Characteristics of the study population
Table 2 presents the distribution of the characteristics of the study population. Overall, 28.6% of the persons aged 18 years and older in Belgium reported to have gained weight in the first 6 weeks of the confinement, 56.9% reported their weight remained stable and 14.5% reported to have lost weight. The overall prevalence of those who have changed at least one health behaviour, positively or negatively, was 82,8%; in case of negatively this was 58,5%. The most frequently reported behaviour changes in these 6 weeks (Table 2) were an increased consumption of sweet or salty snacks (33.2%) and a decrease in physical activity (28.8%).
Table 2 | Distribution of the study population (N=28,029) by sociodemographic covariates and change in self-reported health behaviours in 6 weeks during confinement, second COVID-19 Health Survey, Belgium 2020
Background variables and indicators
|
Crude prevalence (%)
|
Weighted* prevalence (%)
|
SOCIODEMOGRAPHIC AND HEALTH COVARIATES
|
|
|
Gender
Men
Women
|
32.5
67.5
|
50.9
49.1
|
Age group
18-24 years
25-34 years
35-44 years
45-54 years
55-64 years
65+ years
|
2.7
15.0
23.5
24.1
22.0
12.7
|
11.7
15.7
17.0
18.4
17.3
19.9
|
Household composition
Living alone
Couple, without child(ren)
Couple, with child(ren)
Living alone with child(ren)
Living with parents, family,…
Other
|
15.6
29.5
40.1
6.9
6.8
1.1
|
16.7
31.9
30.5
4.7
15.2
1.0
|
Employment
No paid job
Paid job, normal environment
Paid job, but via telework
Paid job, but temporarily unemployed
Paid job, other situation
|
23.8
21.7
40.1
7.8
6.6
|
37.7
21.0
27.2
9.3
4.8
|
Reporting no health problem (EQ-5D - quality of life)
Yes
No
|
27.8
72.2
|
27.1
72.9
|
Region
Flemish
Brussels
Walloon
|
53.2
10.5
36.3
|
60.7
9.4
29.9
|
SELF-REPORTED WEIGHT STATUS AND CHANGE IN HEALTH BEHAVIOUR IN 6 WEEKS INDICATORS
|
Weight status
Underweight
Normal weight
Overweight
Obesity
|
2.1
47.8
32.7
17.4
|
2.4
44.8
34.2
18.6
|
Change in body weight
Lost weight
Weight remained stable
Gained weight
|
14.1
56.1
29.8
|
14.5
56.9
28.6
|
Change in the consumption of sugared-sweetened beverages
Increased
Unchanged
Decreased
|
8.7
84.2
7.1
|
9.2
82.1
8.7
|
Change in the consumption of sweet or salty snacks
Increased
Unchanged
Decreased
|
36.6
56.8
6.6
|
33.2
59.4
7.4
|
Change in the consumption of food prepared out-of-home
Increased
Unchanged
Decreased
|
6.6
51.8
41.6
|
7.3
53.0
39.7
|
Change in physical activity
Increased
Unchanged
Decreased
|
24.6
45.1
30.3
|
23.7
47.5
28.8
|
Change in alcohol consumption
Increased
Unchanged
Decreased
|
21.2
65.0
13.8
|
17.4
64.9
17.7
|
*Weighted for age, gender, education and province
Weight change according to weight status
Figure 1 shows that the proportion of persons who reported some weight gain in the first 6 weeks of the confinement increased with the increasing BMI categories: weight gain was reported by 9.9% of the persons who are underweight, 23.4% of the persons with a normal weight, 31.4% of the persons with overweight and 38.7% of the persons with obesity.
Compared to persons in the normal (healthy) weight range, the odds of gaining weight was higher for overweight persons (OR=1.72 (1.56-1.91), P-value<0.0001) and those with obesity (OR=2.23 (1.98-2.52), P-value<0.0001), and lower for underweight persons (OR=0.30 (0.19-0.46), P-value<0.0001).
Association between health behaviour and weight gain
Table 3 shows that persons with an increased consumption of sugar-sweetened beverages in the first 6 weeks of the confinement had higher odds of weight gain (ORadj=1.39 (1.15-1.68), P-value<0.001). However, persons who decreased their consumption of sugar-sweetened beverages also had higher adjusted odds of weight gain (ORadj=1.29 (1.04-1.60), P-value=0.018). The highest odds of weight gain was observed for persons with an increased consumption of sweet or salty snacks in these 6 weeks (ORadj=3.65 (3.27-4.07), P-value<0.0001). Furthermore, persons who were less physically active in the 6 weeks of confinement were almost twice as likely to gain weight (ORadj=1.91 (1.71-2.13), P-value<0.0001). Persons who were more active in these 6 weeks had lower odds of gaining weight in the adjusted model only (ORadj=0.84 (0.74-0.96), P-value=0.013). Finally, an increased consumption of alcohol in these 6 weeks was positively associated with weight gain (ORadj=1.86 (1.66-2.08), P-value<0.0001). Persons who decreased their consumption had a lower adjusted odds of weight gain (ORadj=0.85 (0.72-0.99), P-value=0.043).
Table 3 | Association between self-reported weight gain in 6 weeks during confinement and change in self-reported health behaviours (N=28,029) by means of crude and adjusted* OR (95% CI) and P-value, second COVID-19 Health Survey, Belgium 2020
Self-reported weight gain by change in self-reported health behaviour
|
Crude
|
|
Adjusted*
|
|
OR
|
95% CI
|
P-value
|
|
OR
|
95% CI
|
P-value
|
Change in the consumption of sugared-sweetened beverages (Reference=Unchanged)
Increased
Decreased
|
2.62
1.09
|
2.24 – 3.06
0.90 – 1.30
|
<.0001
0.375
|
|
1.39
1.29
|
1.15 – 1.68
1.04 – 1.60
|
0.0006
0.022
|
Change in the consumption of sweet or salty snacks (Reference=Unchanged)
Increased
Decreased
|
4.58
0.95
|
4.16 – 5.04
0.76 – 1.19
|
<.0001
0.660
|
|
3.65
0.86
|
3.27 – 4.07
0.66 – 1.12
|
<.0001
0.262
|
Change in the consumption of food prepared out-of-home (Reference=Unchanged)
Increased
Decreased
|
1.94
1.17
|
1.63 – 2.30
1.07 – 1.29
|
<.0001
0.001
|
|
1.20
0.95
|
1.00 – 1.45
0.86 – 1.06
|
0.051
0.390
|
Change in physical activity (Reference=Unchanged)
Increased
Decreased
|
0.99
2.32
|
0.88 – 1.12
2.10 – 2.57
|
0.894
<.0001
|
|
0.84
1.91
|
0.74 – 0.96
1.71 – 2.13
|
0.013
<.0001
|
Change in alcohol consumption (Reference=Unchanged)
Increased
Decreased
|
2.64
0.95
|
2.39 – 2.92
0.82 – 1.10
|
<.0001
0.517
|
|
1.86
0.85
|
1.66 – 2.08
0.72 – 0.99
|
<.0001
0.043
|
* Adjusted for age, gender, household composition, employment and the health behaviour indicators
Association between weight gain and health behaviour stratified by gender
Overall, the associations between changes in health behaviours and weight gain were similar for men and women, although two differences were observed (Table 4): women who increased their consumption of food prepared out-of-home had higher adjusted odds of weight gain in the first 6 weeks of confinement than men (ORadj=1.28 (1.02-1.61), P-value=0.036, and ORadj=1.14 (0.85-1.51), P-value=0.381, respectively) and men who were more physically active in these 6 weeks had lower adjusted odds of weight gain than women (ORadj=0.77 (0.61-0.98), P-value=0.033, and ORadj=0.91 (0.79-1.05), P-value=0.195, respectively).
Table 4 | Association between self-reported weight gain in 6 weeks during confinement and change in self-reported health behaviours by means of adjusted* OR (95% CI) and P-value, stratified by gender, second COVID-19 Health Survey, Belgium 2020
Self-reported weight gain by change in self-reported health behaviour
|
Men (N=9,296)
|
|
Women (N=19,369)
|
|
OR
|
95% CI
|
P-value
|
|
OR
|
95% CI
|
P-value
|
Change in the consumption of sugared-sweetened beverages (Reference=Unchanged)
Increased
Decreased
|
1.44
1.36
|
1.03 – 2.01
0.98 – 1.91
|
0.034
0.068
|
|
1.37
1.18
|
1.14 – 1.64
0.91 – 1.52
|
0.0007
0.219
|
Change in the consumption of sweet or salty snacks (Reference=Unchanged)
Increased
Decreased
|
3.22
0.75
|
2.66 – 3.91
0.49 – 1.16
|
<.0001
0.196
|
|
4.05
0.98
|
3.60 – 4.56
0.71 – 1.34
|
<.0001
0.876
|
Change in the consumption of food prepared out-of-home (Reference=Unchanged)
Increased
Decreased
|
1.14
1.00
|
0.85 – 1.51
0.83 – 1.21
|
0.381
0.964
|
|
1.28
0.92
|
1.02 – 1.61
0.82 – 1.04
|
0.036
0.184
|
Change in physical activity (Reference=Unchanged)
Increased
Decreased
|
0.77
2.15
|
0.61 – 0.98
1.80 – 2.57
|
0.033
<.0001
|
|
0.91
1.69
|
0.79 – 1.05
1.49 – 1.93
|
0.195
<.0001
|
Change in alcohol consumption (Reference=Unchanged)
Increased
Decreased
|
1.86
0.85
|
1.54 – 2.45
0.67 – 1.08
|
<.0001
0.183
|
|
1.84
0.83
|
1.62 – 2.10
0.68 – 1.02
|
<.0001
0.070
|
* Adjusted for age, household composition, employment and the health behaviour indicators
Association between health behaviour and weight gain stratified by age group
Some of the associations between health behaviours and weight gain appear to differ in intensity across age groups (Table 5). In particular, an increased alcohol consumption was more strongly associated with weight gain in older adults (ORadj=2.52 (2.03-3.12), P-value<0.0001). The association between increased snacking and weight gain also appears to strengthen with age (ORadj=3.92 (3.29-4.68), P-value<0.0001). An increased consumption of food prepared out-of-home appears only to be influencing weight gain in the middle age group (ORadj=1.27 (1.00-1.60), P-value=0.048), while a decrease in sugared-sweetened beverages appears to be mostly associated with weight gain in older adults (ORadj=1.55 (1.09-2.20), P-value=0.016).
Table 5 | Association between self-reported weight gain in 6 weeks during confinement and change in self-reported health behaviours by means of adjusted* OR (95% CI) and P-value, stratified by age group, second COVID-19 Health Survey, Belgium 2020
Self-reported weight gain by change in self-reported health behaviour
|
Young adults 18-34 years (N=5,105)
|
Middle aged adults 35-54 years (N=13,617)
|
Older adults 55+ years (N=9,943)
|
|
OR
|
95% CI
|
P-value
|
OR
|
95% CI
|
P-value
|
OR
|
95% CI
|
P-value
|
Change in the consumption of sugared-sweetened
beverages (Reference=Unchanged)
Increased
Decreased
|
1.34
1.18
|
0.95 – 1.90
0.79 – 1.77
|
0.095
0.408
|
1.48
1.21
|
1.23 – 1.78
0.93 – 1.58
|
<.0001
0.159
|
1.33
1.55
|
0.90 – 1.97
1.09 – 2.20
|
0.148
0.016
|
Change in the consumption of sweet or salty
snacks (Reference=Unchanged)
Increased
Decreased
|
3.22
0.99
|
2.48 – 4.18
0.57 – 1.72
|
<.0001
0.977
|
3.73
0.64
|
3.29 – 4.23
0.47 – 0.88
|
<.0001
0.006
|
3.92
0.93
|
3.29 – 4.68
0.63 – 1.37
|
<.0001
0.697
|
Change in the consumption of food prepared
out-of-home (Reference=Unchanged)
Increased
Decreased
|
1.15
0.94
|
0.78 – 1.70
0.73 – 1.21
|
0.477
0.624
|
1.27
0.88
|
1.00 – 1.60
0.77 – 0.99
|
0.048
0.040
|
1.09
1.07
|
0.79 – 1.50
0.89 – 1.30
|
0.615
0.471
|
Change in physical activity
(Reference=Unchanged)
Increased
Decreased
|
0.73
1.54
|
0.54 – 0.98
1.19 – 2.01
|
0.039
0.001
|
0.81
2.10
|
0.70 – 0.94
1.83 – 2.40
|
0.007
<.0001
|
0.98
2.00
|
0.79 – 1.22
1.67 – 2.39
|
0.878
<.0001
|
Change in alcohol consumption
(Reference=Unchanged)
Increased
Decreased
|
1.40
0.90
|
1.08 – 1.80
0.65 – 1.23
|
0.010
0.504
|
1.83
0.84
|
1.60 – 2.09
0.69 – 1.03
|
<.0001
0.090
|
2.52
0.73
|
2.03 – 3.12
0.57 – 0.94
|
<.0001
0.014
|
* Adjusted for gender, household composition, employment and the health behaviour indicators