THE OFFICIAL JOURNAL OF THE BRITISH DIETETIC ASSOCIATION Editor: Simon Langley-Evans Journal of Human Nutrition and Dietetics VOLUME 30 • ISSUE 4 • AUGUST 2017 CHILDREN AND ADOLESCENTS DIETETIC PRACTICE OBESITY AND RELATED DISORDERS INBORN ERRORS OF METABOLISM DIETARY ASSESSMENT AND FOOD BEHAVIOURS jjhn_V30_I4_Issueinfo.inddhn_V30_I4_Issueinfo.indd 1 330-06-20170-06-2017 111:43:481:43:48 Journal of Human Nutrition and Dietetics The Offi cial Journal of the British Dietetic Association Editor-in-Chief Editorial Board Professor Simon Langley-Evans A. Anderson, Centre for Public Health Nutrition Research, University of Dundee, UK Deputy Head of School of Biosciences T. Baranowski, Bayor College of Medicine, USA University of Nottingham, J. Bauer, School of Human Movement Studies, University of Queensland, Australia UK. T. Burrows, University of Newcastle, Australia E-mail: [email protected] J. Coad, Massey University, New Zealand Associate Editors C. Collins, University of Newcastle, Australia S Burden, University of Manchester, UK P. Collins, Faculty of Health, Queensland University of Technology, Australia C Green, Nutricia, The Netherlands K. Davison, Simon Fraser University, Canada J. Harvey, University of Vermont, USA M. Hickson, Faculty of Medicine, Imperial College London, UK J. Hodgson, University of Western Australia, Australia M. Kiely, CountyCollege Cork, Ireland F. Kolahdooz, University of Alberta, Canada I. Lemieux, Quebec Heart Institute, Laval University, Canada S. Lennie, School of Pharmacy and Life Sciences, Robert Gordon University, UK A. Madden, School of Health and Emergency Professions, University of Hertfordshire, UK M. McInley, Queens University Belfast, UK D. Mellor, University of Canberra, Australia C. Nowson, Deakin University, Australia T. Ong, Sao Paolo University, Brazil A. O’Sullivan, Institute of Food and Health, University College Dublin, Ireland M. Pakseresht, University of Alberta, Canada Y. Probst, University of Wollongong, Australia A. Roefs, Faculty of Psychology, Maastricht University, The Netherlands J. Swift, School of Biosciences, University of Nottingham, UK M. Taylor, School of Biomedical Sciences, University of Nottingham, UK K. Whelan, Kings College London, UK L. Williams, Department of Oncology, University of Sheffi eld, UK L. Wood, University of Newcastle, Australia Aims and editorial policy Editors cannot be held responsible for errors or any USA (www.copyright.com), provided the appropriate Journal of Human Nutrition and Dietetics is an consequences arising from the use of information fee is paid directly to the RRO. This consent does not international peer reviewed journal publishing contained in this journal; the views and opinions extend to other kinds of copying such as copying for papers in applied nutrition and dietetics. 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Further information on this journal can be accessed registered with their local Reproduction Rights at wileyonlinelibrary.com/journal/jhn Organisation (RRO), e.g. Copyright Clearance Center Production Editor: Patricia Joyce Tulayan (email: The Publisher, British Dietetic Association and (CCC), 222 Rosewood Drive, Danvers, MA 01923, [email protected]) jjhn_V30_I4_Issueinfo.inddhn_V30_I4_Issueinfo.indd 2 330-06-20170-06-2017 111:43:481:43:48 Journal of Human Nutrition and Dietetics CHILDREN AND ADOLESCENTS Dietary strategies for achieving adequate vitamin D and iron intakes in young children in Ireland L. Kehoe,1 J. Walton,1 B.A. McNulty,2 A.P. Nugent2 & A. Flynn1 1School of Food and Nutritional Sciences, University College Cork, Cork, Ireland 2UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland Keywords Abstract dietary strategies, fortification, iron, supplementation, vitamin D. Background: Inadequate intakes of vitamin D and iron have been reported in young children in Ireland. The present study aimed to identify the main Correspondence foods determining vitamin D and iron intakes and to model the impact of J. Walton, School of Food and Nutritional dietary strategies to improve adequacy of these micronutrients in young Sciences, University College Cork, Republic of children. Ireland, Cork, Ireland. Methods: The present study is based on the Irish National Pre-School Tel.: +353 (0) 214903387 Fax: +353 (0) 21 4270244 Nutrition Survey (NPNS), which estimated food and nutrient intakes in a E-mail: [email protected] representative sample (n = 500) of children (aged 1–4 years) using a 4-day © weighed food record. Dietary strategies were modelled using DaDiet soft- How to cite this article ware (Dazult Ltd, Co. Kildare, Republic of Ireland) and the usual intake dis- Kehoe L., Walton J., McNulty B.A., Nugent A.P. tribution, prevalence of inadequate intakes and risk of excessive intakes & Flynn A. (2017) Dietary strategies for were estimated using the National Cancer Institute method. achieving adequate vitamin D and iron intakes in Results: Fortified foods and nutritional supplements were the key foods young children in Ireland. J Hum Nutr Diet. 30, À influencing the intakes of vitamin D and iron. Adding a 5 lg day 1 vitamin 405–416 doi: 10.1111/jhn.12449 D supplement, fortifying cow’s milk (CM) with vitamin D or replacing CM with growing-up milk (GUM) would modestly increase intakes of vitamin D. A combined strategy of fortifying CM with vitamin D or replacing CM À with GUM plus a 5 lg day 1 vitamin D supplement would increase mean À À intakes of vitamin D (from 3.5 lg day 1 at baseline to ≥11 lg day 1) and substantially reduce the prevalence of inadequate intakes (from >95% to 12–36%). Fortifying CM with iron or replacing CM with GUM would À À increase mean intakes of iron (from 7.3 mg day 1 to >10 mg day 1), achieving adequate intakes across all ages. Conclusions: Based on real food consumption data in a representative sam- ple of Irish children, we have shown that through targeted dietary strategies adequate intakes of iron are achievable and intakes of vitamin D could be greatly improved. Fortified foods and supplements can represent an Introduction opportunity to improve intakes and adequacy of vitamin – – Low intakes of vitamin D and iron (1 7) and biochemical D and iron in all population groups (14 20). The practical evidence of poor vitamin D and iron status have been and theoretical impacts of vitamin D fortification of dairy widely reported in young children in Ireland and across products have been widely investigated, demonstrating – Europe (8 11). As a result of the negative impact of inade- that it is an effective strategy for increasing dietary intake quate vitamin D and iron status on childhood growth and serum 25-hydroxyvitamin D (25(OH)D) concentra- – and development and lifelong health status (12,13), effec- tions in many population groups (21 26). Furthermore, it tive dietary strategies to improve the intakes of these has been frequently reported that the consumption of nutrients in young children are required. breakfast cereals (primarily ready-to-eat breakfast cereals, ª 2016 The British Dietetic Association Ltd. 405 Strategies for adequate vitamin D and iron intakes L. Kehoe et al. which are commonly fortified with a number of nutrients (a) 06/07/10). Written informed consent was obtained including iron), is associated with higher iron intakes and from parents/guardians. a better dietary nutritional profile among all age groups (18,27,28). Several countries, particularly those at Northerly Sampling and recruitment methodology latitudes, currently recommend vitamin D supplements – for many population subgroups (29 32); however, despite Eligible participants were children aged between 12 and recommendations for younger infants and older children 59 months, inclusive, who had not yet started primary and adults in Ireland to take a vitamin D supplement school. A total sample of 500 participants (251 boys and daily, there are currently no recommendations for young