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Micronutrient intakes and the role of nutritional supplements in the diet of school-aged children (5-12y) in Ireland
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Date
2020-11-30
Authors
O'Regan, Stephanie
Journal Title
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Publisher
University College Cork
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Abstract
During childhood, adequate micronutrients intakes are important for growth, acquisition of bone and cognitive development. The aim of this thesis was to examine micronutrient intakes and the role of nutritional supplements in the diets of school-aged children in Ireland. The analyses for this thesis were based on data from the National Children’s Food Survey II (NCFS II), a nationally representative cross-sectional study that collected food and beverage consumption data from 600 children aged 5-12 years in the Republic of Ireland between 2017 and 2018. Dietary intake data were collected (at brand level) using a 4-day weighed food diary and nutrient intakes were estimated using UK and Irish food composition data. Usual micronutrient intakes were estimated using the validated National Cancer Institute (NCI)-Method using SAS Enterprise Guide© version 6.1 and statistical analysis was conducted using SPSS©. The prevalence of inadequate intakes was estimated using estimated average requirements as cut-off points (excluding under-reporters (19.5%)) and the risk of excessive intake of micronutrients was evaluated using tolerable upper intake levels (ULs). The key sources of vitamin D and dietary folate equivalents (DFE) were calculated using the mean proportion method. Dietary determinants of vitamin D and DFE intake were investigated using tertile analysis to determine the food-groups and patterns of consumption which contributed to higher intakes. The NCFS II Dietary Supplement Database (2017-18) was manually constructed in Excel using product labels of the dietary supplements. Nutritional supplement ‘users’ were defined as children who consumed a micronutrient containing supplement at any time over the 4-day recording period. The key findings of this study were that a significant proportion of children had inadequate intakes of vitamin D (94%), calcium (37%), zinc (29%), iron (20%), vitamin C (19%), magnesium (18%) and folate (13%). The key sources of vitamin D were ‘ready-to-eat breakfast cereals’ (RTEBCs) (22%), ‘meat & meat products’ (20%), ‘vitamin D fortified milks & yogurts’ (12%) and nutritional supplements (10%). Nutritional supplements, ‘RTEBCs’ and ‘fortified milks’ were identified as the key dietary determinants of vitamin D intakes. For DFE, the key sources were ‘RTEBCs’ (28%), ‘bread & rolls’ (12%) and ‘milks’ (10%). ‘RTEBCs’, ‘folic acid fortified milks’ and nutritional supplements were identified as the key dietary determinants of DFE intakes. The NCFS II Dietary Supplement Database (2017-18) includes detailed information on the types, potencies, combinations and forms of the 102 dietary supplements used by this population over the 4 recording days. Multivitamin and/or minerals supplements were the most frequent type of supplement recorded followed by single vitamin D and C supplements. Of note, 15% of the nutritional supplements included in the database were recommended for adults and 13% did not specify the population group they were intended for. However, for most nutrients, the P75 of micronutrient content was at or below the NRV. Overall, if supplements are consumed as per label instructions, this is no cause for concern. Twenty-two percent of children in the NCFS II used a nutritional supplement. Nutritional supplements were shown to increase intakes of all vitamins examined in addition to iron and zinc and were not shown to increase the risk of excessive micronutrient intakes in this population group. Findings from this thesis will be useful for research related to nutrition, public health and food safety, and to support the work of agencies responsible for food and nutrition policy in Ireland and the EU. These data will also inform the industry with regard to current practices of nutritional supplement use in the diets of children in Ireland.
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Keywords
Children , Micronutrients , Nutritional supplements
Citation
O'Regan, S. E. 2020. Micronutrient intakes and the role of nutritional supplements in the diet of school-aged children (5-12y) in Ireland. PhD Thesis, University College Cork.