
  11. Vandevijvere S, De Ridder K, Fiolet T, Bel S, Tafforeau J (2018) Consumption of ultra-processed food products and diet quality among children, adolescents and adults in Belgium. European Journal of Nutrition 1-12.
  12. Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 2018;360:322.
  13. Monteiro CA, Cannon G, Levy R, Moubarac JC, Jaime P, Martins AP, Canella D, Louzada M, Parra D (2016) NOVA. The star shines bright. World Nutrition 7: 28-38.
  14. European Food Safety Authority (2019) The EFSA comprehensive food consumption database.