The North/South Ireland Food Consumption Survey: mineral intakes in 18-64-year-old adults

Prevalence of low dietary zinc intake in women and pregnant women in Ireland

Background

In humans, zinc is involved in many biological functions acting as signaling ion, neurotransmitter, structural component of proteins, and cofactor for many enzymes and, through this, is an important regulator of the immune and nervous system. Food supplies zinc to the human body, but a high prevalence of inadequate dietary zinc intake has been reported worldwide.

Aims

The objective of this study was to investigate the zinc intake and bioavailability of over 250 women (pregnant and non-pregnant) based in Ireland, in order to evaluate the dietary inadequacy of zinc.

Methodology

We used a food frequency questionnaire designed to assess the zinc intake and bioavailability of the participants.

Results

Our results show that 58% of participants are at risk of inadequate zinc intake and that 29% may be zinc deficient. The prevalence of inadequate zinc intake was lower for pregnant women (zinc deficient 9%, at risk 38%) than for non-pregnant women due to more frequent consumption of supplements. Low zinc intake was not correlated with the age of participants and resulted from a combination of inadequate intake of zinc-rich food and relatively higher intake of food items rich in phytate, a major zinc uptake inhibitor.

Conclusions

We conclude that at present, low zinc intake may be prevalent in as much as 87% of women, including 47% of pregnant women. Therefore, zinc status needs to be considered as a factor impacting the health of women, and in particular pregnant women, also in industrialized and developed countries such as Ireland.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11845-022-03181-w.

Pre-diagnostic dietary consumption of calcium and magnesium and calcium-to-magnesium intake ratio and ovarian cancer mortality: results from the ovarian cancer follow-up study (OOPS)

PURPOSE

Previous studies have indicated that dietary consumption of calcium (Ca), magnesium (Mg), and the Ca-to-Mg (Ca:Mg) ratio were associated with different health outcomes. However, no study has evaluated the association of pre-diagnostic Ca, Mg, and Ca:Mg ratio consumption with ovarian cancer (OC) survival.

METHODS

The aforementioned associations were investigated in a cohort of 853 Chinese women diagnosed with OC between 2015 and 2020. A validated food frequency questionnaire was used to evaluate pre-diagnostic diet information. Deaths were recorded until March 31, 2021 via medical records and active follow-up. Cox proportional hazards model was applied to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

A total of 130 deaths were observed during a median follow-up of 37.2 months. After adjustment for potential confounders, pre-diagnostic Ca (HR_{< 600 vs. > 1000} = 1.45, 95% CI = 0.47-4.46, p for trend = 0.69) and Mg (HR_{< 250 vs. > 330} = 0.90, 95% CI = 0.39-2.08, p for trend = 0.77) intakes were found to be unrelated to OC survival, whereas a higher Ca:Mg intake ratio was significantly associated with worse survival (HR_{< 1.7 vs. > 2.5} = 2.72, 95% CI = 1.28-5.78, p for trend < 0.05). A significant result was also observed when treating the Ca:Mg ratio as a continuous variable (HR = 1.69, 95% CI = 1.12-2.55) for one-unit increment.

CONCLUSION

Pre-diagnostic consumption of Ca and Mg was unrelated to OC survival, while a higher Ca:Mg intake ratio was strongly associated with worse survival among OC patients.

Dietary riboflavin deficiency induces ariboflavinosis and esophageal epithelial atrophy in association with modification of gut microbiota in rats

PURPOSE

Riboflavin deficiency causes ariboflavinosis, a common nutritional deficiency disease. The purpose of this study is to investigate the effects of riboflavin deficiency on the important internal organs and its potential mechanisms.

METHODS

Experiment 1, male F344 rats were randomly assigned to R₆ (normal riboflavin, 6 mg/kg) and R₀ (riboflavin-deficient, 0 mg/kg) groups. Experiment 2 rats were assigned to R₆, R_0.6 (0.6 mg/kg) and R_0.06 (0.06 mg/kg) groups. Experiment 3 rats were assigned to R₆ and R₀ → R₆ (riboflavin replenishment) groups. Bacterial communities were analyzed based on 16S rRNA gene sequencing.

RESULTS

Riboflavin deficiency induced ariboflavinosis (R_0.06 46.7%; R₀ 72%) and esophageal epithelial atrophy (R_0.06 40%; R₀ 44%) in rats, while the R₆ group did not display symptoms (P < 0.001, respectively). Esophageal epithelial atrophy occurred simultaneously (R_0.06 66.7%; R₀ 63.6%) with ariboflavinosis or appeared alone (R_0.06 33.3%; R₀ 36.4%). Esophagus is the most vulnerable internal organ. Riboflavin deficiency followed by replenishment (R₀ → R₆) was effective in treating ariboflavinosis (83.3% vs. 0%, P < 0.001) and esophageal epithelial atrophy (66.7% vs. 20%, P = 0.17). Riboflavin deficiency modulated gut microbiota composition. The several key genera (Romboutsia, Turicibacter and Clostridium sensu stricto 1) were strongly correlated with ariboflavinosis and esophageal epithelial atrophy (P < 0.01 or P < 0.05). The potential mechanism is that gut microbiota affects body's xenobiotic biodegradation and metabolism, and genomic instability.

CONCLUSIONS

Riboflavin deficiency induces ariboflavinosis and esophageal epithelial atrophy by modulating the gut microbiota, and offers new Queryinsight into riboflavin deficiency and esophageal lesions.

Decreased plasma riboflavin is associated with poor prognosis, invasion, and metastasis in esophageal squamous cell carcinoma

BACKGROUND

Riboflavin deficiency confers a predisposition for esophageal cancer. The role of plasma riboflavin levels in development and prognosis of individuals with digestive tract inflammation and ulcer (DTIU), digestive tract polyps (DTPs), and ESCC is not well understood.

METHODS

We performed a cross-sectional study, including 177 DTIU, 80 DTP, and 324 ESCC cases, to measure the plasma riboflavin levels among the three populations. Correlation between plasma riboflavin levels (categorized as ≥31.8, 6.5-31.8 and ≤6.5 nmol/L groups) and clinical characteristics, as well as survival of ESCC patients (556 cases) was analyzed.

RESULTS

There was no difference in plasma riboflavin levels between DTIU, DTP, and ESCC cases (P > 0.05). Plasma riboflavin levels were inversely correlated with invasive depth (correlation coefficient = -0.09, P = 0.026) and lymph node metastasis (correlation coefficient = -0.11, P = 0.010) of ESCC, and ESCC patients with low riboflavin levels had poor recurrence-free survival (P = 0.035) and overall survival (P = 0.003). Decreased riboflavin was a prognostic factor for poor overall survival (HR = 1.91, 95% CI = 1.19-3.07, P = 0.007).

CONCLUSIONS

Plasma riboflavin levels in DTIU, DTP, and ESCC patients are similar. Plasma riboflavin levels are associated with the development and prognosis of ESCC.

Dietary inflammatory index and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study

The dietary inflammatory index (DIITM) is a novel composite score based on a range of nutrients and foods known to be associated with inflammation. DII scores have been linked to the risk of a number of cancers, including oesophageal squamous cell cancer and oesophageal adenocarcinoma (OAC). Given that OAC stems from acid reflux and that the oesophageal epithelium undergoes a metaplasia-dysplasia transition from the resulting inflammation, it is plausible that a high DII score (indicating a pro-inflammatory diet) may exacerbate risk of OAC and its precursor conditions. The aim of this analytical study was to explore the association between energy-adjusted dietary inflammatory index (E-DIITM) in relation to risk of reflux oesophagitis, Barrett's oesophagus and OAC. Between 2002 and 2005, reflux oesophagitis (n 219), Barrett's oesophagus (n 220) and OAC (n 224) patients, and population-based controls (n 256), were recruited to the Factors influencing the Barrett's Adenocarcinoma Relationship study in Northern Ireland and the Republic of Ireland. E-DII scores were derived from a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of oesophageal lesions according to E-DII intakes, adjusting for potential confounders. High E-DII scores were associated with borderline increase in odds of reflux oesophagitis (OR 1·87; 95 % CI 0·93, 3·73), and significantly increased odds of Barrett's oesophagus (OR 2·05; 95 % CI 1·22, 3·47), and OAC (OR 2·29; 95 % CI 1·32, 3·96), when comparing the highest with the lowest tertiles of E-DII scores. In conclusion, a pro-inflammatory diet may exacerbate the risk of the inflammation-metaplasia-adenocarcinoma pathway in oesophageal carcinogenesis.

Dietary magnesium, calcium:magnesium ratio and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study

Evidence suggests a role of Mg and the ratio of Ca:Mg intakes in the prevention of colonic carcinogenesis. The association between these nutrients and oesophageal adenocarcinoma - a tumour with increasing incidence in developed countries and poor survival rates - has yet to be explored. The aim of this investigation was to explore the association between Mg intake and related nutrients and risk of oesophageal adenocarcinoma and its precursor conditions, Barrett's oesophagus and reflux oesophagitis. This analysis included cases of oesophageal adenocarcinoma (n 218), Barrett's oesophagus (n 212), reflux oesophagitis (n 208) and population-based controls (n 252) recruited between 2002 and 2005 throughout the island of Ireland. All the subjects completed a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of disease according to dietary intakes of Mg, Ca and Ca:Mg ratio. After adjustment for potential confounders, individuals consuming the highest amounts of Mg from foods had significant reductions in the odds of reflux oesophagitis (OR 0·31; 95 % CI 0·11, 0·87) and Barrett's oesophagus (OR 0·29; 95 % CI 0·12, 0·71) compared with individuals consuming the lowest amounts of Mg. The protective effect of Mg was more apparent in the context of a low Ca:Mg intake ratio. No significant associations were observed for Mg intake and oesophageal adenocarcinoma risk (OR 0·77; 95 % CI 0·30, 1·99 comparing the highest and the lowest tertiles of consumption). In conclusion, dietary Mg intakes were inversely associated with reflux oesophagitis and Barrett's oesophagus risk in this Irish population.

Usual dietary intakes of selected trace elements (Zn, Cu, Mn, I, Se, Cr, and Mo) and biotin revealed by a survey of four-season 7-consecutive day weighed dietary records in middle-aged Japanese dietitians

We aimed to identify food sources of selected trace elements (Zn, Cu, Mn, I, Se, Cr, Mo) and biotin in the Japanese diet and to assess usual dietary intakes based on the ratios of within-person to between-person variance. Subjects were 98 middle-aged dietitians living in central Japan who participated in a survey of four-season 7 consecutive day weighed diet records. Based on the latest Standard Tables of Food Composition in Japan published in 2010, food sources of selected nutrients were located according to a contribution analysis, and computed usual dietary intakes. Dietary intakes were checked with the Dietary Reference Intakes for Japanese 2010. Prevalence of inadequacy in a group was determined using the Estimated Average Requirement cut-point method. The major contributors to selected trace elements and biotin were not only meat and milk, but also traditional Japanese food items, including rice, tofu and tofu products, fish, seaweed, chicken eggs, fermented soy bean seasonings, and green tea. Medians of usual intakes were estimated for Zn (men 8.9 mg, women 8.4 mg), Cu (1.32 mg, 1.21 mg), Mn (3.73 mg, 3.76 mg), I (312 μg, 413 μg), Se (97 μg, 94 μg), Cr (10 μg, 9 μg), Mo (226 μg, 184 μg), and biotin (51.7 μg, 47.6 μg). The prevalence of inadequacy of dietary intakes was high for Zn, Cu and Cr. Regarding I, the proportion above the Tolerant Upper Level was overestimated based on the crude mean value. We first identified food sources of selected trace elements and biotin in the Japanese diet, and assessed the usual intakes.

Food and nutrient intake of Irish community-dwelling elderly subjects: who is at nutritional risk?

OBJECTIVES

To assess the dietary intakes of Irish community-dwelling elderly individuals, participating in the ELDERMET project.

DESIGN

Cross-sectional study.

SETTING

Cork city and county region of southern Ireland.

PARTICIPANTS

Two hundred and eight (94 males, 114 females) community-dwelling subjects aged 64-93 yrs.

MEASUREMENTS

Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Anthropometric data were recorded. Nutritional status was assessed using the Mini Nutritional Assessment (MNA).

RESULTS

A high rate of overweight/obesity was observed in this population group. Consumption of energy-dense, low-nutrient foods was excessive among this population group. Older elderly subjects (≥75 yrs) consumed significantly (P<0.01) more desserts/sweets than younger elderly (64-74 yrs). Intakes of dietary fat and saturated fat were high while dairy food consumption was inadequate in both males and females. Elderly females typically had a more nutrient-dense diet than males. A considerable proportion of subjects, particularly males, had inadequate intakes of calcium, magnesium, vitamin D, folate, zinc and vitamin C.

CONCLUSION

The data indicate that the diet of Irish community-dwelling elderly individuals is sub-optimal with respect to nutrient intake, and excessive in terms of fat intake, with implications for the health status of this population group. Reductions in dietary fat and increased low fat dairy food intakes are recommended for the prevention of diet-related disease in older persons. In addition, strategies to improve a number of sub-optimal micronutrient intakes need to be developed and implemented, particularly among elderly males.

The impact of voluntary food fortification on micronutrient intakes and status in European countries: a review

This review aims to assess the efficacy and safety of voluntary fortification as an option to address the occurrence of inadequate micronutrient intakes in population subgroups in Europe. Although legislation is harmonised across the European Union, fortification practices and patterns of consumption of fortified foods vary considerably between countries. While the proportion of children consuming fortified foods is greater than adults, the proportion of dietary energy obtained from fortified foods is generally low (<10% in Ireland, where fortified foods are widely consumed). There are a few systematic studies on the overall nutritional impact of voluntary fortification, but there are several studies on the impact of fortified ready-to-eat breakfast cereals. The available evidence indicates that voluntary fortification can reduce the risk of sub-optimal intakes of a range of micronutrients at a population level and can also improve status for selected micronutrients (e.g. folate, vitamin D and riboflavin) in children and adults. Although concerns have been raised regarding the potential of food fortification to lead to unacceptably high micronutrient intakes, particularly for those consuming higher amounts of fortified foods, data from national surveys on total micronutrient intakes (including fortified foods) in Europe show that small proportions of the population, particularly children, may exceed the upper intake level (UL) for some micronutrients. The risk of adverse effects occurring in these individuals exceeding the UL by modest amounts is low. In conclusion, voluntary fortification practices have been shown to improve intake and status of key micronutrients in European Union population groups and do not contribute appreciably to risk of adverse effects.

Dietary fat and meat intakes and risk of reflux esophagitis, Barrett's esophagus and esophageal adenocarcinoma

The aim of our study was to investigate whether dietary fat and meat intakes are associated with reflux esophagitis (RE), Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). In this all-Ireland case-control study, dietary intake data were collected using a food frequency questionnaire in 219 RE patients, 220 BE patients, 224 EAC patients and 256 frequency-matched controls between 2002 and 2005. Unconditional multiple logistic regression analysis was used to examine the association between dietary variables and disease risk using quartiles of intake, to attain odds ratios (ORs) and 95% confidence intervals (95% CIs), while adjusting for potential confounders. Patients in the highest quartile of total fat intake had a higher risk of RE (OR = 3.54; 95% CI = 1.32-9.46) and EAC (OR = 5.44; 95% CI = 2.08-14.27). A higher risk of RE and EAC was also reported for patients in the highest quartile of saturated fat intake (OR = 2.79; 95% CI = 1.11-7.04; OR = 2.41; 95% CI = 1.14-5.08, respectively) and monounsaturated fat intake (OR = 2.63; 95% CI = 1.01-6.86; OR = 5.35; 95% CI = 2.14-13.34, respectively). Patients in the highest quartile of fresh red meat intake had a higher risk of EAC (OR = 3.15; 95% CI = 1.38-7.20). Patients in the highest category of processed meat intake had a higher risk of RE (OR = 4.67; 95% CI = 1.71-12.74). No consistent associations were seen for BE with either fat or meat intakes. Further studies investigating the association between dietary fat and food sources of fat are needed to confirm these results.

Revision of food-based dietary guidelines for Ireland, Phase 1: evaluation of Ireland's food guide

OBJECTIVE

To evaluate Ireland's food-based dietary guidelines and highlight priorities for revision.

DESIGN

Evaluation with stakeholder input. Energy and nutrient intake goals most appropriate for Ireland were determined. Advice from Ireland's food guide was translated into 4 d food intake patterns representing age and gender groups from 5 to 51+ years. Nutritional content of the food patterns was compared with identified goals and appropriateness of food advice was noted. Feedback from stakeholders was obtained on portion size of foods within the Bread, Cereal and Potato group and of portion descriptors for meat and cereal foods.

SETTING

Government agency/community.

SUBJECTS

General population aged 5+ years, dietitians/nutritionists (n 44) and 1011 consumers.

RESULTS

Goals were identified for energy, macronutrients, fibre, Fe, Ca and vitamin D. Goals not achieved by the food patterns included energy, total fat, saturated fat, fibre and vitamin D. Energy content of food portions within the Bread, Cereal and Potato group varied widely, yet advice indicated they were equivalent. Dietitians/nutritionists agreed with the majority of consumers surveyed (74 %, n 745) that larger portion sizes within the Bread, Cereal and Potato group were more meaningful. 'Palm of hand' as a descriptor for meat portions and a '200 ml disposable cup' for quantifying cereal foods were preferred.

CONCLUSIONS

Revision of the guidelines requires specific guidance on energy and vitamin D intakes, and comprehensive advice on how to reduce fat and saturated fat and increase fibre intakes. Advice should use portion descriptors favoured by consumers and enlarged portion sizes for breads, cereals and potatoes that are equivalent in terms of energy.

Vitamin D, calcium and dairy intake, and risk of oesophageal adenocarcinoma and its precursor conditions

Evidence is accumulating that vitamin D may be protective against carcinogenesis, although exceptions have been observed for some digestive tract neoplasms. The aim of the present study was to explore the association between dietary vitamin D and related nutrients and the risk of oesophageal adenocarcinoma and its precursor conditions, Barrett's oesophagus and reflux oesophagitis. In an all-Ireland case-control study conducted between March 2002 and July 2005, 218 oesophageal adenocarcinoma patients, 212 Barrett's oesophagus patients, 208 reflux oesophagitis patients and 252 population-based controls completed a 101-item FFQ, and provided lifestyle and demographic information. Multiple logistic regression analysis was applied to examine the association between dietary intake and disease risk. Oesophageal adenocarcinoma risk was significantly greater for individuals with the highest compared with the lowest tertile of vitamin D intake (OR 1·99, 95 % CI 1·03, 3·86; P for trend = 0·02). The direct association could not be attributed to a particular vitamin D food source. Vitamin D intake was unrelated to Barrett's oesophagus and reflux oesophagitis risk. No significant associations were observed for Ca or dairy intake and oesophageal adenocarcinoma, Barrett's oesophagus or reflux oesophagitis development. High vitamin D intake may increase oesophageal adenocarcinoma risk but is not related to reflux oesophagitis and Barrett's oesophagus. Ca and dairy product intake did not influence the development of these oesophageal lesions. These findings suggest that there may be population subgroups at an increased risk of oesophageal adenocarcinoma if advice to improve vitamin D intake from foods is implemented. Limited work has been conducted in this area, and further research is required.

The nutrition transition in the Republic of Ireland: trends in energy and nutrient supply from 1961 to 2007 using Food and Agriculture Organization food balance sheets

Over the course of the last 50 years the Republic of Ireland has gone from being one of the poorest countries in Europe to one of the richest; however, it is now experiencing increasing rates of obesity and non-communicable chronic disease. Although several national nutrition surveys have been carried out in Ireland since 1990, there is little information on the Irish diet before then. We analysed the FAO food balance sheets for Ireland from 1961 to 2007 in order to characterise the changes in energy and nutrient supply that took place during that period. Food balance sheets were downloaded from the FAOSTAT database and per capita supply of commodities was analysed using dietary analysis software. Energy from carbohydrate as a percentage of total energy fell from 55 % in 1961 to 46 % in 2007, whereas energy from fat increased from 29 % to 34 %; these values are well outside WHO recommendations for the prevention of chronic disease. Energy from alcohol as a percentage of total energy has doubled within the last 20 years. On a nutrient-density basis, vitamins and minerals met or exceeded WHO recommendations, apart from vitamin D, folate, Ca and Fe. Although there are methodological limitations associated with the use of food balance sheets, the present results demonstrate that the current imbalances in the Irish diet were already evident several decades ago. Because they are so long established, they will be difficult to reverse unless major public health nutrition interventions are implemented.

Methodology for adding and amending glycaemic index values to a nutrition analysis package

Since its introduction in 1981, the glycaemic index (GI) has been a useful tool for classifying the glycaemic effects of carbohydrate foods. Consumption of a low-GI diet has been associated with a reduced risk of developing CVD, diabetes mellitus and certain cancers. WISP (Tinuviel Software, Llanfechell, Anglesey, UK) is a nutrition software package used for the analysis of food intake records and 24 h recalls. Within its database, WISP contains the GI values of foods based on the International Tables 2002. The aim of the present study is to describe in detail a methodology for adding and amending GI values to the WISP database in a clinical or research setting, using data from the updated International Tables 2008.

Iron intake and markers of iron status and risk of Barrett's esophagus and esophageal adenocarcinoma

OBJECTIVE

To investigate the association between iron intake and iron status with Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC).

METHODS

A total of 220 BE patients, 224 EAC patients, and 256 frequency-matched controls completed a lifestyle and food frequency questionnaire and provided serum and toenail samples between 2002 and 2005. Using multiple logistic regression, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated within quartiles of intake/status.

RESULTS

Comparing the fourth to the first quartile, ferritin (OR 0.47; 95% CI: 0.23, 0.97) and transferrin saturation (OR 0.41; 95% CI: 0.20, 0.82) were negatively associated with BE; while total iron binding capacity was positively associated per 50 μg/dl increment (OR 1.47; 95% CI: 1.12, 1.92). Comparing the fourth to the first quartile, iron intake (OR 0.50; 95% CI: 0.25, 0.98), non-heme iron intake per 10 mg/day increment (OR 0.29; 95% CI: 0.08, 0.99), and toenail iron (OR 0.40; 95% CI: 0.17, 0.93) were negatively associated with EAC; while heme iron intake was positively associated (OR 3.11 95% CI: 1.46, 6.61).

PRINCIPAL CONCLUSION

In contrast to the hypothesis that increased iron intakes and higher iron stores are a risk factor for BE and EAC, this study suggests that higher iron intakes and stores may have a protective association with BE and EAC, with the exception of what was found for heme iron intake.

Intake of selected nutrients from foods, from fortification and from supplements in various European countries

BACKGROUND

Recent European Union regulation requires setting of maximum amount of micronutrients in dietary supplements or foods taking into account the tolerable upper intake level (ULs) established by scientific risk assessment and population reference intakes.

OBJECTIVE

To collect and evaluate recently available data on intakes of selected vitamins and minerals from conventional foods, food supplements and fortified foods in adults and children. Intake of calcium, copper, iodine, iron, magnesium, phosphorus, selenium, zinc, folic acid, niacin and total vitamin A/retinol, B(6), D and E was derived from nationally representative surveys in Denmark, Germany, Finland, Ireland, Italy, the Netherlands, Poland, Spain and the United Kingdom. Intake of high consumers, defined as the 95th percentile of each nutrient, was compared to the UL.

RESULTS

For most nutrients, adults and children generally consume considerably less than the UL with exceptions being retinol, zinc, iodine, copper and magnesium. The major contributor to intakes for all nutrients and in all countries is from foods in the base diet. The patterns of food supplements and voluntary fortification vary widely among countries with food supplements being responsible for the largest differences in total intakes. In the present study, for those countries with data on fortified foods, fortified foods do not significantly contribute to higher intakes for any nutrient. Total nutrient intake expressed as percentage of the UL is generally higher in children than in adults.

CONCLUSION

The risk of excessive intakes is relatively low for the majority of nutrients with a few exceptions. Children are the most vulnerable group as they are more likely to exhibit high intakes relative to the UL. There is a need to develop improved methods for estimating intakes of micronutrients from fortified foods and food supplements in future dietary surveys.

How to find information on national food and nutrient consumption surveys across Europe: systematic literature review and questionnaires to selected country experts are both good strategies

The present research was conducted within the framework of the EURopean micronutrient RECommendations Aligned project. In order to identify the best practice in assessing nutrient intakes, a search strategy for collecting data from national food consumption surveys/studies in Europe was developed. Systematic literature searches were carried out on twenty-eight European and the four European Free Trade Association countries. A questionnaire was also sent to two to five experts in each country. Systematic reviews using PubMed yielded 12 703 abstracts that were reduced to 200 studies using inclusion and exclusion criteria. Similarly, a search of ministry web sites yielded 3033 hits, and subsequently reduced to nine surveys. Belgium, France, Germany, Ireland, Sweden, Spain and the United Kingdom were the countries with most data and Slovenia and Liechtenstein were those with the least. Seventy-eight expert questionnaires were obtained from all countries except for Liechtenstein, Luxembourg and Slovakia. Detailed results and references are given. A systematic search and questionnaires are equally good at identifying national surveys across countries. Literature searching provides globally accessible and objective information albeit limited, whereas the questionnaire provides information that, depending upon responders, can be more complete. A combination of both strategies is recommended.

Dietary exposure estimates of twenty-one trace elements from a Total Diet Study carried out in Pavia, Northern Italy

The significant role of trace elements in human health is well documented. Trace elements are those compounds that need to be present in the human diet to maintain normal physiological functions. However, some microelements may become harmful at high levels of exposure, or, on the other hand, may give rise to malnutrition, when their exposure is too low. The aim of the present study was to provide a reliable estimate of the dietary exposure of twenty-one trace elements in a Northern Italian area. For this purpose, trace element analyses were undertaken on total diet samples collected from a university cafeteria in Pavia, Northern Italy. The average daily exposure for the adult people was calculated on the basis of food consumption frequency, portion size and trace element levels in foodstuffs. The mean exposure values satisfy the Italian RDA for all the essential trace elements, except for Fe exposure in females, and are well below the Provisional Tolerable Daily Intake for all the toxic compounds, showing that the probability of dietary exposure to health risks is overall small. As far as Fe exposure is concerned, a potential risk of anaemia in the female adult population should be considered, then studies aimed at evaluating the Fe nutritional status of adult Italian women should be addressed. In conclusion, while not excluding the possibility that the daily exposure determined in the present study may not be representative of the population as a whole, this study provides a good estimate of the Italian adult consumer exposure to twenty-one trace elements.

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

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

Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years

Added sugars are often viewed as 'empty calories', negatively impacting micronutrient intakes, yet reviews consider the evidence inconclusive. This study aimed to quantify associations between dietary added sugars (as a percentage of energy) and micronutrient intake and biochemical status in the National Diet and Nutrition Survey. Using data from 1688 British children aged 4-18 years who completed 7 d weighed dietary records in 1997, micronutrient intakes were examined across quintiles of added sugars. After excluding low energy reporters, mean dietary intakes of most nutrients exceeded the reference nutrient intake, except for zinc. Compared with quintile 1 (9% added sugars), high consumers in quintile 5 (23% added sugars) had micronutrient intakes ranging from 24% lower to 6% higher (mean 14% lower). Zinc intakes in quintile 1 v. quintile 5 averaged 93% v. 78% of reference nutrient intake; magnesium 114% v. 94%; iron 115% v. 100%; and vitamin A 111% v. 92%, respectively. Plasma levels of magnesium, zinc and carotenoids did not vary across quintiles, but weak negative correlations were observed with serum ferritin and transferrin saturation. Plasma selenium was inversely correlated with added sugars (r -0.17; P < 0.0001) but there was no association with glutathione peroxidase. The impact of added sugars on micronutrient intakes appears modest overall but may have relevance for children consuming inadequate amounts of nutrient-rich foods coupled with a diet high in added sugars (approximately 23%). Further work is needed to explore the impact of different sources of added sugars and to refine assessments of inadequate intakes and status.

Assessment of iron and zinc intake and related biochemical parameters in an adult Mediterranean population from southern Spain: influence of lifestyle factors

This study assessed factors influencing iron and zinc intake and associated biochemical parameters in an adult population from southern Spain to identify patterns of intake and groups at risk for deficiency. A cross-sectional survey was done in Andalusia (southern Spain) to study nutrient intakes in a random sample of 3421 subjects (1747 men, 1674 women, age between 25 and 60 years). Blood samples were obtained for biochemical assays in a random subsample of 354 subjects (170 men, 184 women). Food consumption was assessed by 48-h recall. In blood samples, we measured red blood cells, haemoglobin (Hb), haematocrit, total iron binding capacity (TIBC) and plasma concentration of Fe and Zn. Information about educational level, smoking habit, alcohol consumption and physical exercise was collected with a structured questionnaire. Intakes were below two thirds of the recommended dietary allowances (RDA) in 22.45% of the sample for Fe and in 56.45% for Zn. Iron deficiency [two or more abnormal values for plasma Fe, TIBC, transferrin saturation and mean cell volume (MCV)] was found in 12.7% of the sample, and iron-deficient anaemia (low values for Hb, MCV, mean cell Hb and mean corpuscular Hb concentration) was found in 2.1%. In smokers, plasma levels of Fe were higher, and MCV was lower than in nonsmokers. Plasma Zn concentrations were below the reference value in 17.8% of the persons. Age and body mass index correlated inversely with plasma Zn (P<.01). Gender, age, obesity, smoking, alcohol consumption and physical activity were associated with differences in nutrient intakes. Logistic regression analysis showed that female gender and older age were associated with the risk of low intakes of Fe and Zn.

Influence of moderate energy restriction and seafood consumption on bone turnover in overweight young adults

BACKGROUND

Overweight and obesity are increasing in young adults. However, moderate energy restriction aimed at lowering body weight may promote bone turnover and bone loss. Inclusion of fish or fish oils in a weight-loss diet may attenuate these adverse skeletal effects.

OBJECTIVE

We examined the effects of incorporating fish or fish oil into an energy-restricted diet on bone turnover markers in young overweight adults.

DESIGN

While following a strict hypoenergetic (-30% relative to estimated requirements) diet for 8 wk, 276 overweight men and women [body mass index (in kg/m(2)): 27.5-32.5; age: 20-40 y) were randomly assigned to 1 of 4 dietary groups: sunflower-oil capsules (3 g/d; control), cod (3 x 150 g/wk), salmon (3 x 150 g/wk), and fish-oil capsules (3 g/d). Body weight, bone biomarkers, and 25-hydroxyvitamin D were measured at baseline and endpoint. Data were analyzed with repeated-measures analysis of variance and general linear models.

RESULTS

The mean (+/-SD) weight loss was 5.14 +/- 3.0 kg (5.8% +/- 3.2% body weight) during the 8 wk in the 4 dietary groups combined. Urinary N-telopeptides of type I collagen and serum C-terminal telopeptide of type I collagen increased (P < 0.05), whereas serum osteocalcin (but not bone-specific alkaline phosphatase) decreased (P < 0.05) from baseline to endpoint. Increased fish or fish-oil consumption had no effect (P > 0.1) on the changes in bone markers induced by weight loss. In contrast, increased salmon consumption increased serum 25-hydroxyvitamin D (P < 0.01).

CONCLUSIONS

A nutritionally adequate but energy-restricted diet, with different contents of n-3 fatty acids, which resulted in modest weight loss, unfavorably altered bone turnover markers in young overweight adults. Such changes were not prevented by increased fish or fish-oil consumption.

Dietary sugars intake and micronutrient adequacy: a systematic review of the evidence

Guidelines for sugars intake range from a population mean of less than 10 % energy from free sugars, to a maximum for individuals of 25 % energy from added sugars. The aim of the present review was to examine the evidence for micronutrient dilution by sugars and evaluate its nutritional significance. From a web-based search of MEDLINE and hand search of linked papers, forty-eight relevant publications were identified on sugars (total sugars, non-milk extrinsic sugars, or added sugars) or sugar-containing drinks. These included five reports from expert committees, six reviews, thirty-three observational studies and four small-scale interventions. There was inconsistency between studies as to the relationship between sugars intake (however expressed) and micronutrients. The statistical patterns varied between nutrients and population groups. Curvilinear associations were found in some analyses, with lower nutrient intakes at both extremes of sugar intake; however, factors such as dieting and under-reporting may confound the associations observed. Some studies found statistically significant inverse associations but these were weak, with sugars explaining less than 5 % of the variance. Mean intakes of most micronutrients were above the RDA or reference nutrient intake except among very high consumers of sugars. The available evidence does not allow for firm conclusions on an optimal level of added sugars intake for micronutrient adequacy and the trends that exist may have little biological significance except for a few nutrients (for example, Fe). It is established that energy intake is the prime predictor of micronutrient adequacy. A better understanding of valid approaches to energy adjustment, misreporting and the assessment of micronutrient adequacy is crucial to further progress in this area.

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

The objective of this work was to quantify the impact of the voluntary fortification of foods on dietary intakes of vitamins and minerals of Irish adults. Foods that were voluntarily fortified were identified and pre- and post-fortification levels of micronutrients were determined from data supplied by manufacturers and food composition tables. Using food consumption data in 1379 adults aged 18–64 years, estimated using a 7-d food diary during the North/South Ireland Food Consumption Survey, intakes of micronutrients were determined, both including and excluding the fortification component in foods. Of approximately 3000 foods recorded as consumed, 1·9 % were fortified, mainly breakfast cereals and beverages. Median micronutrient content of fortified foods (FF) ranged from 18–33 % EC RDA per typical serving. Among consumers (65 % of men, 68 % of women), FF contributed, on average, 3·9 % (men) and 5·0 % (women) to mean daily intake (MDI) of energy. Relative to their contribution to MDI of energy, FF contribute a greater % MDI for Fe (men 16, women 19), folate (men 18, women 21), vitamins B1(men 14, women 16), B2(men 16, women 18), B6(men 12, women 15), D (men 5, women 11), B12(men 5, women 7) and niacin (men 10, women 12). Fortification significantly improved the adequacy of intake of some micronutrients, particularly of riboflavin, folate, vitamin D and Fe in women and did not contribute to an increased risk of adverse effects from excessive intake of any micronutrient.

Dietary exposure to copper in the European Union and its assessment for EU regulatory risk assessment

EU legislation requires a multimedia exposure assessment for substances supplied within the EU. Dietary intake is the main source of exposure for the majority of the population hence an essential component of the human risk assessment. This paper describes the available data for dietary copper and its use in estimating daily intake including variability and determinants of exposure. Typical and reasonable worst-case estimates are derived for the general population from the available peer reviewed literature. Intakes from drinking water are found to exhibit more variability than those from food. Therefore, different exposure scenarios are derived to reflect the range of acute and chronic exposures that may occur. Estimates of typical copper intakes for the EU population are in the range 0.8-1.8 mg/day. Typical copper intakes of men are higher than those of women while the intake among the general adult population is higher than that of the elderly. Intakes of both men and women are generally close to the WHO normative requirements but may be somewhat lower in specific locations where background levels of copper are unusually low. Alcoholic beverages represent minor contribution daily copper intakes. Intakes for children are rather variable ranging broadly from 0.7 to 1.5 mg/day and are somewhat age and sex dependent. Greater uncertainty applies to the assessment of local exposure incorporating food produced on land directly impacted by contemporary copper industry emissions. Specifically, the extent to which soil is enriched in copper in these conditions is unclear. However, effective homeostatic control mechanisms in plants limit uptake and transfer to the human food chain. A best estimate of 0.25 mg/day in addition to regional exposure was derived. Drinking water is estimated to contribute only marginally to total copper intake in most cases. Higher intakes may occur in areas of poor water quality and/or corroded distribution systems. Such elevated exposures appear unusual but their frequency is unknown.

Consumption of red meat, white meat and processed meat in Irish adults in relation to dietary quality

The aim of the present study was to examine the association of red meat, white meat and processed meat consumption in Irish adults with dietary quality. A cross-sectional study of subjects, randomly selected using the electoral register, estimated habitual food intakes using a 7 d food diary in a nationally representative sample of 662 men and 717 women (not pregnant or lactating) aged 18–64 years. Consumers were classified into thirds, based on the distribution of mean daily intakes for red meat, white meat and processed meat. The mean intakes of red meat, white meat and processed meat were 51, 33 and 26 g/d respectively, and men consumed significantly more (P<0·001) than women for all meat types. In men, red meat consumption was associated with lower (P<0·001) prevalence of inadequacy for Zn, riboflavin and vitamin C intakes. Increasing processed meat intake was associated with a lower (P<0·01) level of compliance with dietary recommendations for fat, carbohydrate and fibre in men. Increasing processed meat consumption was associated with lower (P<0·01) wholemeal bread, vegetables, fruit and fish intakes in men and women. Managerial occupations were associated with lower processed meat intakes. It is important to distinguish between meat groups, as there was a large variation between the dietary quality in consumers of red meat, white meat and processed meat. Processed meat consumption is negatively associated with dietary quality and might therefore be a dietary indicator of poor dietary quality. This has important implications in nutritional epidemiological studies and for the development of food-based dietary guidelines.

The role of dietary calcium in bone health

Approximately 99% of body Ca is found in bone, where it serves a key structural role as a component of hydroxyapatite. Dietary requirements for Ca are determined by the needs for bone development and maintenance, which vary throughout the life stage, with greater needs during the periods of rapid growth in childhood and adolescence, during pregnancy and lactation, and in later life. There is considerable disagreement between expert groups on the daily Ca intake levels that should be recommended, reflecting the uncertainty in the data for establishing Ca requirements. Inadequate dietary Ca in early life impairs bone development, and Ca supplementation of the usual diet for periods of ≤3 years has been shown to enhance bone mineral status in children and adolescents. However, it is unclear whether this benefit is long term, leading to the optimisation of peak bone mass in early adulthood. In later years inadequate dietary Ca accelerates bone loss and may contribute to osteoporosis. Ca supplementation of the usual diet in post-menopausal women and older men has been shown to reduce the rate of loss of bone mineral density at a number of sites over periods of 1–2 years. However, the extent to which this outcome reduces fracture risk needs to be determined. Even allowing for disagreements on recommended intakes, evidence indicates that dietary Ca intake is inadequate for maintenance of bone health in a substantial proportion of some population groups, particularly adolescent girls and older women.

The influence of cereal and dairy consumption on the Irish diet: implications for developing food-based dietary guidelines

Objectives

To estimate the intakes of cereal and dairy products and their contribution to nutrient intakes in men and women from the Republic of Ireland with a view to formulating food-based dietary guidelines.

Design

The North/South Ireland Food Consumption Survey established a database of habitual food and drink consumption using a 7-day food diary. From this database all cereal and dairy products from recipes and identifiable sources were identified and a new database was generated from which analysis of the role of cereal and dairy products in the diet was carried out.

Results

Almost 100% of the population consumed cereal and dairy products over the course of the survey week. In general, men consumed significantly more cereal and dairy products than did women (P<0.05). Cereal products made an important contribution to the mean daily intakes of energy (26%), protein (21%), fat (13%), carbohydrate (41%), fibre (45%), iron (43%) and folate (27%). Dairy products also contributed largely to the mean daily intakes of energy (11%), protein (14%), fat (17%), calcium (48%), phosphorus (24%) and vitamin A (27%). Analysis of nutrient intakes across tertiles of cereal and dairy consumption showed that high consumers of wholemeal bread, breakfast cereals, reduced-fat milk and yoghurt had lower fat and higher carbohydrate, fibre and micronutrient intakes than low consumers of these foods.

Conclusions

Findings from the present study could be used to develop effective health strategies to implement changes in cereal and dairy consumption that could alter fat, fibre and micronutrient intakes in the diet.

Impact of disaggregation of composite foods on estimates of intakes of meat and meat products in Irish adults

Objective

To evaluate the impact of the disaggregation of composite foods on intake estimates of meat and individual meat categories and on the contribution of meat to nutrient intakes in Irish adults.

Design

Data were analysed from the North/South Ireland Food Consumption Survey, which used a 7-day food diary to estimate food intake. Of 742 food codes that contained meat, 320 were codes for meat consumed as an individual portion and 422 were composite foods and were disaggregated to estimate the meat content.

Subjects

A nationally representative sample of 475 men and 483 women (not pregnant or lactating) from the Republic of Ireland aged 18–64 years.

Results

The mean intake of meat was 134 g day−1in consumers (98.5%) and men (168 g day−1) consumed significantly more (P< 0.001) than women (102 g day−1). Mean intakes of meat were higher in subjects with manual skilled occupations (P< 0.01) and lower in those with third-level educational qualifications (P< 0.05). Without disaggregating meat from composite foods, meat intake was overestimated by 43% (57 g day−1) and varied widely by meat category. Meat disaggregated from composite foods contributed 25% of meat intake. The contribution meat made to nutrient intakes ranged from 29% for protein, vitamin B12, zinc and niacin to 20% for vitamin D, 16% for vitamin B6, 15% for thiamine and 14% for iron.

Conclusions

Failure to disaggregat meat from composite foods substantially overestimates meat intake, with a large variation between meat categories. This has important implications for estimates of meat intakes in nutritional epidemiological studies and for food safety purposes.

Whole Blood Analysis of Phagocytosis, Apoptosis, Cytokine Production, and Leukocyte Subsets in Healthy Older Men and Women: The ZENITH Study

Few studies to date have examined age-related changes in markers of immune status in healthy older individuals. The immune status of 93 healthy individuals aged 55-70 years was assessed by two- and three-color flow cytometry and biochemical analysis. There were significant age effects (p <or=.05) on monocyte phagocytic activity and cluster of differentiation (CD) 3/human leukocyte antigen-D-related (HLA-DR) late-activated T lymphocytes (% expression). There was a significant (p <or= 0.1) Age x Sex interaction in absolute counts (x 10(9)/L) of CD3/CD8 total cytotoxic T lymphocytes (CTL), the CD4 T- helper to CD8 CTL ratio, the CD3/CD4/CD45RA naïve T helper to CD3/CD4/CD45RO memory T helper lymphocyte ratio, and interleukin (IL)-1beta (% expression) by activated monocytes. The study shows that alterations in markers of immune status occur between 55 and 70 years, and provides reference values for the lymphocyte measures in healthy men and postmenopausal women in this age group. The study further highlights the need for sex-specific reference ranges for such markers.

Factors influencing the intake and plasma levels of calcium, phosphorus and magnesium in southern Spain

OBJECTIVE

The aim of the study was to assess factors influencing the intake and plasma levels of calcium (Ca), phosphorus (P) and magnesium (Mg) in an adult population from southern Spain, in order to identify patterns of intake and groups at risk for deficiency.

METHODS

A cross-sectional survey was carried out in Andalusia, a western Mediterranean region in southern Spain. Nutrient intakes were studied in a random sample of 3,421 subjects (1,747 men, 1,674 women) between 25 and 60 years of age. Blood samples were obtained for biochemical assays in a random subsample of 354 subjects (170 men, 184 women). Food consumption was assessed by a 48-h recall. Concentrations of Ca, P and Mg were measured in plasma. Information about level of education, smoking habit, alcohol consumption and physical exercise was collected with a structured questionnaire.

RESULTS

Intakes were below two-thirds of the RDA in 39.52% of the sample for Ca, and in 32.31% for Mg. Gender, age, educational level, obesity, smoking, alcohol use and physical activity were associated with differences in nutrient intakes. Plasma concentrations were below the reference value in 14.81% of the sample for Ca, and in 8.82% for Mg. Obese persons [body mass index (BMI) >/= 30 kg/m(2)] consumed less Ca, P and Mg, and had lower plasma Ca concentrations (P < 0.05) than non-obese persons. BMI showed an inverse correlation with plasma concentrations of Ca (r = -0.21, P < 0.05).

CONCLUSION

Our results provide an estimate of the intake of Ca, P and Mg in the adult population of southern Spain. Of the factors that affected the intake of these nutrients, logistic regression analysis showed that only female gender and older age were associated with the risk of low plasma Ca concentrations.

Public health aspects of food fortification: a question of balance

Micronutrient malnutrition is widespread throughout the world, with important health and economic consequences. Tools to address this situation include food fortification, supplementation and dietary diversification, each having different and complementary roles. Fortification (mandatory and voluntary) has been practised over several decades in Western countries as well as in developing countries. Iodised salt was introduced in the USA in 1924 to reduce severe I deficiency. In 1938 voluntary enrichment of flours and breads with niacin and Fe was initiated to reduce the incidence of pellagra and Fe-deficiency anaemia respectively. Micronutrient intakes in European countries appear to be generally adequate for most nutrients. However, a number of population subgroups are at higher risk of suboptimal intakes (below the lower reference nutrient intake) for some micronutrients, e.g. folate, Fe, Zn and Ca in children, adolescents and young women. Dietary surveys indicate that fortified foods play a role in mitigating such risks for several important nutrients. The number of foods suited to fortification are considerably limited by several factors, including technological properties (notably moisture, pH and O2 permeability), leading to unacceptable taste and appearance, as well as cost and consumer expectations. In countries in which voluntary fortification is widely practised micronutrient intakes are considerably below tolerable upper intake levels. Concerns about safety are addressed in relation to the potentially increased level or proportion of fortified foods (e.g. following potential EU legislation), for nutrients with relatively low tolerable upper intake levels and where the potential benefit and risks are in different subpopulations (e.g. folic acid). Recent models for assessing these issues are discussed.

Analysis of the temporal intake of cereal and dairy products in Irish adults: implications for developing food-based dietary guidelines

OBJECTIVES

To analyse the temporal distribution of the intake of cereal and dairy products in the Republic of Ireland.

DESIGN

The North/South Ireland Food Consumption Survey established a database of habitual food and drink consumption using a 7-day food diary. The database also recorded the time and day of food consumption. Mean intakes of cereal and dairy products were calculated for time of the day and day of the week.

RESULTS

At the weekend, the percentage of consumers decreased for nearly all cereal and dairy products. White bread, total cereals, full-fat milk and total dairy intakes were significantly lower at the weekend (P<0.01) compared with weekdays. Intakes of cereal and dairy products over time of the day showed clear mealtime or snacking patterns when the number of consumers was controlled for. White bread, wholemeal bread, total cereals, full-fat milk, reduced-fat milk and total dairy intakes showed mealtime peaks for morning, afternoon and evening. When examined by tertile of intake, tertile of percentage energy from fat and tertile of fibre intake, intakes of cereal and dairy products over time of the day and day of the week were similar to trends described above, regardless of the tertile.

CONCLUSIONS

Temporal analysis of the intakes of cereal and dairy products did not reveal any unusual trends in this population. However, the significant methodological issues raised in this paper will be of benefit to other aspects of research in this area.

Risk-benefit analysis of micronutrients

Traditionally, different approaches have been used to determine the recommended dietary allowances for micronutrients, above which there is a low risk of deficiency, and safe upper levels, below which there is a negligible risk of toxicity. The advice given to risk managers has been in the form of point estimates, such as the recommended dietary allowance (RDA) and the tolerable upper level (UL). In future, the gap between the two intake-response curves may become narrower, as more sensitive indicators of deficiency and toxicity are used, and as health benefits above the recommended daily allowance are taken into account. This paper reviews the traditional approaches and proposes a novel approach to compare beneficial and adverse effects across intake levels. This model can provide advice for risk managers in a form that will allow the risk of deficiency or the risk of not experiencing the benefit to be weighed against the risk of toxicity. The model extends the approach used to estimate recommended dietary allowances to make it applicable to both beneficial and adverse effects and to extend the intake-incidence data to provide a range of estimates that can be considered by the risk manager. The data-requirements of the model are the incidence of a response at one or more levels of intake, and a suitable coefficient of variation to represent the person-to-person variations within the human population. A coefficient of variation of 10% or 15% has been used for established recommended dietary allowances and a value of 15% is proposed as default for considerations of benefit. A coefficient of variation of 45% is proposed as default for considerations of toxicity, based on analyses of human variability in the fate and effects of therapeutic drugs. Using this approach risk managers, working closely with risk assessors, will be able to define ranges of intake based on a balance between the risks of deficiency (or lack of benefit) and toxicity.

A western-style diet reduces bone mass and biomechanical bone strength to a greater extent in male compared with female rats during development

Evidence from epidemiological and animal-feeding trials suggests that a western-style diet that is high in fat, and low in Ca, vitamin D and folic acid may result in low bone mass and poor bone quality: this leads to an increased risk of fragility fracture. The overall objective of the present study was to determine the effect of feeding a western-style diet (low in Ca (0.4 g/kg diet, Ca:P ratio 1:10), cholecalciferol (3 microg/kg diet), folic acid (0.23 mg/kg diet) and fibre (20 g/kg diet), and high in fat (200 g/kg diet)) for 17 weeks on bone mineral content (BMC) and the biomechanical bone strength of rat femurs. A secondary objective was to determine whether femurs from male and female rats (seven to eight rats per group) respond differently to the western-style diet. Male and female rats weighing 150-180 g were fed a western-style diet or a control diet for 17 weeks. At the end of the feeding trial, femur BMC was measured by ashing, and biomechanical properties were determined by three-point bending. Femur BMC and the majority of biomechanical properties measured were lower (P<0.05) among male and female rats fed a western-style diet compared with a control diet, despite similar weight gain and final body weight within genders. However, the western-style diet had a greater negative effect on femur BMC and biomechanical strength properties among male rats compared with females. This may be because male rats experienced greater overall body growth, as assessed by weight gain, than female rats, and suggests that the nutrient composition of the western-style diet did not support the development of strong femurs.

Impact of ready-to-eat breakfast cereal (RTEBC) consumption on adequacy of micronutrient intakes and compliance with dietary recommendations in Irish adults

OBJECTIVE

To describe the consumption of ready-to-eat-breakfast cereals (RTEBCs) in Irish adults and its impact on adequacy and safety of micronutrient intakes and compliance with dietary recommendations.

DESIGN

Analysis for this paper used data from the North/South Ireland Food Consumption Survey that estimated habitual food intake using a 7-day food diary in a representative sample of adults aged 18-64 years ( 662 men, 717 women).

RESULTS

Despite the small quantity consumed (mean 28.6 g day-1 or 4.7% of total energy intake), RTEBCs made an important contribution to the mean daily intake of carbohydrate (8.1%), starch (10.8%), dietary fibre (9.8%) and non-starch polysaccharides (NSP) (10.8%) in consumers. Increased consumption was associated with a more fibre-dense diet and with greater compliance with dietary recommendations for fat, carbohydrate and NSP. Fortified RTEBCs contributed significantly to mean daily intakes of iron (18%), thiamin (14%), riboflavin (17%), niacin (15%), vitamin B6 (13%), total folate (18%) and vitamin D (10%) and most of the contribution was from micronutrients added to RTEBCs. Increased consumption of fortified RTEBCs was associated with an increased nutrient density for a number of micronutrients and with a lower prevalence of dietary inadequacy of calcium, iron, riboflavin and folate, particularly in women. However, it was not associated with intakes in excess of the Tolerable Upper Intake Level for any micronutrient.

CONCLUSIONS

The consumption of RTEBCs is associated with improved compliance with dietary recommendations for fat, carbohydrate and fibre, with a more micronutrient-dense diet and a reduced risk of dietary inadequacy for calcium, iron, riboflavin and folate, without increasing the risk of excessive intakes of micronutrients.

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

OBJECTIVE

To measure the intake of selenium (Se) and the contribution of different food groups to Se intake in adults aged 18-64 y in Ireland. The adequacy of Se intake in the population is also assessed.

DESIGN

Food consumption was estimated using a 7 day food diary for a representative sample (n=1379; men=662, women=717) of 18-64-y-old Irish adults selected randomly from the electoral register. Se intake was estimated using updated tables of food composition.

RESULTS

Mean daily Se intakes (+/-s.d.) from all sources (ie food plus supplements), and from food sources alone, for the group of Irish adults aged 18-64 y were 52 (+/-23) and 50 (+/-21) microg, respectively. Mean daily Se intake (from all sources) was significantly higher in men of all ages than women of all ages at levels of 60 and 44 microg, respectively (P<0.001). Meat/meat products (30%), bread and rolls (24%), fish/fish products (approximately 11%), and milk and yoghurt (9%) were the main contributors to mean daily Se intake. Adequacy of Se intake in population groups was estimated as the percentage of the population with mean daily Se intakes that were lower than the average requirement of 40 microg. Using this measure, 45.6% of women and 17.1% of men had inadequate Se intakes.

CONCLUSION

A significant prevalence of inadequate Se intakes was observed in Irish adults. Therefore, it would seem prudent that the Se status of the Irish population be investigated at this time.

Selenium status of Irish adults: evidence of insufficiency

BACKGROUND

Sub-optimal selenium status may have a role in the aetiology of various pathologies. Selenium status depends on adequate selenium in the diet. A relatively high proportion of Irish adults (17% men; 46% women) have an inadequate dietary intake.

AIM

A study was designed to examine the selenium status of healthy Irish adults.

METHODS

Ninety-one healthy Irish adults, aged 18-67 years, were recruited from the Cork City area. A fasting blood sample was collected from each subject and each was assayed for serum selenium an index of serum selenium.

RESULTS

Mean (+/- SD) serum selenium concentration in healthy Irish adults was 76 (+/- 21)microg/l. There was no significant difference in values between males and females or between postmenopausal and premenopausal women or between the three main age categories.

CONCLUSION

Current serum selenium values of Irish adults would not appear to be sufficient to achieve optimal activity of glutathione peroxidase, which occurs at serum selenium concentration around 95microg/l. Sub-optimal selenium status may increase susceptibility to various chronic disorders.