Sustainability-informed dietetics education: key messages for educators and national dietetics associations.

BACKGROUND: Dietetics curricula currently fail to meet the educational needs of the future dietetic workforce to contribute expertise in sustainable, healthy food systems in the settings in which dietitians work. A 'Global Networking Event on Sustainable Food Systems in Nutrition and Dietetics Education' was held in June 2023 with the goals of building relationships among international stakeholders and informing the development of shared curricula. METHODS: Plenary lectures, panels and roundtable discussions were held over 2 days, designed to provide the background required to generate informed actions. Topics included recent research from practice and education, competency standards and relevant policy documents, examples from the field, 'big questions' about scope and student perspectives. Key messages were summarised thematically to inform educators and national dietetics associations. RESULTS: Fifty-five delegates attended from 11 nations representing education, research, dietetic associations, industry and diverse practice backgrounds. Key priorities identified for educators included co-development of curricular frameworks and pedagogical theory, practical training supports and solutions to limited time and expertise. Key recommendations for national dietetics associations included strategic promotion of sustainable food systems in dietetic roles and practical supports. CONCLUSIONS: Outcomes are anticipated to stimulate ongoing discussion, collaboration and actions on sustainable food systems education within the dietetics profession leading to shared curricular models and supports.

Prevalence and determinants of sarcopenia in community-dwelling older adults in Ireland.

BACKGROUND: Data on the prevalence of sarcopenia among older adults in Ireland are lacking. AIMS: To assess the prevalence and determinants of sarcopenia among community-dwelling older adults in Ireland. METHODS: This cross-sectional analysis involved n = 308 community-dwelling adults aged ≥ 65 y living in Ireland. Participants were recruited via recreational clubs and primary healthcare services. Sarcopenia was defined according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Skeletal muscle mass was estimated using bioelectrical impedance analysis, strength was measured via handgrip dynamometry, and physical performance was assessed using the Short Physical Performance Battery. Detailed information was collected on demographics, health, and lifestyle. Dietary macronutrient intake was measured via a single 24 h recall. Binary logistic regression was used to examine potential demographic, health, lifestyle, and dietary determinants of sarcopenia (where both probable and confirmed sarcopenia were combined). RESULTS: The prevalence of EWGSOP2-defined probable sarcopenia was 20.8% and confirmed sarcopenia was 8.1% (5.8% had severe sarcopenia). Polypharmacy (OR 2.60, 95% confidence interval [CI] 1.3, 5.23), height (OR 0.95, 95% CI 0.91, 0.98), and Instrumental Activities Of Daily Living (IADL) score (OR 0.71, 95% CI 0.59, 0.86) were independently associated with sarcopenia (probable and confirmed combined). There were no independent associations between energy-adjusted macronutrient intakes, as determined by 24 h recall, and sarcopenia. CONCLUSION: Sarcopenia prevalence within this sample of community-dwelling older adults in Ireland is broadly similar to other European cohorts. Polypharmacy, lower height, and lower IADL score were independently associated with EWGSOP2-defined sarcopenia.

Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis.

BACKGROUND: Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS: A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS: Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS: This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.

'It takes a village': a qualitative study on malnutrition and oral nutritional supplements with older adults in Ireland.

BACKGROUND: Malnutrition affects approximately 20% of older adult populations in Europe, yet their views on the condition are rarely explored. This qualitative study aimed to explore the experiences of older adults living with malnutrition and prescribed oral nutritional supplements in the community setting. METHODS: Semi-structured individual interviews were used to collect data from 13 community-dwelling individuals aged ≥60 years with a current or previous prescription for oral nutritional supplements. Self-perceived health status was measured using the EuroQol EQ-5D-5L, a short questionnaire and visual analogue scale. Interviews were audio-recorded and transcribed verbatim. Interview data were organized using NVivo 12 and analyzed using inductive thematic analysis. RESULTS: Median age was 80.0 (interquartile range 19.5) years, seven were male and six were female. Median health score was 60.0 (interquartile range 35.0) out of 100. Almost one-third reported severe or extreme problems with usual activities, and pain or discomfort. One main theme was identified from the interviews: 'It takes a village', with four subthemes (i) 'I get by with a little help from my friends', (ii) 'The obvious diagnosis', (iii) 'The missing T in MDT' and (iv) 'Confusion'. Participants with malnutrition reported relying on friends, family and carers with poor multidisciplinary team communication and lack of dietetic support. CONCLUSIONS: Participants in this study experienced poor management of malnutrition with missing links between the hospital and community healthcare settings, and lack of dietetic services. Patient views should be used to inform public health guidelines and guide future interventions in the community to improve the health status of older adults with malnutrition.

Overweight and obesity in shift workers: associated dietary and lifestyle factors.

BACKGROUND: Approximately 17% of the European Union workforce is engaged in shift work. Shift work has been associated with a number of chronic conditions, including obesity and obesity-related metabolic diseases. The aim of this study was to explore the dietary and lifestyle behaviours of shift workers with a healthy vs. overweight/obese body mass index (BMI). METHODS: A cross-sectional study was conducted on 1080 shift workers using a 15-min, telephone-administered questionnaire developed from qualitative research on Irish shift workers and national dietary intake data. Demographic and work-related factors, as well as dietary and lifestyle behaviours were recorded. BMI was calculated using self-reported height and weight. Univariate and multivariate logistic regression methods were used to analyze data according to BMI category. RESULTS: Over 40% of shift workers were classified as overweight or obese. Multivariate analysis indicated that being male [P < 0.001, aOR = 2.102, 95% CI (1.62-2.73)] and middle- or older-aged were independently associated with overweight and obesity [P < 0.001, aOR = 2.44 95% CI (1.84-3.24) and P < 0.001, aOR = 2.9 95% CI (1.94-4.35), respectively]. Having a medium-high consumption of fried foods was independently associated with overweight and obesity [aOR = 1.38, 95% CI (1.06-1.8)]. CONCLUSIONS: Similar to the general population, overweight and obesity were strongly associated with male sex and middle- or older-age. Male shift workers may benefit from targeted dietary and lifestyle advice specifically focused on limiting fried foods to help protect against overweight and obesity.

Randomised study demonstrates sustained benefits of a pre-school intervention designed to improve nutrition and physical activity practices.

BACKGROUND: Health-promoting programmes must demonstrate sustained efficacy in order to make a true impact on public health. This study aimed to determine the effect of the Healthy Incentive for Pre-schools project on health-promoting practices in full-day-care pre-schools 18 months after a training intervention. METHODS: Thirty-seven pre-schools completed the initial study and were included in this follow-up study. The intervention consisted of one training session with either the pre-school 'manager-only' or 'manager and staff' using a specifically developed needs-based training resource pack comprised of written educational material and a validated health-promoting practice evaluation tool. Direct observation data of health-promoting practices were collected and allocated a score using the evaluation tool by a research dietitian at three time points; pre-intervention, between 6 and 9 months post-intervention and at 18-month follow-up. An award system was used to incentivise pre-schools to improve their scores. RESULTS: Health-promoting practice scores improved significantly (P < 0.001) from the 6-9 month post-intervention to the 18-month follow-up evaluation. No significant differences were observed between 'manager-only' and 'manager and staff' trained pre-schools. CONCLUSIONS: The introduction of a pre-school evaluation tool supported by a training resource was successfully used to incentivise pre-schools to sustain and improve health-promoting practices 18 months after intervention training.

How do adults define the treats they give to children? A thematic analysis.

One in four children on the Island of Ireland are overweight or obese. The consumption of energy-dense, nutrient-poor foods such as snacks, contribute to one fifth of children's calorie intake. However the snack food literature has failed to draw firm conclusions between snack food intake and obesity. Within this literature, the word snack and treat are used interchangeably, inconsistently and in differing contexts, which may explain the poor link between snacks or extra foods, and overweight or obesity. There is currently no academic definition of the word 'treat' relevant to an Irish population. Defining how adults perceive the treats they give children is of particular importance in the context of children's diets, and may provide insight into the relative contribution of treats to energy intakes. With ten focus groups of adult caregivers of children, across the Island of Ireland, this study aimed to investigate treat giving behaviour. This research highlights a paradoxical definition of treats: a treat was identified as an energy-dense food that gave pleasure, was deserved and believed to be infrequent; participants perceived this to be the true definition of treats which was coined "real treats". However, in reality, treats were given and consumed frequently, downgrading the status of these treats to "regular treats" which reflected their real-life use. Developing the definition of treats for an adult population, may enhance our understanding of why adults give food treats to children, the role this has on the development of eating habits, the design of interventions and communication strategies to reduce the consumption of non-nutritive foods, labelled by adults as treats.

A qualitative exploration of the shift work experience: the perceived effect on eating habits, lifestyle behaviours and psychosocial wellbeing.

Background: Approximately 17% of the European workforce is engaged in shift work. How the experience of shift work impacts on the dietary and lifestyle practices of workers is unclear. Methods: Overall, 15 focus groups were conducted by two researchers, with 109 participants. The initial focus group was carried out with both researchers present, to ensure consistency in facilitation. Both researchers thematically analysed all data collected. Results: Shift work was described as affecting many areas of workers' lives. Three overarching themes were identified: (i) impact on eating behaviour; (ii) impact on other lifestyle behaviours including physical activity, sleep, alcohol consumption, smoking; and (iii) impact on psychosocial health and wellbeing. There appeared to be overlap between the effect of shift work and the effect of individual internal factors in influencing workers' decision-making with regard to lifestyle practices. Conclusions: Shift work affects many areas of workers' lives, negatively impacting on eating and lifestyle behaviours and psychosocial health. This study augments the current literature as it highlights the role internal motivation plays in workers' lifestyle choices. The research should help inform the development of public health strategies to minimize the impact of shift work, such as specialist behavioural change interventions specific to this group.

Is it still a real treat? Adults' treat provision to children.

Consumption of high-energy foods in the absence of hunger has been identified as a key target to address in the area of obesity. For children, such foods are often provided by adults as treats. There is limited understating of adults' treat giving. The present study aimed to understand adults' provision of treats to children on the Island of Ireland. A total of 1039 participants, including parents, grandparents, child minders and education practitioners completed a face-to-face survey in their home. Participants defined their treats for children primarily as 'something nice', 'deserved/earned' and 'something special'. The top three motivations for treat foods provision were 'to reward for good behaviour' (42.3%), 'because the child(ren) ask' (42.2%) and 'to make the child(ren) feel better' (29.4%). Almost all participants would provide treat foods at celebrations and 52.5% always did so. In addition, 68% participants had structured weekly and/or daily treat for children. Treats provided to children were dominated by energy-dense foods. The top three were sweets, chocolates and ice-creams, being used by 45.2%, 45.1% and 38.8% participants. Variations were observed across different adult groups, in terms of their treat giving behaviour. The main observation was that adults' treat foods provision has become habitual. The findings can help develop targeted strategies to encourage the reduction or replacement of food treats for children.

Dietary and lifestyle habits and the associated health risks in shift workers.

Traditionally only a small proportion of the workforce was engaged in shift work. Changing economic pressures have resulted in increased engagement in shift work, with approximately 17 % of the workforce in Europe engaged in this work pattern. The present narrative review aimed to summarise the data on the effects of shift work on the diet, lifestyle and health of employees, while addressing the barriers to, and opportunities for, improving health among shift workers. Shift work can result in low-quality diet and irregular eating patterns. Adverse health behaviours are also reported; particularly increased smoking and poor sleep patterns. These altered lifestyle habits, in conjunction with disruption to circadian rhythms, can create an unfavourable metabolic phenotype which facilitates the development and progression of chronic disease. Although the data are inconclusive due to issues such as poor study design and inadequate control for confounding factors; shift workers appear to be at increased mental and physical health risk, particularly with regard to non-communicable diseases. Information is lacking on the obstacles to leading a healthier lifestyle while working shifts, and where opportunities lie for intervention and health promotion among this group. In order to provide an informed evidence base to assist shift workers in overcoming associated occupational hazards, this gap must be addressed. This review highlights the unique nutritional issues faced by shift workers, and the subsequent effect on health. In societies already burdened with increased incidence of non-communicable chronic diseases, there is a clear need for education and behaviour change interventions among this group.

Pre-school manager training: a cost-effective tool to promote nutrition- and health-related practice improvements in the Irish full-day-care pre-school setting.

OBJECTIVE: To evaluate the impact on nutrition- and health-related practice of two methods of delivery of a nutrition and health intervention in Irish full-day-care pre-schools: training of pre-school managers only or training of managers and their staff. DESIGN: A simple randomised study with pre-schools divided into two training groups: 'manager trained' and 'manager and staff trained'. Direct observational data--food and fluid provision, physical activity, outdoor time, staff practices and availability of nutrition and health resources--were recorded during one full day spent in each pre-school both pre- and post-intervention, using a specifically developed and validated Pre-school Health Promotion Activity Scored Evaluation Form. Post-intervention, self-assessment data were also collected using the same evaluation tool. SETTING: Pre-schools, Midlands of Ireland. SUBJECTS: A convenience sample of forty-two pre-schools registered with the Irish Health Service Executive. RESULTS: From pre- to post-intervention, significant improvement (P < 0.05) in nutrition- and health-related practice was observed within both intervention delivery groups in all areas evaluated: environment, food service, meals and snacks. No additional effect attributable to staff training was observed. Scores assigned by direct independent observation were lower than pre-school self-assessment scores. CONCLUSIONS: The implementation of a training intervention in pre-schools significantly improved practice with no significant benefit of additional staff training. Direct independent observation is required to quantify practice accurately.

Accuracy of Resting Metabolic Rate Prediction Equations in Athletes: A Systematic Review with Meta-analysis.

BACKGROUND: Resting metabolic rate (RMR) prediction equations are often used to calculate RMR in athletes; however, their accuracy and precision can vary greatly. OBJECTIVE: The aim of this systematic review and meta-analysis was to determine which RMR prediction equations are (i) most accurate (average predicted values closest to measured values) and (ii) most precise (number of individuals within 10% of measured value). DATA SOURCES: A systematic search of PubMed, CINAHL, SPORTDiscus, Embase, and Web of Science up to November 2021 was conducted. ELIGIBILITY CRITERIA: Randomised controlled trials, cross-sectional observational studies, case studies or any other study wherein RMR, measured by indirect calorimetry, was compared with RMR predicted via prediction equations in adult athletes were included. ANALYSIS: A narrative synthesis and random-effects meta-analysis (where possible) was conducted. To explore heterogeneity and factors influencing accuracy, subgroup analysis was conducted based on sex, body composition measurement method, athlete characteristics (athlete status, energy availability, body weight), and RMR measurement characteristics (adherence to best practice guidelines, test preparation and prior physical activity). RESULTS: Twenty-nine studies (mixed sports/disciplines n = 8, endurance n = 5, recreational exercisers n = 5, rugby n = 3, other n = 8), with a total of 1430 participants (822 F, 608 M) and 100 different RMR prediction equations were included. Eleven equations satisfied criteria for meta-analysis for accuracy. Effect sizes for accuracy ranged from 0.04 to - 1.49. Predicted RMR values did not differ significantly from measured values for five equations (Cunningham (1980), Harris-Benedict (1918), Cunningham (1991), De Lorenzo, Ten-Haaf), whereas all others significantly underestimated or overestimated RMR (p < 0.05) (Mifflin-St. Jeor, Owen, FAO/WHO/UNU, Nelson, Koehler). Of the five equations, large heterogeneity was observed for all (p < 0.05, I2 range: 80-93%) except the Ten-Haaf (p = 0.48, I2 = 0%). Significant differences between subgroups were observed for some but not all equations for sex, athlete status, fasting status prior to RMR testing, and RMR measurement methodology. Nine equations satisfied criteria for meta-analysis for precision. Of the nine equations, the Ten-Haaf was found to be the most precise, predicting 80.2% of participants to be within ± 10% of measured values with all others ranging from 40.7 to 63.7%. CONCLUSION: Many RMR prediction equations have been used in athletes, which can differ widely in accuracy and precision. While no single equation is guaranteed to be superior, the Ten-Haaf (age, weight, height) equation appears to be the most accurate and precise in most situations. Some equations are documented as consistently underperforming and should be avoided. Choosing a prediction equation based on a population of similar characteristics (physical characteristics, sex, sport, athlete status) is preferable. Caution is warranted when interpreting RMR ratio of measured to predicted values as a proxy of energy availability from a single measurement. PROSPERO REGISTRATION: CRD42020218212.

Impact of malnutrition management e-learning module on GPs' knowledge: a pilot study.

BACKGROUND: Malnutrition is underdiagnosed in primary care. GPs are key healthcare contacts for older adults at risk of protein-energy malnutrition; however, lack of knowledge and confidence in its diagnosis and treatment is often reported. AIM: To evaluate the impact of a bespoke online education module on GP malnutrition knowledge and management. DESIGN & SETTING: A prospective pre-post pilot study with 23 GPs and eight GP trainees in the Republic of Ireland. METHOD: The module included units on the following: 'malnutrition definition, prevalence, and latest evidence'; 'identifying malnutrition in clinical practice'; 'food-first advice'; 'reviewing malnutrition'; and 'oral nutritional supplements'. Participant knowledge was measured using a multiple choice questionnaire (MCQ) before and after the module (n = 31), and 6 weeks following completion (n = 11). Case studies assessing identification and management of malnutrition were evaluated by a clinical specialist dietitian with expertise in managing malnutrition. Changes in assessment performance were calculated using paired t-tests. Acceptability was evaluated using a questionnaire. RESULTS: Post-training, 97% of GPs increased MCQ scores from baseline (+25%, P<0.001), with the greatest improvement in 'identifying malnutrition in clinical practice' (mean increase 47%, P<0.001). Eleven GPs completed the 6-week MCQ with scores remaining significantly higher than baseline (mean increase 15%, P = 0.005); 'identifying malnutrition in clinical practice' remained the most highly scored (mean increase 40%, P<0.001). Seventeen GPs completed the case studies; 76% at baseline and 88% post-module correctly calculated malnutrition risk scores. Appropriate malnutrition management improved for 47% of GPs after module completion. CONCLUSION: This e-learning module improved malnutrition knowledge, with good short-term retention in a small cohort. Development of online evidence-based nutrition education may improve GP nutrition care.

Advances in knowledge of screening practices and their use in clinical practice to prevent malnutrition.

Malnutrition is common among older adults and is associated with a progressive decline in overall health and increased mortality. With a rapidly ageing population, the detection, prevention and management of malnutrition require urgent attention within health service planning and delivery. Routine screening for malnutrition among older adults in community settings, which addresses aetiological as well as phenotypic factors, is considered an important step for prevention and early intervention. The aim of this review is to summarise current malnutrition screening literature and highlight research that seeks to understand and address community-based approaches to malnutrition screening and management. Key healthcare professionals (HCPs) that encounter community-dwelling older adults include general practitioners (GPs), community-based nurses, community pharmacists and a range of other health and social care professionals including dietitians, physiotherapists, speech and language therapists, and occupational therapists. The key barriers to implementing screening in primary care include lack of knowledge about malnutrition among non-dietetic HCPs, lack of resources allocated to managing malnutrition, lack of access to dietetic services, and poor GP knowledge about oral nutritional supplement prescribing. In addition, older adults have poor insight into the clinical condition and the associated negative health implications. Investment in education among HCPs and public awareness is required, as well as accompanying resources to successfully implement malnutrition screening programmes for community-dwelling older adults.

Reflections on recruiting healthcare professionals as research participants: Learning from the ONSPres Study.

The involvement of healthcare professionals (HCPs) as research participants is essential to generate high quality evidence for enhancing health services and practice.  Research teams face many challenges in recruiting HCPs for research, and barriers and enablers for interdisciplinary research are not well described in the literature.  The Oral Nutritional Supplement Prescribing Malnutrition Research Study (ONSPres Study) examined malnutrition identification, management, and appropriate oral nutritional supplement prescribing in primary care in Ireland.  The ONSPres Study offers a unique view of recruiting HCPs for research because a range of disciplines were sought for participation in a mixed methods study.  The purpose of this open letter is to describe the experiences of recruitment and participation.  Sixteen general practitioners (GPs) were recruited to participate in one-to-one interviews, eighty health and social care professionals working in community care (including nurses, pharmacists, dietitians, physiotherapists, speech and language therapists, and occupational therapists) were recruited to take part in 12 focus groups, and 31 GPs and trainee GPs were recruited to participate in an education programme developed by the study team.   Strategies required to gain access and reach HCPs differed between disciplines.   Professional networks enhanced access to HCPs working in practice and recruitment was slower and more tailored when those networks were less available to the team.  An interest in malnutrition, to assist in research, to advance patient care, and the opportunity for learning were incentives for the participating HCPs.  Limitations in the diversity of the sample arose, with a bias towards female participants and GPs motivated by an interest in the topic.  It is recommended that study teams collaborate early with relevant HCP disciplines so they can contribute to recruitment planning at project concept and design stages.  To enhance and incentivise HCP participation in research, dedicated time and acknowledgement of participation as continuous professional development is proposed.

Disparities in Oral Nutritional Supplement Usage and Dispensing Patterns across Primary Care in Ireland: ONSPres Project.

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of 'Moderate' (<75th centile), 'High' (75th-89th centile) and 'Very High' ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann-Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). 'Moderate' ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), 'High' users were dispensed 420 units (EUR 806) and 'Very High' users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.

Nutrition policy: developing scientific recommendations for food-based dietary guidelines for older adults living independently in Ireland.

Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the 'over-65s' to optimise health is critically important. Older adults represent a diverse population - some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate for older adults. Published international reports were used to update nutrient intake goals for older adults, and available Irish data on dietary intakes and nutritional status biomarkers were explored from a population-based study (the National Adult Nutrition Survey; NANS) and two longitudinal cohorts: the Trinity-Ulster and Department of Agriculture (TUDA) and the Irish Longitudinal Study on Ageing (TILDA) studies. Nutrients of public health concern were identified for further examination. While most nutrient intake goals were similar to those for the general adult population, other aspects were identified where nutritional concerns of ageing require more specific food-based dietary guidelines. These include, a more protein-dense diet using high-quality protein foods to preserve muscle mass; weight maintenance in overweight or obese older adults with no health issues and, where weight-loss is required, that lean tissue is preserved; the promotion of fortified foods, particularly as a bioavailable source of B vitamins and the need for vitamin D supplementation.

The body composition, nutritional knowledge, attitudes, behaviors, and future education needs of senior schoolboy rugby players in Ireland.

PURPOSE: This study examined the body composition, nutritional knowledge, behaviors, attitudes, and educational needs of senior schoolboy rugby players in Ireland. METHODS: Participants included 203 male rugby players age 15-18 yr competing at Senior School's Cup level in Leinster, Ireland. Estimation of body composition included measurement of height, weight, and percentage body fat (PBF; using bioelectrical impedance analysis, Tanita BC-418). Nutritional knowledge, behaviors, attitudes, and education needs were assessed by questionnaire. RESULTS: The range of PBF was 5.1-25.3%. Sixty-eight percent of the players in this study had a healthy PBF (10-20%), 32 (22%) were classified as underweight (<10% body fat), and 9.7% (n = 14) were overweight. Assessment of nutritional knowledge demonstrated poor knowledge of the foods required for refueling, appropriate use of sports drinks, and the role of protein in muscle formation. Alcohol consumption and dietary supplement use were reported by 87.7% and 64.5%, respectively. A perception that greater body size enhances sport performance did not predict dietary supplement use. Nutritional advice had been previously sought by 121 players from coaches (66.9%), magazines (42.1%), Web sites (38.8%), peers (35.5%), family (28.1%), sport organizations (16.5%), and health professionals (8.2%). Nutritional knowledge was no better in these players, nor did better nutritional knowledge correlate with positive dietary behaviors or attitudes. CONCLUSIONS: Most players had a healthy PBF. Despite a positive attitude toward nutrition, poor nutritional knowledge and dietary practices were observed in many players. Young athletes' nutritional knowledge and dietary practices may benefit from appropriate nutritional education.

Associations between Neighborhood Deprivation Index, Parent Perceptions and Preschooler Lifestyle Behaviors.

Parental perceptions and use of neighborhood facilities are important factors that are related to children's dietary intake and physical activity. The aim of this study was to examine the association between neighborhood deprivation index, parents' perceptions of their neighborhood environment, and healthy/unhealthy markers of child dietary intake, physical activity, and TV screen time. This cross-sectional study was conducted in Dublin, Ireland. The lifestyle behaviors among children and parental perceptions of their neighborhood environment were reported by the parents of 276 children aged 3-5 years by using parent-completed questionnaires. Deprivation index was assessed using the geographic information system (GIS). Data were analyzed using binary logistic regression, adjusting for socio-demographic confounders. In adjusted models, high deprivation index was associated with parental perception of the neighborhood as unsafe for walking and cycling due to crime (OR 1.59, 95% CI 1.04-2.43, p = 0.031) and children's low engagement in structured physical activity (OR 0.35, 95% CI 0.17-0.72, p = 0.004). Parental perceptions of an unsafe neighborhood due to heavy traffic were negatively correlated with children's active play (OR 0.73, 95% CI 0.55-0.95, p = 0.022). Children whose parents reported high satisfaction with the number of local sit-in and takeaway restaurants were 41% more likely to consume confectionary/sugar sweetened beverages (SSBs) weekly. In this age group, parents play an important role in children's lifestyle behaviors; therefore, a better understanding of parents' perceptions and their use of neighborhood facilities could contribute to creating a healthy environment for this age group.