M. J. Gibney

High saturated-fat and low-fibre intake: a comparative analysis of nutrient intake in individuals with and without type 2 diabetes

Objective:The aim of dietary modification, as a cornerstone of type 2 diabetes (T2DM) management, is to optimise metabolic control and overall health. This study describes food and nutrient intake in a sample of adults with T2DM, and compares this to recommendations, and to intake in age, sex, body mass index (BMI) and social-class matched adults without T2DM.Design:A cross-sectional analysis of food and nutrient intake in 124 T2DM individuals (64% male; age 57.4±5.6 years, BMI 32.5±5.8u2009kgu2009m−2) and 124 adults (age 57.4±7.0 years, BMI 31.2±5.0u2009kgu2009m−2) with no diabetes (ND) was undertaken using a 4-day semiweighed food diary. Biochemical and anthropometric variables were also measured.Results:While reported energy intake was similar in T2DM vs ND (1954 vs 2004u2009kcal per day, P=0.99), T2DM subjects consumed more total-fat (38.8% vs 35%, P⩽0.001), monounsaturated-fat (13.3% vs 12.2%; P=0.004), polyunsaturated-fat (6.7% vs 5.9%; P<0.001) and protein (18.6% vs 17.5%, P⩽0.01). Both groups exceeded saturated-fat recommendations (14.0% vs 13.8%). T2DM intakes of carbohydrate (39.5% vs 42.9%), non-milk sugar (10.4% vs 15.0%) and fibre (14.4 vs 18.9u2009g) were significantly lower (P<0.001). Dietary glycaemic load (GL) was also lower in T2DM (120.8 vs 129.2; P=0.02), despite a similar glycaemic index (59.7 vs 60.1; P=0.48). T2DM individuals reported consuming significantly more wholemeal/brown/wholegrain breads, eggs, oils, vegetables, meat/meat products, savoury snacks and soups/sauces and less white breads, breakfast cereals, cakes/buns, full-fat dairy, chocolate, fruit juices, oily fish and alcohol than ND controls.Conclusion:Adults with T2DM made different food choices to ND adults. This resulted in a high saturated-fat diet, with a higher total-fat, monounsaturated-fat, polyunsaturated-fat and protein content and a lower GL, carbohydrate, fibre and non-milk sugar content. Dietary education should emphasise and reinforce the importance of higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources, in energy balanced conditions.

Trends in the portion size of savoury snack intakes in Irish adults during 2001 and 2011

Larger portion sizes of foods and increased “snacking” have been linked to an overall increase in energy intake. In terms of snacking, recent U.S. research cites “salty snacks” as the most influential snack in the increase of overall energy intake from 18–24%. Trends in the portion sizes of foods such as savoury snacks have not previously been investigated. Food portion sizes (g), defined as the weight of the food consumed per eating occasion, were estimated using data from the North/South Ireland Food Consumption Survey (NSIFCS) and the National Adult Nutrition Survey (NANS). The NSIFCS collected data from 1274 adults (18–64 years) between 1997–1999 using a 7-d semi-weighed food record, while the NANS used a 4-day semi-weighed food record to collect data from 1379 adults (2009–2010). Total savoury snacks and the most frequently consumed sub-groups of savoury snacks, as well as total nuts and seeds were selected for analysis, accounting for 2803 of 214,563 eating occasions in NSIFCS and 98,466 in NANS. Of the savoury snacks selected, the majority (87% and 92% in NSIFCS and NANS, respectively) of food weights were quantified by weighed data. Data are presented for consumers only (51.3% and 36.9% of NSIFCS and NANS, respectively) at a total population level.

Development and validation testing of a short nutrition questionnaire to identify dietary risk factors in preschoolers aged 12 36 months

Background Although imbalances in dietary intakes can have short and longer term influences on the health of preschool children, few tools exist to quickly and easily identify nutritional risk in otherwise healthy young children. Objectives To develop and test the validity of a parent-administered questionnaire (NutricheQ) as a means of evaluating dietary risk in young children (12–36 months). Design Following a comprehensive development process and internal reliability assessment, the NutricheQ questionnaire was validated in a cohort of 371 Irish preschool children as part of the National Preschool Nutrition Survey. Dietary risk was rated on a scale ranging from 0 to 22 from 11 questions, with a higher score indicating higher risk. Results Children with higher NutricheQ scores had significantly (p<0.05) lower mean daily intakes of key nutrients such as iron, zinc, vitamin D, riboflavin, niacin, folate, phosphorous, potassium, carotene, retinol, and dietary fibre. They also had lower (p<0.05) intakes of vegetables, fish and fish dishes, meat and infant/toddler milks and higher intakes of processed foods and non-milk beverages, confectionery, sugars and savoury snack foods indicative of poorer dietary quality. Areas under the curve values of 84.7 and 75.6% were achieved for ‘medium’ and ‘high’ dietary risk when compared with expert risk ratings indicating good consistency between the two methods. Conclusion NutricheQ is a valid method of quickly assessing dietary quality in preschoolers and in identifying those at increased nutritional risk. In Context Analysis of data from national food and nutrition surveys typically identifies shortfalls in dietary intakes or quality of young children. This can relate to intakes of micronutrients such as iron or vitamin D as well as to the balance of macronutrients they consume (e.g. fat or sugar). Alongside this lie concerns regarding overweight and obesity and physical inactivity. This combination of risk factors has potential negative effects for both short and longer term health. Hence, screening tools, such as NutricheQ described here, offer an opportunity for early identification and subsequent appropriate timely intervention from 12 months of age. This paper describes the development and validation of NutricheQ, a short user-friendly questionnaire. Designed to be administered by parents or carers, it aims to help healthcare professionals identify children at risk based on known, evidence-based nutritional risk factors. It is hoped in the longer term that this tool can be adapted for use globally and improve child health through early identification, which can be followed up by targeted, cost-effective interventions.

Phenotypic and genotypic determinants of postprandial lipaemic response variation in healthy adults

Response to dietary fat plays a key role in metabolic and cardiovascular health. While this response can vary widely between individuals, variation within an individual and the associated contribution of phenotypic and genotypic factors is less well defined. Understanding these issues is fundamental to the goal of achieving personalised nutrition. This work aimed to describe withinand between-person variation in lipaemic response to a repeated oral lipid tolerance test (OLTT) in 51 healthy adults as part of a larger randomised controlled trial. Fasting and postprandial plasma were collected hourly over 5 hours, from which SNP genotype and detailed biochemistry data, including triglyceride (TAG), non-esterified fatty acid, glucose and hormonal, were collected. Body composition (DXA, BodPod1), strength (isokinetic dynamometry), metabolic rate (indirect calorimetry) and fitness (sub-VO2max) among other variables were also assessed. A TAG variability score (Sv), derived from the cumulative difference in TAG level at each time point across OLTTs, was assigned to each person as a proxy measure of lipaemic response. Those with the lowest variation in TAG concentration across OLTTs (LOW n 17) were compared to those of the highest variation (HIGH n 17). Analysis showed postprandial TAG response did not differ (p = 0.64) between visits for the group as a whole, with 82% exhibiting low variation (Sv<3.48) in TAG response. When LOW and HIGH individuals were compared however, significant phenotypic and genotypic differences were observed. Phenotype association: HIGH individuals were significantly (p<0.05) younger, heavier, taller, had a larger waist circumference, higher truncal bone mineral density and metabolic rate (kJ/kg FFM) and displayed higher TAG and lower NEFA levels at fasting. Genotype association: Exploratory analysis revealed associations between high Sv and SNPs in genes associated with satiety, lipoprotein metabolism, adipogenesis and type 2 diabetes risk after correction for phenotypic variables. In conclusion this work (1) confirms preliminary findings that postprandial lipaemic response is highly constant within the majority of healthy adults, and (2) strongly suggests that people who do exhibit the most variable response have a defined set of phenotypic and genotypic characteristics that warrant further research.

Effects of multicomponent exercise on blood lipids in the elderly

According to recent Eurostat projections, the Irish population over 65 years will increase from 11% in 2010 up to 22% in 2060. This will lead to a workforce decline and increased health care costs with a consequent economical impact. To address the challenges of an aged population, multicomponent training (MCT) has been shown to be effective in preserving functional abilities, reducing the risk for falls and improving health and quality of life in the elderly. However, there is very little data regarding the effects of this training program on metabolic health. Thus, the aim of the present study was to examine the effect of MCT on blood lipid profiles in an older Irish population. The study was approved by the Human Research Ethics Committee of University College Dublin and written informed consent was obtained. Twenty one healthy, sedentary women (n = 14) and men (n = 7) aged between 65 and 75 years (70 3 years) completed a 12-week, twice a week supervised MCT program (attendance level = 90 9%). Classes took approximately 60–75 minutes and exercises were designed to improve functional ability, strength, balance, coordination, flexibility and cognitive function. Fasting blood samples were collected prior to and following the MCT intervention and serum total cholesterol, triglycerides, LDL-C and HDL-C and NEFA were measured. Total body composition was measured by dual energy x-ray absorptiometry. Subjects completed an EPIC FFQ to assess baseline dietary intakes.