Nutritional quality of the school-day diet in Irish children (5-12 years)

BACKGROUND

The European Commission has identified schools as a priority setting for health promotion, including nutrition education and intervention. The present study examined the school-day diet of Irish primary-school children with the aim of identifying opportunities for dietary improvement.

METHODS

Data from The National Children's Food Survey (2003-2004) were used to establish a dataset of school-days. Dietary intake data were collected from 594 children (5-12 years) using a 7-day weighed food-record. The nutritional quality of the diet was examined for the total school-day and for food eaten 'before school', 'at school' and 'after school'.

RESULTS

Examination of dietary intake on school-days has highlighted nutritional imbalances for intakes of fat, saturated fat, added sugars, sodium and dietary fibre (DF). Mean energy (E) intake for the overall school-day was 7.1 MJ, with 16% of energy provided from food eaten 'before school', 33%E from food eaten 'at school' and 53% of energy from food eaten 'after school'. Relative to the overall school-day, food eaten 'before school' was lower in saturated fat and sodium, and higher in DF and many micronutrients. Food eaten 'at school' was relatively high in added sugars and sodium; lower in DF and micronutrients; and similar in saturated fat compared to the overall school-day. Food eaten 'after school' was relatively high in DF and vitamin A; similar in saturated fat, magnesium and sodium; and lower in added sugars and other micronutrients compared to the overall school-day.

CONCLUSIONS

To improve the overall nutritional quality of the school-day diet, food eaten at school should be targeted.

An examination of the influence of eating location on the diets of Irish children

OBJECTIVES

To examine the influence of eating location on the quality of the diets of Irish children and to compare intakes at home with intakes at other people's homes and intakes outside the home, and to compare intakes at various locations outside the home.

DESIGN

Food intake was measured using a 7-day weighed diary in 594 children from the Republic of Ireland (aged 5-12 years). Details of where the food was prepared or obtained were also recorded.

RESULTS

Eighty-nine per cent of all eating occasions occurred at home; < 6% occurred at both other people's homes and outside the home (takeaway, restaurant, shop, other). The percentage of food energy from fat was above the recommended 35% at other people's homes and outside the home, specifically at takeaways and restaurants. Fibre and micronutrient intakes (per 10 MJ) were significantly higher at home than at the other locations (P < 0.05). Within the 'out' locations, fibre and micronutrient intakes were generally higher at restaurants and lower at shops. High consumers of foods outside the home had a statistically significant, but relatively small decline in nutrient intakes compared with non- or low consumers. Chips and processed potatoes, meat products, savouries, sugars and confectionery, and savoury snacks made the greatest contribution to foods consumed outside the home.

CONCLUSIONS

The main focus of nutrition policies to improve the diets of Irish children should be the home environment rather than the food service sector. However, guidelines could call for better food choices outside the home to improve nutrient intakes.

Prevalence of overweight and obesity in Irish school children, using four different definitions

OBJECTIVE

To determine the prevalence of overweight and obesity in Irish children using four different weight-for-height methods and to examine secular trends from previous national data.

DESIGN

A cross-sectional survey. Weight and height were measured according to standard procedures and used to determine the prevalence of overweight and obesity using four weight-for-height methods of assessment, actual relative weight, the Centers for Disease Control and Prevention body mass index (BMI) for age charts for boys and girls, the BMI reference curves for the UK 1990 and the International Obesity Task Force age- and sex-specific BMI cutoffs.

SETTING

The survey was carried out between 2003 and 2004 in the Republic of Ireland.

SUBJECTS

Random representative sample of 596 children aged 5-12 years.

RESULTS

The prevalence of overweight and obesity in Irish children is high, but varies considerably with each method. The prevalence of obesity in boys ranged from 4.1 to 11.2 % and in girls from 9.3 to 16.3%. Between 1990 and 2005, depending on the method used, there was a two-to-fourfold increase in obesity in children aged 8-12 years.

CONCLUSION

It is evident given the variation displayed in the prevalence of obesity when using the different methods, that there is a discernible need for a single definition to identify the obese child in Ireland. The findings show a high prevalence of overweight and obesity in Irish school children and the increase in the prevalence of obesity over the last 15 years highlights this growing public health issue.

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.

The efficacy and safety of nutritional supplement use in a representative sample of adults in the North/South Ireland Food Consumption Survey

OBJECTIVE

To describe the current use of nutritional supplements and their contribution to micronutrient intakes in a representative sample of Irish adults, to evaluate the impact of supplement use on the adequacy of micronutrient intakes and to assess the risk to supplement users of exceeding tolerable upper intake levels (UL).

STUDY DESIGN AND SUBJECTS

Food intake data were collected in 1379 (662 male and 717 female) randomly selected Irish adults aged 18 to 64 years using a 7-day food diary. The current use of nutritional supplements was assessed using a self-administered questionnaire and respondents entered each supplement as it was consumed into the food diary.

RESULTS

Twenty-three per cent of respondents regularly used nutritional supplements. Twice as many women used supplements as men. The intakes of micronutrients were significantly higher (P<0.001) in supplement users than in non-users. Micronutrient intakes from food sources were similar in male users and non-users of supplements, but were significantly higher (P<0.01) in female users, by 3 to 13%, for Fe, Mg, Mn, vitamins C and E and niacin than in non-users. The percentage of female users between 18 and 50 years who had mean Fe intakes below the average requirement (AR) (10 mg) decreased from 50 to 25 when the contribution from supplements was included. The use of supplements reduced the percentage of men who had mean intakes below the AR for Zn from 19 to 13, for riboflavin from 14 to 6 and for vitamin A from 20 to 5, and reduced the percentage of women with intakes below the AR for Ca from 23 to 16 and for riboflavin from 23 to 14. Twenty-one women out of 80 aged between 18 and 50 years, who consumed supplemental folate, achieved the intake of 600 microg recommended to prevent neural tube defects. Twenty-two per cent of the women who took iron and 15% of the women who took vitamin B6 in supplemental form had mean daily intakes that exceeded that UL for these nutrients. Supplement users did not exceed the UL for the other micronutrients.

CONCLUSIONS

Supplementation appears to be beneficial in promoting adequate intakes of some micronutrients, particularly Fe and folate in women aged 18-50 years and vitamin A in men. There appears to be little risk to supplement users of experiencing adverse side effects due to excessive intakes of micronutrients.

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

OBJECTIVE

To measure mineral intakes and the contribution of different food groups to mineral intakes in adults aged 18-64 years in Ireland. Intakes are reported for Ca, Mg, P, Fe, Cu and Zn. The adequacy of mineral intakes in the population and the risk of occurrence of excessive intakes are also assessed.

DESIGN

Food consumption was estimated using a 7-day food diary for a representative sample (n=1379; 662 men, 717 women) of 18-64-year-old adults in the Republic of Ireland and Northern Ireland selected randomly from the electoral register. Mineral intakes (Ca, Mg, P, Fe, Cu and Zn) were estimated using tables of food composition.

RESULTS

Mean nutrient density of intakes was higher for women than men for Ca and Fe and increased with age for all minerals, except Ca for men and Fe for women. Meat and meat products were the major contributor to mean daily intakes of Zn (38%), P (23%), Fe (18%), Cu (15%) and Mg (13%); dairy products (milk, yoghurt and cheese) to Ca (44%), P (22%), Zn (14%) and Mg (11%); bread and rolls to Fe (21%), Cu (18%), Ca and Mg (17%), Zn (13%) and P (12%); potatoes and potato products to Cu (16%), Mg (14%) and Fe (10%); and breakfast cereals to Fe (13%). In women of all ages nutritional supplements contributed 7.6%, 4.4%, 3.6% and 2.2% of mean daily intake of Fe, Zn, Cu and Ca, respectively, while in men of all ages, nutritional supplements contributed 2.7%, 2.3%, 1.7% and 0.6%, respectively, to mean daily intakes of Fe, Zn, Cu and Ca. Adequacy of minerals intakes in population groups was assessed using the average requirement (AR) as a cut-off value. A significant prevalence of intakes below the AR was observed for Ca, Fe, Cu and Zn but not P. A higher proportion of women than men had intakes below the AR for all minerals. Almost 50% of 18-50-year-old females had intakes below the AR for Fe, while 23%, 23% and 15% of women of all ages had intakes below the AR for Ca, Cu and Zn, respectively. For men of all ages, 11%, 8% and 13% had intakes below the AR for Ca, Cu and Zn, respectively. There appears to be little risk of excessive intake of Ca, Mg, P, Cu or Zn in any age/sex category. However, 2.9% of women of all ages had intakes above the tolerable upper intake level for Fe (45 mg) due to supplement use.

CONCLUSION

Almost 50% of women aged 18-50 years had Fe intakes below the AR and relatively high proportions of women of all ages had intakes below the AR for Ca, Cu and Zn. With the possible exception of iron intake from supplements in women, there appears to be little risk of excessive intake of minerals in the adult population. Meat and meat products, dairy products (milk, cheese and yoghurt), bread and rolls, potatoes and potato products and breakfast cereals are important sources of minerals; nutritional supplements make only a small contribution to mineral intakes in the population as a whole but may contribute significantly to intakes among supplement users.

Effects of acid-base correction on hemodynamics, oxygen dynamics, and resuscitability in severe canine hemorrhagic shock

OBJECTIVE

To compare the effects of hypertonic saline, sodium bicarbonate, and Carbicarb resuscitation on acid-base balance, hemodynamics, and oxygen dynamics in a reperfused, canine hemorrhagic shock model.

DESIGN

Prospective, randomized trial.

SETTING

Laboratory at a university medical center.

SUBJECTS

Thirty-five anesthetized, mongrel dogs.

INTERVENTIONS

After the administration of anesthesia, the dogs were intubated and mechanically ventilated. Vascular catheters were inserted into each femoral artery, for continuous blood pressure monitoring, intermittent blood sampling, and for establishing controlled hemorrhage. A pulmonary artery catheter was inserted via the right jugular vein. Inhaled and exhaled gases were continuously analyzed using a metabolic gas monitor. The animals were subjected to 90 mins of controlled hemorrhagic shock. They were then randomly given a 2.5-mL/kg equimolar injection of 8.4% sodium bicarbonate, Carbicarb, or 5.84% hypertonic saline. The sodium load per kilogram of body weight was identical in all three groups. Thirty minutes later, the animals were retransfused with the shed blood over 15 mins and further observed for 120 mins.

MEASUREMENTS AND MAIN RESULTS

Carbicarb and sodium bicarbonate both significantly increased bicarbonate concentrations compared with saline. Arterial and venous blood pH increased more with Carbicarb than with bicarbonate but this increase was not statistically significant. After shock but before retransfusion, all three treatments moderately increased blood pressure, cardiac index, oxygen delivery index, and oxygen consumption index to a similar extent. After retransfusion, blood pressure, cardiac index, and oxygen dynamics temporarily improved in all groups, without significant improvement in the bicarbonate and Carbicarb-treated animals, despite their excellent acid-base status.

CONCLUSIONS

In severe canine hemorrhagic shock, Carbicarb, bicarbonate, and hypertonic saline appear to possess similar hemodynamic properties despite the buffering properties of bicarbonate and Carbicarb. The similar responses may be due to their identical sodium content. Arterial pH correction does not appear to further improve the responses to blood retransfusion.