Elaine K. McCarthy

Background: Young children have high nutritional requirements relative to their size and energy intakes, yet inadequate nutrient intakes are widespread. Factors impacting the ability of caregivers to provide nutritionally adequate diets to young children are understudied.Objective: To evaluate key influences on the dietary patterns and eating behaviours of young children in Ireland.Methods: Parents and guardians with a child aged 18–36 months were invited to complete a self‐administered online survey. The 103‐question survey was delivered across 5 subsections (Socio‐Demographics, Parental Nutrition Knowledge, Parental Feeding Practice, Child Food Fussiness, Barriers to Healthy Eating and Dietary Patterns). Adherence (%) to current Dietary Guidelines for 1–5‐year‐olds and the Children's Food Pyramid were assessed using a food frequency approach to create an adherence score based on 7 components, including consumption of red and processed meat, fish, dairy, fruit and vegetables, confectionary and beverages.Results: We received 1158 responses, mostly from mothers (96.3%) born in Ireland (85.5%), of whom 80.1% had at least a primary degree. The mean (±SD) age of children was 26.2 ± 5.8 months and 54.6% were enrolled in an early years service, of which 74.3% provided food. The mean (±SD) dietary guideline adherence score among children was 55.5% ± 19.7%. The Children's Food Pyramid was recognised by 76.3% of parents and mean (±SD) nutrition knowledge score was 57.9% ± 14.6%, which was associated with dietary guideline adherence (r = 0.122, p < 0.001). Reported barriers to healthy eating were “food fussiness” (49%), “time to prepare healthy foods” (47%) and “provision of unhealthy foods by caregivers outside the home” (47%). Moderate to severe fussy eating was noted in 36% of children and food fussiness was associated with lower dietary guideline adherence (r = −0.172, p < 0.001). The children of respondents (13.1%) following restrictive diets (e.g., vegetarian, gluten‐free) had a lower than average dietary guideline adherence score (50.2% ± 18.3% p < 0.001).Conclusions: Many associated factors influence the dietary patterns of young children. Improved understanding of these influences may help to guide the design of targeted nutrition supports and education programmes for this age group.

Purpose: To provide a comprehensive assessment of nutrition knowledge, supplementation practices and access to nutrition supports in third-level/university student athletes in Ireland. Methods: Nutrition knowledge was assessed using the Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ), with additional questions on nutrition information sources, access to nutritional supports and supplement use. Results: 138 student athletes completed the online questionnaire. Participants had a mean (± SD) Total Nutrition Knowledge (TNK) score of 51.6 ± 13.7%, classed as “average”. Scores were higher in the General Nutrition Knowledge (GNK) (61.4 ± 15.4%) sub-section, while Sports Nutrition Knowledge (SNK) scores (47.2 ± 15.5%) were considered “poor”. Athletes that studied nutrition/dietetics at university level had higher GNK (69.9 ± 12.3% vs. 60.3 ± 15.5%), SNK (61.5 ± 13.7% vs. 45.3 ± 14.8%) and TNK (64.1 ± 11.8% vs. 50.0 ± 13.1%) scores than other students (all p < 0.05). Athletes with prior nutrition education/training also had significantly better TNK, GNK and SNK scores than those with no previous education/training (p < 0.001). Dietary supplements were used by 62.4% of participants, 64.0% of whom used 3 or more supplements. The most popular supplements were protein (77.9%), vitamin D (47.7%) and multivitamins (47.7%). Only 49.3% of participants had previous access to nutrition supports, but 80.4% of participants wanted more support. Conclusions: Student athletes demonstrated inadequate levels of nutrition knowledge, particularly in the areas of sports nutrition, coupled with a high prevalence of nutritional supplement use. Athletes with higher education levels and prior nutrition education/training demonstrated greater nutrition knowledge, although a high desire for more nutrition supports was reported by the athletes in this cohort.

Influences on the dietary patterns and eating behaviours of 18–36-month-old toddlers in Ireland. Authors: Ben Leen Smith1, Mairead E Kiely1,2, El | POSTER

Background: Healthy nutritional status, appropriate gestational weight gain and a balanced diet are important predictors of perinatal health outcomes. However, gaps exist in the translation of nutrition recommendations into dietary practices of women before and during pregnancy. The present study explored the relationship between access to nutrition advice, nutrition knowledge, attitudes and practices among pregnant women.Methods: Pregnant women aged > 18 years in Ireland were eligible to complete a self‐administered survey consisting of four subsections (demographics, nutrition knowledge, attitudes and practices) delivered online through Qualtrics.Results: In this convenience sample (n = 334, median [interquartile range] gestation, 25.0 [16.0, 34.0] weeks), 85% had at least an honours bachelor degree and 88.9% planned their pregnancy. Two out of five women received nutrition advice during their pregnancy, mostly from a midwife. Based on the percentage of correct answers (of 15 questions), women with previous nutrition education (e.g., school home economics) had better median [interquartile range] nutrition knowledge than those with none (80.0% [66.7, 86.7%] vs. 73.3% [60.0, 80.0%],p < 0.001). Those who received nutrition advice during pregnancy did not score higher than those who did not (73.3% [66.7, 80.0%] vs. 73.3% [66.7, 80.0%],p = 0.6). Over three‐quarters of participants considered nutritional supplement use to be very or extremely important. Although 73.6% and 92.4% took supplements prior to and during pregnancy, only 25.7% reported compliance with periconceptional folic acid supplementation guidelines. Half of respondents considered healthy eating during pregnancy as very or extremely important.Conclusions: Access to nutrition advice during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed. Accessible, evidence‐based nutrition education for women prior to and during pregnancy is required.

Iron is essential for the functioning of all cells and organs, most critically for the developing brain in the fundamental neuronal processes of myelination, energy and neurotransmitter metabolism. Iron deficiency, especially in the first 1000 days of life, can result in long-lasting, irreversible deficits in cognition, motor function and behaviour. Pregnant women, infants and young children are most vulnerable to iron deficiency, due to their high requirements to support growth and development, coupled with a frequently inadequate dietary supply. An unrecognised problem is that even if iron intake is adequate, common pregnancy-related and lifestyle factors can affect maternal–fetal iron supply in utero, resulting in an increased risk of deficiency for the mother and her fetus. Although preterm birth, gestational diabetes mellitus and intrauterine growth restriction are known risk factors, more recent evidence suggests that maternal obesity and delivery by caesarean section further increase the risk of iron deficiency in the newborn infant, which can persist into early childhood. Despite the considerable threat that early-life iron deficiency poses to long-term neurological development, life chances and a country's overall social and economic progress, strategies to tackle the issue are non-existent, too limited or totally inappropriate. Prevention strategies, focused on improving the health and nutritional status of women of reproductive age are required. Delayed cord clamping should be considered a priority. Better screening strategies to enable the early detection of iron deficiency during pregnancy and early-life should be prioritised, with intervention strategies to protect maternal health and the developing brain.

Iron is critical to the developing brain, but fetal iron accretion is compromised by several maternal and pregnancy-related factors. Little consideration has been given to the long-term neurologic consequences of neonatal iron deficiency, especially in generally healthy, low-risk populations. We aimed to investigate the association between neonatal iron deficiency and neurologic development at 2 and 5 y of age. We measured umbilical cord serum ferritin concentrations in the prospective maternal-infant Cork BASELINE (Babies after SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints) Birth Cohort. Lifestyle and clinical data were collected from 15 weeks of gestation to 5 y of age. Standardized neurologic assessments were performed at 2 y [Bayley Scales of Infant Development/Child Behavior Checklist (CBCL)] and 5 y (Kaufman Brief Intelligence Test/CBCL). Among 697 maternal-infant pairs, median (IQR) cord ferritin concentrations were 200.9 (139.0, 265.8) µg/L; 8% had neonatal iron deficiency (ferritin <76 µg/L). Using fully adjusted models, there was no association between neonatal iron deficiency and cognitive or behavioral outcomes at 2 or 5 y. We conducted an a priori sensitivity analysis in 306 high-risk children, selected using known risk factors for neonatal iron deficiency (smoking/obesity/cesarean section delivery/small-for-gestational age birth). In this high-risk subgroup, children with iron deficiency at birth (12%) had similar cognitive outcomes, but the behavioral assessments showed higher internalizing [9.0 (5.3, 12.0) compared with 5.0 (3.0, 10.0), P = 0.006; adjusted estimate (95% CI): 2.8 (0.5, 5.1), P = 0.015] and total [24.5 (15.3, 40.8) compared with 16.0 (10.0, 30.0), P = 0.009; adjusted estimate (95% CI): 6.6 (0.1, 13.1), P = 0.047] problem behavior scores at 5 y compared with those born iron sufficient. We have demonstrated lasting behavioral consequences of neonatal iron deficiency in high-risk children from our generally healthy, low-risk maternal-infant cohort. Although larger investigations are warranted, this study provides strong association data to suggest that interventions and strategies targeting the fetal and neonatal period should be prioritized for the prevention of iron deficiency and associated neurologic consequences.

Iron deficiency is the most common micronutrient deficiency worldwide. Iron is essential for the development of multiple organ systems, most especially the developing brain. Iron deficiency, particularly during sensitive periods of brain development, such as in early childhood, is associated with long‐lasting adverse consequences for cognition, motor function and behaviour. Little consideration has been given to iron deficiency in newborn infants and its potential health consequences. Fetal iron accretion is compromised by pregnancy complications such as pre‐term birth and gestational diabetes mellitus, and our work has identified an increased risk of low iron stores at birth from maternal lifestyle factors such as smoking and obesity. Early‐life events, including Caesarean section delivery, further add to the cumulative risk of neonatal iron deficiency, which can persist throughout infancy into early childhood. While investigations into the long‐term neurological consequences of neonatal iron deficiency are limited, there is evidence of poorer memory, motor function and language ability in children born iron deficient. Recently, we also identified significant behavioural consequences of neonatal deficiency persisting from 2 to 5 years of age, with effects particularly apparent in ‘high‐risk’ children born to obese or smoking mothers or delivered by Caesarean section. Interventions targeting the fetal/neonatal period could therefore represent a key opportunity for the prevention of iron deficiency and its associated long‐term health consequences. A dual approach is required, comprising public health strategies targeting prevention, to improve health in women of reproductive age, and the development of screening strategies for the early detection of iron deficiency in newborn infants.