A 7-day diet history was completed by 1213 subjects in Ireland between the ages of 8 and 80 years. Subjects were divided into breakfast skippers, cereal eaters or non-cereal eaters.Ninety-seven per cent of the population ate breakfast. Sixty-eight per cent were breakfast-cereal consumers and of these 62% ate breakfast six to seven times per week. The contribution which breakfast cereal makes to the total daily nutrient intake was calculated for males and females separately, and also for the two age-groups 8-18 years and >18 years. Iron intakes were lower than the RNI for all females but cereal consumers appeared more likely to achieve their RNI than br0akfas.t skippers and non-cereal consumers. Breakfast-cereal consumers had significantly higher intakes of vitamins B,, B2, niacin, folate.BIZ, vitamin D, calcium and iron. For females not consuming a breakfast cereal. mean nutrient intakes of folate and calcium were lower than the RNI. From this study, it appears that breakfast cereal consumption makes a significant contribution to nutrient intake in the Irish diet.
The aim of this paper is to describe innovations taking place in national nutrition surveys in the UK and the challenges of undertaking innovations in such settings. National nutrition surveys must be representative of the overall population in characteristics such as socio-economic circumstances, age, sex and region. High response rates are critical. Dietary assessment innovations must therefore be suitable for all types of individuals, from the very young to the very old, for variable literacy and/or technical skills, different ethnic backgrounds and life circumstances, such as multiple carers and frequent travel. At the same time, national surveys need details on foods consumed. Current advances in dietary assessment use either technological innovations or simplified methods; neither lend themselves to national surveys. The National Diet and Nutrition Survey (NDNS) rolling programme, and the Diet and Nutrition Survey of Infants and Young Children (DNSIYC), currently use the 4-d estimated diary, a compromise for detail and respondent burden. Collection of food packaging enables identification of specific products. Providing space for location of eating, others eating, the television being on and eating at a table, adds to eating context information. Disaggregation of mixed dishes enables determination of true intakes of meat and fruit and vegetables. Measurement of nutritional status requires blood sampling and processing in DNSIYC clinics throughout the country and mobile units were used to optimise response. Hence, innovations in national surveys can and are being made but must take into account the paramount concerns of detail and response rate.
Fieldwork for the Diet and Nutrition Survey of Infants and Young Children (DNSIYC) was carried out during 2011 to provide detailed quantitative information on food and nutrient intakes, nutrient sources and nutritional status of a representative sample of infants aged 4-18 months in the UK. In 2009-10 a preliminary study was carried out to assess the effectiveness and validity of using calibrated utensils to measure food and drink consumption in infants aged 4-18 months. The aim was to determine if the use of calibrated utensils influenced the portion size offered to the infant and so affect their daily nutrient intake.Food and drink intakes of 50 infants in North-East England were recorded using both an ESTIMATED and a WEIGHED 4-day food diary in random order, completed by the infant's parent/carer, over a 2 week period. Parents were provided with 4 graduated containers for food preparation and serving (2 · 150 ml and 2 · 300 ml), as well as 6 spoons (1.25 ml-15 ml), and were encouraged to use these to record all portion sizes in the ESTIMATED diary. Volume measures were converted to gram weights by the application of conversion factors, calculated for each food and drink consumed.The table below shows the mean daily intakes for each method. 41 % of the sample had mean daily intakes (g) for the estimated method which were within 10 % of the weighed intakes. 96 % were within 50 % of the weighed intakes. There was no difference in mean intakes between the two methods for different food types e.g. discrete food items and amorphous foods. Mean daily intakes Weighed EstimatedFood weight (g) 932 958 Energy (kcal) 721 776 The results indicated that the estimated intake method, supported by the use of measuring equipment, gave very similar results to those of weighed intakes. However the diary coding stage for these pilot data found the use of the equipment resulted in a much slower coding rate and a high number of queries. Based on the number of participants taking part in the main stage of DNSIYC, it was calculated many more coders would be required to manage the queries and meet deadlines. The final decision was to proceed with a household measures approach for dietary data collection; this method required no additional equipment and fewer coding resources. Although the household measures method has been extensively used in older age groups, (1) further work is proposed to validate this method against weighed intakes in 4-18 month infants. The study will follow the same method described above and will determine whether the household measures approach results in similar intakes as the weighed method.
The National Diet and Nutrition Survey assesses dietary intakes and nutritional status of the UK population P18 months, including iron, where there are concerns about adequacy of intakes and status (1) . Recognising the need for similar information about those younger than 18 months, the Department of Health commissioned a survey of infants and young children aged 4-18 months, which was carried out in 2011. Iron intakes and status are reported here.The sample was drawn using a multi-stage random probability design from Child Benefit records, in two waves to ensure sufficient numbers at each end of the age range. Background information was collected using home interviews for socio-demographic and health information, and dietary data collected using an estimated food diary of four consecutive days. Diaries were coded using DINO (Diet In Nutrients Out), HNR's dietary recording and analysis system, with food composition from the Department of Health's Nutrient Databank. Fully productive participants were those completing P3 days of diary; these were invited to attend a clinic or have a home visit for anthropometry and blood sampling (3.9 ml non-fasting), from February to August 2011. For diet, results were subdivided into: 4-6 months, 7-9 months, 10-11 months, and 12-18 months; for clinic, groupings were 5-11 months and P12 months. Iron status was assessed through measurements of haemoglobin (Hb), ferritin, and transferrin receptors (sTfR). Ferritin and sTfR were measured on a Siemens Dimension Xp analyser by "sandwich" immunoassay methods. Lower limits were: Hb: 10.5 g/dL (5-6 months), 10.0 g/dL (7-9 months), 11.0 g/dL (P10 months); ferritin: 9 mg/L (5-6 months), 5 mg/L (7-9 months), 12 mg/L (P10 months). The upper limit for sTfR was 11 mg/mL for all ages. Weighting factors ensured representativeness (2) . There were 2,683 fully productive children in DNSIYC (response rate 62 %), with the achieved sample close to the UK population in terms of age, sex, ethnicity and region. 44 % (n = 973) of eligible fully productive children attended a clinic visit, of whom 55 % successfully provided a blood sample. Mean iron intakes were > RNI for children 4-6 months (135 % of RNI) and close to the RNI for 7-9 months (94%), 10-11 months (98%) and 12-18 months (93 %). Infant formula was the main source of iron for children 4-6 months (56%), 7-9 months (48 %) and 10-11 months (42 %), while for 12-18 months, it was cereals and cereal products (41%). 7 % of children 5-11 months and 11 % of 12-18 months were below ferritin reference limits. 6% of those 5-11 months and 15 % of 12-18 months were > upper sTfR reference limit. 13 % of children 5-11 months and 15 % of P12 months fell below the lower Hb limit. 3 % of those 5-11 months and 2 % of 12-18 months were < both ferritin and Hb limits, a sign of iron deficiency anaemia.For most infants, iron status is satisfactory although some infants were outside reference limits. Infant formula provides the major intake source.
The National Diet and Nutrition Survey assesses the dietary intakes and nutritional status of the UK population P18 months, including vitamin D, where there are concerns about adequacy of intakes, exposure to sunlight and status (1) . Recognising the need for information about those < 18 months, the Department of Health commissioned a survey of infants and young children aged 4-18 months, which was carried out in 2011. Intakes and status of vitamin D are reported here.The sample was drawn using a multi-stage random probability design from Child Benefit records, drawn in two waves to ensure sufficient numbers at each end of the age range. Background information was collected using home interviews for socio-demographic status and health information, and dietary data collected using an estimated food diary of four consecutive days. Diaries were coded using DINO (Diet In Nutrients Out), HNR's dietary recording and analysis system, with food and supplement composition from the Department of Health's Nutrient Databank. Vitamin D in breast milk was not included as estimates vary widely; breastfed and non-breastfed are reported separately. Fully productive participants were those who completed P3 days of diary; these were asked to attend a clinic or have a home visit for anthropometry and blood sampling, from February to August 2011. For diet, results were subdivided into 4 groups: 4-6 months, 7-9 months, 10-11 months, and 12-18 months; for clinic, groupings were 5-11 months and P12 months. Vitamin D status was measured using the DiaSorin Liaison method for 25-hydroxyvitamin D (25-OHD), a direct, competitive chemiluminescence immunoassay. Weighting factors ensured representativeness. The lower threshold for vitamin D adequacy is 25 nmol/L of 25-OHD (2) . There were 2,683 fully productive children in DNSIYC (response rate 62 %), the achieved sample close to the UK population in terms of age, sex, ethnicity and region. 44 % (n = 973) of eligible fully productive children attended a clinic visit, of whom 55 % provided a blood sample. For non-breastfed, mean intakes of vitamin D from all sources were > RNI for 4-11 months (7.7-10.0 mg/d, 111-125 % of RNI) but < RNI for 12-18 months (3.9mg/d) (55 % of RNI). Infant formula provided 85 % of intake for 4-6 months, 80 % for 7-9 months, 72 % for 10-11 months, but only 29 % for 12-18 months. Mean intake of vitamin D (excluding breast milk) of breastfed children were < RNI, ranging from 37 % to 54 % of RNI (2.6-3.8 mg/d). Supplement use was low. Mean 25-OHD for 5-11 months was 68.6 nmol/L and 64.3 nmol/L for 12-18 months. 6 % of 5-11 months were < lower threshold of vitamin D adequacy, 2 % of those 12-18 months.For most infants, vitamin D status is satisfactory and for non-breastfed, infant formula provides the major intake source.
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