Project Spraoi: Dietary Intake, Nutritional Knowledge, Cardiorespiratory Fitness and Health Markers of Irish Primary School Children


  • A. Merrotsy Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology
  • A.L. McCarthy Department of Biological Sciences, Cork Institute of Technology
  • J. Flack Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology
  • S. Lacey Department of Mathematics, Cork Institute of Technology
  • T Coppinger Department of Sport, Leisure and Childhood Studies, Cork Institute of Technology



Dietary Intake, Nutritional Knowledge, CRF, BP, Health Markers, Irish Children.


Objective: Examine dietary intake (DI), anthropometric measures, cardiorespiratory fitness (CRF) and nutritional knowledge (NK) of school children.

Design: Cross-sectional study. Food Diary, NK questionnaire and 550m walk/run test were used to assess DI, NK and CRF respectively. Blood pressure (BP) was also taken and body mass index (BMI) and waist to height ratio (WHtR) were calculated.

Setting: Two primary schools, Cork, Ireland.

Subjects: Six (n = 49, age 5.9 ± 0.6 years) and ten (n = 52, age 9.8 ± 0.5 years) year olds.

Results: Intakes of fruit and vegetables, fibre, calcium and iron were sub-optimal. Unhealthy snacks and saturated fat intakes were higher than recommended. A total of 24.4% of six year olds and 35.4% of ten year olds were classified as ‘fast’. Furthermore, 45.9% of six and ten year olds had high-normal BP and 27.9% had high BP. NK was negatively correlated with sugar intake (r = -0.321, p = 0.044) in ten year olds. WHtR was negatively correlated with servings of vegetables in six year olds (r = -0.377, p = 0.014). For ten year olds, there was a positive correlation between WHtR and run score (r = 0.350, p = 0.014) and BMI and run score (r = 0.482, p = 0.001).

Conclusion: This study highlights, for the first time, DI, NK, CRF, BP and anthropometric data for Irish children and their potential combined effect on overall health. Study results suggest preventive initiatives are needed, in children as young as 6 years of age.


[1] Rampersaud G, Pereira M, Girar B, Adams J, Metzl JD. Breakfast Habits, Nutritional Status, Body Weight, and Academic Performance in Children and Adolescents. Journal of the American Dietetic Association 2005; 105(5): 743-760.
[2] Finucane FM. Obesity in Irish youth: epidemiology and implications. Irish Journal of Medical Science 2009; 178(3): 249-55.
[3] Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care 2015; 4(2): 187-192.
[4] World Health Organisation 2017.
[5] World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consultation. World Health Organ (WHO) Technical Report Series no. 916. Geneva: WHO 2003.
[6] Irish Nutrition Universities Alliance. The National Children’s Food Survey 2011.
[7] Ardoy DN, Fernandez-Rodriguez JM, Ruiz JR, Chillón P, España-Romero V, Castillo MJ, et al. Improving physical fitness in adolescents through a school-based intervention: the EDUFIT study. Revista Espanola de Cardiologia 2011; 64: 484-491.
[8] Ortega FB, Ruiz JR, Castillo MJ, Sjöström M. Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity (Lond) 2008; 32: 1-11.
[9] Hurtig-Wennlöf A, Ruiz J, Harro M, Sjostrom M. Cardio-respiratory fitness relates more strongly than physical activity to cardiovascular disease risk factors in healthy children and adolescents: the European Youth Heart Study. European Journal of Preventive Cardiology 2007; 14(4): 575-581.
[10] Mesa JL, Ortega FB, Ruiz JR, Castillo MJ, Hurtig-Wennlof A, Sjöström M, et al. The importance of cardiorespiratory fitness for healthy metabolic traits in children and adolescents: the AVENA Study. Journal Public Health 2006; 14: 178.
[11] Tomkinson G, Annandale M, Ferrar K. Global Changes in Cardiovascular Endurance of Children and Youth since 1964: Systematic Analysis of 25 Million Fitness Test Results from 28 Countries. American Heart Association. Circulation 2013; 128: A13498.
[12] Hussey J, Bell C, Bennett K, O'Dwyer J, Gormley J. Relationship between the intensity of physical activity, inactivity, cardiorespiratory fitness and body composition in 7-10?year?old Dublin children. British Journal of Sports Medicine 2007; 41(5): 311-316.
[13] Fryar CD, Gu Q, Ogden CL. Anthropometric reference data for children and adults: United States, 2007-2010. National Center for Health Statistics Vital and Health Statistics 2012; 11: 1-40.
[14] Gonçalves R, Szmuchrowski LA, Damasceno VO, de Medeiros ML, Couto BP, Lamounier JA. Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children. Revista Paulista de Pediatria 2014; 32(3): 208-214.
[15] Raj M. Obesity and cardiovascular risk in children and adolescents. Indian Journal of Endocrinology and Metabolism 2012; 16(1): 13-19.
[16] Andersen L, Wedderkopp N, Hansen H, Cooper AR, Froberg K. Biological cardiovascular risk factors cluster in Danish children and adolescents: the European Heart Study. Preventive Medicine 2003; 37: 363-67.
[17] Ribeiro R, Coutinho M, Bramorski M, Giuliano IC, Pavan J. Association of the waist-to-height ratio with cardiovascular risk factors in children and adolescents: the three cities heart study. International Journal of Preventive Medicine 2010; 1: 39-49.
[18] Savva S, Tornaritis M, Savva M, Kourides Y, Panagi A, Silikiotou N, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. International Journal of Obesity and Related Metabolic Disorders 2000; 24: 1453-8.
[19] Pérez-Rodrigo C, Aranceta J. School-based nutrition education: lessons learned and new perspectives. Public Health Nutrition 2001; 4(1a): 131-139.
[20] Silveira J, Taddei J, Guerra P, Nobre MR. Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. Jornal De Pediatria [serial online]. September 2011; 87(5): 382-392. Accessed April 18.
[21] Toomer O. Nutrition Education and Promotion in the USA. Journal of Food, Nutrition and Population Health 2016; 1: 1.
[22] Conference Board of Canada. What’s to Eat? Improving Food Literacy in Canada 2013.
[23] Walton J, Hannon E, Flynn A. Nutritional quality of the school-day diet in Irish children (5-12 years). Journal of Human Nutrition & Dietetics 2015; 28(Suppl.1): 73-82.
[24] Coppinger T, Lacey S, ONeill C, Burns C. Project Spraoi: A Randomized Control Trial to Improve Nutrition and Physical Activity in School Children. Contemporary Clinical Trials Communications 2016; 3: 94-101.
[25] The Educational Impact of the Size of Primary Schools: A Literature Review carried out by Dublin City University School of Education Studies, Commissioned by Educate Together. Research-lit-review-school-size.pdfhttps
[26] Keane E, Kearney PM, Perry IJ, Browne GM, Harrington JM. Diet, Physical Activity, Lifestyle Behaviors, and Prevalence of Childhood Obesity in Irish Children: The Cork Children’s Lifestyle Study Protocol. JMIR Research Protocols 2014; 3(3): e44.
[27] Foster E, Hawkins A, Adamson A. London: Food Standards Agency. [2014-07-15]. website Young person's food atlas primary 2010. foodatlasprimary0310.pdf.
[28] Lyons J, Giltinan M. The Irish Food Portion Sizes Database 2013. Irish-Food-Portion-Sizes-Database.pdf (accessed October 2014).
[29] Schofield W, Schofield C, James W. Basal metabolic rate - Review and prediction together with an annotated bibliography of source material. Human Nutrition Clinical Nutrition 1985; 39(1): 5-41.
[30] Torun B, Davies PS, Livingstone MB, Paolisso M, Sackett R, Spurr GB. Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old. European Journal of Clinical Nutrition 1996; 50(Suppl 1): S37-80; discussion S80-S81.
[31] Gower J, Laurie MS, Moyer-Mileur J, Slater H, Jordan KC. Validity and Reliability of a Nutrition Knowledge Survey for Assessment in Elementary School Children. Journal of American Dietetics Association 2010; 452-456.
[32] Food Safety Authority. Scientific Recommendations for Healthy Eating Guidelines in Ireland 2011, available: [accessed: 21 December 2016]
[33] US Department of Agriculture. MyPyramid for Kids. Web site. index.html. Accessed May, 2017.
[34] Cole TJ, Freeman JV, Preece MA. Body mass index reference curves for the UK, 1990. Archives of Disease in Childhood 1995; 73: 25-9.
[35] Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatric Obesity 2012; 7: 284-294.
[36] Jackson LV, Thalange NK, Cole TJ. Blood pressure centiles for Great Britain. Archives of Disease in Childhood 2007; 92(4): 298-303.
[37] Ashwell M. Obesity risk: importance of the waist-to-height ratio. Nursing Standard 2009; 23: 49-54; 55.
[38] Schwandt P, Bertsch P, Hass G. Anthropometric screening for silent cardiovascular risk factors in adolescents: the PEP Family Heart Study. Atherosclerosis 2010; 211: 667-671.
[39] Albon HM, Hamlin MJ, Ross JJ. Secular trends and distributional changes in health and fitness performance variables of 10-14-year-old children in New Zealand between 1991 and 2003. British Journal of Sports Medicine 2008; 44: 263-269.
[40] Hamlin MJ, Fraser M, Lizamore C, Draper N, Shearman JP, Kimber NE. Measurement of Cardiorespiratory Fitness in Children from Two Commonly Used Field Tests After Accounting for Body Fatness and Maturity. Journal of Human Kinetics 2014; 40: 83-92.
[41] Rush E, Obolonkin V. Waikato 2011 centile charts for assessment of time to run 550m [Microsoft Excel work-book] 2014. (accessed July 2017).
[42] Cohen J. Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum 1988.
[43] Food Safety Authority. Scientific Recommendations for Healthy Eating Guidelines in Ireland 2011, available: [accessed: 21 December 2016].
[44] Healthy Ireland. Healthy Eating Guidelines [Online] 2016. Available from: [Accessed: 16th January 2017].
[45] Cork Children’s Lifestyle Study (CCLaS) 2014. (accessed March 2017).
[46] Irish Universities Nutrition Alliance (IUNA), Trinity College, Dublin and the University of Ulster. () National Children’s Food Survey [Online] 2005. Available from: [Accessed: 5th October 2017].
[47] Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. International Review of Psychiatry 2012; 24(3): 176-188.
[48] Williams JG, Greene S, Doyle S, Harris E, Layte R, McCoy S, et al. Growing up in Ireland National Longitudinal Study of Children, The Lives of 9-Year-Olds. The Stationary Office: Dublin 2009.
[49] Central Statistics Office Schema. census2006results/PSER/PSER_Appendix%203-9%20Details%20and%20Classifications.pdf
[50] Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers and cardiovascular disease. American Journal of Clinical Nutrition 2004; 80: 1678S-88S.
[51] Dietary Supplement Fact Sheet: Iron, 2007, Office of Dietary Supplements (ODS), National Institutes of Health US.
[52] Glackin LM, Fraser M, O Neill MB. The adequacy of dietary fibre intake in 5-8 year old children. Irish Medical Journal. 2008; 101: 118-20.
[53] Anderson JW, Baird P, Davis Jr R, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutrition Reviews 2009; 67: 188-205.
[54] Edwards C, Xie C, Garcia A. Dietary fibre and health in children and adolescents. Proceedings of the Nutrition Society 2015; 74(3): 292-302.
[55] EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA). Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal 2010; 8(3): 1461. [107 pp.].
[56] World Health Organisation. Sugars intake for adults and children Guideline 2015. guidelines/sugars_intake/en/
[57] SACN. Carbohydrates and Health 2015.
[58] O'Neill JL, McCarthy SN, Burke SJ, Hannon EM, Kiely M, Flynn A, et al. Prevalence of overweight and obesity in Irish school children, using four different definitions. European Journal of Clinical Nutrition 2007; 61: 743-51.
[59] Moynihan P. Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake. Advances in Nutrition 2016; 7(1): 149-156.
[60] Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ: British Medical Journal 2012; 346: e7492.
[61] Riley M, Bluhm B. High blood pressure in children and adolescents. American Family Physician 2012; 85: 693-700.
[62] Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: A systematic review and meta-regression analysis. Circulation 2008; 117(25): 3171-3180.
[63] Naeeni MM, Jafari S, Fouladgar M, Heidari K, Farajzadegan Z, Fakhri M, et al. Nutritional Knowledge, Practice, and Dietary Habits among school Children and Adolescents. International Journal of Preventive Medicine 2014; 5(Suppl 2): S171-S178.
[64] Walsh A, Nelson R. The link between diet and health: an exploratory study of adolescents in Northern Ireland using foodmaps. International Journal of Consumer Studies 2010; 34: 190-195.
[65] Rush E, McLennan S, Obolonkin V, Vandal AC, Hamlin M, Simmons D, et al. Project Energize: whole-region primary school nutrition and physical activity programme; evaluation of body size and fitness 5 years after the randomised controlled trial. British Journal of Nutrition 2014; 111(2): 363-71.
[66] Rush E, McLennan S, Obolonkin V, Cooper R, Hamlin M. Beyond the randomised controlled trial and BMI evaluation of effectiveness of through-school nutrition and physical activity programmes. Public Health Nutrition 2015; 18(9): 1578-81.






General Articles