Introduction
The micronutrient intake table showed that there were no significant differences between the total energy diet only (MJ) between Northern Ireland (NI) and the rest of the UK (p= 0.468). A similar trend was observed in the total energy diet only in kcal (p= 0.470). However, the energy (EAR) in MJ was higher in NI (mean= 7.6004) than the rest of the UK (mean= 7.4597). This difference was significant at p= 0.016. Conversely, there were slight differences between the food energy in MJ and kcal between NI and the rest of the UK.
These disparities were not statistically significant (p= 0.470 for food energy in MJ and p= 0.468 for food energy in kcal, respectively). For proteins, there was a notable difference between the mean values in grams for NI and the UK. Nonetheless, these differences did not amount to any statistical significance (p= 0.073). Furthermore, there were minor differences between the fat, saturated fatty acids, cis n-6 fatty acids, cis n-3 fatty acids, trans-fatty acids, carbohydrate and total sugars in grams between NI and the rest of the UK.
However, these differences were not statistically significant at p= 0.985 (fats), p= 0.719 (saturated fatty acids), p= 0.870 (cis n-6 fatty acids), p= 0.969 (cis n-3 fatty acids), p= 0.434 (trans fatty acids), p= 0.436 (carbohydrate) and p= 0.617 (total sugars). There was a significant difference between the AOAC fibre in grams between NI and the rest of the UK (p= 0.001). The fibre levels were higher for the rest of the UK (mean=14.2290 g) than NI (mean= 13.59476).
Vitamin A Intake Difference
For the micronutrient intake, there were differences in the intakes of vitamin A in retinol equivalents and micrograms between NI and the rest of the UK. The retinol level in retinol equivalents was higher in the rest of the UK (mean= 560.3668) than NI (mean= 486.8236), which was statistically significant at (p= 0.001). In contrast, the retinol level in micrograms was higher in NI (mean= 231.89 micrograms) than the rest of the UK (mean= 228.52 micrograms).
However, this difference was not statistically significant (p= 0.071). There were no statistically significant differences in the levels of vitamin B6 (p= 0.016), vitamin B12 (p= 0.201), vitamin C (p= 0.144), vitamin D (p= 0.269), E (p= 0.340), thiamine (p= 0.101), folate (p= 0.679), iron (p= 0.506), magnesium (p= 0.436), below LRNI magnesium (p=0.839), manganese (p= 0.058) and below LRNI iodine (p= 0.111). Conversely, there were statistically significant differences in the levels of riboflavin (p= 0.013), niacin equivalent (p= 0.035), calcium (p= 0.006), potassium (p= 0.003), zinc (p= 0.044), below LRNI zinc (p= 0.002), copper (p= 0.025), iodine (p= 0.021), phosphorus (p= 0.022) and sodium (p= 0.028).
Portions Difference
In the food groups intake table, there were differences between the consumption of 5 or more portions of fruit and vegetables per day between NI and the rest of the UK. More fruits and vegetables were consumed in the rest of the UK (mean= 4.4255) than NI (mean = 4.0204). However, this difference was not statistically significant (p= 0.095). An opposite trend was observed in the quantity of oily fish eaten with fewer people in NI than the rest of the UK. This difference, however, was not statistically significant (p= 0.071). Processed red meat was eaten more in NI (15.2425g) than the rest of the UK (11.8864g). This difference was statistically significant (p= 0.003).
There are no major differences between NI and government dietary recommendations. The UK government recommends that people aged 11 years and older should have at least 5 portions of fruits and vegetables per day, which is equivalent to 400 grams. This stipulation aligns with NI dietary recommendations. Conversely, adults should restrict their intake of red and processed meat to at 70 grams per day, whereas adults and children should have at least 140 grams of oily fish (Kranz, Jones & Monsivais 2017).
However, an analysis of the findings in Table 3 showed that the consumption of fruits and vegetables was below the recommended levels. Similarly, the consumption of oily fish was less than the recommended range of 7 to 17 grams per day (the observed consumption was 1.6868 grams). These results suggest that the key nutritional needs of NI children are fruits and vegetables, oily fish and micronutrients. However, the consumption of saturated fatty acids, processed meats and red meat need to be reduced.
Nutrients Difference
There are no studies that compare the consumption of various nutrients in NI and the UK. However, available studies on the topic have yielded mixed outcomes. Syriad et al. (2016) observed that the daily energy intake, protein and most micronutrients surpassed the UK dietary reference values in children at 21 months of age, thereby predisposing them to obesity. Conversely, the intake of vitamin D and Fe did not meet the stipulated standards despite supplementation efforts.
Breakfast is linked with higher general dietary sufficiency compared to other meals. Gaal et al. (2018) investigated the nutrient and dietary intake of UK nationals aged between 5 and 96 years based on their breakfast composition. About 20 to 22% of the total energy intake was obtained from breakfast. The intake of carbohydrate and non-milk extrinsic sugars exceeded the relative daily intakes (RDI), whereas total fat, protein and saturated fatty acids were lower than the RDIs. The most abundant nutrients in breakfasts included iron, iodine, calcium, B vitamins, magnesium and vitamin D.
Miller, Spiro and Stanner (2016) reported that calcium, folate, iron, vitamin D and iodine were micronutrients that are deficient in specific categories of the UK population, including teenagers, ethnic minorities, and economically challenged. Eating habits can also determine the consumption of different food groups. Taylor et al. (2016) investigated the consumption of micro and macronutrients among picky and nonpicky eaters between the ages of 2 and 5.5 years and noted that the former had higher average iron, carotene, and zinc intakes than the latter. Additionally, fish, vegetables and meat were consumed in lower quantities among picky eaters. However, the intake of sugar exceeded the recommended levels in picky eaters.
Overall, the main nutritional requirements of children in NI are fruits and vegetables, oily fish and micronutrients such as vitamin A, B vitamins, calcium, potassium, zinc, copper, iodine and phosphorus. Nonetheless, the intake of saturated fatty acids, processed and red meat ought to be cut down. The nutritional status of children in NI can be improved by guiding their parents towards the attainment of healthy energy and nutrient levels for young children and teenagers (Taylor et al. 2016).
Given that eating habits play a significant role in the intakes of various nutrients and food groups, there is a need to address this issue to improve the nutritional status of children in NI. Parents of picky eaters should expand their children’s diets to incorporate more fruits and vegetables. In contrast, parents should monitor the quantities of sugary foods. The findings by Gaal et al. (2018) suggest that breakfast is a viable target when attempting to enhance the consumption of specific nutrients.
School canteens can adopt strategies such as graphical representations of the nutritional rating on the front of food packaging. This strategy has produced satisfactory results in promoting healthy food purchases (Reilly et al. 2018). Including product nutritional rating facts can increase the availability of healthier choices on canteen menus and play a role in enhancing child dietary intake. Pricing and promotion strategies can also be employed to create awareness of healthy foods and make them affordable to the student population (Yoong et al. 2015). The school administration should implement nutrition policies such as banning fatty and sugary foods and promoting the sale of fruits and vegetables (Nathan et al. 2016; Yoong et al. 2016).
Cultural Influence on Dietary Intakes
The findings suggest that culture influences dietary intakes. There was a significant difference in the dietary intakes across the five cultural groups in NI versus the rest of the UK (p= 0.000). Additionally, clustering the ethnic groups as white and non-white revealed a significant difference in the dietary intakes.
These disparities can further be narrowed down to the different types of nutrients. Macronutrient intakes across various ethnicities showed that there were significant differences in the consumption of cis n-3 fatty acids (p= 0.020) and total sugars (p= 0.000) between whites and non-whites. However, there was no significant difference in the intakes of total energy (p= 0.209), food energy (p= 0.202), protein (p=0.230), fat (p= 0.222), cis n-6 fatty acids (p= 0.072) and carbohydrates (p= 0.067) between the two ethnic groups. Overall, the values of total energy, food energy, fat, carbohydrates and total sugars were higher in whites than non-whites. In contrast, the values of protein, cis n-6 fatty acids and cis n-3 fatty acids were higher in non-whites than whites.
For the micronutrient intake, there were significant differences in the intakes of vitamin E (p= 0.018), thiamine (p= 0.000), riboflavin (p= 0.021), calcium (p= 0.008) and sodium (p= 0.000) between whites and non-whites. Nonetheless, there was no significant difference in the consumption of vitamin A (p= 0.260), vitamin B6 (p= 0.072), vitamin B12 (p= 0.556), vitamin C (p= 0.671), Vitamin D (p= 0.519), niacin (p= 0.499), folate (p= 0.474), potassium (p= 0.370), iron (p= 0.612) and zinc (p= 0.115). The levels of vitamins A, B6, B12, thiamine, riboflavin, folate, potassium, calcium and sodium were greater in whites than non-whites, whereas vitamins C, D, E, niacin, iron and zinc levels were higher in non-whites than whites.
There were statistically significant differences between the consumption of processed red meat (p= 0.000) and oily fish (p= 0.002) between whites and non-whites. The intake of processed red meat was higher in whites (mean=13.6897 g) than non-whites (mean= 5.0267 g), whereas the consumption of oily fish was higher in non-whites (mean= 4.1083 g) than whites (mean= 1.8150 g). Conversely, there was no difference between the consumption of 5 of more portions of fruits and vegetable per day between whites and non-whites (p= 0.383).
These differences can be explained based on information available in the literature regarding known dietary habits of various communities. The growth of immigrant populations in developing countries is mainly responsible for some of the observed dietary patterns. For example, Dekker et al. (2014) investigated ethnic disparities and the functions of socioeconomic factors on dietary patterns in a multi-ethnic community. A cross-sectional multi-ethnic study was conducted in Amsterdam, the Netherlands. Three distinct food patterns were identified: “‘Noodle/rice dishes and white meat’, ‘red meat, snacks and sweets’ and ‘vegetables, fruit and nuts’“ (Dekker et al. 2014, p. 1).
African and South Asian Surinamese adhered mainly to a white meat, noodles and rice pattern, which was characteristic of a conventional Surinamese diet. On the contrary, Dutch nationals adhered to the other two patterns. It was also observed that an increase in the socioeconomic standing of the Surinamese brought about a shift in dietary patterns to a fruit and vegetable one while still maintaining the noodle/rice and white meat-eating model. The dataset used in this study indicates that Asian or Asian British comprise only 7.6% of the total population, which could explain why the influence of noodle/rice and white meat consumption was not substantial enough to shift the patterns of the whole population.
The impact of ethnicity on dietary patterns reflects an interaction of numerous factors such as poverty income ratio and average nutrient requirements for each ethnicity. For instance, Malek et al. (2019) examined the effect of race and income differences on achieving the reference dietary intakes in a US population. Data from 24-hour recalls were collected and evaluated. It was noted that significant differences existed in the percentage estimated average requirements for 15 nutrients, including vitamin A, vitamin B12, B6, C, D, zinc, calcium, iron and folate.
The requirement for riboflavin and vitamin B12 differed substantially between Hispanics, non-Hispanic blacks and other ethnic groups when likened to non-Hispanic whites. Similarly, the supplementation of foods with vitamin D resulted in a reduced need for the micronutrient in Hispanics compared to non-Hispanic whites. The tolerable upper intake levels of also differed from one ethnic group to another. These findings suggest the involvement of a genetic or biological component in the requirement and intake of various nutrients and micronutrients and have informed the need for nutrient supplementation to meet the dietary requirements of various groups (Blumberg et al. 2017). This area shows a need for further studies to elucidate this relationship.
Reference List
Blumberg, J, Frei, B, Fulgoni III, V, Weaver, C & Zeisel, S 2017, ‘Contribution of dietary supplements to nutritional adequacy in race/ethnic population subgroups in the United States’, Nutrients, vol. 9, no. 12, pp. 1-10.
Dekker, LH, Nicolaou, M, van Dam, RM, de Vries, JH, de Boer, EJ, Brants, HA, Beukers, MH, Snijder, MB & Stronks, K 2015, ‘Socio-economic status and ethnicity are independently associated with dietary patterns: the HELIUS-Dietary Patterns study’, Food & Nutrition Research, vol. 59, no. 1, pp. 1-11.
Gaal, S, Kerr, M, Ward, M, McNulty, H & Livingstone, M 2018, ‘Breakfast consumption in the UK: patterns, nutrient intake and diet quality. A study from the International Breakfast Research Initiative Group’, Nutrients, vol. 10, no. 8, p. 999.
Kranz, S, Jones, N, & Monsivais, P 2017, ‘Intake levels of fish in the UK paediatric population’, Nutrients, vol. 9, no. 4, pp. 1-10.
Malek, AM, Newman, JC, Hunt, KJ & Marriott, BP 2019, ‘Race/ethnicity, enrichment/fortification, and dietary supplementation in the US population, NHANES 2009–2012’, Nutrients, vol. 11, no. 5, pp. 1-21.
Miller, R, Spiro, A &Stanner, S 2016, ‘Micronutrient status and intake in the UK–where might we be in 10 years’ time?’, Nutrition Bulletin, vol. 41, no. 1, pp. 14-41.
Nathan, N, Yoong, SL, Sutherland, R, Reilly, K, Delaney, T, Janssen, L, Robertson, K, Reynolds, R, Chai, LK, Lecathelinais, C & Wiggers, J 2016, ‘Effectiveness of a multicomponent intervention to enhance implementation of a healthy canteen policy in Australian primary schools: a randomised controlled trial’, International Journal of Behavioral Nutrition and Physical Activity, vol. 13, no. 1, pp. 1-9.
Reilly, K, Nathan, N, Wu, JH, Delaney, T, Wyse, R, Cobcroft, M, Wiggers, J, Sutherland, R, Buffett, K, Yoong, SL & Wolfenden, L 2018, ‘Assessing the potential impact of a front-of-pack nutritional rating system on food availability in school canteens: a randomised controlled trial’, Appetite, vol. 121, pp. 309-315.
Syrad, H, Llewellyn, CH, Van Jaarsveld, CHM, Johnson, L, Jebb, SA & Wardle, J 2016, ‘Energy and nutrient intakes of young children in the UK: findings from the Gemini twin cohort’, British Journal of Nutrition, vol. 115, no. 10, pp. 1843-1850.
Taylor, CM, Northstone, K, Wernimont, SM & Emmett, PM 2016, ‘Macro-and micronutrient intakes in picky eaters: a cause for concern?’, The American Journal of Clinical Nutrition, vol. 104, no. 6, pp. 1647-1656.
Yoong, SL, Nathan, N, Wolfenden, L, Wiggers, J, Reilly, K, Oldmeadow, C, Wyse, R, Sutherland, R, Delaney, T, Butler, P & Janssen, L 2016, ‘CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: a randomised controlled trial’, International Journal of Behavioral Nutrition and Physical Activity, vol. 13, no. 1, pp. 1-11.
Yoong, SL, Nathan, NK, Wyse, RJ, Preece, SJ, Williams, CM, Sutherland, RL, Wiggers, JH, Delaney, TM & Wolfenden, L 2015, ‘Assessment of the school nutrition environment: a study in Australian primary school canteens’, American Journal of Preventive Medicine, vol. 49, no. 2, pp. 215-222.