The food environment influences food choices made by populations. On-the-go snacking has become an integral part of modern Irish life and must be considered when shaping such environments, considering that the Republic of Ireland population consume an average of 2.5 snacks daily, with 22% of snacking occasions occurring outside the home. This has driven the increased prevalence of snack food vending machines which typically stock unhealthy products that are high in energy, fat and sugar. The Health Service Executive (HSE) implemented the Healthier Vending Policy in 2015 to increase the availability of healthier products across HSE premises. This research examined the nutrient content of snacks and beverages purchased in vending machines on HSE premises following the implementation of the HSE Healthier Vending Policy.

Vending machines product and sales data were obtained from two vending machines companies at baseline in 2015 and following policy implementation in 2016. Product labels and online product information were used to obtain the energy and nutrient contents. The products were assigned to a snack or beverage category; nuts, mints, cereal bars, chocolates, sweets, crisps, waters, juices, carbonated drinks and other. New variables were computed, descriptive analyses were undertaken and Wilcoxon-signed rank tests performed using SPSS Statistics 24. Statistical significance was set at p < 0.05.

Snacks and beverages sold in 295 vending machines across 89 HSE premises were analysed. There were statistically significant decreases in median energy sold per packet (9.7%) and per 100 g (7.1%) following policy implementation. Reductions in total fat (53.2%), saturated fat (32.4%), sugar (10.0%) and sodium (20.0%) sold also occurred. When snacks were analysed separately the findings were less positive, as a statistically significant increase in energy sold per packet and an increase in total fat sold per 100 g occurred. The findings in relation to beverages were mixed. The effect of the policy varied across snack categories, with particularly large reductions in energy sold per packet in carbonated drinks (54.0%) and cereal bars (44.2%).

Adecrease in the amount of energy, total fat, saturated fat, sugar and sodium sold was observed following the implementation of the policy. The HSE Healthier Vending Policy seemed to promote a healthier environment. It is recommended that this policy continues to be implemented and is reviewed to ensure the best possible outcomes nationally. It is also advisable to bring this policy to other settings to combat obesogenic environments and promote public health.

This study was undertaken in a convenience sample of 33 Irish children aged 7–9 years old from urban Dublin-based primary schools. Food group intake estimates were collected with the FGFQand compared with those obtained with a 7-day semi-weighed food diary. Agreement between frequencies of intake between the two instruments were examined using Spearman's correlation coefficient, cross-classification analyses and weighted kappa.

The FGFQ over-estimated the number of portions for most of the food groups as compared with the reference method. Spearman correlation coefficients ranged from 0.75 (cheese) to 0.03 (flavoured milk). Level of agreement was moderate with an average correlation coefficient of 0.45. The proportion of children classified in the same category ranged from 96.9% (sweet treats) to 60.6% (vegetables). Misclassification was less than 15% for fruit, soft drinks, low fat milk, fish, savoury snacks and sweet treats and above 30% for vegetables, dairy products and pastries & biscuits. Weighted kappa statistic values ranged from 0.84 (sweet treats) to 0.10 (vegetables). Mean level of agreement was moderate (0.39). No agreement (< 0.0) was found for soft drinks.

Although the strength of association estimates varied by food group, strong to moderate levels of relative validity were observed. Our results show that the FGFQ gives acceptable estimates of food group intakes among Irish school-aged children and that the tool can be used for ranking subjects according to food group intakes.

The foetal programming hypothesis posits that optimising early life factors e.g. maternal diets can help avert the burden of adverse childhood outcomes e.g. childhood obesity. To improve applicability to public health messaging, we investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity in a large consortium.

We harmonized and pooled individual participant data from up to 8,769 mother-child pairs in 7 European mother-offspring cohorts. Maternal early-, late-, and whole-pregnancy dietary quality and inflammatory potential were assessed with Dietary Approaches to Stop Hypertension (DASH) and energy-adjusted Dietary Inflammatory Index (E-DII), respectively. Primary outcome was childhood overweight and obesity (OWOB), defined as age- and sex-specific body-mass-index-z score (BMIz) > 85th percentile based on WHO growth standard. Secondary outcomes were sum-of-skinfold-thickness (SST), fat-mass-index (FMI) and fat-free-mass-index (FFMI) in available cohorts. Outcomes were assessed in early- [mean (SD) age: 2.8 (0.3) y], mid- [6.2 (0.6) y], and late-childhood [10.6 (1.2) y]. We used multivariable regression analyses to assess the associations of maternal E-DII and DASH with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses. Analyses were adjusted for maternal age, pre-pregnancy BMI, parity, lifestyle factors, energy intake, educational attainment, offspring age and sex.

A more pro-inflammatory maternal diet, indicated by higher E-DII, was associated with a higher risk of offspring late-childhood OWOB [pooled-OR (95% CI) comparing highest vs. lowest E-DII quartiles: 1.22 (1.01,1.47) for whole-pregnancy and 1.38 (1.05,1.83) for early-pregnancy; both P < 0.05]. Moreover, higher late-pregnancy E-DII was associated with higher mid-childhood FMI [pooled-β (95% CI): 0.11 (0.003,0.22) kg/m2; P < 0.05]; trending association was observed for whole-pregnancy E-DII [0.12 (-0.01,0.25) kg/m2; P = 0.07]. A higher maternal dietary quality, indicated by higher DASH score, showed a trending inverse association with late-childhood OWOB (pooled-OR (95% CI) comparing highest vs. lowest DASH quartiles: 0.58 (0.32,1.02; P = 0.06). Higher early-pregnancy DASH was associated with lower late-childhood SST [pooled-β (95% CI): -1.9 (-3.6,-0.1) cm; P < 0.05] and tended to be associated with lower late-childhood FMI [-0.34 (-0.71,0.04) kg/m2; P = 0.08]. Higher whole-pregnancy DASH tended to associate with lower early-childhood SST [-0.33 (-0.72,0.06) cm; P = 0.10]. Results were similar when modelling DASH and E-DII continuously.

Analysis of pooled data suggests that pro-inflammatory, low-quality maternal antenatal diets may influence offspring body composition and obesity risk, especially during mid- or late-childhood. Due to variation of data availability at each timepoint, our results should be interpreted with caution. Because most associations were observed at mid-childhood or later, future studies will benefit from a longer follow-up.

Restricting access to lethal means is an effective suicide prevention strategy. However, there is little discussion in the literature about the potential contribution of prescribing practices on discharge from inpatient psychiatric care (which has been established as a high-risk period for suicide) to suicide deaths by overdose of prescribed medication. This study aimed to assess the quantity, toxicity and potential lethality of psychotropic medication being prescribed on discharge from psychiatric care to those with and without indices of suicidality.

Patient demographic, clinical and prescription data were collected from 50 randomly selected charts following discharge from inpatient psychiatric care. Psychotropic medications (dose × duration) on discharge were converted to their equivalent doses of neuroleptics, antidepressants and anxiolytics to rate toxicity and potential lethality, using the Maudsley Prescribing Guidelines. Mood stabilizing medications were also documented.

39% of prescriptions analysed contained toxic and potentially fatal doses of either neuroleptic or antidepressant equivalent medication.

Patient discharge from inpatient psychiatric care presents a golden opportunity to moderate access to potentially fatal psychotropic medication. Iatrogenic provision of lethal means for suicide during a period of increased risk and in a group at increased suicide risk may impact suicide prevention efforts and requires further in-depth research. Current prescribing practices may be a missed opportunity to intervene in this regard.

To examine the influence of health behaviours and psychological well-being on gestational weight gain using a biopsychosocial model.

A prospective cohort study of pregnant women consecutively recruited at their first antenatal care visit. A self-administered questionnaire was used to collect data on health behaviours and psychological well-being in early pregnancy. Linear regression and logistic regression were used to identify predictors of total weight gain in kilograms and weight gain outside the current Institute of Medicine recommendations, respectively.

A maternity hospital in the Republic of Ireland.

Data on 799 women were analysed.

Pre-pregnant BMI ≥30·0 kg/m2, short stature, parity >0, decreased food intake and absence of health insurance predicted lower absolute gestational weight gain, while foreign nationality, consumption of takeaway meals more than once weekly and increased food intake predicted higher absolute gestational weight gain. Overweight and obesity, foreign nationality, increased food intake and height >170 cm were risk factors for excessive weight gain, while antenatal depression was protective against excessive weight gain. Notably, physical activity measures were not related to the gestational weight gain outcomes. Pre-pregnancy overweight and increased food intake were the strongest predictors of excessive gestational weight gain.

None of the psychological well-being measures examined, with the exception of antenatal depression, was associated with any of the weight gain outcomes. The behavioural predictors of gestational weight gain were increased food intake and takeaway consumption. Public health promotions should target pre-pregnancy BMI and pregnancy-associated change in food intake.

The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children's diet and also maternal–child aggregation patterns during pregnancy and early childhood.

Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child's FFQ version was used for children. Anthropometric and sociodemographic variables were also collected.

Three-generation familial cohort representative of the contemporary Irish national population.

Children aged 5 years (n 567) and their parents and grandparents.

Associations for energy, macronutrient and fibre intakes were compared using Pearson's correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderate-strength positive correlations were observed for nutrient intakes in children's nuclear families (ICC (range) = 0·22–0·28). The father–child associations (r (range) = 0·13–0·20) were weaker than the mother–child associations (r (range) = 0·14–0·33). In general, associations were stronger for maternal postnatal intake–child intake than for maternal prenatal intake–child intake, except for percentage of energy from fat (adjusted β = 0·16, 95 % CI 0·05, 0·26; P = 0·004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted β = 0·28, 95 % CI 0·12, 0·44; P = 0·001). Among all grandparents, correlations were significant only for maternal grandmother–mother pairs (r (range) = 0·10–0·36). Significant positive ICC were observed for nutrient intakes of maternal grandmother–mother–child triads (ICC (range) = 0·12–0·27), not found in paternal lines.

These findings suggest that maternal-environment programming influences dietary intake.

To investigate the relationships between food poverty and food consumption, health and life satisfaction among schoolchildren.

Analysis of the 2002 Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey that employs a self-completion questionnaire in a nationally representative random sample of school classrooms in the Republic of Ireland.

A total of 8424 schoolchildren (aged 10–17 years) from 176 schools, with an 83% response rate from children.

Food poverty was found to be similarly distributed among the three social classes (15.3% in the lower social classes, 15.9% in the middle social classes and 14.8% in the higher social classes). It was also found that schoolchildren reporting food poverty are less likely to eat fruits, vegetables and brown bread, odds ratio (OR) from 0.66 (95% confidence interval (CI) 0.45–0.87) to 0.81 (95% CI 0.63–0.99); more likely to eat crisps, fried potatoes and hamburgers, OR from 1.20 (95% CI 1.00–1.40) to 1.62 (95% CI 1.39–1.85); and more likely to miss breakfast on weekdays, OR from 1.29 (95% CI 0.33–1.59) to 1.72 (95% CI 1.50–1.95). The risk of somatic and mental symptoms is also increased, OR from 1.48 (95% CI 1.18–1.78) to 2.57 (95% CI 2.33–2.81); as are negative health perceptions, OR from 0.63 (95% CI 0.43–0.83) to 0.52 (95% CI 0.28–0.76) and measures of life dissatisfaction, OR from 1.88 (95% CI 1.64–2.12) to 2.25 (95% CI 2.05–2.45). Similar results were found for life dissatisfaction in an international comparison of 32 countries. All analyses were adjusted for age and social class.

Food poverty in schoolchildren is not restricted to those from lower social class families, is associated with a substantial risk to physical and mental health and well-being, and requires the increased attention of policy makers and practitioners.

The aim of this study was to identify differences in food habits and lifestyle behaviours by dieting status among young people in Ireland.

Cross-sectional survey. Participants responded to a self-completion questionnaire designed by researchers on the World Health Organization's collaborative study – Health Behaviour in School Aged Children. Pupils were selected by school and classroom and the sample was stratified to be representative of the geographical distribution of school students in Ireland.

Data were collected by teachers from school pupils in their classrooms.

Data were collected from 187 schools which included 8497 pupils (51% girls) aged 9–17 years.

While a minority of pupils (12% of girls, 4% of boys) reported that they were on a diet to lose weight, a substantial proportion (28% of girls, 18% of boys) said that they should be on a diet. Dieters reported consuming unhealthy foods less frequently than non-dieters, but did not report an increased consumption of fruit and vegetables. Rather, some categories of dieters reported higher levels of coffee and tobacco use and lower exercise levels than non-dieters.

The results could indicate substitution of unhealthy foods by other unhealthy behaviours as opposed to an increased consumption of healthier foodstuffs, and suggest that both smoking and exercise need to be addressed alongside nutrition in youth health promotion.

To assess the impact and suitability of a pilot dietary educational programme for primary school pupils. The Nutrition Education at Primary School (NEAPS) programme aimed to build awareness of the benefits of healthy eating, induce positive behaviour change and increase the children's knowledge.

A comparative quasi-experimental study with follow-up after 3 months.

Eight primary schools in the Eastern and North Western Health Boards and three control schools in the same board regions.

Data were used from 821 Irish school children aged 8–10 years old.

The education programme comprised 20 sessions over 10 weeks including circular worksheets, homework assignments and an aerobic exercise regime. At baseline and after 3 months pupils completed food diaries and a validated food pairing questionnaire on food behaviour, knowledge and preferences.

Significant differences were found in the intervention children's behaviour and preference levels after the NEAPS programme (P < 0.01 in both sections). Knowledge levels were very high at baseline and though some individual items improved, average change overall was not significant. Rural children appeared to benefit more in behaviour and preferences from the programme (P < 0.01). The NEAPS programme appeared to be less effective in pupils in disadvantaged areas (P < 0.01 for each of the sections: behaviour, preference and knowledge). One hundred and eighty-seven children completed food diaries. The intervention children's consumption of fruit and vegetables increased, and they consumed less salty snacks after the programme. Rural children were confirmed to have healthier diets at baseline.

Following the NEAPS pilot programme positive changes were seen in the school children's eating behaviour and preferences for healthier foodstuffs. This suggests successful development of a culturally sensitive nutrition education programme for school children aged 8–10 years.

To identify, using the novel application of multivariate classification trees, the socio-economic, sociodemographic and health-related lifestyle behaviour profile of adults who comply with the recommended 4 or more servings per day of fruit and vegetables.

Cross-sectional 1998 Survey of Lifestyle, Attitudes and Nutrition.

Community-dwelling adults aged 18 years and over on the Republic of Ireland electoral register.

Six thousand five hundred and thirty-nine (response rate 62%) adults responded to a self-administered postal questionnaire, including a semi-quantitative food-frequency questionnaire.

The most important determining factor of compliance with the fruit and vegetable dietary recommendations was gender. A complex constellation of sociodemographic and socio-economic factors emerged for males whereas the important predictors of 4 or more servings of fruit and vegetable consumption among females were strongly socio-economic in nature. A separate algorithm was run to investigate the importance of health-related lifestyle and other dietary factors on compliance with the fruit and vegetable recommendations. Following an initial split on compliance with dairy recommendations, a combination of non-dietary behaviours showed a consistent pattern of healthier options more likely to lead to compliance with fruit and vegetable recommendations. There did, however, appear to be a compensatory element between the variables, particularly around smoking, suggesting the non-existence of an exclusive lifestyle for health risk.

Material and structural influences matter very much for females in respect to compliance with fruit and vegetable recommendations. For males, while these factors are important they appear to be mediated through other more socially contextual-type factors. Recognition of the role that each of these factors plays in influencing dietary habits of men and women has implications for the manner in which dietary strategies and policies are developed and implemented.