E. M. Hannon

The efficacy and safety of nutritional supplement use in a representative sample of adults in the North/South Ireland Food Consumption Survey

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 SUBJECTS Food 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 self-administered questionnaire and respondents entered each supplement as it was consumed into the food diary. RESULTS Twenty-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 microg recommended to prevent neural tube defects. Twenty-two per cent of the women who took iron and 15% of the women who took vitamin B6 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. CONCLUSIONS Supplementation 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.

Prevalence of overweight and obesity in irish school children, using four different definitions

Objective:To determine the prevalence of overweight and obesity in Irish children using four different weight-for-height methods and to examine secular trends from previous national data.Design:A cross-sectional survey. Weight and height were measured according to standard procedures and used to determine the prevalence of overweight and obesity using four weight-for-height methods of assessment, actual relative weight, the Centers for Disease Control and Prevention body mass index (BMI) for age charts for boys and girls, the BMI reference curves for the UK 1990 and the International Obesity Task Force age- and sex-specific BMI cutoffs.Setting:The survey was carried out between 2003 and 2004 in the Republic of Ireland.Subjects:Random representative sample of 596 children aged 5–12 years.Results:The prevalence of overweight and obesity in Irish children is high, but varies considerably with each method. The prevalence of obesity in boys ranged from 4.1 to 11.2 % and in girls from 9.3 to 16.3%. Between 1990 and 2005, depending on the method used, there was a two-to-fourfold increase in obesity in children aged 8–12 years.Conclusion:It is evident given the variation displayed in the prevalence of obesity when using the different methods, that there is a discernible need for a single definition to identify the obese child in Ireland. The findings show a high prevalence of overweight and obesity in Irish school children and the increase in the prevalence of obesity over the last 15 years highlights this growing public health issue.

The impact of voluntary fortification of foods on micronutrient intakes in Irish adults.

The objective of this work was to quantify the impact of the voluntary fortification of foods on dietary intakes of vitamins and minerals of Irish adults. Foods that were voluntarily fortified were identified and pre- and post-fortification levels of micronutrients were determined from data supplied by manufacturers and food composition tables. Using food consumption data in 1379 adults aged 18-64 years, estimated using a 7-d food diary during the North/South Ireland Food Consumption Survey, intakes of micronutrients were determined, both including and excluding the fortification component in foods. Of approximately 3000 foods recorded as consumed, 1.9 % were fortified, mainly breakfast cereals and beverages. Median micronutrient content of fortified foods (FF) ranged from 18-33 % EC RDA per typical serving. Among consumers (65 % of men, 68 % of women), FF contributed, on average, 3.9 % (men) and 5.0 % (women) to mean daily intake (MDI) of energy. Relative to their contribution to MDI of energy, FF contribute a greater % MDI for Fe (men 16, women 19), folate (men 18, women 21), vitamins B1 (men 14, women 16), B2 (men 16, women 18), B6 (men 12, women 15), D (men 5, women 11), B12 (men 5, women 7) and niacin (men 10, women 12). Fortification significantly improved the adequacy of intake of some micronutrients, particularly of riboflavin, folate, vitamin D and Fe in women and did not contribute to an increased risk of adverse effects from excessive intake of any micronutrient.

Selenium intakes in 18-64-y-old Irish adults.

Objective: To measure the intake of selenium (Se) and the contribution of different food groups to Se intake in adults aged 18–64 y in Ireland. The adequacy of Se intake in the population is also assessed.Design: Food consumption was estimated using a 7 day food diary for a representative sample (n=1379; men=662, women=717) of 18–64-y-old Irish adults selected randomly from the electoral register. Se intake was estimated using updated tables of food composition.Results: Mean daily Se intakes (±s.d.) from all sources (ie food plus supplements), and from food sources alone, for the group of Irish adults aged 18–64 y were 52 (±23) and 50 (±21) µg, respectively. Mean daily Se intake (from all sources) was significantly higher in men of all ages than women of all ages at levels of 60 and 44 µg, respectively (P<0.001). Meat/meat products (30%), bread and rolls (24%), fish/fish products (∼11%), and milk and yoghurt (9%) were the main contributors to mean daily Se intake. Adequacy of Se intake in population groups was estimated as the percentage of the population with mean daily Se intakes that were lower than the average requirement of 40 µg. Using this measure, 45.6% of women and 17.1% of men had inadequate Se intakes.Conclusion: A significant prevalence of inadequate Se intakes was observed in Irish adults. Therefore, it would seem prudent that the Se status of the Irish population be investigated at this time.

Analysis of the impact of fortified food consumption on overall dietary quality in Irish adults.

The aim of the present study was to assess the impact of fortified food (FF) consumption on overall dietary quality in Irish adults. Data for this analysis was based on the North/South Ireland Food Consumption Survey w7/15/2008hich used a 7 d food diary to collect food and beverage intake data in a representative sample of 1379 Irish adults (662 men and 717 women) aged 18-64 years. Foods contained in the database that are fortified were identified from the presence of vitamins and/or minerals in the ingredient list on the label. The results showed that an increased level of FF consumption was associated with lower intakes (percentage food energy) of total fat and saturated fat (women only) and higher intakes of total carbohydrate, total sugars (but not added sugars) and starch. Increased consumption was associated with a more micronutrient-dense diet and a reduced prevalence of dietary inadequacies of Ca, Fe, riboflavin and folate, particularly in women. Higher FF consumption was associated with higher intakes of fruit, lower intakes of alcohol and a lower likelihood of smoking in men and women. Thus it appears that FF consumption is a marker of both better dietary quality and healthy lifestyle behaviours.

Impact of voluntary food fortification practices in Ireland: trends in nutrient intakes in Irish adults between 1997-9 and 2008-10

Because of the discretionary nature of voluntary food fortification in the European Union, there is a need to monitor fortification practices and consumption of fortified foods in order to assess the efficacy and safety of such additions on an ongoing basis. The present study aimed to investigate the nutritional impact of changes in voluntary fortification practices in adults aged 18-64 years using dietary intake data from two nationally representative cross-sectional food consumption surveys, the North/South Ireland Food Consumption Survey (NSIFCS) (1997-9) and the National Adult Nutrition Survey (NANS) (2008-10). The supply of fortified foods increased between 1997-9 and 2008-10, resulting in a higher proportion of adults consuming fortified foods (from 67 to 82 ) and a greater contribution to mean daily energy intake (from 4.6 to 8.4%). The overall nutrient profile of fortified foods consumed remained favourable, i.e. higher in starch and dietary fibre and lower in fat and saturated fat, with polyunsaturated fat, sugars and Na in proportion to energy. Women, particularly those of childbearing age, remained the key beneficiaries of voluntary fortification practices in Ireland. Continued voluntary fortification of foods has increased protection against neural tube defect-affected pregnancy by folic acid and maintained the beneficial impact on the adequacy of Fe intake. Increased consumption of fortified foods did not contribute to an increased risk of intakes exceeding the tolerable upper intake level for any micronutrient. Recent increases in voluntary fortification of foods in Ireland have made a favourable nutritional impact on the diets of adults and have not contributed to an increased risk of adverse effects.

Micronutrient intakes in Irish teenagers (13–17 years)

The objective of the present study was to estimate micronutrient intakes and the contribution of different food groups to micronutrientintakes in Irish teenagers. The prevalence of inadequacy of micronutrients was also assessed. Analysis was based on The National TeensFood Survey, which was carried out between September 2005 and September 2006 to establish a database of habitual food and drinkconsumption in a representative sample of Irish teenagers aged 13Ð17 years. A 7d semi-weighed food record was used to collect foodintake data from 441 teenagers (224 males, 217 females). Analysis of dietary intake data was carried out using WISP

Energy and macronutrient intakes of Irish teenagers aged 13-17 years

Meat & meat products (22%), sugars, confectionery, preserves & savouries (13%), milk & yoghurt (12 %) Saturated fat Milk & yoghurt (19%), meat & meat products (19%), sugars, confectionery, preserves & savouries (15 %) Monounsaturated fat Meat & meat products (26%), sugars, confectionery, preserves & savouries (15%), potatoes & potato products (11%) Polyunsaturated fat Meat & meat products (19%), potatoes & potato products (18 %), butter, spreading fats & oils (13 %) Carbohydrate Bread & rolls (18%), sugars, confectionery, preserves & savouries (13%), potatoes & potato products (13%) Added sugars Sugars, confectionery, preserves & savouries (32 %), beverages (29%), breakfast cereals (11 %) Protein Meat & meat products (41%), milk & yogurt (13%), bread & rolls (11 %) At a population level, compliance with the UK goals for saturated fat, monounsaturated fat, polyunsaturated fat, carbohydrate and added sugars ranged from 30 to 93 %. Although compliance with the goal for total fat was 95 % at a population level, 56 % of Irish teenagers exceeded the US maximum recommended fat intake of 35 %TE (4) .

The effect of nutritional supplements on adequacy of micronutrient intakes in Irish teenagers aged 13–17 years

The objective of the study was to investigate the contribution of nutritional supplements to micronutrient intake and adequacy in Irish teenagers. Analysis was based on the National Teens’ Food Survey (NTFS), which was carried out between September 2005 and September 2006 to establish a database of habitual food and drink consumption in a representative sample of Irish teenagers aged 13–17 years. A 7 d semi-weighed food record was used to collect food intake data from 441 teenagers (224 males, 217 females). Analysis of dietary intake data was carried out using WISPg (Tinuviel Software, Llanfechell, Anglesey, UK), which is based on McCance and Widdowson’s The Composition of Foods, Sixth Edition. Nutritional supplement use was recorded by the respondent in the food diary. The food composition database was updated to include all nutritional supplements consumed (n 74). Approximately one-quarter (24%) of Irish teenagers consumed a nutritional supplement at least once during the 7 d of recording. Of the seventy-four nutritional supplements consumed during the NTFS 38% (n 28) were multivitamins and minerals, 16% (n 12) were multivitamins, 12% (n 9) were fish or cod-liver oils and 12% (n 9) were vitamin C supplements. The percentage with mean daily intakes (MDI) below the estimated average requirement (EAR) for selected micronutrients is reported as an estimate of the prevalence of inadequate intakes in both supplement users (from all sources and from food sources only, excluding supplements) and non-users.

Determination of food group intakes in Irish teenagers aged 13–17 years

The objective of the present study was to determine the food group intakes in Irish teenagers. Analysis was based on the National Teens’ Food Survey (NTFS), which was carried out between September 2005 and September 2006 to establish a database of habitual food and drink consumption in a representative sample of Irish teenagers aged 13–17 years. A 7 d semi-weighed food record was used to collect food intake data from 441 teenagers (224 males, 217 females). Analysis of dietary intake data was carried out using WISPg (Tinuviel Software, Llanfechell, Anglesey, UK), which is based on McCance and Widdowson’s The Composition of Foods Sixth Edition.