Nutrient intakes, compliance with recommendations and key sources in women of child-bearing age (18-50y) in Ireland

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Date
2022-02-09
Authors
O'Mahony, Abigail
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University College Cork
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Abstract
Background: Women’s pre-conceptional health (including nutritional status) is important for both the health of the individual themselves and also for the lifelong health of any occurring offspring. However, it has been estimated that up to 50% of pregnancies are unplanned, thus optimal nutritional status is important for all women of child-bearing age (WCBA) not just those with pregnancy intentions. Despite the accumulation of evidence of the importance of nutritional status at this life-stage, nutrient recommendations for WCBA for the most part don’t differ from recommendations for other population groups. The notable exception to this is that all WCBA are recommended to take a folic acid supplement to reduce the risk of neural tube defects (NTDs) in an occurring pregnancy. Objectives: The overall aim of this thesis was to estimate the nutrient intakes among WCBA in Ireland. The first aim was to estimate the mean daily intake of energy, macronutrients, dietary fibre and salt, to determine compliance with dietary guidelines and to identify the key dietary sources of these nutrients in WCBA. A further aim was to estimate the mean daily intake of micronutrients, the prevalence of inadequate intakes and risk of excessive intakes and to identify the key dietary sources of micronutrient intakes in this population group. Methods: The analysis for this research was based on data from the subset of WCBA (18-50 years) (n 487) in the Irish National Adult Nutrition Survey (NANS) (2008-2010). Food and beverage intakes were estimated using a 4-day semi-weighed food record. Nutrient intakes were estimated using WISP® which uses data from ‘McCance and Widdowson’s the Composition of Foods’, Sixth Edition (plus all nine supplemental volumes). During the NANS, modifications were made to the food composition database to include recipes of composite dishes, fortified foods, nutritional supplements, generic Irish foods that were commonly consumed and new foods on the market. The mean daily intake (MDI) of energy and nutrients were estimated by summing the total amount of energy and each nutrient consumed and dividing the total by the number of recording days (four) using SPSS® Version 26. Compliance with dietary guidelines was examined for macronutrients, dietary fibre and salt. The prevalence of inadequate micronutrient intakes (%<estimated average requirement (EAR)) was examined (excluding under-reporters for energy intake (31%)) and the risk of excessive intakes (%> upper levels (UL)) was also determined. The percent contribution of specific food groups to mean daily intakes of energy, macro- and micro-nutrients was calculated by the mean proportion method. Results: This study found that that while protein intakes are sufficient among WCBA in Ireland, a large proportion of this population have total fat intakes above recommendations (42%) and carbohydrate intakes below recommendations (59%). This population group also have high intakes of saturated fat (13% of total energy (%TE)), free sugar (9%TE) and salt (5.5g/d from food sources only) and low intakes of dietary fibre (17g/d). Important sources of energy in the diet were ‘cereal & cereal products’ (including potatoes) ‘meat, fish & eggs’ and ‘dairy & dairy products’ which when combined contributed over two-thirds of energy intake on average. However ‘top-shelf’ foods (i.e. ‘sugars, confectionery, preserves & savoury snacks’, ‘biscuits, cakes & pastries’ and ‘sugar-sweetened beverages’) also contributed a high proportion of energy intake (21%) in addition to contributing significantly to intakes of fat (15%), saturated fat (16%) and free sugars (59%). This population group also have high intakes of saturated fat (13% of total energy (%TE)), free sugar (9%TE) and salt (5.5g/d from food sources only) and low intakes of dietary fibre (17g/d). With regard to micronutrients, significant proportions of WCBA have inadequate intakes of vitamin D (93%), vitamin C (48%), calcium (41%), folate (32%), iodine (26%), riboflavin (25%), vitamin A (18%), magnesium (18%) and iron (10%). There was little risk of excessive intakes of micronutrients among WCBA with negligible proportions (<3%) of this population having intakes of vitamin B6 and iron greater than the UL. Important sources of vitamins and minerals were milk and milk products, meats, breads and cereals, especially fortified breakfast cereals, and fruits and vegetables. Conclusions: In summary, this study has found unfavourable intakes of total and saturated fat, carbohydrate, sugar, salt and dietary fibre together with low intakes of key micronutrients in WCBA in Ireland. The data presented in this study will have important implications for public health guidance for this vulnerable population group. Furthermore, information about the relative contributions of specific foods to nutrient intakes will be useful to both policy makers and the food industry to develop targeted dietary strategies to improve the diets of WCBA in Ireland.
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Keywords
Child-bearing age , Nutrient intakes , Recommendations
Citation
O'Mahony, A. 2022. Nutrient intakes, compliance with recommendations and key sources in women of child- bearing age (18-50y) in Ireland. MSc Thesis, University College Cork.
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