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.

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.

Food and nutrient intakes and compliance with recommendations in school-aged children in Ireland: findings from the National Children's Food Survey II (2017-2018) and changes since 2003-2004.

The childhood years represent a period of increased nutrient requirements during which a balanced diet is important to ensure optimal growth and development. The aim of this study was to examine food and nutrient intakes and compliance with recommendations in school-aged children in Ireland and to examine changes over time. Analyses were based on two National Children's Food Surveys; NCFS (2003-2004) (n 594) and NCFS II (2017-2018) (n 600) which estimated food and nutrient intakes in nationally representative samples of children (5-12 years) using weighed food records (NCFS: 7-d; NCFS II: 4-d). This study found that nutrient intakes among school-aged children in Ireland are generally in compliance with recommendations; however, this population group have higher intakes of saturated fat, free sugars and salt, and lower intakes of dietary fibre than recommended. Furthermore, significant proportions have inadequate intakes of vitamin D, Ca, Fe and folate. Some of the key dietary changes that have occurred since the NCFS (2003-2004) include decreased intakes of sugar-sweetened beverages, fruit juice, milk and potatoes, and increased intakes of wholemeal/brown bread, high-fibre ready-to-eat breakfast cereals, porridge, pasta and whole fruit. Future strategies to address the nutrient gaps identified among this population group could include the continued promotion of healthy food choices (including education around 'healthy' lifestyles and food marketing restrictions), improvements of the food supply through reformulation (fat, sugar, salt, dietary fibre), food fortification for micronutrients of concern (voluntary or mandatory) and/or nutritional supplement recommendations (for nutrients unlikely to be sufficient from food intake alone).

Determining the food choice motivations of Irish teens and their association with dietary intakes, using the Food Choice Questionnaire.

During adolescence, teens start making their own food choices. While health and nutrition are important, practical and social concerns are also influential. This study aims to determine factors that motivate the food choices of Irish teens (using Food Choice Questionnaire), using data from the National Teens' Food Survey II (N = 428, 50% male, 13-18 years), and to identify how these motivations relate to dietary intakes (4-day semi-weighed food diaries). Data analysis used PCA to determine the food choice motivation subscales, and correlation and comparative statistical tests (t-test, ANOVA). Eight motivating factors were identified for Irish teens: Sensory Appeal, Price & Availability, Health & Natural Content, Familiarity, Ease of Preparation, Mood, Weight Control, and Ethical Concerns. Health and practical aspects to food choice (Price, Availability, Ease of Preparation) are important for teens, but taste (Sensory Appeal) remains a key influence. Food choice motivations vary by sex and by age, BMI status and weight perception, where girls were more motivated by health, weight control, mood and ethical concerns, and older teens were more influenced by mood and ease of preparation. Both those classified as overweight and those who perceived they were overweight were motivated more by weight control and mood for their food choices, whereas those who perceived their weight to be correct placed more importance on health and natural content. Those motivated by weight control had lower energy and higher protein intakes, and those motivated by health and natural content had more health promoting behaviours, with higher physical activity, lower screen time, and higher protein intakes. Understanding the motivations of teens' food choice can help understand why they struggle to meet dietary recommendations, and help to develop more effective health promotion messages by capitalising on the key motivations in the population.

Adequacy of calcium and vitamin D nutritional status in a nationally representative sample of Irish teenagers aged 13-18 years.

CONTEXT AND PURPOSE: In light of the key roles of vitamin D and calcium in adolescent bone health, there is a critical need for representative data on nutritional status for both micronutrients in teenagers. The present work used data from the recent representative National Teens' Food Survey II (2019-2020) to assess calcium and vitamin D intakes of teenagers in Ireland, including adequacy of such intakes, as well as, for the first time, to characterise serum 25-hydroxyvitamin D (25(OH)D) concentrations and their determinants. METHODS: Usual calcium and vitamin D intake estimates were generated using food intake data (via 4-day weighed food records) from a nationally representative sample of teenagers aged 13-18 years in Ireland (n 428). Serum 25(OH)D was measured (via LC-MS/MS) in the 57.5% (n 246) who provided a blood sample. RESULTS: Sixty-seven and 94% of Irish teenagers had intakes of calcium and vitamin D below the respective Estimated Average Requirements values, reflecting a high degree of inadequacy of intake for both micronutrients (and higher in girls than boys; P < 0.001). In addition, 21.7% and 33.1% of teenagers had serum 25(OH)D < 30 nmol/L (risk of vitamin D deficiency) and 30-49.9 nmol/L (inadequacy), respectively. Extended winter sampling, being aged 16-18 years, low total vitamin D intake, being overweight/obese or being of non-white skin type were significant (P < 0.05) predictors of serum 25(OH)D < 30 nmol/L. CONCLUSIONS: There was a high prevalence of inadequacy of intake of calcium and vitamin D in Irish teenagers, and a fifth were at increased risk of vitamin D deficiency.

Food neophobia and its relationship with dietary variety and quality in Irish adults: Findings from a national cross-sectional study.

Food neophobia is characterised by a reluctance to eat novel or unfamiliar foods and has been linked to reduced dietary variety and quality. However, this link has been primarily studied in children. Therefore, we aimed to explore the relationship between food neophobia and dietary variety and quality in adults using a sub-sample of the National Adults Nutrition Survey collected between 2008 and 2010 (n = 1088). Food and nutrient intakes were assessed using a 4-day semi-weighed food diary. Food neophobia was measured using the Food Neophobia Scale (FNS). Dietary variety was assessed in three ways; Total Dietary Variety (TDV), Food-Group Variety (FGV) and Fruit and Vegetable Variety (FVV). Diet quality was assessed using the Mean Adequacy Ratio (MAR) and Nutrient-Rich Food Index (NRF9.3). A multivariate general linear model was used to assess the linear relationships between FNS score and all dietary measures, controlling for age, sex, education level, social class, location and BMI. Food neophobia was found to be inversely associated with TDV, FGV and FVV. In addition, food neophobia was negatively associated with vitamin C, magnesium and fruit and vegetable intakes and positively associated with percentage energy from free sugars. However, food neophobia was not significantly associated with all other nutrients, MAR and NRF9.3. While these results suggest food neophobia may not be a particularly important risk factor for poor nutrient status, adherence to certain dietary recommendations remains low within the Irish population and food neophobia may further inhibit the adaption of healthy and sustainable diets. Future research should seek to understand the implications of food neophobia on dietary behaviour change.

Dietary fat intakes in Irish children: changes between 2005 and 2019.

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.

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project.

BACKGROUND: Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension. METHODS: Observational data on 6076 adults of 18-102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008-2012 using standardised methods. RESULTS: The variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34-6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027). CONCLUSIONS: The MTHFR 677TT genotype is associated with higher BP independently of homocysteine and predisposes adults to an increased risk of hypertension and poorer BP control with antihypertensive treatment, whilst better riboflavin status is associated with a reduced genetic risk. Riboflavin intervention may thus offer a personalised approach to prevent the onset of hypertension in adults with the TT genotype; however, this requires confirmation in a randomised trial in non-hypertensive adults.

Modelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B12 deficiency in older adults.

PURPOSE: The rate of neural tube defects (NTDs) in Europe has remained similar since the 1990s despite folic acid supplement recommendations (400 µg/day) for women of childbearing age. Mandatory folic acid fortification of staple foods has proved effective for reducing the prevalence of NTDs in over 80 countries. This study estimated the impact of addition of folic acid to bread or flour in the Republic of Ireland on reducing the risk of occurrence of NTD-affected pregnancies and the possible risk of masking (undiagnosed) vitamin B12 deficiency in older adults. METHODS: Analyses were based on the Irish National Adult Nutrition Survey (2008-2010). Folic acid fortification was modelled using DaDiet© software. Estimates were made of the increase in average daily folic acid intake in women (18-50 years) and the risk of exceeding the tolerable upper intake level (UL) of 1000 µg for folic acid in adults over 50 years of age. RESULTS: The fortification scenarios examined would reduce the risk of NTD-affected pregnancies by 8-32%, corresponding to an increase of 39-152 µg in the mean daily folic acid intake of WCBA. The risk of masking anaemia associated with vitamin B12 deficiency in older adults would be negligible as the probability of exceeding the UL for folic acid, even by a small amount, is very low (≤ 0.2%). CONCLUSIONS: These levels of addition of folic acid to bread or flour would effectively reduce the risk of NTDs while allowing safe consumption of folic acid at current levels from other fortified foods and supplements.

Iodine status of teenage girls on the island of Ireland.

PURPOSE: The trace element iodine is a vital constituent of thyroid hormones. Iodine requirements increase during pregnancy, when even mild deficiency may affect the neurocognitive development of the offspring. Urinary iodine concentration (UIC) is the means of assessing iodine status in population surveys; a median UIC of 100-199 µg/L is deemed sufficient in a non-pregnant population. Milk is the main dietary source of iodine in the UK and Ireland. METHODS: We surveyed the iodine status of 903 girls aged 14-15 years in seven sites across the island of Ireland. Urine iodine concentration was measured in spot-urine samples collected between March 2014 and October 2015. Food group intake was estimated from iodine-specific food-frequency questionnaire. Milk-iodine concentration was measured at each site in summer and winter. RESULTS: The median UIC overall was 111 µg/L. Galway was the only site in the deficient range (median UIC 98 µg/L). All five of the Republic of Ireland sites had UIC ≤ 105 µg/L. In the two sites surveyed twice, UIC was lower in summer vs winter months [117 µg/L (IQR 76-165) vs 130 µg/L (IQR 91-194) (p < 0.01)]. Milk samples collected from Galway and Roscommon had a lower mean iodine concentration than those from Derry/Londonderry (p < 0.05). Milk intake was positively associated with UIC (p < 0.001). CONCLUSIONS: This is the largest survey of its kind on the island of Ireland, which currently has no iodine-fortification programme. Overall, the results suggest that this young female population sits at the low end of sufficiency, which has implications if, in future, they enter pregnancy with borderline status.

The role of meat in the European diet: current state of knowledge on dietary recommendations, intakes and contribution to energy and nutrient intakes and status.

The role of meat in the diet has come under scrutiny recently due to an increased public emphasis on providing healthy diets from sustainable food systems and due to health concerns relating to the consumption of red and processed meat. The present review aimed to summarise dietary guidelines relating to meat, actual meat intakes and the contribution of meat to energy and nutrient intakes of children, teenagers and adults in Europe. The available literature has shown that food-based dietary guidelines for most countries recommend consuming lean meat in moderation and many recommend limiting red and processed meat consumption. Mean intakes of total meat in Europe range from 40 to 160 g/d in children and teenagers and from 75 to 233 g/d in adults. Meat contributes to important nutrients such as protein, PUFA, B vitamins, vitamin D and essential minerals such as Fe and Zn; however, processed meat contributes to significant proportions of saturated fat and Na across population groups. While few data are available on diaggregated intakes of red and processed meat, where data are available, mean intakes in adults are higher than the upper limits recommended by the UK Scientific Advisory Committee on Nutrition (70 g/d) and the World Cancer Research Fund (500 g/week). While there are no recommendations for red and processed meat consumption in children and teenagers, intakes currently range from 30 to 76 g/d. The present review provides a comprehensive overview of the role of meat in the European diet which may be of use to stakeholders including researchers, policy makers and the agri-food sector.

The prevalence of overweight and obesity in Irish children between 1990 and 2019.

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.

A modelling approach to investigate the impact of consumption of three different beef compositions on human dietary fat intakes.

OBJECTIVE: To apply a dietary modelling approach to investigate the impact of substituting beef intakes with three types of alternative fatty acid (FA) composition of beef on population dietary fat intakes. DESIGN: Cross-sectional, national food consumption survey - the National Adult Nutrition Survey (NANS). The fat content of the beef-containing food codes (n 52) and recipes (n 99) were updated with FA composition data from beef from animals receiving one of three ruminant dietary interventions: grass-fed (GRASS), grass finished on grass silage and concentrates (GSC) or concentrate-fed (CONC). Mean daily fat intakes, adherence to dietary guidelines and the impact of altering beef FA composition on dietary fat sources were characterised. SETTING: Ireland. PARTICIPANTS: Beef consumers (n 1044) aged 18-90 years. RESULTS: Grass-based feeding practices improved dietary intakes of a number of individual FA, wherein myristic acid (C14 : 0) and palmitic acid (C16 : 0) were decreased, with an increase in conjugated linoleic acid (C18 : 2c9,t11) and trans-vaccenic acid (C18 : 1t11; P < 0·05). Improved adherence with dietary recommendations for total fat (98·5 %), SFA (57·4 %) and PUFA (98·8 %) was observed in the grass-fed beef scenario (P < 0·001). Trans-fat intakes were increased significantly in the grass-fed beef scenario (P < 0·001). CONCLUSIONS: To the best of our knowledge, the present study is the first to characterise the impact of grass-fed beef consumption at population level. The study suggests that habitual consumption of grass-fed beef may have potential as a public health strategy to improve dietary fat quality.

Cross-sectional association of dietary water intakes and sources, and adiposity: National Adult Nutrition Survey, the Republic of Ireland.

PURPOSE: Drinking (plain) water intake has been associated with weight loss and reducing energy intake in intervention trials. In free-living populations, replacing other beverages with drinking water is associated with reduced obesity risk. However, the association of total water intake and its sources, and body fat distribution remain unevaluated. Thus, the aim of this study was to investigate total water intake and its sources and the association with anthropometric measures. METHODS: Cross-sectional study of 1500 adults aged 18-90 years (Irish National Adult Nutrition Survey, 2008-2010). Total water intake and its sources were estimated using food records. Associations of total water, drinking water, beverage moisture and food moisture intakes split by tertile, and BMI (kg/m2), waist circumference (cm), and bio-impedance derived body fat (%) were evaluated using covariate-adjusted linear regression analyses including adjustment for energy intake and energy expenditure. RESULTS: Higher consumption of total water was associated with lower waist circumference [ß-coefficient (95% CI), p trend, tertile 3 versus tertile 1: - 2.19 (- 4.06, - 0.32), 0.036], but not BMI [- 0.44 (- 1.16, 0.28), 0.336] or body fat [- 0.87 (- 1.91, 0.17), 0.146]. Higher consumption of drinking water and food moisture were associated with lower BMI [- 0.65 (- 1.30, - 0.01), 0.027; - 0.64 (- 1.41, - 0.13), 0.014, respectively], body fat [- 1.51 (- 2.43, - 0.59), 0.001; - 1.00 (- 2.12, - 0.12), 0.001], and waist circumference [- 2.83 (- 4.51, - 1.16), < 0.001; - 1.84 (- 3.86, - 0.19), 0.082]. Beverage moisture was not associated with any of the anthropometric measurements. CONCLUSIONS: Consumption of drinking water and food moisture and not total water or beverage moisture were inversely associated with adiposity, independent of energy intake and expenditure. Advice encouraging drinking water and food moisture intake may be beneficial in addition to energy balance advice, in combating obesity.

Whole grain intakes in Irish adults: findings from the National Adults Nutrition Survey (NANS).

PURPOSE: Observational studies link high whole grain intakes to reduced risk of many chronic diseases. This study quantified whole grain intakes in the Irish adult population and examined the major contributing sources. It also investigated potential dietary strategies to improve whole grain intakes. METHODS: Whole grain intakes were calculated in a nationally representative sample of 1500 Irish adults using data from the most recent national food survey, the National Adult Nutrition Survey (NANS). Food consumption was assessed, at brand level where possible, using a 4-day semi-weighed food diary with whole grain content estimated from labels on a dry matter basis. RESULTS: Mean daily whole grain intakes were 27.8 ± 29.4 g/day, with only 19% of the population meeting the quantity-specific recommendation of 48 g per day. Wheat was the highest contributor to whole grain intake at 66%, followed by oats at 26%. High whole grain intakes were associated with higher dietary intakes of fibre, magnesium, potassium, phosphorus, and a higher alternative Mediterranean Diet Score. Whole grain foods were most frequently eaten at breakfast time. Regression analysis revealed that consumption of an additional 10 g of whole grain containing 'ready-to-eat breakfast cereals', 'rice or pastas', or 'breads' each day would increase intake of whole grains by an extra 5, 3.5, and 2.7 g, respectively. CONCLUSIONS: This study reveals low intakes of whole grains in Irish adults. Recommending cereals, breads, and grains with higher whole grain content as part of public health campaigns could improve whole grain intakes.

Estimation of Chicken Intake by Adults Using Metabolomics-Derived Markers.

BACKGROUND: Improved assessment of meat intake with the use of metabolomics-derived markers can provide objective data and could be helpful in clarifying proposed associations between meat intake and health. OBJECTIVE: The objective of this study was to identify novel markers of chicken intake using a metabolomics approach and use markers to determine intake in an independent cohort. METHODS: Ten participants [age: 62 y; body mass index (in kg/m2): 28.25] in the NutriTech food intake study consumed increasing amounts of chicken, from 88 to 290 g/d, in a 3-wk span. Urine and blood samples were analyzed by nuclear magnetic resonance and mass spectrometry, respectively. A multivariate data analysis was performed to identify markers associated with chicken intake. A calibration curve was built based on dose-response association using NutriTech data. A Bland-Altman analysis evaluated the agreement between reported and calculated chicken intake in a National Adult Nutrition Survey cohort. RESULTS: Multivariate data analysis of postprandial and fasting urine samples collected in participants in the NutriTech study revealed good discrimination between high (290 g/d) and low (88 g/d) chicken intakes. Urinary metabolite profiles showed differences in metabolite levels between low and high chicken intakes. Examining metabolite profiles revealed that guanidoacetate increased from 1.47 to 3.66 mmol/L following increasing chicken intakes from 88 to 290 g/d (P < 0.01). Using a calibration curve developed from the NutriTech study, chicken intake was calculated through the use of data from the National Adult Nutrition Survey, in which consumers of chicken had a higher guanidoacetate excretion (0.70 mmol/L) than did nonconsumers (0.47 mmol/L; P < 0.01). A Bland-Altman analysis revealed good agreement between reported and calculated intakes, with a bias of -30.2 g/d. Plasma metabolite analysis demonstrated that 3-methylhistidine was a more suitable indicator of chicken intake than 1-methylhistidine. CONCLUSIONS: Guanidoacetate was successfully identified and confirmed as a marker of chicken intake, and its measurement in fasting urine samples could be used to determine chicken intake in a free-living population. This trial was registered at clinicaltrials.gov as NCT01684917.

Iodine intakes and status in Irish adults: is there cause for concern?

I is an important mineral for health, required for the production of key thyroid hormones, which are essential for cellular metabolism, growth and physical development. Hence, adequate I is crucial at all stages of life, but imperative during pregnancy for fetal brain development and during a child's early life for neurodevelopment. Within Ireland, limited information exists on population I intakes and status. Therefore, the purposes of the present analysis were to estimate dietary I intakes and to analyse urinary iodine (UI) status using the cross-sectional National Adult Nutrition Survey 2008-2010 and the most recent Irish Total Diet Study. Median I intakes in the total population (n 1106) were adequate with only 26 % of the population being classified as below the estimated average requirement (EAR). Milk consumption was the major source of I in the diet, contributing 45 % to total intake. Likewise, median UI concentrations (107 µg/l) indicated 'optimal' I nutrition according to the WHO cut-off points. In our cohort, 77 % of women of childbearing age (18-50 years) did not meet the EAR recommendation set for pregnant women. Although I is deemed to be sufficient in the majority of adult populations resident in Ireland, any changes to the current dairy practices could significantly impact intake and status. Continued monitoring should be of priority to ensure that all subgroups of the population are I sufficient.

Processed red meat contribution to dietary patterns and the associated cardio-metabolic outcomes.

Evidence suggests that processed red meat consumption is a risk factor for CVD and type 2 diabetes (T2D). This analysis investigates the association between dietary patterns, their processed red meat contributions, and association with blood biomarkers of CVD and T2D, in 786 Irish adults (18-90 years) using cross-sectional data from a 2011 national food consumption survey. All meat-containing foods consumed were assigned to four food groups (n 502) on the basis of whether they contained red or white meat and whether they were processed or unprocessed. The remaining foods (n 2050) were assigned to twenty-nine food groups. Two-step and k-means cluster analyses were applied to derive dietary patterns. Nutrient intakes, plasma fatty acids and biomarkers of CVD and T2D were assessed. A total of four dietary patterns were derived. In comparison with the pattern with lower contributions from processed red meat, the dietary pattern with greater processed red meat intakes presented a poorer Alternate Healthy Eating Index (21·2 (sd 7·7)), a greater proportion of smokers (29 %) and lower plasma EPA (1·34 (sd 0·72) %) and DHA (2·21 (sd 0·84) %) levels (P<0·001). There were no differences in classical biomarkers of CVD and T2D, including serum cholesterol and insulin, across dietary patterns. This suggests that the consideration of processed red meat consumption as a risk factor for CVD and T2D may need to be re-assessed.

The role of fortified foods and nutritional supplements in increasing vitamin D intake in Irish preschool children.

PURPOSE: There are limited data on the contribution of fortified foods and nutritional supplements to intakes of vitamin D in young children. Our objective was to examine the intake, adequacy, risk of excessive intake and sources of dietary vitamin D. METHODS: The nationally representative cross-sectional dietary survey of young children (aged 1-4 years) (n 500) was used to evaluate vitamin D intake and quantify the contribution of the base diet, fortified foods and nutritional supplements to total intake. RESULTS: Median (IQR) intakes of vitamin D were generally low in this young population, ranging from 2.0 (1.9) to 2.5 (4.9) µg/day. Ninety-three and 78 % of children had intakes below 10 and 5 µg/day, respectively. While vitamin D supplement users (17 %) had the highest intakes [6.7 (6.4) µg/day] (P < 0.001), 74 % had intakes below 10 µg/day. Vitamin D-fortified foods, consumed by 77 % of children [2.2 (2.0) µg/day], made nutritionally significant contributions to intake [0.8 (1.6) µg/day], particularly in younger children [1.5 (4.6) µg/day]. Children who did not use nutritional supplements or fortified foods had significantly (P < 0.001) lower intakes of vitamin D than the other groups [1.0 (0.8) µg/day]. Our analyses show the importance of milk and yoghurt, meat and fortified ready-to-eat cereals as sources of vitamin D in this age group. The use of nutritional supplements or fortified foods at current levels does not represent a risk of intakes exceeding the European Food Safety Authority (EFSA) tolerable upper intake level (UL) (50 µg/day), as intakes did not exceed or even approach the UL (P95: 22 % of UL). CONCLUSION: Intakes of vitamin D in preschool children in Ireland are generally low. Nutritional supplements and fortified foods make significant contributions to intakes of vitamin D, without risk of unacceptably high intakes. Though supplements are effective in raising intakes of vitamin D in users, uptake is low (17 %). Food fortification may represent a suitable public health approach to increasing vitamin D intakes. The national food consumption data of Irish preschool children provide the ideal starting point for modelling of fortification scenarios to identify which foods and levels of addition will ensure effective and safe increases in vitamin D intake.

Estimating safe maximum levels of vitamins and minerals in fortified foods and food supplements.

PURPOSE: To show how safe maximum levels (SML) of vitamins and minerals in fortified foods and supplements may be estimated in population subgroups. METHODS: SML were estimated for adults and 7- to 10-year-old children for six nutrients (retinol, vitamins B6, D and E, folic acid, iron and calcium) using data on usual daily nutrient intakes from Irish national nutrition surveys. RESULTS: SML of nutrients in supplements were lower for children than for adults, except for calcium and iron. Daily energy intake from fortified foods in high consumers (95th percentile) varied by nutrient from 138 to 342 kcal in adults and 40-309 kcal in children. SML (/100 kcal) of nutrients in fortified food were lower for children than adults for vitamins B6 and D, higher for vitamin E, with little difference for other nutrients. Including 25 % 'overage' for nutrients in fortified foods and supplements had little effect on SML. Nutritionally significant amounts of these nutrients can be added safely to supplements and fortified foods for these population subgroups. The estimated SML of nutrients in fortified foods and supplements may be considered safe for these population subgroups over the long term given the food composition and dietary patterns prevailing in the respective dietary surveys. CONCLUSIONS: This risk assessment approach shows how nutrient intake data may be used to estimate, for population subgroups, the SML for vitamins and minerals in both fortified foods and supplements, separately, each taking into account the intake from other dietary sources.

The Development, Validation, and User Evaluation of Foodbook24: A Web-Based Dietary Assessment Tool Developed for the Irish Adult Population.

BACKGROUND: The application of technology in the area of dietary assessment has resulted in the development of an array of tools, which are often specifically designed for a particular country or region. OBJECTIVE: The aim of this study was to describe the development, validation, and user evaluation of a Web-based dietary assessment tool "Foodbook24." METHODS: Foodbook24 is a Web-based, dietary assessment tool consisting of a 24-hour dietary recall (24HDR) and food frequency questionnaire (FFQ) alongside supplementary questionnaires. Validity of the 24HDR component was assessed by 40 participants, who completed 3 nonconsecutive, self-administered 24HDR using Foodbook24 and a 4-day semi-weighed food diary at separate time points. Participants also provided fasted blood samples and 24-hour urine collections for the identification of biomarkers of nutrient and food group intake during each recording period. Statistical analyses on the nutrient and food group intake data derived from each method were performed in SPSS version 20.0 (SPSS Inc). Mean nutrient intakes (and standard deviations) recorded using each method of dietary assessment were calculated. Spearman and Pearson correlations, Wilcoxon Signed Rank and Paired t test were used to investigate the agreement and differences between the nutritional output from Foodbook24 (test method) and the 4-day semi-weighed food diary (reference method). Urinary and plasma biomarkers of nutrient intake were used as an objective validation of Foodbook24. To investigate the user acceptability of Foodbook24, participants from different studies involved with Foodbook24 were asked to complete an evaluation questionnaire. RESULTS: For nutrient intake, correlations between the dietary assessment methods were acceptable to very good in strength and statistically significant (range r=.32 to .75). There were some significant differences between reported mean intakes of micronutrients recorded by both methods; however, with the exception of protein (P=.03), there were no significant differences in the reporting of energy or macronutrient intake. Of the 19 food groups investigated in this analysis, there were significant differences between 6 food groups reported by both methods. Spearman correlations for biomarkers of nutrient and food group intake and reported intake were similar for both methods. A total of 118 participants evaluated the acceptability of Foodbook24. The tool was well-received and the majority, 67.8% (80/118), opted for Foodbook24 as the preferred method for future dietary intake assessment when compared against a traditional interviewer led recall and semi-weighed food diary. CONCLUSIONS: The results of this study demonstrate the validity and user acceptability of Foodbook24. The results also highlight the potential of Foodbook24, a Web-based dietary assessment method, and present a viable alternative to nutritional surveillance in Ireland.