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The efficacy and safety of nutritional supplement use in a representative sample of adults in the North/South Ireland Food Consumption Survey
- M Kiely, A Flynn, KE Harrington, PJ Robson, N O'Connor, EM Hannon, MM O'Brien, S Bell, JJ Strain
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- Journal:
- Public Health Nutrition / Volume 4 / Issue 5a / October 2001
- Published online by Cambridge University Press:
- 03 July 2008, pp. 1089-1097
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Objective
To describe the current use of nutritional supplements and their contribution to micronutrient intakes in a representative sample of Irish adults, to evaluate the impact of supplement use on the adequacy of micronutrient intakes and to assess the risk to supplement users of exceeding tolerable upper intake levels (UL).
Study design and subjectsFood intake data were collected in 1379 (662 male and 717 female) randomly selected Irish adults aged 18 to 64 years using a 7-day food diary. The current use of nutritional supplements was assessed using a selfadministered questionnaire and respondents entered each supplement as it was consumed into the food diary.
ResultsTwenty-three per cent of respondents regularly used nutritional supplements. Twice as many women used supplements as men. The intakes of micronutrients were significantly higher (P < 0.001) in supplement users than in non-users. Micronutrient intakes from food sources were similar in male users and non-users of supplements, but were significantly higher (P < 0.01) in female users, by 3 to 13%, for Fe, Mg, Mn, vitamins C and E and niacin than in non-users. The percentage of female users between 18 and 50 years who had mean Fe intakes below the average requirement (AR) (10 mg) decreased from 50 to 25 when the contribution from supplements was included. The use of supplements reduced the percentage of men who had mean intakes below the AR for Zn from 19 to 13, for riboflavin from 14 to 6 and for vitamin A from 20 to 5, and reduced the percentage of women with intakes below the AR for Ca from 23 to 16 and for riboflavin from 23 to 14. Twenty-one women out of 80 aged between 18 and 50 years, who consumed supplemental folate, achieved the intake of 600 |xg recommended to prevent neural tube defects. Twenty-two per cent of the women who took iron and 15% of the women who took vitamin B$ in supplemental form had mean daily intakes that exceeded that UL for these nutrients. Supplement users did not exceed the UL for the other micronutrients.
ConclusionsSupplementation appears to be beneficial in promoting adequate intakes of some micronutrients, particularly Fe and folate in women aged 18–50 years and vitamin A in men. There appears to be little risk to supplement users of experiencing adverse side effects due to excessive intakes of micronutrients.
The North/South Ireland Food Consumption Survey: vitamin intakes in 18–64-year-old adults
- MM O'Brien, M Kiely, KE Harrington, PJ Robson, JJ Strain, A Flynn
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- Journal:
- Public Health Nutrition / Volume 4 / Issue 5a / October 2001
- Published online by Cambridge University Press:
- 03 July 2008, pp. 1069-1079
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Objective
To estimate vitamin intakes and assess the contribution of different food groups to vitamin intakes in adults aged 18–64 years in Ireland as estimated in the North/South Ireland Food Consumption Survey. Intakes are reported for retinol, carotene, total vitamin A, vitamin D, vitamin E, thiamin, riboflavin, pre-formed niacin, total niacin equivalents, vitamin B6, vitamin B12, folate, biotin, pantothenate and vitamin C. The adequacy of vitamin intakes in the population and the risk of occurrence of excessive vitamin intakes are also assessed.
DesignFood consumption was estimated using a 7-day food diary for a representative sample (n = 1379; 662 men and 717 women) of 18–64-year-old adults in the Republic of Ireland and Northern Ireland selected randomly from the electoral register. Vitamin intakes were estimated using tables of food composition.
ResultsIn general, the percentage of the population with vitamin intakes below the average requirement (AR) was low. Mean daily intake of total vitamin A was below the AR in 20.2% and 16.6% of men and women, respectively, and mean daily intake of riboflavin was below the AR in 12.5% and 20.6% of men and women, respectively. Mean daily folate intakes were below the AR for folate in 11.2% and 6.6% of women aged 18–35 years and 36–50 years, respectively. Only 2.2% of women aged 18–35 years and 52% of women aged 36–50 years achieved the recommended folate intake of 600 (μg day−1 for women of reproductive age for the prevention of neural tube defects. A high proportion of the population has a low dietary vitamin D intake and is largely dependent on sunlight exposure to maintain adequate vitamin D status. Except for pre-formed niacin, the 95th percentile intake of vitamins did not exceed the tolerable upper intake level (UL) for any group and was much less than the UL for most vitamins. Although 20.8% of men and 6.3% of women exceeded the UL for pre-formed niacin (which is 35 mg, based on nicotinic-acid-induced flushing), the large contribution of meat and fish to the intake of niacin (as nicotinamide) suggests that the risk of overexposure to nicotinic acid is much lower than this and is probably solely related to supplement use. A small proportion of men (4.0%) and women (1.2%) aged 51-64 years had retinol intakes that exceeded the UL (3000 μg) and while the 95th percentile intake of women in the 18–50 year age group was well below the UL, 1.5% of 18–35-year-old and 2.4% of 36–50-year-old women had mean daily retinol intakes above the UL. About 2.0% of women had intakes of vitamin B6 that exceeded the UL (25 mg). There were significant differences by age and sex in nutrient densities of vitamin intakes between men and women and between age groups, which may be explained by differences in consumption of particular food groups as well as different patterns of supplement use.
ConclusionNutritional adequacy of the population for most vitamins was good. Folate intake in women of childbearing age is not meeting current recommendations for the prevention of neural tube defects. The public health significance of the relatively high proportion of men and women with inadequate intakes of vitamin A and riboflavin and with low dietary intakes of vitamin D is unclear and should be investigated further. With the possible exception of niacin (flushing) and vitamin B6 (neuropathy), there appears to be little risk of the occurrence of adverse effects due to excessive consumption of vitamins in this population, based on current dietary practices.
The importance of composite foods for estimates of vegetable and fruit intakes
- MM O'Brien, M Kiely, M Galvin, A Flynn
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- Journal:
- Public Health Nutrition / Volume 6 / Issue 7 / October 2003
- Published online by Cambridge University Press:
- 22 December 2006, pp. 711-726
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Objective:
To evaluate the contribution of composite foods to vegetable and fruit intakes in Irish adults and to compliance with dietary guidelines for vegetable and fruit intake.
Design:Data were analysed from the North/South Ireland Food Consumption Survey of 18–64-year-old adults (n = 1379; 662 men, 717 women), which used a 7-day food diary to estimate food intake.
Results:The mean intake of vegetables (excluding potatoes) was 140g day−1 (men 149g day−1; women 132g day−1), of fruit was 136 g day−1 (men 133g day−1; women 140 g day−1) and of potatoes was 227 g day−1 (men 296g day−1; women 163 g day−1). The mean daily intakes of vegetables, fruit and potatoes from composite foods were 37 g (26%), 6 g (5%) and 17 g (7%), respectively. The mean intake of vegetables from composite foods was unrelated to age or gender, but increased with increasing social class and level of education attained. The proportions of men and women meeting the recommendation for ≥400g day−1 (5 servings of 80 g per day) of vegetables and fruit were 21% (15% excluding composite foods) and 19% (12% excluding composite foods), respectively. Compliance with the dietary recommendation decreased with decreasing levels of educational attainment and social class.
Conclusion:Intakes of vegetables and fruit are low compared with current dietary recommendations, particularly in those of lower levels of educational attainment and social class. Composite foods are an important source of vegetables (less importantly of fruit) and should be included when estimating vegetable intakes. Failure to do so may result in bias in estimates of intake and of compliance with dietary guidelines for population groups, as well as misclassification of individuals by level of intake.