A review of sugar consumption from nationally representative dietary surveys across the world.

BACKGROUND: Government and health organisations worldwide have recently reviewed the evidence on the role of dietary sugars in relation to health outcomes. Hence, it is timely to review current intakes of dietary sugars with respect to this guidance and as a benchmark for future surveillance. METHODS: This review collates data from nationally representative dietary surveys across the world and reports estimates of intakes of total and added sugars, and sucrose in different population subgroups. Total sugars includes all mono- and disaccharides; namely, glucose, fructose, lactose, sucrose and maltose. Added and free sugars differ in the quantity of natural sugars included in their definitions. Free sugars include sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, whereas added sugars typically only refer to those added during processing. RESULTS: Most countries reported intakes of total sugars, with fewer reporting intakes of added sugars and sucrose. No country reported intakes of free sugars. The available data suggest that total sugars as a percentage of energy were highest in the infant (<4 years), with mean values ranging from 20.0% to 38.4%, and decreased over the lifespan to 13.5–24.6% in adults. Intakes of added sugars were higher in school-aged children and adolescents (up to 19% of total energy) compared to younger children or adults. CONCLUSIONS: Further research into the dietary patterns contributing to added sugars intake in children and adolescents is warranted. It would also be beneficial to policy guidance if future dietary surveys employed a uniform way of expressing sugars that is feasible to measure and has public health significance

Rapid and quantitative determination of hexanal in cooked muscle foods

A simple and rapid method was developed to quantify hexanaJ in cooked muscle foods. The method involves extraction of the 2,4-dinitrophenylhydrazones of carbonyls with hexane and their separation by reversed-phased high performance liquid chromatography. The method compared well with the classical thiobarbituric acid test. The method was successfully used to quantify hexana) in cooked beef and pork burgers during storage at 4 °C for up to 1 week as well as in cooked turkey burgers after diet supplementation with vitamin E. After 7 days' storage at 4 °C, the contents of hexanal increased from 0.71 to 22.50 μ.mol/kg in beef burgers, from 0.89 to 32.7S μmol / kg in pork burgers and from 1.31 to S2.16 μmol / kg in turkey burgers (20 mg vitamin E per kg feed). Supplementation of turkey feeds with 600 mg Yitamin E per kg resulted in a 24% reduction in hexanal content in cooked turkey burgers after storage for 7 days at 4 °C, compared to the control (unsupplemented) group

Diet, lifestyle and body weight in Irish children: findings from Irish Universities Nutrition Alliance national surveys

Childhood obesity is an issue of public health concern globally. This review reports on levels of overweight and obesity in Irish children and examines some aspects of their diet and lifestyle proposed to promote or protect against increasing body fatness in children. While there is still some debate with regard to the most appropriate cut-off points to use when assessing body fatness in children, approximately one in five Irish children (aged 2–17 years) have been classified as overweight (including obese) according to two generally accepted approaches. Furthermore, comparison with previous data has shown an increase in mean body weight and BMI over time. On examining dietary patterns for Irish children, there was a noticeable transition from a less energy dense diet in pre-school children to a more energy dense diet in older children and teenagers, associated with a change to less favourable dietary intakes for fibre, fat, fruit and vegetables, confectionery and snacks and sugar-sweetened beverages as children got older. A significant proportion of school-aged children and teenagers reported watching more than 2 h television per day (35 % on school-days and 65 % on week-ends) compared with 13 % of pre-school children. For children aged 5–12 years, eating out of the home contributed just 9 % of energy intake but food eaten from outside the home was shown to contribute a higher proportion of energy from fat and to be less fibre-dense than food prepared at home. Improvements in dietary lifestyle are needed to control increasing levels of overweight and obesity in children in Ireland

Modelling the impact of specific food policy options on coronary heart disease and stroke deaths in Ireland

Objective: To estimate the potential reduction in cardiovascular (CVD) mortality possible by decreasing salt, trans fat and saturated fat consumption, and by increasing fruit and vegetable (F/V) consumption in Irish adults aged 25–84years for 2010. Design: Modelling study using the validated IMPACT Food Policy Model across two scenarios. Sensitivity analysis was undertaken. First, a conservative scenario: reductions in dietary salt by 1 g/day, trans fat by 0.5% of energy intake, saturated fat by 1% energy intake and increasing F/V intake by 1 portion/day. Second, a more substantial but politically feasible scenario: reductions in dietary salt by 3 g/day, trans fat by 1% of energy intake, saturated fat by 3% of energy intake and increasing F/V intake by 3 portions/day. Setting: Republic of Ireland. Outcomes: Coronary heart disease (CHD) and stroke deaths prevented. Results: The small, conservative changes in food policy could result in approximately 395 fewer cardiovascular deaths per year; approximately 190 (minimum 155, maximum 230) fewer CHD deaths in men, 50 (minimum 40, maximum 60) fewer CHD deaths in women, 95 (minimum 75, maximum 115) fewer stroke deaths in men, and 60 (minimum 45, maximum 70) fewer stroke deaths in women. Approximately 28%, 22%, 23% and 26% of the 395 fewer deaths could be attributable to decreased consumptions in trans fat, saturated fat, dietary salt and to increased F/V consumption, respectively. The 395 fewer deaths represent an overall 10% reduction in CVD mortality. Modelling the more substantial but feasible food policy options, we estimated that CVD mortality could be reduced by up to 1070 deaths/year, representing an overall 26% decline in CVD mortality. Conclusions: A considerable CVD burden is attributable to the excess consumption of saturated fat, trans fat, salt and insufficient fruit and vegetables. There are significant opportunities for Government and industry to reduce CVD mortality through effective, evidence-based food policies

Iodine intakes and status in Irish adults is there cause for concern?

I is an important mineral for health, required for the production of key thyroid hormones, which are essential for cellular metabolism, growth and physical development. Hence, adequate I is crucial at all stages of life, but imperative during pregnancy for fetal brain development and during a child’s early life for neurodevelopment. Within Ireland, limited information exists on population I intakes and status. Therefore, the purposes of the present analysis were to estimate dietary I intakes and to analyse urinary iodine (UI) status using the cross-sectional National Adult Nutrition Survey 2008–2010 and the most recent Irish Total Diet Study. Median I intakes in the total population (n 1106) were adequate with only 26 % of the population being classified as below the estimated average requirement (EAR). Milk consumption was the major source of I in the diet, contributing 45 % to total intake. Likewise, median UI concentrations (107 µg/l) indicated ‘optimal’ I nutrition according to the WHO cut-off points. In our cohort, 77 % of women of childbearing age (18–50 years) did not meet the EAR recommendation set for pregnant women. Although I is deemed to be sufficient in the majority of adult populations resident in Ireland, any changes to the current dairy practices could significantly impact intake and status. Continued monitoring should be of priority to ensure that all subgroups of the population are I sufficient

Modeling tool for calculating dietary iron bioavailability in iron-sufficient adults

Background: Values for dietary iron bioavailability are required for setting dietary reference values. These are estimated from predictive algorithms, nonheme iron absorption from meals, and models of iron intake, serum ferritin concentration, and iron requirements. Objective: We developed a new interactive tool to predict dietary iron bioavailability. Design: Iron intake and serum ferritin, a quantitative marker of body iron stores, from 2 nationally representative studies of adults in the United Kingdom and Ireland and a trial in elderly people in Norfolk, United Kingdom, were used to develop a model to predict dietary iron absorption at different serum ferritin concentrations. Individuals who had raised inflammatory markers or were taking iron-containing supplements were excluded. Results: Mean iron intakes were 13.6, 10.3, and 10.9 mg/d and mean serum ferritin concentrations were 140.7, 49.4, and 96.7 mg/L in men, premenopausal women, and postmenopausal women, respectively. The model predicted that at serum ferritin concentrations of 15, 30, and 60 mg/L, mean dietary iron absorption would be 22.3%, 16.3%, and 11.6%, respectively, in men; 27.2%, 17.2%, and 10.6%, respectively, in premenopausal women; and 18.4%, 12.7%, and 10.5%, respectively, in postmenopausal women. Conclusions: An interactive program for calculating dietary iron absorption at any concentration of serum ferritin is presented. Differences in iron status are partly explained by age but also by diet, with meat being a key determinant. The effect of the diet is more marked at lower serum ferritin concentrations. The model can be applied to any adult population in whom representative, good-quality data on iron intake and iron status have been collected. Values for dietary iron bioavailability can be derived for any target concentration of serum ferritin, thereby giving risk managers and public health professionals a flexible and transparent basis on which to base their dietary recommendations. This trial was registered at clinicaltrials.gov as NCT01754012

Comparison of a web-based 24-h dietary recall tool (Foodbook24) to an interviewer-led 24-h dietary recall

Web-based tools have the potential to reduce the cost of dietary assessment; however, it is necessary to establish their performance compared to traditional dietary assessment methods. This study aims to compare nutrient and food intakes derived from Foodbook24 to those obtained from an interview-led 24-h dietary recall (24HDR). Seventy-nine adult participants completed one self-administered 24HDR using Foodbook24 and one interviewer-led 24HDR on the same day. Following a 10 days wash-out period the same process was completed again in opposite order to the previous study visit. Statistical analysis including Spearman’s rank order correlation, Mann-Whitney U tests, cross-classification analysis, and “Match”, “Omission”, and “Intrusion” rates were used to investigate the relationship between both methods. Strong, positive correlations of nutrient intake estimated using both methods was observed (rs = 0.6–1.0; p < 0.001). The percentage of participants classified into the same tertile of nutrient intake distribution using both methods ranged from 58% (energy) to 82% (vitamin D). The overall match rate for food intake between both methods was 85%, while rates for omissions and intrusions were 11.5% and 3.5%, respectively. These results, alongside the reduced cost and participant burden associated with Foodbook24, highlight the tool’s potential as a viable alternative to the interviewer-led 24HDR

The prevalence and trends in overweight and obesity in Irish adults between 1990 and 2011

Obesity is a serious public health issue, the prevalence of which is increasing globally. The present study aimed to investigate trends in overweight and obesity in Irish adults between 1990 and 2011. Anthropometric data from three Irish national food consumption surveys were used to calculate trends in BMI, waist circumference and waist:hip ratio. Three cross-sectional food consumption surveys: the Irish National Nutrition Survey (1990), the North/South Ireland Food Consumption Survey (2001) and the National Adult Nutrition Survey (2011). A collective sample of free-living Irish adults (n 3125), aged 18–64 years. There were significant increases in mean weight, height and BMI from 1990 to 2011. Significant increments were also reported in waist and hip circumferences and waist:hip ratio between 2001 and 2011, with concurrent increases in the proportion of individuals at risk of developing CVD, particularly females aged 18–35 years. In 2011, 23·4 % of the Irish population was classified as obese; with the mean BMI increasing by 1·1 kg/m2 between 1990 and 2001 and by 0·6 kg/m2 between 2001 and 2011. The present paper characterises obesity levels in Irish adults from 1990 to 2011. Absolute levels of overweight and obesity have increased between these time points. Of concern is the increase in the proportion of young women classified as at risk of CVD, using waist circumference and waist:hip ratio. Effective prevention strategies are needed to avoid further increases

Development and validation testing of a short nutrition questionnaire to identify dietary risk factors in preschoolers aged 12-36 months.

Background: Although imbalances in dietary intakes can have short and longer term influences on the health of preschool children, few tools exist to quickly and easily identify nutritional risk in otherwise healthy young children. Objectives: To develop and test the validity of a parent-administered questionnaire (NutricheQ) as a means of evaluating dietary risk in young children (12–36 months). Design: Following a comprehensive development process and internal reliability assessment, the NutricheQ questionnaire was validated in a cohort of 371 Irish preschool children as part of the National Preschool Nutrition Survey. Dietary risk was rated on a scale ranging from 0 to 22 from 11 questions, with a higher score indicating higher risk. Results: Children with higher NutricheQ scores had significantly (p<0.05) lower mean daily intakes of key nutrients such as iron, zinc, vitamin D, riboflavin, niacin, folate, phosphorous, potassium, carotene, retinol, and dietary fibre. They also had lower (p<0.05) intakes of vegetables, fish and fish dishes, meat and infant/toddler milks and higher intakes of processed foods and non-milk beverages, confectionery, sugars and savoury snack foods indicative of poorer dietary quality. Areas under the curve values of 84.7 and 75.6% were achieved for ‘medium’ and ‘high’ dietary risk when compared with expert risk ratings indicating good consistency between the two methods. Conclusion: NutricheQ is a valid method of quickly assessing dietary quality in preschoolers and in identifying those at increased nutritional risk

Dietary vitamin D2 - a potentially underestimated contributor to vitamin D nutritional status of adults?

It has been suggested that vitamin D2 is not very prevalent in the human food chain. However, data from a number of recent intervention studies suggest that the majority of subjects had measurable serum 25-hydroxyvitamin D2 (25(OH)D2) concentrations. Serum 25(OH)D2, unlike 25(OH)D3, is not directly influenced by exposure of skin to sun and thus has dietary origins; however, quantifying dietary vitamin D2 is difficult due to the limitations of food composition data. Therefore, the present study aimed to characterise serum 25(OH)D2 concentrations in the participants of the National Adult Nutrition Survey (NANS) in Ireland, and to use these serum concentrations to estimate the intake of vitamin D2 using a mathematical modelling approach. Serum 25(OH)D2 concentration was measured by a liquid chromatography–tandem MS method, and information on diet as well as subject characteristics was obtained from the NANS. Of these participants, 78·7 % (n 884) had serum 25(OH)D2 concentrations above the limit of quantification, and the mean, maximum, 10th, 50th (median) and 90th percentile values of serum 25(OH)D2 concentrations were 3·69, 27·6, 1·71, 2·96 and 6·36 nmol/l, respectively. To approximate the intake of vitamin D2 from these serum 25(OH)D2 concentrations, we used recently published data on the relationship between vitamin D intake and the responses of serum 25(OH)D concentrations. The projected 5th to 95th percentile intakes of vitamin D2 for adults were in the range of 0·9–1·2 and 5–6 μg/d, respectively, and the median intake ranged from 1·7 to 2·3 μg/d. In conclusion, the present data demonstrate that 25(OH)D2 concentrations are present in the sera of adults from this nationally representative sample. Vitamin D2 may have an impact on nutritional adequacy at a population level and thus warrants further investigation