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The childhood years represent a period of increased nutrient requirements during which a balanced diet is important to ensure optimal growth and development. The aim of this study was to examine food and nutrient intakes and compliance with recommendations in school-aged children in Ireland and to examine changes over time. Analyses were based on two National Children’s Food Surveys; NCFS (2003–2004) (n 594) and NCFS II (2017–2018) (n 600) which estimated food and nutrient intakes in nationally representative samples of children (5–12 years) using weighed food records (NCFS: 7-d; NCFS II: 4-d). This study found that nutrient intakes among school-aged children in Ireland are generally in compliance with recommendations; however, this population group have higher intakes of saturated fat, free sugars and salt, and lower intakes of dietary fibre than recommended. Furthermore, significant proportions have inadequate intakes of vitamin D, Ca, Fe and folate. Some of the key dietary changes that have occurred since the NCFS (2003–2004) include decreased intakes of sugar-sweetened beverages, fruit juice, milk and potatoes, and increased intakes of wholemeal/brown bread, high-fibre ready-to-eat breakfast cereals, porridge, pasta and whole fruit. Future strategies to address the nutrient gaps identified among this population group could include the continued promotion of healthy food choices (including education around ‘healthy’ lifestyles and food marketing restrictions), improvements of the food supply through reformulation (fat, sugar, salt, dietary fibre), food fortification for micronutrients of concern (voluntary or mandatory) and/or nutritional supplement recommendations (for nutrients unlikely to be sufficient from food intake alone).
Genesis reflects a robust example of inter-cultural conversation. This chapter will summarize the major categories of commonality between Genesis and the ancient Near Eastern world in three major categories: (1) creation and humanity; (2) perceptions about the gods; (3) ancestor narratives. A truism of comparative studies is that similarities as well as differences require attention, and examples of both will be discussed.
Sudden onset severe headache is usually caused by a primary headache disorder but may be secondary to a more serious problem, such as subarachnoid hemorrhage (SAH). Very few patients who present to hospital with headache have suffered a SAH, but early identification is important to improve patient outcomes. A systematic review was undertaken to assess the clinical effectiveness of different care pathways for the management of headache, suspicious for SAH, in the Emergency Department. Capturing the perspective of patients was an important part of the research.
The project team included a patient collaborator with experience of presenting to the Emergency Department with sudden onset severe headache. Three additional patients were recruited to our advisory group. The patient's perspective was collected at various points through the project including at team meetings, during protocol development and when interpreting the results of the systematic review and drawing conclusions.
Patients were reassured by the very high diagnostic accuracy of computed tomography (CT) for detecting SAH. Patients and clinicians emphasized the importance of shared decision making about whether to undergo additional tests to rule out SAH, after a negative CT result. When lumbar puncture was necessary, patients expressed a preference to have it on an ambulatory basis; further research on the safety and acceptability of ambulatory lumbar puncture was recommended.
Patient input at the protocol development stage helped researchers understand the patient experience and highlighted important outcomes for assessment. Patient involvement added context to the review findings and highlighted the preferences of patients regarding the management of headache.
Sudden onset severe headache is usually caused by a primary headache disorder but occasionally is secondary to a more serious problem, such as subarachnoid hemorrhage (SAH). Guidelines recommend non-contrast brain computed tomography (CT) followed by lumbar puncture (LP) to exclude SAH. However, guidelines pre-date the introduction of more sensitive modern CT scanners. A systematic review was undertaken to assess the clinical effectiveness of different care pathways for the management of headache in the Emergency Department.
Eighteen databases (including MEDLINE and Embase) were searched to February 2020. Studies were quality assessed using criteria relevant to the study design; most studies were assessed using the QUADAS-2 tool for diagnostic accuracy studies. Where sufficient information was reported, diagnostic accuracy data were extracted into 2 × 2 tables to calculate sensitivity, specificity, false-positive and false-negative rates. Where possible, hierarchical bivariate meta-analysis was used to synthesize results, otherwise studies were synthesized narratively.
Fifty-one studies were included in the review. Eight studies assessing the accuracy of the Ottawa SAH clinical decision rule were pooled; sensitivity was 99.5 percent, specificity was 23.7 percent. The high false positive rate suggests that 76.3 percent SAH-negative patients would undergo further investigation unnecessarily. Four studies assessing the accuracy of CT within six hours of headache onset were pooled; sensitivity was 98.7 percent, specificity was 100 percent. CT sensitivity beyond six hours was considerably lower (≤90%; 2 studies). Three studies assessing LP following negative CT were pooled; sensitivity was 100 percent, specificity was 95.2 percent. LP-related adverse events were reported in 5.3–9.5 percent of patients.
The evidence suggests that the Ottawa SAH Rule is not sufficiently accurate for ruling out SAH and does little to aid clinical decision making. Modern CT within six hours of headache onset (with images assessed by a neuroradiologist) is highly accurate, but sensitivity reduces considerably over time. The CT-LP pathway is highly sensitive for detecting SAH, although LP resulted in some false-positives and adverse events.
In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.
Arrhythmias are common in the post-operative course of patients with hypoplastic left heart syndrome. We sought to determine the types, incidence, risk factors, and impact of arrhythmias in patients with HLHS and anatomic variants.
We performed a retrospective chart review of 120 consecutive patients with HLHS and anatomical variants, who had single-ventricle palliation at our institution from January, 2006 to December, 2016.
A total of thirty-one patients (26%) had 37 episodes of arrhythmias over a median follow-up period of 3.5 years. Of the 37 episodes, 12 (32.4%) were ectopic atrial tachycardia, 9 (24.3%) were paroxysmal supraventricular tachycardia, 4 (10.8%) were junctional ectopic tachycardia, 5 (13.6%) were sinus node dysfunction, 3 (8.1%) were heart block, 2 (5.4%) were atrial flutter, and 2 (5.4%) were ventricular tachycardia. Twenty-four (65%) of the arrhythmias occurred at post-stage 1 surgery. Most (64.8%) of the arrhythmias were resolved. Arrhythmias that occurred at post-stage 1 surgery were more likely to resolve compared to post-stages 2 or 3 (p = 0.006). No anatomical, surgical, or clinical variables were associated with arrhythmia except for age (OR per unit decrease in age at stage 1 palliation: 1.12 (95% CI 1.003, 1.250); p = 0.0439). Arrhythmias were not associated with length of hospital stay or mortality.
Arrhythmias are common in patients with HLHS and anatomic variants, with EAT and PSVT being the most common types. Arrhythmias were associated with younger age at surgery, but did not affect mortality or length of hospital stay.
To examine current dietary fat intakes and compliance in Irish children and to examine changes in intakes from 2005 to 2019.
Analyses were based on data from the Irish National Children’s Food Survey (NCFS) and the NSFS II, two cross-sectional studies that collected detailed food and beverage intake data through 7-day and 4-day weighed food diaries, respectively.
NCFS and NCFS II, Republic of Ireland.
A nationally representative sample of 594 (NCFS) and 600 (NCFS II) children aged 5–12 years. Current intakes from the NCFS II were compared with those previously reported in the NCFS (www.iuna.net).
Current intakes of total fat, SFA, MUFA, PUFA and trans fat as a percentage of total energy are 33·3, 14·0, 13·6, 5·6 and 0·5 %, respectively. Total fat, SFA and trans fat intakes since 2005 remained largely stable over time with all displaying minor decreases of <1 %. Adherence to SFA recommendations remains inadequate, with only 7 % of the population complying. Insufficient compliance with PUFA (71 %) and EPA and DHA (DHA; 16 %) recommendations was also noted.
Children in Ireland continue to meet the total fat and trans fat target goals. Adherence to MUFA and PUFA recommendations has also significantly improved. However, deviations for some fats remain, in particular SFA. These findings are useful for the development of dietary strategies to improve compliance with current recommendations.
To describe the eating behaviour styles of Irish teens and to explore the relationships between demographic factors, BMI and dietary intake and these eating behaviour styles.
Cross-sectional data from the Irish National Teens’ Food Survey (2005–2006). The Dutch Eating Behaviour Questionnaire assessed three eating behaviour styles in teens: restrained, emotional and external eating. Data were stratified by sex and age groups.
The Republic of Ireland.
Nationally representative sample of teens aged 13–17 years (n 441).
The highest scoring eating behaviour style was external eating (2·83 external v. 1·79 restraint and 1·84 emotional). Girls scored higher than boys on all three scales (Restraint: 2·04 v. 1·56, P < 0·001, Emotional: 2·15 v. 1·55, P < 0·001 and External: 2·91 v. 2·76, P = 0·03), and older teens scored higher than younger teens on the Emotional (1·97 v. 1·67, P < 0·001) and External scales (2·91 v. 2·72, P = 0·01). Teens classified as overweight/obese scored higher than those classified as normal weight on the Restraint scale (2·15 v. 1·71, P < 0·001) and lower on the External scale (2·67 v. 2·87, P < 0·03). Daily energy intake was negatively correlated with the Restraint (r −0·343, P < 0·001) and Emotional scales (r −0·137, P = 0·004) and positively correlated with the External scale (r 0·110, P = 0·02).
External eating is the predominant eating behaviour style among Irish teens, but sex, age, BMI and dietary differences exist for each eating behaviour style. Including measures of eating behaviour styles into future dietary research could help understand both how and why as well as what people eat.
The present study aimed to examine the temporal prevalence of overweight and obesity in Irish children through different methodologies and evaluate the change in rates between 1990 and 2019.
Anthropometric data from three Irish national food consumption surveys were used to examine the change in the prevalence of BMI and waist circumference-derived overweight and obesity levels.
Three cross-sectional food consumption surveys from the Republic of Ireland: the Irish National Nutrition Survey (1990), the National Children’s Food Survey (2005) and The Second National Children’s Food Survey (2019).
A demographically representative sample of Irish children aged 5–12 years: 1990 (n 148), 2005 (n 594) and 2019 (n 596).
Twelve percentage of children had overweight/obesity in 1990, which was significantly higher in 2005 at 25 % and significantly lower in 2019 at 16 % (P = 0·003). In 2019, more girls had overweight/obesity in comparison with boys (19 v. 14 %), whilst children from the lowest social class group had the highest levels of overweight/obesity (P = 0·019). Overall, the proportion of children with abdominal overweight/obesity was significantly lower in 2019 in comparison with 2005 (P ≤ 0·001).
Evidence from the most recent national survey suggests that overweight and obesity levels are plateauing and in some cases reducing in children in Ireland. Despite this, rates remain high, with the highest prevalence in 2019 observed in girls and in those from the lowest social class group. Thus, overweight/obesity prevention and intervention policies are necessary and should be continued.
The aim of this study was to determine the types of eating behaviours most common among Irish teenagers and to explore their association with age, sex and Body Mass Index (BMI). Eating behaviour data from the National Teenage Food Consumption Survey (NTFS1 2005/06 n = 441, m/f 224/217) were analysed. The Dutch Eating Behaviour Questionnaire (DEBQ) contains 33 items, which make up 3 scales: Restraint (DEBQ-Res, 10 items), Emotional (DEBQ-Em, 13 items), External (DEBQ-Ex, 10 items). All items are answered on a 5 point Likert scale. Descriptive statistics, non-parametric Wilcoxin-Mann-Whitney U tests and Kruskal-Wallis tests, one-way ANOVA with post-hoc Tukey analysis, and Spearman correlations were run to test associations between age, sex and BMI variables and the 3 DEBQ scales. Data were analysed for the full group and stratified by sex and age groups (13–14/15–17 years). BMI categories were determined using age and sex-specific IOTF cut-offs. Mean(SD) scores among the whole group were DEBQ-Ex = 2.83(0.72), DEBQ-Res = 1.79(0.84), DEBQ-Em = 1.84(0.79). Females scored higher than males on all 3 scales; DEBQ-Res P < 0.001, DEBQ-Em P < 0.001, DEBQ-Ex P = 0.037. Older teens scored significantly higher than younger teens on DEBQ-Em (P < 0.001) and DEBQ-Ex (P = 0.005). Scores were higher for older males compared with younger males on DEBQ-Em (P = 0.009) and DEBQ-Ex (P = 0.017), and for older females compared with younger females on DEBQ-Res (P = 0.031) and DEBQ-Em (P = 0.001). BMI was positively correlated with DEBQ-Res for both males (r = 0.18, P = 0.007) and females (r = 0.337, P < 0.001) and with DEBQ-Em for females (r = 0.153 P = 0.026). When comparing BMI categories, teens classified as overweight (P < 0.001) and obese (P = 0.005) scored higher on DEBQ-Res than normal-weight teens. Similar associations were observed when the sample was split by sex and by age group. Overall, Irish teens’ eating behaviours are mostly influenced by external factors, such as the sight or smell of food, rather than by restrained eating or emotional cues for eating. However, not all teens respond to the same influences. Females respond more than males to emotional cues for eating. Older teens have higher scores than younger teens on all scales. BMI is mostly associated with restrained eating, which is consistent with other literature suggesting that heavier teens are more aware of what they are eating and make focussed food choices to prevent weight gain. When targeting food choice messages to teens, a “one-size-fits-all” model may not be appropriate. Multiple factors, including age, sex and BMI differences, should be considered in order to encourage a positive change in eating behaviours.
Milk is widely recognised as a nutrient dense food, supporting the growth and development of children. Nevertheless some milk types such as whole milk can consist of high levels of saturated fat, which is recognised for its association with chronic disease risk in adults when intakes are elevated. In Ireland, current dietary guidelines recommend that children from two years onwards should consume low fat milk. Previous research has shown low levels of compliance with this guideline. Therefore the aim of this study is to review the current consumption of milk and non-dairy milk-based alternatives among Irish children and compare these with previous intakes.
Dietary intakes of ‘whole milk’ decreased over time from 232 ± 186g/d to current intakes of 131 ± 154g/d. In contrast, increases were noted in ‘reduced fat milks’ (26 ± 86g/d to 52 ± 110g/d) and ‘non-dairy alternatives’ (0.2 ± 4g/d to 3 ± 19g/d). A total of 68% of children were classified as consumers of whole milk (193 ± 151g/d) compared to 90% (257 ± 178g/d) previously. ‘Reduced fat milk’ consumers increased from 17% to 31% and ‘non-dairy alternatives’ consumers also increased from < 1% to 3%.
Our preliminary results indicate that the number of Irish children consuming whole milk have decreased over the last number of years. In contrast consumers of ‘reduced fat milks’ have significantly increased, indicating potential improvement to healthy eating guidelines adherence. Further analysis to examine current intakes and sources of saturated fat is warranted to establish additional changes in dietary patterns and compliance with recommendations within this age group.
Current dietary recommendations encourage increased fibre and reduced sugar consumption. In the UK, specific targets and benchmarks have been established for the sugar content of some foods but not for fibre. National Food Consumption Surveys provide comprehensive information of all foods consumed by representative population samples. The Irish national food surveys as completed by the Irish Universities Nutrition Alliance (IUNA) capture dietary data at brand level with all details as gathered on pack entered into a discrete but inter-linked database, the Irish National Food Ingredient Database (INFID). The aim of this study was to profile the carbohydrate quality of a convenience sub-sample of packaged foods as eaten by Irish children during the National Children's Food Survey II (2017/2018) as entered into INFID.
Materials and Methods:
All on-pack details from 385 available foods in the categories ‘white breads and rolls’; ‘brown breads and rolls’; ‘other breads and scones’; ‘ready to eat breakfast cereals (RTEBC)’; ‘biscuits’; and ‘cakes, buns and pastries’ were entered in to INFID and quality control completed. The carbohydrate profile of the products was assessed with respect to fibre labelling criteria and UK sugar guidelines and targets. SPSS Version 25 was used for all analyses.
Although 56% (n210) of all products entered were eligible to make a ‘source of’ or ‘high’ fibre claim, only 20% (n78) made such a claim. Of this, 46% stated ‘high fibre’ and 32% ‘source’, predominately in the ‘brown breads and rolls’ and ‘RTEBC’ groups. When compared to UK Department of Health guidance for ‘low’, ‘medium’ and ‘high’ sugar, 65% of all products examined (n250) were either ‘low’ or ‘medium’ sugar. Comparison of median sugar contents with Public Health England sugar reformulation targets revealed different responses in each category, with all categories other than foods deemed as “morning goods” yet to meet the 2020 target of 20% reduction in sugar content.
This small pilot study of a convenience sample of foods suggests that for the limited number of foods examined, for some there remains challenges to reduce sugar and increase fibre contents. Strategies such as reformulation, change in portion size, flexibility in labelling and/or a shift in sales portfolios could be considered but only alongside technological and safety considerations. Further research to broaden this analysis and to link nutrient levels as listed on pack with actual consumption patterns could help ensure all recent initiatives including reformulation are recognised.
Research suggests that food fussiness (FF) and food neophobia (FN) are two separate constructs. Food fussiness is the tendency to be selective about a large proportion of familiar and unfamiliar foods, while food neophobia is the refusal of novel foods. Therefore, the aim of this study is to explore the association between parental feeding practices and child's FF or FN.
Analysis was based on cross-sectional data from the nationally representative Irish National Children's Food Survey II (NCFSII; 2017–2018). The NCFSII collected detailed eating behaviour data from children aged 5–12 (n = 596) using the Children's Eating Behaviour Questionnaire (CEBQ). This questionnaire contained four items from the food fussiness subscale that represented FN and two items that represented FF. The Feeding Practices & Structure Questionnaire (FPSQ) assessed non-responsive and structure-related parental feeding practices. Spearman's correlation established the association between parental feeding practices and child's FF and FN. Moderation analyses was conducted to explore the extent to which child's age moderates the association.
Higher levels of child's FN was weakly to moderately associated with higher parental reports of reward for eating (RE) (r = .210, p < 0.001), persuasive feeding (PF) (r = .340, p < 0.001), overt restriction (OR) (r = .195, p < 0.001) and lower reports of structured meal settings (SMS) (r = -.085, p = 0.039) and family meals (FMS) (r = -.387, p < 0.001). Higher levels of child's FF had a slightly stronger association with the same parental feeding as FN, with additional associations with structured meal timings (SMT) (r = -.089, p = 0.031) and covert restriction (CR) (r = -.083, p = 0.045). Age moderated the association between both child's FF [b = .22, p < 0.001] and FN [b = .17, p = 0.002] and parental reports of PF, along with moderating the association between child's FF [b = .11, p = 0.04] and parental reports of SMT.
Overall, child's FN and FF were both associated with higher levels of non-responsive feeding practices and lower reports of structure-related feeding practices, with child's FF associated with more parental feeding practices than FN. These findings suggest that it is important to address FN and FF as separate constructs, with more structure-related feeding practices inversely associated with higher levels of FF only. In addition, as children get older findings suggest that less parental feeding practices are utilised, however, higher levels of child's FF/FN are associated with similar levels of PF and SMT (FF only) regardless of age.
Being physically active is associated with fundamental health benefits and assists with the maintenance of normal weight in children. The current World Health Organizations’ recommendation is for children to accumulate 60 minutes of physical activity (PA) per day to obtain such benefits. Conversely, time spent in sedentary behaviours including watching screens (ST) are positively associated with the risk of overweight and obesity in young people. The aim of this research was to estimate PA levels and ST usage of Irish children and to examine the relationship with body fat.
This analysis was based on data collected from a nationally representative sample of Irish children aged 5–12-years (n = 591, 50% female) from The National Children's Food Consumption Survey II (www.iuna.net). The Child/Youth Physical Activity Questionnaires (C-PAQ/Y-PAQ) were used to measure PA and ST in 5–8 and 9–12-year-olds respectively. Both questionnaires were self-administered, recall instruments that assessed the frequency/duration of activities participated in over the previous 7-day period. The MET minutes (metabolic cost of the activity multiplied by the duration in minutes) of the PA's were calculated per child. Percentage body fat (%BF) was measured by a Tanita BC420MA device and participants were classified into categories based on their %BF, age and gender. Independent t-tests and ANOVA (post-hoc DunnettT-3) were used to assess differences between gender and %BF category.
Overall, children spent 93 mins/d being physically active with 69% meeting the > 1hr recommendation. There was a significant difference in the time spent undertaking PA between boys (99 mins/d) and girls (88 mins/d) p = 0.020. Children spent 107 mins/d watching screens with 68% meeting the < 2hr guidance. Girls spent significantly less time watching screens (89 mins/d) than boys (124 mins/d) p ≤ 0.001. Children who had a normal %BF accumulated more PA MET mins/day compared to those who were classified as obese, which was significant in the total population (p = 0.007), for boys (p ≤ 0.001), but not girls (p = 0.929).
This preliminary analysis indicates that a high proportion of Irish children are meeting the PA and ST recommendations, with boys being more physically active and spending more time watching screens compared to girls. However, results should be interpreted with caution as PA and ST usage were self-reported by participants. The association between PA MET minutes and %BF suggest that advice to encourage PA participation to combat excess adiposity in Irish children is justified. Future work should examine the role of other potential determinants of obesity in this cohort.
The Food Safety Authority of Ireland (FSAI) have set target maximum daily salt intakes for children (4–6y: 3 g, 7–10y: 5 g, 11–14y: 6g) while the European Food Safety Authority (EFSA) have set Adequate Intakes (AI) for potassium of 1100mg/d, 1800mg/d and 2700mg/d for children of the same respective age groups. An individual's sodium to potassium (Na:K) intake ratio is an important predictor of hypertension and the World Health Organization (WHO) recommend a Na:K intake ratio of ≤ 1.0mmol/mmol for both adults and children. Although the morbidities associated with hypertension may not be seen until adulthood, blood pressure in childhood has a significant association with blood pressure in adulthood. Therefore, estimation of Na:K intake ratios (best measured by urinary excretion) in children may predict their susceptibility to hypertension related diseases in later life. The aim of this study was to estimate sodium and potassium intake and mean molar Na:K intake ratio of Irish children and to assess compliance with dietary guidance.
Morning spot urine samples were collected for 572 children aged 5–12 years (95% of total sample) as part of the nationally representative Irish National Children's Food Survey II (2017–2018) (NCFSII; www.iuna.net). Samples were transported, processed and stored using best practice procedures. Urinary excretion of sodium and potassium were measured using a Randox RX Daytona and were corrected for gender and age-specific 24-hour urine volume estimations based on 24-hour urine volume estimates from Australian children. SPSS Version 25 was used for all analyses.
Mean 24-hour urinary sodium excretion was 2018mg/d, equivalent to an average salt excretion of 5.0g/d exceeding the FSAI maximum target intake for all age groups except 11–12 year olds. Mean 24-hour urinary potassium excretion was 1411mg/d with mean intakes below the AI from EFSA for all age groups with the exception of 5–6 year olds. The mean molar Na:K ratio of Irish children was 2.8 for boys and 3.4 for girls. Only 5% of Irish children met the WHO recommendation for a Na:K ratio of ≤ 1.0mmol/mmol.
High intakes of sodium and low intakes of potassium reported in this study result in a low compliance with the WHO recommendation of a Na:K ratio ≤ 1.0mmol/mmol. This may lead to a higher risk of hypertension and related morbidities in later life. Based on these findings, dietary interventions to combat hypertension related diseases (such as lowering sodium and increasing potassium intakes) should be implemented from childhood.
Under Regulation (EC) No 1924/2006 the usage of nutrition and health claims are permitted, however foods that are high in fat, sugars and salt are advised not to use such claims as foods promoted with these claims may influence consumer food choice. The use of nutrient profiles has been proposed as a means of avoiding the potential of such claims masking the overall nutritional status of a product. Ready to eat breakfast cereals (RTEBC) often display nutrition claims whilst also contributing significantly to total sugar and energy intake. The aim of this study was to profile a variety of RTEBC and compare nutrient composition and claim information between nutrient profile categories.
The Irish National Food Ingredient database (INFID) is a record of brand specific information from food labels collected during the Irish national food surveys. A convenience sub-sample of RTEBC as eaten by Irish children during the National Children's Food Survey 2 (2017/2018) were selected (n = 102). Nutrient profile (NP) scores were calculated using the UK Nutrient Profiling Model (FSA). NP scores were calculated based on a set of negative macronutrient indicators (energy, saturated fat, total sugars and sodium) minus positive indicators (protein, fibre, “fruit, vegetables and nuts”) present per 100 g. Foods scoring four points or more were classified as “less healthy”.
More than half of RTEBC were classed “less healthy” (53%) with a median NP score of 8.0 with “healthy” RTEBC scoring significantly lower at -0.0 (p < 0.001). “Healthy” RTEBC had a median sugar content of 13.4g/100 g compared to 24g/100 g in the “less healthy” (p < 0.001). “Healthy” RTEBC had a higher fibre content of 8.8g/100 g compared to 5.72g/100 g in the “less healthy” (p = 0.001), with 35% of healthy and 28% of less healthy RTEBC making a substantiated “high in fibre” claim. Micronutrient contents of all RTEBC were similar, with only iron significantly higher in “healthy” (13.3mg/100g) compared to “less healthy” (9.5mg/100g) (p = 0.02). The prevalence of substantiated micronutrient related claims was the same between “healthy” and “less healthy” RTEBC.
“Healthy” and “less healthy” RTEBC display similar micronutrient profiles, with most of the nutrition claims on both pertaining to the micronutrient and fibre content, potentially overshadowing the macronutrient contribution of the cereals. This analysis shows the ability of nutrient profiling to distinguish products by macronutrient profiles however it identifies the complexity of application with respect to micronutrient content. Further research is required to investigate the contribution of the profiled RTEBC to total nutrient intakes.