19 results
A food-exchange model for achieving the recommended dietary intakes for saturated fat in Irish children: analysis from the cross-sectional National Children’s Food Survey II
- Aileen O’Connor, Maria Buffini, Anne P Nugent, Laura Kehoe, Albert Flynn, Janette Walton, John Kearney, Breige McNulty
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- Public Health Nutrition / Accepted manuscript
- Published online by Cambridge University Press:
- 03 May 2024, pp. 1-29
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Objective:
To identify the main foods determining saturated fatty acid (SFA) intakes and model the impact of food exchanges to improve compliance with dietary fat recommendations in Irish children.
Design:Estimated food and nutrient intakes were obtained from a cross-sectional study, the National Children’s Food Survey II. Participants were categorised into low, medium, and high SFA consumers, and the contribution of food categories to SFA intakes were compared. A food-exchange model was developed, whereby a selected range of high SFA foods were exchanged with lower SFA or unsaturated fat alternatives.
Setting:Participants were randomly selected from primary schools throughout the Republic of Ireland.
Participants:A representative sample of 600 Irish children (5–12 years).
Results:The main determinants of low and high SFA consumers were milk, cheese, and butter. These foods, including snack foods, and meat and meat products, were considered exchangeable foods within the model. Compared with baseline data, modelled intakes for total fat, SFA, monounsaturated fatty acids (MUFA) and trans-fat presented decreases of 3.2, 2.7, 1.6 and <0.1% of total energy (% TE), respectively. Polyunsaturated fatty acid (PUFA), omega 6, omega 3 and alpha-linolenic acid showed increases of 1.0, 0.8, 0.2 and 0.1% TE, respectively. Compliance with total fat, MUFA and trans-fat recommendations remained adequate (100%). Adherence to SFA and PUFA recommendations improved from 18 to 63%, and 80 to 100%, respectively.
Conclusion:The food-exchange model decreased SFA intakes and increased PUFA intakes, suggesting modest dietary changes to children’s diets can effectively improve their overall dietary fat profile.
Late Surges in COVID-19 Cases and Varying Transmission Potential Partially Due to Public Health Policy Changes in 5 Western States, March 10, 2020, to January 10, 2021
- Xinyi Hua, Aubrey R.D. Kehoe, Joana Tome, Mina Motaghi, Sylvia K. Ofori, Po-Ying Lai, Sheikh Taslim Ali, Gerardo Chowell, Anne C. Spaulding, Isaac Chun-Hai Fung
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- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 03 November 2022, e277
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Objective:
This study investigates the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission potential in North Dakota, South Dakota, Montana, Wyoming, and Idaho from March 2020 through January 2021.
Methods:Time-varying reproduction numbers, Rt, of a 7-d-sliding-window and of non-overlapping-windows between policy changes were estimated using the instantaneous reproduction number method. Linear regression was performed to evaluate if per-capita cumulative case-count varied across counties with different population size or density.
Results:The median 7-d-sliding-window Rt estimates across the studied region varied between 1 and 1.25 during September through November 2020. Between November 13 and 18, Rt was reduced by 14.71% (95% credible interval, CrI, [14.41%, 14.99%]) in North Dakota following a mask mandate; Idaho saw a 1.93% (95% CrI [1.87%, 1.99%]) reduction and Montana saw a 9.63% (95% CrI [9.26%, 9.98%]) reduction following the tightening of restrictions. High-population and high-density counties had higher per-capita cumulative case-count in North Dakota on June 30, August 31, October 31, and December 31, 2020. In Idaho, North Dakota, South Dakota, and Wyoming, there were positive correlations between population size and per-capita weekly incident case-count, adjusted for calendar time and social vulnerability index variables.
Conclusions:Rt decreased after mask mandate during the region’s case-count spike suggested reduction in SARS-CoV-2 transmission.
Dietary fat intakes in Irish children: changes between 2005 and 2019
- Aileen O’Connor, Maria Buffini, Anne Nugent, Laura Kehoe, Albert Flynn, Janette Walton, John Kearney, Breige McNulty
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- Public Health Nutrition / Volume 24 / Issue 5 / April 2021
- Published online by Cambridge University Press:
- 26 October 2020, pp. 802-812
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Objective:
To examine current dietary fat intakes and compliance in Irish children and to examine changes in intakes from 2005 to 2019.
Design:Analyses were based on data from the Irish National Children’s Food Survey (NCFS) and the NSFS II, two cross-sectional studies that collected detailed food and beverage intake data through 7-day and 4-day weighed food diaries, respectively.
Setting:NCFS and NCFS II, Republic of Ireland.
Participants:A nationally representative sample of 594 (NCFS) and 600 (NCFS II) children aged 5–12 years. Current intakes from the NCFS II were compared with those previously reported in the NCFS (www.iuna.net).
Results:Current intakes of total fat, SFA, MUFA, PUFA and trans fat as a percentage of total energy are 33·3, 14·0, 13·6, 5·6 and 0·5 %, respectively. Total fat, SFA and trans fat intakes since 2005 remained largely stable over time with all displaying minor decreases of <1 %. Adherence to SFA recommendations remains inadequate, with only 7 % of the population complying. Insufficient compliance with PUFA (71 %) and EPA and DHA (DHA; 16 %) recommendations was also noted.
Conclusion:Children in Ireland continue to meet the total fat and trans fat target goals. Adherence to MUFA and PUFA recommendations has also significantly improved. However, deviations for some fats remain, in particular SFA. These findings are useful for the development of dietary strategies to improve compliance with current recommendations.
The prevalence of overweight and obesity in Irish children between 1990 and 2019
- Aisling O’Donnell, Maria Buffini, Laura Kehoe, Anne Nugent, John Kearney, Janette Walton, Albert Flynn, Breige McNulty
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- Journal:
- Public Health Nutrition / Volume 23 / Issue 14 / October 2020
- Published online by Cambridge University Press:
- 17 June 2020, pp. 2512-2520
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Objective:
The present study aimed to examine the temporal prevalence of overweight and obesity in Irish children through different methodologies and evaluate the change in rates between 1990 and 2019.
Design:Anthropometric data from three Irish national food consumption surveys were used to examine the change in the prevalence of BMI and waist circumference-derived overweight and obesity levels.
Setting:Three cross-sectional food consumption surveys from the Republic of Ireland: the Irish National Nutrition Survey (1990), the National Children’s Food Survey (2005) and The Second National Children’s Food Survey (2019).
Participants:A demographically representative sample of Irish children aged 5–12 years: 1990 (n 148), 2005 (n 594) and 2019 (n 596).
Results:Twelve percentage of children had overweight/obesity in 1990, which was significantly higher in 2005 at 25 % and significantly lower in 2019 at 16 % (P = 0·003). In 2019, more girls had overweight/obesity in comparison with boys (19 v. 14 %), whilst children from the lowest social class group had the highest levels of overweight/obesity (P = 0·019). Overall, the proportion of children with abdominal overweight/obesity was significantly lower in 2019 in comparison with 2005 (P ≤ 0·001).
Conclusions:Evidence from the most recent national survey suggests that overweight and obesity levels are plateauing and in some cases reducing in children in Ireland. Despite this, rates remain high, with the highest prevalence in 2019 observed in girls and in those from the lowest social class group. Thus, overweight/obesity prevention and intervention policies are necessary and should be continued.
Intakes and status of riboflavin in a representative sample of Irish adults aged 18–90 years screened for MTHFR C677T polymorphism
- Emma O'Sullivan, Laura Kehoe, Janette Walton, Helene McNulty, Mary Ward, Liadhan McAnena, Sinead M. Hopkins, Breige A. McNulty, Anne P. Nugent, Albert Flynn
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E71
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Meta-analyses of epidemiological data report that adults who carry a common polymorphism, the MTHFR 677C→T, in the gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) have a 40% increased risk of CVD and an 87% increased risk of hypertension. Riboflavin (vitamin B2), in its co-enzymatic form flavin adenine nucleotide (FAD), is required as a co-factor by MTHFR and previous trials in hypertensive patients have shown a blood pressure lowering response to riboflavin supplementation that is specific to individuals homozygous for this polymorphism (TT genotype). Low folate status is commonly reported in adults with the TT genotype however the effect of this genetic variant on riboflavin status has not previously been investigated. The aim of this study, therefore, was to investigate dietary intake and biomarker status of riboflavin by MTHFR genotype in Irish adults using data from the National Adult Nutrition Survey (2008–2010) (www.iuna.net).
A 4-day semi-weighed food record was used to collect food and beverage intake data from a representative sample of 1500 Irish adults (18–90 years). Dietary intake data were analysed using WISP© based on UK food composition tables (modified to include recipes of composite dishes, nutritional supplements, fortified foods and generic Irish foods that were commonly consumed). Usual intakes were calculated via the NCI-method using SAS© Enterprise Guide. Blood samples (n = 1126) were collected by venepuncture by a trained professional and were processed and analysed using standard operating procedures. Biomarker status of riboflavin was determined by erthyrocyte gluthathione reductase activation coefficient (EGRac), a functional assay that measures the activity of the enzyme glutathione reductase before and after in vitro activation with its prosthetic group FAD; a lower value indicates better status.
It was found that 12% of the population had the TT genotype. As expected, there was no significant difference in riboflavin intake across the genotype (CC, CT or TT) groups. Similarly, no significant genotype differences in riboflavin status (EGRac) were observed (1.36 vs 1.37 vs 1.38 respectively). Overall, 61% of the total population had EGRac values > 1.3, indicative of low/deficient status with no significant difference observed between the genotype groups (60%,61% and 61%, respectively).
These data suggest that riboflavin status is not influenced by the C677T polymorphism in MTHFR in this cohort of nationally representative Irish adults. Further research is needed to see the impact of riboflavin status on blood pressure across the genotype groups in this nationally representative cohort of Irish adults.
Intakes and sources of menaquinones (vitamin K2) in the Irish population aged 1–90 years
- Ciara Kingston, Laura Kehoe, Janette Walton, Breige McNulty, Anne Nugent, Kevin Cashman, Albert Flynn
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E347
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Recent evidence suggests that menaquinones (Vitamin K2) may be important for both bone health and cardiovascular health. With the exception of menaquinone-4 which is formed from the tissue specific conversion of phylloquinone or menadione, menaquinones are synthesized by bacteria. They are typically found in foods of animal origin such as meat, dairy and fermented foods and may account for up to 25% of total vitamin K intake. There are few data available on menaquinone intakes in population groups due to lack of available composition data. The Irish food composition database however has recently been updated to include data on menaquinones. Therefore, the aim of this study was to use these data to estimate the intakes and key dietary sources of menaquinones (menaquinone-4 & menaquinone-5–10) in the Irish population.
Analyses included data from four nationally representative surveys of the Irish population; The National Pre-School Nutrition Survey (1–4y; 2010–2011), the National Children's Food Survey (5–12y; 2003–2004), the National Teens’ Food Survey (13–17y; 2005–2006) and the National Adult Nutrition Survey (18–90y; 2008–2010) (www.iuna.net). For all of the surveys, food and beverage intake data (including supplements) were collected using food records and quantified using food scales, photographic atlases, household measures and standard portion sizes. Mean daily intakes of menaquinone-4 and menaquinone-5–10 were estimated using UK food composition tables and analytical values from published papers. The percent contribution of food groups to menaquinone intake was calculated by the mean proportion method (which provides information about the sources that are contributing to the nutrient intake ‘per person’). Statistical analyses were carried out using SPSS© V22.
Mean intakes of menaquinone-4 ranged from 8–12μg/d and 10–14μg/d in children aged 1–17 years and adults aged 18–90 years, respectively. Mean combined intakes of menaquinone-5–10 ranged from 32–43μg/d and 32–50μg/d in children aged 1–17 years and adults aged 18–90 years, respectively. ‘Meat & meat products’ were the top contributor of menaquinone-4 (50–66%) intakes across all population groups followed by ‘milks’ (9–25%). ‘Meat & meat products’ (44–61%) and ‘cheeses’ (21–37%) were important contributors to menaquinone-5–10 intakes across all population groups examined.
This study is the first of its kind to report the intakes and sources of menaquinones in the Irish population. ‘Meat & meat products’, ‘cheeses’ and ‘milks’ are important contributors to intakes of menaquinones in the Irish diet. Further research is required to fully understand the role of the menaquinones in human health.
Changes in consumption of milk in Irish children (5–12 years): preliminary analysis from the National Children's Food Survey II
- Aileen O'Connor, Maria Buffini, Anne Nugent, Laura Kehoe, Janette Walton, John Kearney, Albert Flynn, Breige McNulty
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E349
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Introduction:
Milk is widely recognised as a nutrient dense food, supporting the growth and development of children. Nevertheless some milk types such as whole milk can consist of high levels of saturated fat, which is recognised for its association with chronic disease risk in adults when intakes are elevated. In Ireland, current dietary guidelines recommend that children from two years onwards should consume low fat milk. Previous research has shown low levels of compliance with this guideline. Therefore the aim of this study is to review the current consumption of milk and non-dairy milk-based alternatives among Irish children and compare these with previous intakes.
Materials and methods:Analyses are based on data from the nationally representative National Children's Food Survey (NCFS, 2003–2004) and the National Children's Food Survey II (NCFSII 2017–2018) (www.iuna.net). The NCFS and NCFS II collected detailed food and beverage intake data from 7-d and 4-d weighed food diaries respectively, of Irish children aged 5–12 years (NCFS, n594; NCFS II, n600). Dietary intakes were analysed using WISP© in NCFS and Nutritics V5.02 (Nutritics, Dublin, Ireland) in NCFS II. Milk intakes were categorised into three food groups: ‘Whole milk’, ‘reduced fat milk’, and ‘non-dairy milk alternatives’. Mean daily intakes (MDIs) were calculated for the total population and consumers only using SPSS© V24.0.
Results:Dietary intakes of ‘whole milk’ decreased over time from 232 ± 186g/d to current intakes of 131 ± 154g/d. In contrast, increases were noted in ‘reduced fat milks’ (26 ± 86g/d to 52 ± 110g/d) and ‘non-dairy alternatives’ (0.2 ± 4g/d to 3 ± 19g/d). A total of 68% of children were classified as consumers of whole milk (193 ± 151g/d) compared to 90% (257 ± 178g/d) previously. ‘Reduced fat milk’ consumers increased from 17% to 31% and ‘non-dairy alternatives’ consumers also increased from < 1% to 3%.
Conclusion:Our preliminary results indicate that the number of Irish children consuming whole milk have decreased over the last number of years. In contrast consumers of ‘reduced fat milks’ have significantly increased, indicating potential improvement to healthy eating guidelines adherence. Further analysis to examine current intakes and sources of saturated fat is warranted to establish additional changes in dietary patterns and compliance with recommendations within this age group.
The role of breakfast in the diets of Irish adults (18–90y)
- Ioana Rusu, Laura Kehoe, Breige A. McNulty, Anne P. Nugent, Albert Flynn, Janette Walton
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E458
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Breakfast is often referred to as ‘the most important meal of the day’ and is consumed after the longest postprandial fast (an overnight fast). Breakfast consumption has been positively linked to many health benefits and has been shown in many studies to be associated with a better diet quality. The aim of this study was to characterise breakfast in Irish adults and to investigate the contribution of breakfast to overall daily nutrient intake.
Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010) (www.iuna.net). A 4 day semi-weighed food record was used to collect food and beverage intake data from a nationally representative sample of 1500 adults in the Republic of Ireland. Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. Breakfast was subjectively defined by the participant and reported in the food diary. In line with recommendations on breakfast studies, this study confined analyses to nutrients derived from breakfast foods and not nutritional supplements. Usual intakes of energy and selected nutrients (from breakfast foods only and total diet (including nutritional supplements)) were calculated via the NCI-method using SAS© Enterprise Guide.
Breakfast was consumed on at least one recording day by 99% of participants with an uptake of 93% of potential breakfast occasions. The mean (SD) energy intake at breakfast was 365 (162) kcal, contributing on average 19% to overall daily energy intake. Energy intake from breakfast comprised of 56% carbohydrate, 14% fat and 29% protein. The most frequently consumed foods at breakfast included breakfast cereals, white/brown/wholemeal breads and rolls, butters and fat spreads, jams and marmalades, fruits, eggs, yogurts and some meats. The most frequently consumed beverages included teas, coffees, ‘fruit juices & smoothies’, waters and milk (in teas/coffees, with cereals and as a beverage). The contribution of breakfast to total daily nutrient intakes was 25% for carbohydrate, 16% for fat and 16% for protein. Breakfast also contributed to total daily intakes of dietary fibre (22%), total sugars (28%), saturated fat (18%), B-vitamins (20–32%), vitamins C (23%), D (24%), E (19%) calcium (28%), iron (26%) and sodium (18%).
Breakfast was widely consumed among Irish adults and was typically a nutrient dense meal which contributed significantly to total dietary intakes of a number of important macro- and micro- nutrients but also contributed to total sugars and relatively small proportions of total fat, saturated fat, and sodium.
Characterising the plant based component of the Irish diet in terms of its nutritional quality
- Gráinne Kent, Laura Kehoe, Róisín McCarthy, Breige A. McNulty, Anne P. Nugent, Albert Flynn, Janette Walton
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
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- 10 June 2020, E562
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A diet rich in plant-based foods with fewer animal products may offer improved health and environmental benefits. There is little consensus on the definition for a plant-based diet in the literature with some defining it as one rich in vegetables, legumes, fruits, wholegrains, nuts and seeds, excluding animal foods and with heavy restrictions on processed foods. Other definitions make no reference to the inclusion/exclusion of processed foods and refer only to the exclusion of all animal foods from the total diet. This study aimed to examine the nutritional quality of the Irish diet using each of these plant-based diet definitions.
A 4-day semi-weighed food record collected food intake data from 1500 Irish adults (18–90y) in the National Adult Nutrition Survey (NANS). Nutrient intake was analysed using WISP© based on UK and Irish food composition databases. All foods and beverages consumed in the NANS were categorised (included/excluded) into the two definitions; 1.plant-based component of the diet and 2.total diet excluding all animal components. The plant-based component included vegetables, legumes, fruits, wholegrains, nuts and seeds and excluded all animal foods and processed foods. The second categorisation included all non-animal foods regardless of processing. Nutritional quality was assessed by estimating energy-adjusted intakes of macronutrients, saturated fat, free sugars, dietary fibre and sodium. Stastical analysis was conducted using SPSS© v24.
The plant-based component of the diet provided 309 ± 214kcal/d (1.3 ± 0.9MJ/d) comprising of 68% carbohydrate, 20% fat and 12% protein. Mean intakes of saturated fat and free sugars from the plant-based component of the diet were 5% of energy (%E) and 1%E, respectively. Mean intakes of dietary fibre and sodium were 70g/10MJ and 1855mg/10MJ, respectively.
Allowing for inclusion of processed foods, mean energy intake from the total diet excluding all animal foods was 1051 ± 411kcal/d (4.4 ± 1.7MJ/d) comprising of 66% carbohydrate, 23% fat and 10% protein. Mean intakes of saturated fat and free sugars were 7%E and 14%E, respectively. Mean intakes of dietary fibre and sodium were 40g/10MJ and 2642mg/10MJ, respectively.
Overall, the macronutrient profile of the plant-based component of the diet and the total diet excluding animal foods were similar. However, the plant-based component of the diet was of higher nutritional quality; providing lower intakes of saturated fat, free sugar and sodium and higher intakes of dietary fibre compared to the total diet excluding animal foods. This study highlights the variability in nutritional quality between different definitions of plant based-diets.
Dietary determinants of iron intake in women of child-bearing age (WCBA) (18–50y) in Ireland
- Amy Fahy, Laura Kehoe, Janette Walton, Breige A. McNulty, Anne P. Nugent, Albert Flynn
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
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- 10 June 2020, E448
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Dietary iron requirements are higher among women of child-bearing age (WCBA) to replenish blood loss during menses, to prevent iron deficiency anaemia and to support a healthy foetus during pregnancy. Low intakes of iron have previously been reported among WCBA in Ireland and across Europe and data from European countries have shown that there is evidence of anaemia and low iron stores in this population group. The aim of this study was to investigate the dietary patterns influencing iron intakes in WCBA (18–50 years) in Ireland.
Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010) (www.iuna.net). A 4 day semi-weighed food record was used to collect food and beverage intake data (including nutritional supplement use) from a nationally representative sample of 1500 adults (487 women (18–50y)). Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. On the basis of mean daily intake of iron, WCBA were divided into three intake groups: low, medium and high. The food groups that accounted for the greatest proportion of the difference between the high (top third) and low (bottom third) of iron intakes were identified.
The difference in iron intakes between the high and low intake groups (25 v 6.7mg/d) was 18.3mg/d. Nutritional supplements and ready-to–eat breakfast cereals (RTEBC) (commonly fortified with iron) accounted for 58 and 20% of the difference in intakes between the high and low intake group, respectively. The contribution of nutritional supplements to the difference in iron intakes can be explained by the proportion of users in the high vs low intake group (27% vs < 1%). The contribution of RTEBC to the difference in iron intakes can be explained by both a higher proportion of those in the high vs low intake group consuming RTEBC and those in the high intake group having a higher mean daily intake of RTEBC (78% vs 36%; 32g/d vs 7g/d).
Most of the difference in iron intake between high and low consumers is attributable to nutritional supplement use and the patterns of consumption of fortified RTEBC. These findings will aid in the development of strategies to improve iron intakes in WCBA in Ireland.
The utility of linking National Food Ingredient Databases to National Food Consumption surveys: a pilot study on fibre and sugar
- Sarah Kelly, Aoibhinn Moore-Heslin, Mengna Yang, Maria Buffini, Laura Kehoe, John Kearney, Janette Walton, Albert Flynn, Breige McNulty, Anne Nugent
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E575
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Introduction:
Current dietary recommendations encourage increased fibre and reduced sugar consumption. In the UK, specific targets and benchmarks have been established for the sugar content of some foods but not for fibre. National Food Consumption Surveys provide comprehensive information of all foods consumed by representative population samples. The Irish national food surveys as completed by the Irish Universities Nutrition Alliance (IUNA) capture dietary data at brand level with all details as gathered on pack entered into a discrete but inter-linked database, the Irish National Food Ingredient Database (INFID). The aim of this study was to profile the carbohydrate quality of a convenience sub-sample of packaged foods as eaten by Irish children during the National Children's Food Survey II (2017/2018) as entered into INFID.
Materials and Methods:All on-pack details from 385 available foods in the categories ‘white breads and rolls’; ‘brown breads and rolls’; ‘other breads and scones’; ‘ready to eat breakfast cereals (RTEBC)’; ‘biscuits’; and ‘cakes, buns and pastries’ were entered in to INFID and quality control completed. The carbohydrate profile of the products was assessed with respect to fibre labelling criteria and UK sugar guidelines and targets. SPSS Version 25 was used for all analyses.
Results:Although 56% (n210) of all products entered were eligible to make a ‘source of’ or ‘high’ fibre claim, only 20% (n78) made such a claim. Of this, 46% stated ‘high fibre’ and 32% ‘source’, predominately in the ‘brown breads and rolls’ and ‘RTEBC’ groups. When compared to UK Department of Health guidance for ‘low’, ‘medium’ and ‘high’ sugar, 65% of all products examined (n250) were either ‘low’ or ‘medium’ sugar. Comparison of median sugar contents with Public Health England sugar reformulation targets revealed different responses in each category, with all categories other than foods deemed as “morning goods” yet to meet the 2020 target of 20% reduction in sugar content.
Discussion:This small pilot study of a convenience sample of foods suggests that for the limited number of foods examined, for some there remains challenges to reduce sugar and increase fibre contents. Strategies such as reformulation, change in portion size, flexibility in labelling and/or a shift in sales portfolios could be considered but only alongside technological and safety considerations. Further research to broaden this analysis and to link nutrient levels as listed on pack with actual consumption patterns could help ensure all recent initiatives including reformulation are recognised.
Parental feeding practices and child's level of food fussiness and neophobia – Preliminary analysis from NCFSII
- Stephanie Rahill, Aileen Kennedy, Laura Kehoe, Janette Walton, Albert Flynn, Maria Buffini, Breige McNulty, Anne Nugent, John Kearney
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E446
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Research suggests that food fussiness (FF) and food neophobia (FN) are two separate constructs. Food fussiness is the tendency to be selective about a large proportion of familiar and unfamiliar foods, while food neophobia is the refusal of novel foods. Therefore, the aim of this study is to explore the association between parental feeding practices and child's FF or FN.
Analysis was based on cross-sectional data from the nationally representative Irish National Children's Food Survey II (NCFSII; 2017–2018). The NCFSII collected detailed eating behaviour data from children aged 5–12 (n = 596) using the Children's Eating Behaviour Questionnaire (CEBQ). This questionnaire contained four items from the food fussiness subscale that represented FN and two items that represented FF. The Feeding Practices & Structure Questionnaire (FPSQ) assessed non-responsive and structure-related parental feeding practices. Spearman's correlation established the association between parental feeding practices and child's FF and FN. Moderation analyses was conducted to explore the extent to which child's age moderates the association.
Higher levels of child's FN was weakly to moderately associated with higher parental reports of reward for eating (RE) (r = .210, p < 0.001), persuasive feeding (PF) (r = .340, p < 0.001), overt restriction (OR) (r = .195, p < 0.001) and lower reports of structured meal settings (SMS) (r = -.085, p = 0.039) and family meals (FMS) (r = -.387, p < 0.001). Higher levels of child's FF had a slightly stronger association with the same parental feeding as FN, with additional associations with structured meal timings (SMT) (r = -.089, p = 0.031) and covert restriction (CR) (r = -.083, p = 0.045). Age moderated the association between both child's FF [b = .22, p < 0.001] and FN [b = .17, p = 0.002] and parental reports of PF, along with moderating the association between child's FF [b = .11, p = 0.04] and parental reports of SMT.
Overall, child's FN and FF were both associated with higher levels of non-responsive feeding practices and lower reports of structure-related feeding practices, with child's FF associated with more parental feeding practices than FN. These findings suggest that it is important to address FN and FF as separate constructs, with more structure-related feeding practices inversely associated with higher levels of FF only. In addition, as children get older findings suggest that less parental feeding practices are utilised, however, higher levels of child's FF/FN are associated with similar levels of PF and SMT (FF only) regardless of age.
The role of fortified foods and nutritional supplements in the diets of older Irish adults
- Laura Kehoe, Janette Walton, Breige A. McNulty, Anne P. Nugent, Albert Flynn
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E451
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Low intakes and suboptimal status of vitamin D, riboflavin, vitamin B12, folate and calcium have been reported in older adults across Europe. Dietary strategies to improve micronutrient intakes and status could include food fortification (mandatory or voluntary) and/or the use of nutritional supplements. This study aims to examine the impact of fortified food consumption and nutritional supplement use on nutrient intakes and nutritional status of vitamin D, riboflavin, vitamin B12, dietary folate equivalents (DFE) and calcium in older Irish adults.
Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010). A 4 day semi-weighed food record was used to collect food and beverage intake data (including nutritional supplement use) from a nationally representative sample of 1500 adults (226 older adults (≥ 65y)). Blood samples (n 1126 (n 145 ≥ 65y)) were collected, processed and analysed using standard operating procedures. Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. Fortified foods were identified as those that had one or more micronutrients added in the ingredient list and a nutritional supplement was defined as a supplement containing vitamins and/or minerals (i.e. excludes herbal/non-nutritional supplements). A fortified food consumer or nutritional supplement user was defined as a participant who consumed a fortified food or took a nutritional supplement at any time over the 4-day recording period. Usual intakes of micronutrients were calculated via the NCI-method using SAS© Enterprise Guide and analyses of biomarker data were carried out using SPSS©.
The consumption of fortified foods and/or use of nutritional supplements increased mean intakes of vitamin D (3.6 to 6.9μg/d), riboflavin (1.6 to 2.3mg/d), vitamin B12 (4.5 to 6.0μg/d), DFE (228 to 408μg/d) and calcium (784 to 947mg/d) in older Irish adults and reduced the prevalence of inadequate intakes of these micronutrients by up to 40%. Furthermore, consumers of fortified foods and/or nutritional supplements had improved biomarker status and reduced prevalence of low/deficient status for vitamin D (62 vs 16%), riboflavin (65 vs 11%), vitamin B12 (8 vs 0%) and folate (serum folate:18 vs 0%; red blood cell folate: 0% across all groups) when compared to non-consumers.
This study has shown that fortified foods and/or nutritional supplements represent an opportunity to improve intakes and status of key micronutrients in older adults. The data presented in this study will serve to inform the development and implementation of updated dietary recommendations for older adults in Ireland.
Levels of physical activity and screen time usage - Preliminary analysis from the Irish National Children's Food Consumption Survey II
- Aisling O'Donnell, Maria Buffini, Laura Kehoe, Aoibhín Moore Heslin, Anne Nugent, John Kearney, Janette Walton, Albert Flynn, Breige McNulty
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E352
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Being physically active is associated with fundamental health benefits and assists with the maintenance of normal weight in children. The current World Health Organizations’ recommendation is for children to accumulate 60 minutes of physical activity (PA) per day to obtain such benefits. Conversely, time spent in sedentary behaviours including watching screens (ST) are positively associated with the risk of overweight and obesity in young people. The aim of this research was to estimate PA levels and ST usage of Irish children and to examine the relationship with body fat.
This analysis was based on data collected from a nationally representative sample of Irish children aged 5–12-years (n = 591, 50% female) from The National Children's Food Consumption Survey II (www.iuna.net). The Child/Youth Physical Activity Questionnaires (C-PAQ/Y-PAQ) were used to measure PA and ST in 5–8 and 9–12-year-olds respectively. Both questionnaires were self-administered, recall instruments that assessed the frequency/duration of activities participated in over the previous 7-day period. The MET minutes (metabolic cost of the activity multiplied by the duration in minutes) of the PA's were calculated per child. Percentage body fat (%BF) was measured by a Tanita BC420MA device and participants were classified into categories based on their %BF, age and gender. Independent t-tests and ANOVA (post-hoc DunnettT-3) were used to assess differences between gender and %BF category.
Overall, children spent 93 mins/d being physically active with 69% meeting the > 1hr recommendation. There was a significant difference in the time spent undertaking PA between boys (99 mins/d) and girls (88 mins/d) p = 0.020. Children spent 107 mins/d watching screens with 68% meeting the < 2hr guidance. Girls spent significantly less time watching screens (89 mins/d) than boys (124 mins/d) p ≤ 0.001. Children who had a normal %BF accumulated more PA MET mins/day compared to those who were classified as obese, which was significant in the total population (p = 0.007), for boys (p ≤ 0.001), but not girls (p = 0.929).
This preliminary analysis indicates that a high proportion of Irish children are meeting the PA and ST recommendations, with boys being more physically active and spending more time watching screens compared to girls. However, results should be interpreted with caution as PA and ST usage were self-reported by participants. The association between PA MET minutes and %BF suggest that advice to encourage PA participation to combat excess adiposity in Irish children is justified. Future work should examine the role of other potential determinants of obesity in this cohort.
The role of unprocessed beef and lamb in the diets of Irish children and teenagers (5–17 years)
- Jacqueline Lyons, Christopher Cocking, Laura Kehoe, Breige McNulty, Anne Nugent, Janette Walton, Kevin Cashman, Albert Flynn
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E453
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Introduction
Meat is a nutrient-dense food that plays a central role in the diets of many children globally, contributing significantly to intakes of energy, protein and a number of essential micronutrients. However, nutritive quality is variable across meat types and cuts, and dietary guidelines across Europe typically encourage the consumption of lean meats whilst limiting the consumption of processed meats. The current work aimed to estimate intakes of unprocessed beef and lamb and their contribution to nutrient intakes in Irish children and teenagers.
MethodsAnalyses were based on data from the Irish National Children's Food Survey (NCFS) (2003–2004; 5–12 years; n 594) and National Teens’ Food Survey (NTFS) (2005–2006; 13–17 years; n 441) (www.iuna.net). Both surveys used a 7-day weighed (NCFS) or semi-weighed (NTFS) food record to collect dietary intake data from nationally representative samples of Irish children. Dietary intake data were converted to nutrient data using WISP©, based on UK and Irish food composition tables. Unprocessed beef and lamb was defined as beef or lamb that had not undergone any preserving process other than chilling, freezing or salting, and included beef or lamb dishes that were wrapped in a controlled atmosphere. Meat intakes from composite dishes (e.g. beef lasagne) were estimated following disaggregation of the non-meat components. Statistical analyses were carried out using SPSS© v23.0.
ResultsUnprocessed beef was consumed by 79% of children and 83% of teenagers, while unprocessed lamb was consumed by 19% of children and 20% of teenagers. Mean daily intakes of unprocessed beef were 21 g and 34 g in children and teenagers (consumers only), while mean daily intakes of unprocessed lamb were 14 g and 23 g. Unprocessed beef and lamb contributed 5–6% to mean daily energy intakes and contributed the following proportions to daily nutrient intakes in children and teenagers, respectively: protein (11%, 15%), total fat (7%, 9%), saturated fat (7%, 10%), monounsaturated fat (9%, 11%), iron (7%, 10%), zinc (18%, 23%), vitamin A (7%, 7%), vitamin D (12%, 16%), total niacin (9%, 13%), vitamin B6 (6%, 9%), vitamin B12 (15%, 22%), sodium (6%, 7%).
DiscussionUnprocessed beef and lamb are valuable sources of nutrients for Irish children and teenagers. Relative to their energy contribution, they contribute higher proportions of a number of important nutrients, such as protein, zinc, vitamin D, vitamin B12 and total niacin, while contributing relatively small proportions of total fat, saturated fat and sodium. This research was funded by Meat Technology Ireland.
Estimates of Sodium and Potassium intake and their molar ratio in Irish children: Preliminary findings from NCFSII
- Eoin Morrissey, Laura Kehoe, Aoibhin Moore Heslin, Maria Buffini, Breige McNulty, Anne Nugent, John Kearney, Albert Flynn, Janette Walton
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E162
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The Food Safety Authority of Ireland (FSAI) have set target maximum daily salt intakes for children (4–6y: 3 g, 7–10y: 5 g, 11–14y: 6g) while the European Food Safety Authority (EFSA) have set Adequate Intakes (AI) for potassium of 1100mg/d, 1800mg/d and 2700mg/d for children of the same respective age groups. An individual's sodium to potassium (Na:K) intake ratio is an important predictor of hypertension and the World Health Organization (WHO) recommend a Na:K intake ratio of ≤ 1.0mmol/mmol for both adults and children. Although the morbidities associated with hypertension may not be seen until adulthood, blood pressure in childhood has a significant association with blood pressure in adulthood. Therefore, estimation of Na:K intake ratios (best measured by urinary excretion) in children may predict their susceptibility to hypertension related diseases in later life. The aim of this study was to estimate sodium and potassium intake and mean molar Na:K intake ratio of Irish children and to assess compliance with dietary guidance.
Morning spot urine samples were collected for 572 children aged 5–12 years (95% of total sample) as part of the nationally representative Irish National Children's Food Survey II (2017–2018) (NCFSII; www.iuna.net). Samples were transported, processed and stored using best practice procedures. Urinary excretion of sodium and potassium were measured using a Randox RX Daytona and were corrected for gender and age-specific 24-hour urine volume estimations based on 24-hour urine volume estimates from Australian children. SPSS Version 25 was used for all analyses.
Mean 24-hour urinary sodium excretion was 2018mg/d, equivalent to an average salt excretion of 5.0g/d exceeding the FSAI maximum target intake for all age groups except 11–12 year olds. Mean 24-hour urinary potassium excretion was 1411mg/d with mean intakes below the AI from EFSA for all age groups with the exception of 5–6 year olds. The mean molar Na:K ratio of Irish children was 2.8 for boys and 3.4 for girls. Only 5% of Irish children met the WHO recommendation for a Na:K ratio of ≤ 1.0mmol/mmol.
High intakes of sodium and low intakes of potassium reported in this study result in a low compliance with the WHO recommendation of a Na:K ratio ≤ 1.0mmol/mmol. This may lead to a higher risk of hypertension and related morbidities in later life. Based on these findings, dietary interventions to combat hypertension related diseases (such as lowering sodium and increasing potassium intakes) should be implemented from childhood.
Nutrient profiling of ready to eat breakfast cereals reveals substantial differences in macronutrient composition despite similar nutrition claim usage
- Aoibhin Moore Heslin, Mengna Yang, Maria Buffini, Anne Nugent, Laura Kehoe, John Kearney, Janette Walton, Albert Flynn, Breige McNulty
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- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E718
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Under Regulation (EC) No 1924/2006 the usage of nutrition and health claims are permitted, however foods that are high in fat, sugars and salt are advised not to use such claims as foods promoted with these claims may influence consumer food choice. The use of nutrient profiles has been proposed as a means of avoiding the potential of such claims masking the overall nutritional status of a product. Ready to eat breakfast cereals (RTEBC) often display nutrition claims whilst also contributing significantly to total sugar and energy intake. The aim of this study was to profile a variety of RTEBC and compare nutrient composition and claim information between nutrient profile categories.
The Irish National Food Ingredient database (INFID) is a record of brand specific information from food labels collected during the Irish national food surveys. A convenience sub-sample of RTEBC as eaten by Irish children during the National Children's Food Survey 2 (2017/2018) were selected (n = 102). Nutrient profile (NP) scores were calculated using the UK Nutrient Profiling Model (FSA). NP scores were calculated based on a set of negative macronutrient indicators (energy, saturated fat, total sugars and sodium) minus positive indicators (protein, fibre, “fruit, vegetables and nuts”) present per 100 g. Foods scoring four points or more were classified as “less healthy”.
More than half of RTEBC were classed “less healthy” (53%) with a median NP score of 8.0 with “healthy” RTEBC scoring significantly lower at -0.0 (p < 0.001). “Healthy” RTEBC had a median sugar content of 13.4g/100 g compared to 24g/100 g in the “less healthy” (p < 0.001). “Healthy” RTEBC had a higher fibre content of 8.8g/100 g compared to 5.72g/100 g in the “less healthy” (p = 0.001), with 35% of healthy and 28% of less healthy RTEBC making a substantiated “high in fibre” claim. Micronutrient contents of all RTEBC were similar, with only iron significantly higher in “healthy” (13.3mg/100g) compared to “less healthy” (9.5mg/100g) (p = 0.02). The prevalence of substantiated micronutrient related claims was the same between “healthy” and “less healthy” RTEBC.
“Healthy” and “less healthy” RTEBC display similar micronutrient profiles, with most of the nutrition claims on both pertaining to the micronutrient and fibre content, potentially overshadowing the macronutrient contribution of the cereals. This analysis shows the ability of nutrient profiling to distinguish products by macronutrient profiles however it identifies the complexity of application with respect to micronutrient content. Further research is required to investigate the contribution of the profiled RTEBC to total nutrient intakes.
Who attends outpatient adolescent mental health services?
- Carol Fitzpatrick, McAuley Catherine, Anne Kehoe, Nina Devlin, Sinead Glackin, Lorna Power, Suzanne Guerin
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- Irish Journal of Psychological Medicine / Volume 28 / Issue 3 / September 2011
- Published online by Cambridge University Press:
- 13 June 2014, pp. 118-123
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- September 2011
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Objectives: This study set out to profile the diagnoses and level of suicidal behaviour of adolescents aged 12-15 years newly referred to a Child and Adolescent Mental Health Service (CAMHS). Information on the nature and range of disorders and level of functional impairment among adolescents attending outpatient CAMHS is important for service planning and development.
Methods: A total of 100 newly referred adolescents were assessed using the KSADS-PL standardised interview. Overall level of functional impairment was measured using The Clinical Global Impressions Scale and The Children's Global Assessment Scale.
Results: Results showed that the majority of adolescents had more than one disorder, with almost one quarter having four or more disorders. Behavioural disorders were the most common diagnostic category, followed by anxiety disorders, and affective disorders. Although relatively uncommon, levels of functional impairment were highest in those with psychotic disorders, followed by substance abuse disorders. The most common pattern of comorbid disorders were depressive disorders plus anxiety disorders, followed by anxiety disorders plus behavioural disorders and depressive disorders plus behavioural disorders. One quarter of the young people had engaged in suicidal acts in the six months prior to attendance, while this had been the case in over one half of those with a depressive disorder.
Conclusion: This study showed that adolescents attending CAMHS tend to have multiple disorders, high levels of suicidality, and are significantly functionally impaired. These factors need to be taken into account in the development of effective treatments.
Reduction in Hospitalwide Incidence of Infection or Colonization with Methicillin-Resistant Staphylococcus aureus With Use of Antimicrobial Hand-Hygiene Gel and Statistical Process Control Charts
- Glenys Harrington, Kerrie Watson, Michael Bailey, Gillian Land, Susan Borrell, Leanne Houston, Rosaleen Kehoe, Pauline Bass, Emma Cockroft, Caroline Marshall, Anne Mijch, Denis Spelman
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 28 / Issue 7 / July 2007
- Published online by Cambridge University Press:
- 02 January 2015, pp. 837-844
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- July 2007
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Objective.
To evaluate the impact of serial interventions on the incidence of methicillin-resistant Staphylococcus aureus (MRSA).
Design.Longitudinal observational study before and after interventions.
Setting.The Alfred Hospital is a 350-bed tertiary referral hospital with a 35-bed intensive care unit (ICU).
Interventions.A series of interventions including the introduction of an antimicrobial hand-hygiene gel to the intensive care unit and a hospitalwide MRSA surveillance feedback program that used statistical process control charts but not active surveillance cultures.
Methods.Serial interventions were introduced between January 2003 and May 2006. The incidence and rates of new patients colonized or infected with MRSA and episodes of MRSA bacteremia in the intensive care unit and hospitalwide were compared between the preintervention and intervention periods. Segmented regression analysis was used to calculate the percentage reduction in new patients with MRSA and in episodes of MRSA bacteremia hospitalwide in the intervention period.
Results.The rate of new patients with MRSA in the ICU was 6.7 cases per 100 patient admissions in the intervention period, compared with 9.3 cases per 100 patient admissions in the preintervention period (P = .047). The hospitalwide rate of new patients with MRSA was 1.7 cases per 100 patient admissions in the intervention period, compared with 3.0 cases per 100 patient admissions in the preintervention period (P < .001). By use of segmented regression analysis, the maximum and conservative estimates for percentage reduction in the rate of new patients with MRSA were 79.5% and 42.0%, respectively, and the maximum and conservative estimates for percentage reduction in the rate of episodes of MRSA bacteremia were 87.4% and 39.0%, respectively.
Conclusion.A sustained reduction in the number of new patients with MRSA colonization or infection has been demonstrated using minimal resources and a limited number of interventions.
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