BackgroundDietary assessment methods are important tools for nutrition research. Online dietary assessment tools have the potential to become invaluable methods of assessing dietary intake because, compared with traditional methods, they have many advantages including the automatic storage of input data and the immediate generation of nutritional outputs.ObjectiveThe aim of this study was to develop an online food frequency questionnaire (FFQ) for dietary data collection in the “Food4Me” study and to compare this with the validated European Prospective Investigation of Cancer (EPIC) Norfolk printed FFQ.MethodsThe Food4Me FFQ used in this analysis was developed to consist of 157 food items. Standardized color photographs were incorporated in the development of the Food4Me FFQ to facilitate accurate quantification of the portion size of each food item. Participants were recruited in two centers (Dublin, Ireland and Reading, United Kingdom) and each received the online Food4Me FFQ and the printed EPIC-Norfolk FFQ in random order. Participants completed the Food4Me FFQ online and, for most food items, participants were requested to choose their usual serving size among seven possibilities from a range of portion size pictures. The level of agreement between the two methods was evaluated for both nutrient and food group intakes using the Bland and Altman method and classification into quartiles of daily intake. Correlations were calculated for nutrient and food group intakes.ResultsA total of 113 participants were recruited with a mean age of 30 (SD 10) years (40.7% male, 46/113; 59.3%, 67/113 female). Cross-classification into exact plus adjacent quartiles ranged from 77% to 97% at the nutrient level and 77% to 99% at the food group level. Agreement at the nutrient level was highest for alcohol (97%) and lowest for percent energy from polyunsaturated fatty acids (77%). Crude unadjusted correlations for nutrients ranged between .43 and .86. Agreement at the food group level was highest for “other fruits” (eg, apples, pears, oranges) and lowest for “cakes, pastries, and buns”. For food groups, correlations ranged between .41 and .90.ConclusionsThe results demonstrate that the online Food4Me FFQ has good agreement with the validated printed EPIC-Norfolk FFQ for assessing both nutrient and food group intakes, rendering it a useful tool for ranking individuals based on nutrient and food group intakes.

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Objective: Low micronutrient intakes in adolescents are frequently reported. We assessed micronutrient intakes in adolescents to determine whether supplement use optimises intakes. Methods: Dietary intake was assessed using a food frequency questionnaire in 17 year old participating in the Western Australian Pregnancy Cohort (Raine) Study (n = 991). We calculated median daily micronutrient intakes in supplement users and non-users (from food sources only and from food and supplements), along with the percentage of adolescents meeting the Estimated Average Requirements (EAR) or Adequate Intake (AI) where appropriate. Results: Intakes of calcium, magnesium, folate and vitamins D and E from food only were low. Although supplements significantly increased micronutrient intakes in supplement users, more than half of supplement users failed to meet the EAR or AI for some key micronutrients. Compared with non-users, supplement users had higher micronutrient intakes from food sources with the exception of vitamins D and B12 and were more likely to achieve the EAR or AI for many micronutrients from food only. Conclusions: Intakes of some key micronutrients were low in this population, even among supplement users. Those facing the greatest risk of micronutrient deficiencies were less likely to use supplements.

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the ‘framework approach’ described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Objective: Adequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attentiondeficit hyperactivity disorder. We aimed to investigate the prospective association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population-based cohort of adolescents. Design: Prospective analysis (general linear mixed models) of dietary intakes of Zn and Mg assessed using a validated FFQ and mental health symptoms assessed using the Youth Self-Report (YSR), adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake. Setting: Western Australian Pregnancy Cohort (Raine) Study. Subjects: Adolescents (n 684) at the 14-and 17-year follow-ups. Results: Higher dietary intake of Mg (per SD increase) was significantly associated with reduced externalising behaviours (β = −1·45; 95 % CI −2·40, −0·50; P = 0·003). There was a trend towards reduced externalising behaviours with higher Zn intake (per SD increase; β = −0·73; 95 % CI −1·57, 0·10; P = 0·085). Conclusions: The study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for Zn intake. Randomised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents. Keywords Magnesium Dietary intake Raine Study Mental healthZn and Mg are essential minerals involved in functioning of the central nervous system. Dietary sources of Zn include red meat, poultry, legumes, nuts and seeds, certain types of seafood (e.g. oysters, crab and lobster), whole grains, fortified breakfast cereals and dairy products. Mg is widely distributed in plant foods, particularly green leafy vegetables, legumes, nuts, seeds and whole grains. Zn is a cofactor of many enzymes that play a role in brain function (1) and is present in regions of the brain associated with the pathophysiology of mood disorders, including the amygdala, hippocampus and cerebral cortex (2) . Zn modulates neuronal excitability by inhibiting both the GABA (γ-aminobutyric acid) and NMDA (N-methyl-D-aspartate) receptors (3) and has shown antidepressant-like activities in animal models (4)(5)(6) . Mg is another potent antagonist of the NMDA receptor complex (7) and Mg deficiency has been related to symptoms such as agitation, anxiety, irritability and hyperexcitability (8) . In rodent models, Mg depletion increases anxiety and depression-like behaviours (9,10) , and mice with low erythrocyte Mg levels have been found to exhibit more aggressive behaviour than those with high Mg levels (11) .Recently, Jacka et al. reported that dietary intakes of Zn and Mg were inversely and cross-sectionally associated with depressive and anxiety scores in a population-based sample of women (n 1046) (12) . Other studies have shown...

Adequate zinc and magnesium intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attention-deficit hyperactivity disorder. Zinc is a co-factor of many enzymes that play a role in brain function (1) and zinc modulates neuronal excitability by inhibiting both the gamma-aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA) receptors (2) . Magnesium is another potent antagonist of the NMDA receptor complex (3) and magnesium deficiency has been related to symptoms such as agitation, anxiety, irritability and hyperexcitability (4) . We aimed to investigate the prospective associations of dietary intakes of zinc and magnesium with internalising and externalising behaviour problems in adolescents participating in both the 14 and 17 year follow-ups of the Western Australian Pregnancy Cohort (Raine) Study (n 684).Dietary intakes of zinc and magnesium were assessed using a validated food frequency questionnaire and mental health symptoms were assessed using the Youth Self-Report (YSR). General linear mixed models were used to investigate the prospective relationships between zinc and magnesium intakes and YSR T-scores, adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake.After adjusting for potential confounders, higher dietary intake of magnesium (per standard deviation) was significantly associated with reduced externalising behaviours and there was a trend towards reduced externalising behaviours with higher zinc intake.This study shows an inverse association between dietary magnesium intake and externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for zinc intake. Promoting increased consumption of mineral-rich foods, such as leafy/cruciferous vegetables, nuts and legumes, along with supplementation to address identified micronutrient deficiencies, may be a useful strategy to prevent mental health and behavioural problems in adolescents. In order to determine any benefit of magnesium and/or zinc supplementation in the prevention and treatment of externalising behaviour problems, randomised controlled trials using optimal doses are necessary.

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