Lactogenesis stage II, also known as when a mother's milk “comes in”, is characterised by copious milk production. Delayed lactogenesis II, when onset occurs after 72 hours post-partum, has been linked to early breastfeeding cessation. It has been suggested that caesarean section is a risk factor for late onset of lactogenesis II. It is unknown why lactogenesis II may be delayed in caesarean section but there are several potential reasons such as volume of blood loss, maternal stress, delayed breastfeeding initiation and difficulties with mobility and positioning. Analysis of timing of lactogenesis and breastfeeding frequency was carried out on data from the PROMESA and IMPRINT studies, which were looking at the supplementation of breast milk with a probiotic Bifidobacterium infantis. IMPRINT was carried out in California and enrolled eighty women prior to birth or before postnatal day 4. The PROMESA study in the UK only recruited women who were booked for elective caesarean sections, and also enrolled eighty mother-baby dyads. As part of both studies mothers filled out a variety of surveys and daily logs, including a daily feeding log, along with self-reported lactogenesis. Using logistic regression, we looked at whether mode of birth (spontaneous vaginal delivery, emergency and elective caesarean section) was associated with the timing of onset of lactogenesis, and linear regression to look at the difference in breastfeeding frequency between modes of birth. Mode of birth was significantly associated with delayed onset of lactogenesis > 3 days (OR 3.38, 95% CI 2.48–4.61). There was also a reduced frequency of breastfeeding in the first week post-partum in mother-baby dyads who underwent an elective caesarean section. These findings suggest that mothers who give birth by elective caesarean section may need additional support with breastfeeding in the early days post-partum, as well as ongoing support long-term to reduce the likelihood of early cessation of breastfeeding.

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.

Dietary iron requirements are higher among women of child-bearing age (WCBA) to replenish blood loss during menses, to prevent iron deficiency anaemia and to support a healthy foetus during pregnancy. Low intakes of iron have previously been reported among WCBA in Ireland and across Europe and data from European countries have shown that there is evidence of anaemia and low iron stores in this population group. The aim of this study was to investigate the dietary patterns influencing iron intakes in WCBA (18–50 years) in Ireland.

Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010) (www.iuna.net). A 4 day semi-weighed food record was used to collect food and beverage intake data (including nutritional supplement use) from a nationally representative sample of 1500 adults (487 women (18–50y)). Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. On the basis of mean daily intake of iron, WCBA were divided into three intake groups: low, medium and high. The food groups that accounted for the greatest proportion of the difference between the high (top third) and low (bottom third) of iron intakes were identified.

The difference in iron intakes between the high and low intake groups (25 v 6.7mg/d) was 18.3mg/d. Nutritional supplements and ready-to–eat breakfast cereals (RTEBC) (commonly fortified with iron) accounted for 58 and 20% of the difference in intakes between the high and low intake group, respectively. The contribution of nutritional supplements to the difference in iron intakes can be explained by the proportion of users in the high vs low intake group (27% vs < 1%). The contribution of RTEBC to the difference in iron intakes can be explained by both a higher proportion of those in the high vs low intake group consuming RTEBC and those in the high intake group having a higher mean daily intake of RTEBC (78% vs 36%; 32g/d vs 7g/d).

Most of the difference in iron intake between high and low consumers is attributable to nutritional supplement use and the patterns of consumption of fortified RTEBC. These findings will aid in the development of strategies to improve iron intakes in WCBA in Ireland.

Low intakes and suboptimal status of vitamin D, riboflavin, vitamin B12, folate and calcium have been reported in older adults across Europe. Dietary strategies to improve micronutrient intakes and status could include food fortification (mandatory or voluntary) and/or the use of nutritional supplements. This study aims to examine the impact of fortified food consumption and nutritional supplement use on nutrient intakes and nutritional status of vitamin D, riboflavin, vitamin B12, dietary folate equivalents (DFE) and calcium in older Irish adults.

Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010). A 4 day semi-weighed food record was used to collect food and beverage intake data (including nutritional supplement use) from a nationally representative sample of 1500 adults (226 older adults (≥ 65y)). Blood samples (n 1126 (n 145 ≥ 65y)) were collected, processed and analysed using standard operating procedures. Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. Fortified foods were identified as those that had one or more micronutrients added in the ingredient list and a nutritional supplement was defined as a supplement containing vitamins and/or minerals (i.e. excludes herbal/non-nutritional supplements). A fortified food consumer or nutritional supplement user was defined as a participant who consumed a fortified food or took a nutritional supplement at any time over the 4-day recording period. Usual intakes of micronutrients were calculated via the NCI-method using SAS© Enterprise Guide and analyses of biomarker data were carried out using SPSS©.

The consumption of fortified foods and/or use of nutritional supplements increased mean intakes of vitamin D (3.6 to 6.9μg/d), riboflavin (1.6 to 2.3mg/d), vitamin B12 (4.5 to 6.0μg/d), DFE (228 to 408μg/d) and calcium (784 to 947mg/d) in older Irish adults and reduced the prevalence of inadequate intakes of these micronutrients by up to 40%. Furthermore, consumers of fortified foods and/or nutritional supplements had improved biomarker status and reduced prevalence of low/deficient status for vitamin D (62 vs 16%), riboflavin (65 vs 11%), vitamin B12 (8 vs 0%) and folate (serum folate:18 vs 0%; red blood cell folate: 0% across all groups) when compared to non-consumers.

This study has shown that fortified foods and/or nutritional supplements represent an opportunity to improve intakes and status of key micronutrients in older adults. The data presented in this study will serve to inform the development and implementation of updated dietary recommendations for older adults in Ireland.

Interesterified (IE) saturated-rich fats are widely used to replace partially-hydrogenated fats as hard fats with functional properties needed for spreads/margarines, baked goods, and confectionary, while avoiding the health hazards of trans fats. However, the amount of IE fat consumed and their predicted pubic health impact relative to other application-appropriate fats is unknown. We investigated current intakes of IE fats and the dietary impact of substitution of IE with functionally-equivalent replacement fats using observational data from the UK National Diet and Nutrition Survey (NDNS) (years 5–6 (2012–2014), n = 2546) and technical manufacturing data from a UK IE fat supplier. The major sources, types and quantities of IE fat intake were calculated for the total population and different age, ethnic and socioeconomic groups.

IE fat contributes 3.4% of total fat and 1.1% of % total energy intake (TEI) (range 0–10.3%), with 19–64 yr old males consuming 1.1% and females 0.9% TEI from IE fats. 19–64 yr old quartiles of TEI intake were: 0.1%, 0.5%, 1.0% and 2.2%. The 65 yr + age category consumed the most IE fat (1.5% Energy), followed by 11–18 yr (1.2%) and 19–64 yr (1.0%). TEI from IE fats was 1% for high-income households, 1.1% for the middle-income group and 1.2% for the low-income group. White individuals consumed more energy from IE fat (1.2% TEI) than all other ethnic groups (0.7% TEI).

The main sources of IE fats in the UK are from retail spreads (margarines); 54.2%, baked goods; 22.1%, biscuits; 7.7%, non-dairy creams; 5.9% and confectionery; 5.6%. Palmitic/lauric acid-rich IE fats, formulated from palm and palm kernel oils, account for 70% of IE fat consumed. Reformulation of the largest contributor to IE intakes (spreads) to remove IE fat, but retain the same functional characteristics, increased the saturated fatty acid (SFA) composition from 22% to 37%, 25% to 36%, 39% to 42% in three most commonly consumed spread formulations. Replacement of IE fats with non-IE alternative formulations would increase population SFA intake by 0.3% of TEI.

IE fats contribute a small but important amount to the fat intake of the UK population. Removal of IE fat would result in an increase in SFA intake which may have public health implications. Previous research has not focused on the most commonly consumed IE fat blends identified (Palmitic/lauric rich), therefore a re-prioritisation of future research work is recommended to assess the potential impact of IE fats consumed by the UK population.

Vitamin D deficiency (VDD) has been associated with severe adverse health outcomes during pregnancy is increasingly recognised as a public health concern and maternal and infant VDD is closely associated. The aim of this study was to evaluate the magnitude of VDD and associated factors in pregnant women and newborns in the postpartum period. A cross-sectional study was carried out in a total of 66 pregnant women at > 37 weeks of gestation and newborns at the Gaziantep University Faculty of Medicine, Department of Obstetrics and Gynecology in Gaziantep, Turkey. Demographic characteristics, 24-h dietary recalls, intake of food supplements were determined in pregnant women, maternal and newborn anthropometric measurements and serum (25-OHD) levels were assessed. Mean age (± SD) of pregnant women was 28.8 ± 6.9 years. Although Turkey has “National Vitamin D Supplementation Programme for Pregnant Women” only 33.3% of women had VD supplementation during pregnancy, not all in the recommended levels (1200 IU/day). Mean (± SD) serum 25(OH)D levels in pregnant women and cord blood of newborns were 17.3 ± 9.0 ng/mL [non-supplemented women (NSW): 16.5 ± 7.9 ng/mL; supplemented women (SW): 18.8 ± 11.0 ng/mL] and 16.6 ± 9.9 ng/mL [newborns of non-supplemented women (NNSW): 13.9 ± 8.7 ng/mL and newborns of supplemented women (NSW): 22.1 ± 10.1 ng/mL], respectively. Vitamin D severe deficiency (< 10 ng/dL) was noted in 22.7%, deficiency (11–19 ng/mL) 51.5%, insufficiency (20–29 ng/mL) 15.2% and sufficiency (≥ 30 ng/mL) 10.6% of the women whereas severe deficiency, deficiency, insufficiency and sufficiency respectively, were determined in 33.3%, 39.5%, 13.6% and 13.6% of newborns (NNSW vs NSW, p = 006, p < 0.05). Median serum VD levels of NSW were statistically higher than NNSW (p = 0.000, p < 0.05). Out of total, 86.4% of women were dressing traditionally covered, and had lower serum VD level (p = 0.049, p > 0.05). SW had higher median body weight (p = 0.026) and body mass index (BMI) (p = 0.036) levels than NSW (p < 0.05). No statistically significant differences were found between anthropometric measurements of NNSW and NSW groups, although birth weights of NNSW and NSW groups were determined as 3005.1 ± 456.1 g and 3153 ± 422.5 g (p > 0.05), respectively. Maternal serum vitamin D levels strongly were correlated with newborn levels. Maternal vitamin D deficiency is a great problem and “National Vitamin D Supplementation Programme for Pregnant Women and Infants” should be effectively implemented and monitored. Also fortification programme should be a national policy.

Over the last years, there has been increasing interest in Baby-Led Weaning (BLW), an approach in which infants feed themselves with finger foods. Previous studies have shown that BLW may be associated with lower food fussiness and risk of obesity, but in the other hand with growth flattering. However, the results are limited and still inconclusive. The aim of this study was to investigate the associations between complementary feeding method and body mass index (BMI) z-score in children aged 19–36 months from Poland and Austria. This anonymously, the cross-sectional internet-based study was conducted in 2018 and 2019 among 6645 mothers of children aged 12–36 months, recruited through social media. The analysis included data from 5856 mothers (35.5% from Austria) with complete data. Complementary feeding method was categorized as traditional spoon feeding (TSF), partial BLW (children was both spoon-fed and fed themselves), as well as BLW. BMI z-score was calculated based on declared body mass and height using the WHO cut-off points. BLW method was used in 16.4% of children, whereas the TSF in 30.5% of the total study group. Normal BMI z-score was observed in 73.8% of the total study group, thinness in 9.6% and overweight and obesity in 4.3%. The BLW increased the risk of thinness only in children aged 31–36 months (aOR: 1.48; 95%CI: 1.04–2.11) but did not influence the risk of overweight and obesity. In this present large cross-sectional study conducted in two European countries, we did not find an association between BLW and overweight and obesity risk. However, in the older group, BLW increased the risk of thinness. Previous studies observing a risk of thinness were also cross-sectional, although conducted among smaller study groups. In contrary to this, In contrary to this, the RCT trials using modified BLW version Baby-Led Introduction to SolidS (BLISS) did not observe any case of growth flattering. In another cross-sectional study investigating dietary intake of infants aged 6–8 months, who were complementary fed using BLW or TSF method, authors did not observe a difference in energy intake between the two groups. Further studies investigating the role of complementary feeding method and subsequent BMI, especially in long-term are necessary.

Breakfast is often referred to as ‘the most important meal of the day’ and is consumed after the longest postprandial fast (an overnight fast). Breakfast consumption has been positively linked to many health benefits and has been shown in many studies to be associated with a better diet quality. The aim of this study was to characterise breakfast in Irish adults and to investigate the contribution of breakfast to overall daily nutrient intake.

Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010) (www.iuna.net). A 4 day semi-weighed food record was used to collect food and beverage intake data from a nationally representative sample of 1500 adults in the Republic of Ireland. Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. Breakfast was subjectively defined by the participant and reported in the food diary. In line with recommendations on breakfast studies, this study confined analyses to nutrients derived from breakfast foods and not nutritional supplements. Usual intakes of energy and selected nutrients (from breakfast foods only and total diet (including nutritional supplements)) were calculated via the NCI-method using SAS© Enterprise Guide.

Breakfast was consumed on at least one recording day by 99% of participants with an uptake of 93% of potential breakfast occasions. The mean (SD) energy intake at breakfast was 365 (162) kcal, contributing on average 19% to overall daily energy intake. Energy intake from breakfast comprised of 56% carbohydrate, 14% fat and 29% protein. The most frequently consumed foods at breakfast included breakfast cereals, white/brown/wholemeal breads and rolls, butters and fat spreads, jams and marmalades, fruits, eggs, yogurts and some meats. The most frequently consumed beverages included teas, coffees, ‘fruit juices & smoothies’, waters and milk (in teas/coffees, with cereals and as a beverage). The contribution of breakfast to total daily nutrient intakes was 25% for carbohydrate, 16% for fat and 16% for protein. Breakfast also contributed to total daily intakes of dietary fibre (22%), total sugars (28%), saturated fat (18%), B-vitamins (20–32%), vitamins C (23%), D (24%), E (19%) calcium (28%), iron (26%) and sodium (18%).

Breakfast was widely consumed among Irish adults and was typically a nutrient dense meal which contributed significantly to total dietary intakes of a number of important macro- and micro- nutrients but also contributed to total sugars and relatively small proportions of total fat, saturated fat, and sodium.

More than half of women in developed countries are overweight or obese. Studies show that 20–25% of women in the UK enter pregnancy as obese. Healthy diet patterns such as the Mediterranean diet (MD) are linked with lower adiposity among women of childbearing age. However there is evidence that maternal diet in the UK is poor and stress increases the consumption of saturated-fat, sweets, and energy-dense foods. There is limited evidence on dietary patterns and stress among women of childbearing age, therefore this study aimed to investigate the association.

This was an anonymous online survey of female university students. The survey included: socio-demographic characteristics, physical activity, self-reported BMI and waist circumference. Dietary assessment was done via a validated 100-food item food frequency questionnaire and perceived stress via the Perceived Stress Scale (PSS). The dietary data were compared to the a priori defined Mediterranean Diet Score (MDS) and scored according to eight components (vegetables, legumes, fruit and nuts, cereals, fish, dairy products, meat and meat products, and the ratio of unsaturated to saturated fat). The scores ranged from 0 to 8 with MDS adherence groups being 0–3 low, 4–5 medium, and 6–8 high. Factor analysis was also applied on 11 food components (g/d) (the eight above plus eggs, potatoes, sweets and drinks) to reveal the latent major dietary patterns (DP) in the studied cohort.Negative binomial regression was used to examine the association between stress and the diet patterns, controlling for the socioeconomic factors, physical activity, marital status, BMI, and waist.

One hundred twenty-three students (mean age 27.7 (SD 7.3)) participated. Participants had medium (n = 49) or low MD adherence (n = 48), with fewer participants having high adherence (n = 26). Stress was not significantly associated with MD adherence, but was positively associated with sweets intake (p = 0.03). The scree plot of Factor analysis showed that the number of factors generated by the analysis is three.

Using minimum loading cut-off of 0.4, factor analysis revealed three latent diet patterns; the first (DP-1) contained: cereals, sweets and potatoes (comfort foods), DP-2 consisted: eggs, fish and meat (high protein) and DP-3 consisted of: vegetables, fruits, nuts, and legumes (vegan). Results showed a significant positive association between stress and DP-1 (p < 0.01). No association was found between other diet patterns and any other psychosocial and physical variables.

Future well designed randomised controlled trials are needed to investigate further the relationship between perceived stress and dietary patterns in women of childbearing age.

Reduced occupational energy expenditure and increased energy intake are important contributors to the increasing prevalence of obesity. The aim of this study was to examine whether sedentary occupations, and specific indicators of energy intake and expenditure are associated with obesity risk in Australian women. Data were from 3,444 participants in the Australian Longitudinal Study on Women's Health, who reported their weight, dietary intake, physical activity and occupation in 2009 (at age 31–36), and weight in 2012. Participants were categorised as having a ‘less sedentary’ or ‘sedentary work’, based on occupation and activity patterns at work. Multivariate models were conducted to examine the odds of being obese (> 30 body-mass index) and risk of obesity in the two occupational groups based on energy balance factors (diet and physical activity). Models were adjusted for major confounders (smoking, education, income, number of children).There was no significant difference in the prevalence of obesity between groups (20.3% less sedentary vs 22.7% sedentary work, p = 0.11) at baseline. Being in the highest total energy intake tertile, saturated fat intake > 35g/d and drinking 3 or more sugar-sweetened beverages per week increased the odds of being obese in both groups. But to a higher extent in ‘less sedentary work’ (OR 2.11 95%CI 1.41–3.19; OR 3.04 95%CI 2.09–4.45; 2.07 95%CI 1.45–2.97, respectively). High physical activity (> 1000MET.min/week) was consistently associated with lower odds of being obese (OR 0.64 95%CI 0.43–0.97 ‘less sedentary’; OR 0.58 95%CI 0.36–0.93 ‘sedentary work’) but lower incidence of obesity only in ‘less sedentary work’ group (IRR 0.52 95%CI 0.30–0.88, absolute risk 14%). High sugar-sweetened beverages increased the incidence of obesity only in this group (IRR 1.72 95%CI 1.08–2.73, absolute risk 23%). Having a sedentary work per se did not play a major role in obesity prevalence and risk in women. Instead, high saturated fat and SSB intake, and physical inactivity remained the major contributors to obesity prevalence and risk, particularly for those in less sedentary jobs.

Colorectal cancer (CRC) is the fourth most common cancer in the UK; 95% of CRCs develop from colorectal adenomas. Adults in England aged 60–74 years are screened for colorectal cancer through the national Bowel Cancer Screening Programme (BCSP) which aims to detect colorectal cancer early, and also remove colorectal adenomas. However, adenoma recurrence is common. The World Cancer Research Fund (WCRF) estimates that around 45% of CRC cases could be prevented by a healthy lifestyle. There are no specific dietary guidelines to protect against adenoma recurrence and patients do not receive dietary advice in the care pathway. Nonetheless understanding the dietary intake of people with adenoma who are at high-risk of developing CRC and their subsequent dietary behaviour post-diagnosis may design future intervention strategies.

This study aims to describe the diet of colorectal adenoma patients and evaluate whether there were elective changes in diet following diagnosis.

The data used in this study were obtained from colorectal adenoma patients at high risk of recurrence, recruited to the seAFOod polyp prevention trial through the English BCSP. Dietary intake was assessed using the EPIC Food Frequency Questionnaire at two time points: during the 12 months before and during the 12 months after adenoma diagnosis. FETA dietary analysis software was used to extract data. Paired Sample-T-Tests and Wilcoxon Signed-Rank Test were used to assess change in intake using SPSS version 25.

Of the 709 patients recruited to the main study, 526 completed the FFQ on both occasions, of whom 81.7% were males. The mean age was 65 years (SD 4.8), 83.4% were overweight or obese with mean BMI = 29.5 kg/m2 (SD 5.7). The majority of nutrient intakes met UK DRVs, with the exception of low intake of fibre, vitamin D and selenium. Following diagnosis, a significant reduction was detected in daily intake of energy (from 7.7 to 7.5 MJ, p < 0.05) meat and meat products (from 124 to 111 g, p < 0.005), non-alcoholic beverages (from 939 to 898 g, p < 0.05) and nuts (from 5.5 to 4.3 g, p < 0.05). Subgroup analysis revealed that dietary changes were confined to men where the reduction in energy was by 293 kj/day and in meat by 1.5 portions per week.

Patients do modify diet following a diagnosis of adenoma and changes correspond to WCRF healthy diet guidelines. Whether detected difference between males and females was due to the sample size or due to actual difference in behavior is not clear.