Breakfast cereals are widely consumed in Ireland with over 80% of adults choosing ready-to-eat cereals or porridge. In terms of healthy eating, breakfast cereals are considered a nutritious choice and are not expected to contribute significantly to daily salt intakes. Since 2003, the Food Safety Authority of Ireland has coordinated a salt reduction programme to achieve voluntary reduction by the food industry in the salt content of processed foods available in Ireland. This study aims to examine whether salt levels of breakfast cereals are decreasing due to reformulation practices.

A random selection of breakfast cereals on the Irish market were sampled using the following categories: rice-based, bran-based, cornflake-type, biscuit-based, multigrain, muesli and no added salt/low salt varieties in 2003, 2007, 2011 and 2015 (muesli and no added salt/low salt varieties were not sampled again in 2015) (n687). Samples were analysed for sodium content using atomic emission spectrophotometry and converted to salt (g) per 100 g of the food product by multiplying by 2.54. Results were analysed using IBM SPSS (version 25). As data was not normally distributed, median values (minimum and maximum) were investigated across breakfast cereal categories at the different time-points. Differences between the time-points were assessed using Krusal-Wallis test and Mann-Whitney U tests.

In 2003, salt levels were found to be highest in cornflake-type cereals and lowest in no added salt/low salt cereals (2.02 g (0.20–2.31) and 0.01 g (0.0–0.03) per 100 g respectively). The salt content of rice-based, bran-based, cornflake-type, biscuit-based and multigrain varieties significantly decreased (up to 65% in cornflake-type cereals) until 2011. No further reduction was achieved for rice-based, bran-based and cornflake-type varieties in 2015 and a significant increase in salt was observed for biscuit-based (p = 0.001) and multigrain products (p = 0.007). Between 2003 and 2011, no reduction in salt levels was observed for muesli or no added salt/low salt products.

This study revealed there has been a significant reduction in the salt content of breakfast cereals since 2003 – an important finding considering breakfast cereals are recommended for healthy eating. However, this work also shows that continuous salt monitoring is necessary to ensure this reduction in breakfast cereals is maintained. Future FSAI reformulation work will examine a range of nutrients in food products as the food industry have committed to achieve a gradual reduction in fat, saturated fat and sugar, as well as salt, as part of the National Obesity Policy and Action Plan.

Over half of the Irish population is overweight or obese. The Obesity Policy and Action Plan 2016–2025 will set reformulation targets for fat, saturated fat and sugar in Ireland and review progress. In 2016, the Food Safety Authority of Ireland undertook a cross-sectional market scan of yoghurts to evaluate the energy, fat, saturated fat and sugar content based solely on declared nutrition labels. The aims of this 2018 study were to verify the accuracy of declared nutrition information on yoghurts and to confirm the suitability of declared nutrition labels for energy, fat, saturated fat and sugar reformulation monitoring.

Yoghurts identified in the 2016 market scan (n578) were weighted based on categorisation of manufacturer type (branded, own brand), product category (natural, flavoured and luxury) and declared nutrition content. Samples (n200) were randomly selected from these weighted groups and tested by a laboratory accredited for energy, fat, saturated fat, and sugar analysis. Data was analysed using IBM SPSS (version25). As data was not normally distributed, median values were investigated for declared and tested energy, fat, saturated fat and sugar content using Wilcoxon Signed-Rank Test and Spearman Rank-Order Correlation.

Of the tested yoghurts, 3% (n6), 5% (n9) and 19% (n31) were outside the recommended European Commission (EC) labelling tolerance for fat, saturated fat and sugar, respectively. Tested nutrient content was consistently lower than declared. There was a statistically significant difference in declared vs. tested energy (87kcal vs. 84kcal p = 0.03), fat (2.7 g vs. 2.5 g p < 0.001), and sugar (9.9 g vs. 8.7 g p < 0.001) content per 100 g yoghurt. Declared vs. tested sugar content per 100 g yoghurt was statistically significant across all yoghurt types, including natural (4.8 g vs. 3.4 g p < 0.001), flavoured (9.7 g vs. 8.6 g p < 0.001) and luxury (15 g vs. 13.6 g p = 0.002). There was a statistically significant difference between declared vs. tested fat (2.8 g vs. 2.5 g p < 0.001) and saturated fat (1.9 g vs.1.6 g p = 0.017) content of own brand yoghurts per 100 g. There was a positive correlation between energy content and portion size (r = .2,p < 0.01).

There was a high level of agreement between declared vs. tested fat and saturated fat content of yoghurts, but a lower level of agreement between declared vs. tested sugar content of yoghurts. This indicates that declared nutrition labels are suitable for reformulation monitoring of fat and saturated fat, but may not be suitable for sugar. This finding will be further investigated and tested in future work planned for nutrition label verification of other food categories.

The World Health Organisation (WHO) strongly recommends reducing free sugar intake to < 10% energy, and suggests a further conditional reduction to < 5% energy. This study aims to assess how achievable these free sugar intake recommendations are in healthy diets of 1–5 year olds in Ireland and to identify the main food contributors.

Using minimal added sugar, fat and no added salt, four-day food intake patterns were developed for 1–5 year old children (n30 girls; n30 boys) representing different percentile levels on the WHO growth charts. These food intake patterns were based on foods commonly consumed in the Irish National Pre-school Nutrition Survey and adjusted to meet energy, macronutrient and micronutrient requirements. The free sugar content of each food used was identified according to the WHO definition and estimated using food composition tables. Free sugar content of the four-day patterns was assessed against the two WHO recommendations. Subjects were compared depending on recommendations achieved. Where necessary, nutrients were estimated per 500kcal to control for energy.

Food intake patterns of all subjects (n60) achieved the WHO recommendation of < 10% energy, with 50% (n30) meeting the further recommendation of < 5% energy. Subjects with free sugar intakes < 5% energy compared with those not meeting this recommendation, were younger (2 years vs. 3.5 years, p < 0.001), had lower energy intakes (946kcal vs. 1263.8kcal, p < 0.001), higher fat intakes (37% vs. 29%, p < 0.001), higher saturated fat intakes (18% vs. 13%, p < 0.001) and lower carbohydrate intakes (46% vs. 53%, p < 0.001). When estimated per 500kcal they had lower intakes of fibre (5.0 g vs. 6.2 g, p < 0.001) and vitamin D (5.9μg vs. 6.3μg, p < 0.001) and higher intakes of vitamin A (177.3μg vs. 108.5μg, p < 0.001) and DHA and EPA (0.3 g vs. 0.2 g, p < 0.001). The main foods contributing to free sugar intakes in these subjects were cereals (29% of free sugar intake), yoghurts (27%), breads (5%) and ice cream (4%). By comparison the main foods contributing to free sugar in subjects whose intakes exceeded 5% energy included yoghurts (22%), stewed apples (9%) and puddings (6%).

This analysis demonstrates the WHO strong recommendation of < 10% energy for free sugar was easily achievable, but the further conditional recommendation (< 5%) was more difficult. This was only achieved at younger ages and was associated with increased intakes of fat and saturated fat and lower intakes of fibre and vitamin D. The main food contributors to free sugar in healthy diets for 1–5 year olds are important sources of nutrients.

The use of nutrition and health claims on food is legislated for in Commission Regulation 1924/2006 and SI No. 11 of 2014. This legislation ensures that any claim made on a food label is clear, accurate and substantiated, enabling consumers to make informed choices. A study undertaken by the Food Safety Authority of Ireland (FSAI) in 2009 found that yoghurts were the food category with the highest use of nutrition and health claims on the Irish market.

In 2018, the FSAI undertook a nutrition label verification study to verify the accuracy of declared nutrition information on yoghurts. The aims of this study were to measure the use of nutrition and health claims on a sample of yoghurts available on the Irish market in 2018 and assess their compliance with Regulation 1924/2006 Nutrition and Health Claims made on Food.

Yoghurts identified in a 2016 market scan (n578) were weighted based on categorisation of manufacturer type (branded, own brand), product category (natural, flavoured and luxury) and declared nutrition content. Samples (n200) were randomly selected from these weighted groups for the 2018 nutrition label verification study. A subsample (n100) was randomly sampled and checked for presence of nutrition and health claims. Presence of nutrition and health claims was recorded in Microsoft Excel and checked for compliance with Regulation 1924/2006.

Of the yoghurts reviewed, 67% (n67) made at least one nutrition claim and 34% (n34) made at least one health claim. Of these, 29% (n29) made a nutrition and a health claim. Branded yoghurts were more likely to make nutrition and health claims than own brand yoghurts (78% (n49) vs. 48% (n18)). Of yoghurts with a health claim, 88% (n30) were branded and 12% (n4) were own brand. Of yoghurts with a nutrition claim, 1.5% (n1) made a nutrition claim which was potentially non-compliant with Regulation 1924/2006. Of yoghurts with a health claim, 74% (n23) made a health claim which was potentially non-compliant with Regulation 1924/2006. The majority of potentially non-compliant health claims were in relation to probiotic strains and ‘live cultures’.

In conclusion, yoghurts continue to be a food category which often uses nutrition and health claims. Nutrition and health claims are more frequently used by branded than own brand products. Potentially non-compliant health claims are an issue amongst this food category which will be further investigated and followed up.

In 1988, there were two outbreaks of legionellosis in Bolton Health District. Altogether 37 cases of Legionnaires' disease and 23 cases of non-pneumonic legionellosis were identified. Twenty-five patients with Legionnaires' disease were associated with an engineering plant, 4 with Bolton town centre, and 8 with both the plant and town centre. Twenty-two people with non-pneumonic legionellosis were linked with the engineering plant and one with the plant and the town centre. A case-control study carried out among 37 employees with legionellosis and 109 control subjects at the plant showed that infection was associated with one of the 15 cooling towers on the site. Legionella pneumophila indistinguishable by serological and genetic typing methods was isolated from this cooling tower and from sputum samples from two patients. In the town centre, no one tower was linked with infection and L. pneumophila was not cultured from any of the nine towers identified. Control measures were implemented and to date there have been no further cases of legionellosis associated with Bolton Health District.