All 270 patients presenting with Henoch-Schönlein Purpura over a 13-year period from a total childhood population of 155,000 were studied. This is an incidence of 13.5/100,000 children per year. Fifty-five (20%) were found to have initial evidence of renal involvement, and were re-examined at a mean of 8.3 years later. The 37 with isolated haematuria or haematuria with mild proteinuria (67%) recovered completely. Eighteen (33%) had nephritic or combined nephritic/nephrotic features, of these one died in the acute phase of the illness, only three others have persistent urinary abnormalities but have no biochemical evidence of renal impairment and only minor histological changes. The overall prognosis in this unselected population is therefore good with a mortality less than 1% overall and low long term morbidity of 1.1%. This study indicates a more optimistic outcome in this condition than the majority of published estimates based on more selected groups of patients.

Objective-To report micronutrient intakes in Northern Ireland schoolchildren, and to establish the contribution of fortified breakfast cereal to overall nutrient intakes and achievement of current dietary recommendations.Design-Analysis of dietary intakes and physical characteristics of participants in a randomly selected 2% population sample of 1015 schoolchildren aged 12 and 15 years in Northern Ireland during the 1990/1 school year.Main outcome measures-Dietary intakes, physical characteristics, and their association with consumption of fortified breakfast cereal. Results-Mean micronutrient intakes were generally adequate with the exception oflow intakes offolate (boys and girls) and iron (girls). Fortified breakfast cereals, consumed by a high proportion (94% boys; 83% girls) of the sample, were associated with higher daily intakes of most micronutrients and fibre and with a macronutrient profile consistent with current nutritional recommendations. Appreciable proportions of subjects who did not consume fortified breakfast cereals had daily intakes that fell below the lower reference nutrient intake for riboflavin, niacin, folate, vitamin B-12, and iron (girls).Conclusions-The results demonstrate the potential of fortification in contributing to micronutrient intakes of schoolchildren, particularly where requlirements are high, or for those on marginal diets of low nutritional quality.(Arch Dis Child 1996;75:474-481)

Death rates from coronary heartdisease (CHD) The aim of the present study was to establish the nature and extent of factors associated with coronary risk in the children of Northern Ireland, the hypothesis being that the high incidence of CHD in the adult population would be reflected by risk status in its childhood population. Such information should prove invaluable in devising and monitoring public health strategies aimed at reducing levels of coronary risk from an early age. Subjects and methodsThe sampling procedure was designed to select a sample of approximately 250 children from each of the following four age-sex groups: 12 year old boys, 12 year old girls, 15 year old boys, 15 year old girls, taking into account geographical spread and the different categories of school in Northern Ireland. The target sample size of 250 was based on the variability of pilot study results.7 These numbers of children amount to a 2% random sample of each age population in the province.Schools were stratified by education area board (representing five geographical regions) and within an area board by selection policy (selective=grammar, non-selective= secondary or comprehensive). From each stratum, a two stage cluster sample of children was obtained. The primary units were the schools that were selected with probability proportional to school size, resulting in a total of 16 schools. Within a chosen school, children were randomly selected from the school roll within the appropriate agesex groups. The target number of pupils from a specific age-sex group in a school was determined by the selective:non-selective ratio for the given age-sex group and also by the proportions in different area boards. To allow for non-response the target numbers were increased by approximately 20%. An overall response rate of 78% resulted in a total of 1015 subjects being tested.Reasons for non-participation were obtained from 1% (63-2%) of non-responders. Of the remaining 114 (36 8%), 55 were officially absent from school while 37 were marked present but not traceable. A further 22 children felt unable to volunteer any reasons for non-response. Objection to blood sampling emerged as the most commonly stated reason for non-response (n=69 children), followed by a reluctance to do any part of the study (n= 37). Thirty four children gave recent illness or being under medical supervision, for example for asthma, as a reason for non-participation. Parental opposition cited either by the child or in writing from parents was also a prominent reason (n= 37).

Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20 % respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18 %), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-ll%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (1619%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15 % of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5 % of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (59 and 6.3% of daily total energy intake) for girls of these ages. About 1.3 YO for boys and 1.4 % for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified.

Physical activity during the first three decades of life may increase peak bone mass and reduce future osteoporosis risk. The aim of this study was to determine the extent to which different components of physical activity may influence bone mineral status within a representative population sample of young men and women. Bone mineral density (BMD) and content (BMC) were determined at the lumbar spine and femoral neck in 242 men and 212 women, aged 20 -25 years, by dual-energy X-ray absorptiometry. Physical activity was assessed by a self-report questionnaire designed to measure the frequency and duration of physical activity and its components (i.e., work, non-sports leisure, sports-related activities, and peak strain sports activities). Potential confounding factors such as height, weight, diet, and smoking habits were also assessed. In multivariate linear regression models, sports activity and peak strain sports activity undertaken by men were strongly associated with both lumbar spine BMD (␤ ‫؍‬ , respectively) (all p < 0.01), but work and non-sports leisure activities were not. In women, there were no associations between bone measurements and any component of physical activity. In models involving all subjects the gender/sports activity, but not the gender/peak strain, interaction term was statistically significant. Sports activity explained 10.4% of the observed variance in lumbar spine BMD in men, but <1% in women. These results demonstrate the importance of sports activities, especially those involving high peak strain, in determining peak bone status in young men. Failure to observe this association in women reflects their lower participation in such activities, but they may have the same capacity to benefit from these activities as men. Intervention studies are warranted to determine whether peak bone density in women can be improved by participating, during childhood and adolescence, in sports activities involving high peak strain. 0