National Adult Nutrition Survey - Doctoral Theses
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- ItemThe role of plant-based foods and dietary fibre in school-aged children (5-12y) in Ireland(University College Cork, 2020-05-01) McCarthy, Róisín; Flynn, Albert; Cashman, Kevin; Kehoe, Laura; Walton, Janette; Food Institutional Research MeasureThe consumption of plant-based foods has been associated with a variety of health benefits and a more sustainable environment. Plant-based foods including wholegrains cereals, vegetables and fruit provide important nutrients in the diet and are particularly promoted in food based dietary guidelines (FBDG) for their high dietary fibre (DF) content. The aim of this thesis was to examine the role of ‘cereals, grains & potatoes’ and ‘fruit & vegetables’, and DF in the diets of school-aged children (5-12y) in Ireland. A further aim was to investigate any changes in the intakes of these food groups and DF in school-aged children between 2003-04 and 2017-18. The analyses for this thesis were based on data from the National Children’s Food Survey II (NCFS II) which was 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. Findings from the NCFS II were compared to the previous NCFS (2003-04). For each survey, dietary data were collected (at brand level) using weighed food diaries and nutrient intakes were estimated using UK and Irish food composition data. Mean daily intakes (MDI) of ‘cereals, grains & potatoes’ and ‘fruit & vegetables’ were estimated using SPSS© and their contribution to energy and nutrient intakes were estimated using the mean proportion method. Usual DF intakes were estimated using the validated National Cancer Institute (NCI)-Method. Dietary determinants of DF intake were investigated using tertile analysis to determine the food-groups and patterns of consumption which contributed to higher intakes of DF. The MDI of ‘cereals, grains & potatoes’ was 271g/d (approx. 3.7 servings/day) of which 1.7 servings was wholemeal/brown or from unprocessed potatoes. This is below the recommendation of 3-5 servings of wholemeal cereals & breads, potatoes, pasta and rice daily. The MDI of ‘fruit & vegetables’ was 221g/d (approx. 2.8 servings/day) which is below the World Health Organisation recommendation of ≥ 400g of fruit & vegetables per day and the Irish FBDG of 5-7 servings of fruit & vegetables per day (≤ 150ml/day from unsweetened fruit juice or smoothies). Despite these low intakes, ‘cereals, grains & potatoes’ made an important contribution to intake of energy, carbohydrate, DF, B vitamins, vitamin D, iron and calcium but also contributed to intakes of saturated fat, free sugar and sodium. ‘Fruit & vegetables’ made important contributions to intakes of DF, vitamin A, vitamin C, B-vitamins, potassium and magnesium but also contributed to intakes of total and free sugars. While overall intakes of ‘cereals, grains & potatoes’ and ‘fruit & vegetables’ were similar to the previous NCFS (2003-04), intakes of wholemeal breads, high fibre ready-to-eat breakfast cereals (RTEBC), porridge, pasta, whole fruit and smoothies were higher and intakes of low fibre RTEBC, potatoes and fruit juice were lower. The intake of DF in school-aged children in Ireland was 14.4 g/d which is below the adequate intake for normal bowel function in children but higher than that reported in the previous NCFS (2003-04) (12.4g/d). Determinants of a higher DF intake were wholemeal/brown breads, high fibre RTEBC, fruit and vegetables. The consumption patterns associated with a higher DF intake were a higher proportion of children consuming these foods (except for vegetables), consuming these foods more frequently and having a higher intake per eating occasion (except for fruit). Findings from this thesis may provide evidence for public health campaigns to promote the consumption of plant-based foods to increase compliance with the food based dietary guidelines and to improve DF intakes in this population group.
- ItemVitamin K in the diet of the Irish population (1-90 years)(University College Cork, 2020-03-31) Kingston, Ciara; Flynn, Albert; Cashman, Kevin; Kehoe, Laura; Walton, Janette; Department of Agriculture, Food and the Marine, Ireland; Food Institutional Research MeasureVitamin K is required to maintain normal blood coagulation and may also function in other areas including bone health and the inhibition of vascular calcification. The aim of this thesis was to estimate the intake, adequacy and dietary sources of vitamin K1 and vitamin K2 in the Irish population (1-90y) and to examine any changes in vitamin K1 or vitamin K2 intakes and sources in school-aged children (5-12y) between 2003-04 and 2017-18. This research was based on data from five nationally representative dietary surveys carried out by the Irish Universities Nutrition Alliance (www.iuna.net). These surveys included the National Children’s Food Survey (NCFS) (5-12y) (2003-04), the National Teens’ Food Survey (13-17y) (2005-06), the National Adult Nutrition Survey (18-90y) (2008-10), the National Pre-school Nutrition Survey (1-4y) (2010-11) and the NCFS II (5-12y) (2017-18). For each survey, dietary data were collected (at brand level) using weighed/semi-weighed food diaries. Each food, beverage and dietary supplement recorded was assigned a unique food code according to its food descriptor and nutritional profile. Using these food codes, the Irish Food Composition Database (IFCD) (2012) was updated to include food composition data for vitamin K1 and vitamin K2 (menaquinone-4 (MK-4) and menaquinones-5-10 (MK-5-10)). Vitamin K1 is typically found in green vegetables and certain plant oils. MK-4 is formed in mammals from the tissue specific conversion from vitamin K1 or from menadione (a synthetic form of vitamin K added to animal feed). The longer chained menaquinones, MK-5-10, are synthesized by bacteria capable of food fermentation and are found in fermented foods and foods of animal origin. As there are no analytical data available for vitamin K content of foods in Ireland, composition data for vitamin K1, MK-4 and MK-5-10 were assigned to each food code using published analytical values from the UK Composition of Foods Integrated Dataset, the United States Department of Agriculture National Nutrient Database or published papers, recipe calculation based on individual ingredients, and from nutritional information on product labels. In addition, foods that were either not fermented or of animal origin were assigned a composition value of 0µg for each menaquinone group. For a small number of food codes, vitamin K1 values were assigned based on the fat content of a similar product.. Overall, foods highest in vitamin K1 were herbs and ‘vegetable & vegetable dishes’. Foods highest in MK-4 and MK-5-10 were ‘meat & meat products’, ‘eggs & egg dishes’ and ‘cheese’. The distribution of vitamin K1 and vitamin K2 (MK-4 and MK-5-10) intakes in the Irish population were carried out using SPSS© for Windows™ Version 22.0. The mean intakes of vitamin K1 were above the European Food Safety Authority Adequate Intake (AI) of 1µg/kg/d (required to maintain normal blood coagulation) for children aged 1-12y. However, vitamin K1 intakes were below the same AI for teenagers aged 13-17y. ‘Vegetable & vegetable dishes’ (primarily green vegetables) was the key source of vitamin K1 for both children and teenagers. Mean intakes of MK-4 and MK-5-10 ranged from 8-13µg/d and 32-45µg/d in the Irish population aged 1-90y, respectively. The key dietary sources of MK-4 and MK-5-10 were ‘meat & meat products’, ‘milks’ and ‘cheese’. There was no difference in the intake and dietary sources of vitamin K1 or vitamin K2 in Irish children (5-12y) between 2003-04 and 2017-18. The data presented in this study will add to the small pool of data available on vitamin K intakes and sources in nationally representative samples of population groups. The Irish food composition database for vitamin K will support future researchers in the assessment of vitamin K intakes at individual or population level.
- ItemNutritional status of older adults in Ireland(University College Cork, 2018) Kehoe, Laura; Flynn, Albert; Walton, Janette; Department of Agriculture, Food and the MarinePopulation ageing is rapidly progressing and it is estimated that by 2050, one in every five people globally will be aged 60 years or over. Adequate nutritional status can play a key role in preventing or delaying the progression of age related diseases. The aim of this thesis was to estimate usual macro- and micro-nutrient intakes, to determine the key sources, compliance with recommendations and to investigate the nutritional status of older Irish adults (≥65 years). This thesis also aimed to examine the impact of fortified foods and nutritional supplements on micronutrient intakes, prevalence of inadequate intakes and nutritional status of older adults. The analysis for this research was based on data from the subset of older adults aged ≥65 years (n 226) in the Irish National Adult Nutrition Survey (NANS) (2008-2010). Food and beverage intakes were estimated using a 4-day semi-weighed food record. Sixty-four per cent of older adults provided a blood sample (of which 79% were fasting) and 67% of older adults provided a morning first void urine sample for the analysis of nutritional biomarkers. Nutrient intakes were estimated using WISP® which estimates nutrient intake using data from ‘McCance and Widdowson’s The Composition of Foods’, Sixth Edition (plus all nine supplemental volumes). Usual intakes of macro- and micro- nutrients were calculated using the NCI-method implemented in SAS® macros. The prevalence of inadequate micronutrient intakes (% upper levels (UL)) was also calculated. The distribution of nutrient status was examined using SPSS® and the prevalence of deficiency was examined using published cut-off ranges. In summary, this study has highlighted unfavourable intakes of total and saturated fat, sugar, salt and dietary fibre together with low intakes and/or suboptimal status of key micronutrients such as vitamin D, riboflavin, vitamin B12, folate, calcium and magnesium in older Irish adults. Furthermore, the consumption of fortified foods and use of nutritional supplements make significant contributions to intakes and status of these micronutrients. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt), food fortification or supplementation to support successful ageing of our population. The data presented in this study will serve to inform policy makers in the development and implementation of updated dietary recommendations for older adults in Ireland. Furthermore, information about the relative contributions of specific foods to micronutrient intakes will be useful to both policy makers and the food industry to develop targeted dietary strategies to improve the diets of older Irish adults.