Ilse Pynaert

Dietary intakes and food sources of fatty acids for Belgian women, focused on n-6 and n-3 polyunsaturated fatty acids.

The intake of fat, saturated and monounsaturated FA (SFA and MUFA), and omega-6 and omega-3 PUFA has been estimated in 641 Belgian women (age 18-39 y). Their food intake was recorded using a 2-d food diary. The PUFA included were linoleic (LA), alpha-linolenic (LNA), arachidonic (AA), eicosapentaeonoic (EPA), docosapentaenoic (DPA) and docosahexaenoic (DHA) acids. The mean total fat intake corresponded to 34.3% of total energy intake (E). The mean intake of the FA groups corresponded to 13.7%, 13.1%, and 6.0% of E, for SFA, MUFA, and PUFA, respectively. The mean intake of LA was 5.3% of E and of LNA was 0.6% of E, with a mean LA/LNA ratio of 8.7. The mean intake of AA was 0.03% of E. The mean intake of EPA, DPA, and DHA was 0.4%, 0.01%, and 0.06% of E, respectively. According to the Belgian recommendations, the total fat and SFA intake was too high for about three-quarters of the population. The mean LA and overall n-6 PUFA intake corresponded with the recommendation, with part of the population exceeding the upper level. Conversely, the population showed a large deficit for LNA and n-3 PUFA. The major food source for LA and LNA was fats and oils, followed by cereal products. The main sources of long-chain PUFA were fish and seafood, and meat, poultry, and eggs. From a public health perspective, it seems desirable to tackle the problem of low n-3 PUFA intake.

Determinants of nutrition knowledge in young and middle-aged Belgian women and the association with their dietary behaviour

The present study investigated the role of socio-demographic and lifestyle determinants on the nutrition knowledge of Belgian women and the association between their knowledge and dietary behaviour. A total of 803 women, aged 18-39 years, were included in a cross-sectional study and completed a general and nutrition knowledge questionnaire and a 2-day food record. Their height and weight were measured under standardised conditions. Linear regression models showed independent significant associations between the following determinants and the womens nutrition knowledge (in order of importance): educational level, age, kind of occupation, smoking behaviour, and work status. Inconsistent or no associations were found for body mass index, physical activity, living situation, and whether or not they had children. The investigated determinants accounted for 13-14.5% of variance in total nutrition knowledge. A rise in nutrition knowledge was associated with a significant rise in consumption of vegetables and fruit, but no differences were seen for other dietary indicators. Most important determinants of the womens nutrition knowledge were educational level, age and their kind of occupation. Women who had better knowledge of nutrition also exhibited better dietary behaviour, thus underlying the importance of nutrition education for improving dietary behaviour.

Determinants of ferritin and soluble transferrin receptors as iron status parameters in young adult women.

OBJECTIVE To investigate associations between nutritional and non-nutritional variables and Fe status parameters, i.e. serum ferritin and soluble transferrin receptors (sTfR). DESIGN Cross-sectional design. Fe status parameters were determined on a fasting venous blood sample. Nutritional variables were assessed using a 2 d food record and non-nutritional variables by a general questionnaire. A general linear model was used to investigate associations between the variables and Fe status parameters. SETTING Region of Ghent, Dutch-speaking part of Belgium. SUBJECTS Random sample of 788 women (aged 18-39 years). RESULTS Median (interquartile range) ferritin and sTfR were 26.3 (15.9, 48.9) ng/ml and 1.11 (0.95, 1.30) mg/l, respectively. BMI and alcohol intake were positively associated and tea intake was negatively associated with serum ferritin. Women who used a non-hormonal intra-uterine device, who gave blood within the past year or who had been pregnant within the past year had lower serum ferritin values than their counterparts. Significant determinants of sTfR were smoking habit and pregnancy, with higher values for non-smokers and women who had been pregnant within the past year. CONCLUSIONS The present study indicates that contraceptive use, time since last blood donation, time since last pregnancy, BMI, alcohol and tea intake are determinants of Fe stores, whereas smoking habit and time since last pregnancy are determinants of tissue Fe needs. When developing strategies to improve Fe status, special attention should be given to women who use a non-hormonal intra-uterine device, gave blood within the past year and had been pregnant within the past year.

Validity and reproducibility of a computerised tool for assessing the iron, calcium and vitamin C intake of Belgian women

Objective: To determine the relative validity of a newly developed iron intake assessment tool, designed specifically to assess iron, calcium and vitamin C intake.Design: Estimates of iron, calcium and vitamin C intake from a computerised iron intake assessment tool compared with those from 11-day estimated dietary records.Setting: Region of Ghent (N=±225 000), a city in Flanders, the Dutch-speaking part of Belgium.Subjects: In all, 50 women aged 18–39 y, participating in a large-scale epidemiological study on iron intake and iron status.Main results: Mean dietary iron intake from the 11-day food record, the unadjusted dietary iron intake assessment tool and the adjusted tool was, respectively, 10.5±2.7, 10.4±4.3 and 9.6±2.9 mg. For the different nutrients, the correlation coefficients vary from 0.45 to 0.60 for adjusted intake. The mean difference of iron intake by the two methods (0.8±2.9 mg) did not differ significantly from zero. The new method correctly classified 38% (iron), 38% (calcium) and 58% (vitamin C) of the subjects to the correct tertile. The correlation coefficients ranged from 0.48 for adjusted vitamin C intake to 0.73 for adjusted calcium intake between two administrations.Conclusion: The newly developed instrument can be used to assess mean group intakes of iron, calcium and vitamin C in women consuming a Western diet. However, since the ranking capability of the new tool is rather weak, further refinement of the tool is required to produce a robust method for assessing iron, calcium and vitamin C intakes of individuals.Sponsorship: This research was supported by the Belgian National Fund for Scientific Research/Flemish Division (Fund No G.0152.01).

Iron intake in relation to diet and iron status of young adult women.

Aims: To determine the iron intake and food sources of iron in young adult women and to compare women with high versus low iron intake on diet and iron status. Methods: Iron intake and food sources were assessed by a 2-day estimated food record. Iron status was determined by a fasting venous blood sample. Differences in diet and iron status between women with high versus low iron intake were examined by comparing women of the fourth respectively first quartile of total iron intake (mg/day). Results: The median total, heme and non-heme iron intake was 10.6, 0.6 and 9.8 mg/day, respectively. The median iron intake was 93 and 131% of the estimated average requirement (EAR) of the UK (11.4 mg/day) and USA (8.1 mg/day), respectively. The most important iron intake contributors were cereals and cereal products (31%), meat and meat products (12%) and vegetables (10%). Women with a high iron intake showed a significantly higher energy-adjusted intake of alcoholic beverages and soups and a lower intake of non-alcoholic beverages than women with a low iron intake. Approximately 5% of the women had anemia, of which 3% had iron deficiency anemia (IDA). Almost 20% was iron-deficient non-anemic. In this regard, no significant differences were found between the iron intake quartiles. Conclusion: The median iron intake in this study population is considerably below the national recommended dietary allowance (20 mg/day). However, based on the approach of the Dietary Guidelines Advisory Committee, iron intake seems to pose no major health problem when using the EAR as a reference. The number of women with IDA was indeed not alarming (3%), although 20% was iron-deficient non-anemic. The question remains whether an increase in iron intake can improve iron status.

Iron intake and dietary sources of iron in Flemish adolescents

Objective:To investigate the dietary iron intake and food sources of iron in Flemish adolescents.Design:Cross-sectional survey; dietary assessment method: a 7-day estimated food record.Setting:Private and public secondary schools in Ghent, a city in the Dutch-speaking part of Belgium.Subjects:A total of 341 adolescents (129 boys and 212 girls), 13–18 y, randomly selected by a multistage clustered sampling technique.Results:The mean total iron intake (s.d.) for boys was 13.4 (±2.91) mg/day and for girls 10.1 (±2.79) mg/day. A proportion of 38.8% of the boys and 99.5% of the girls had a mean total iron intake below the Belgian Recommended Dietary Allowance and 3.1% of the boys and 71.2% of the girls below the British Estimated Average Requirement. When bioavailable iron intake is considered, 84.5% of the boys and only 16.5% of the girls met the age-specific requirement. The food groups with the highest mean proportional contribution to total iron intake in both males and females were bread, meat and meat products, cereals and potatoes. A comparison of adolescents from the highest tertile of iron intake (mg/day) with adolescents from the lowest tertile showed a significantly higher energy-adjusted intake of brown bread and a significantly lower intake of soft drinks in the former group in both boys and girls. A significantly higher energy-adjusted intake of breakfast cereals in adolescents of the highest tertile than those of the lowest tertile was seen in girls only. Analyses in consumers only did not change this overall picture.Conclusions:One can conclude that the mean iron intake of Flemish girls is considerably lower than the current recommendations. An increased iron intake in this subgroup of the population is therefore advisable.Sponsorship:This work was financially supported by the National Fund for Scientific Research (fund no. 31557898), the Kelloggs Benelux Company, Unilever Belgium and the Belgian Nutrition Information Center.

Human transferrin G277S mutation and iron deficiency in pregnancy.

Transferrin (TF) is the most important iron carrying plasma protein. Minor TF mutations may cause mild disorders of iron metabolism. A polymorphism in exon 7 of TF, G fi A at nucleotide 829 (G277S) was associated with a reduction in total iron-binding capacity (TIBC) and a predisposition in menstruating women to iron deficiency anaemia (Lee et al, 2001). Iron deficiency anaemia was found to be present in 27% of homozygous G277S/G277S women, 10% of G277G/G277S heterozygous women and 5% of homozygous wild-type G277G/G277G women (Lee et al, 2001). No data are known about the significance of transferrin G277S mutation in pregnancy. As pregnancy is associated with a marked increase in dietary iron needs, we studied the possible effect of the G277S polymorphism on iron status during pregnancy. Data collected included TF sequence for G277S, measurements of serum ferritin, iron, transferrin, soluble transferrin receptors, haemoglobin and haematocrit. For TF genotyping, exon 7 was amplified as described previously (Beutler et al, 2000). Agreement with the Hardy–Weinberg equilibrium was evaluated using chi-square test. Differences between TF genotype groups were assessed using analysis of variance (anova). Ninety-two pregnant women were followed longitudinally during pregnancy. Of these women, 14 (15%) exhibited iron deficiency anaemia, defined as a haemoglobin level <12 g/dl and a ferritin level <20 lg/l in the second trimester and 20 (22%) in the third trimester. In 71 women, only wild type TF was found, 18 women were heterozygous and three women were homozygous for G277S, corresponding to an allele frequency of 0Æ13. These data are in agreement with the Hardy–Weinberg equilibrium. However, iron status did not differ according to the TF G277S polymorphism during pregnancy (Table I). The G277S variant was found to be more frequent when compared with the allele frequencies reported in US Whites (0Æ063), African-Americans (0Æ009), Hispanics (0Æ005) and Asians (absent). In contrast to the findings of Lee et al (2001), no relationship between transferrin concentration, iron status and the G277S variant was found. In the subgroup of iron

Evaluation of a 2-day food record to determine iron, calcium and vitamin C intake in young Belgian women

Objective:Evaluation of a 2-day food record (FR) for the assessment of iron, calcium and vitamin C intake.Design:In a subsample of a large-scale epidemiological study, iron, calcium and vitamin C intake were estimated using a 2-day FR and compared to the nutrient intakes assessed by an 11-day FR (reference method).Setting:City of Ghent, Dutch speaking part of Belgium.Subjects:A number of 51 non-pregnant women (18–39 years).Results:Mean iron, calcium and vitamin C intakes were not significantly different between the reference method and 2-day FR. Correlation coefficients of 0.63 (iron) and 0.76 (calcium, vitamin C) were reached. The iron intake of 95% of the individuals assessed by the 2-day FR varied between 5 mg above or below the reference intake. Over 50% of the women were correctly classified and 4% or fewer were extremely misclassified by the 2-day FR. Mean 11-day FR intakes increased progressively over the tertiles defined by the 2-day FR. The 11-day energy intake was under-reported by 28% of the women; no over-reporters were identified.Conclusions:The 2-day FR is able to estimate mean iron, calcium and vitamin C intake and to rank individuals along the distribution of intakes.Sponsorship:Fund for Scientific Research – Flanders (Belgium).