Myopia is one of the leading causes of preventable blindness in the world. Its prevalence has risen drastically over recent decades, and it is estimated that close to half the world population will be myopic by 2050.The rise in myopia is lifestyle related. Myopia occurs as a consequence of excessive eye growth, which may be related to general growth. Diet, therefore, is a potential risk factor. A number of Asian studies have reported lower levels of zinc in myopic adolescents, when compared to controls. Currently, there are no reliable indicators of zinc status. This study explores the association between zinc status and myopia using a combination of zinc assessment methods.

Participants from two different population-based studies were used. Data from 1,095 adolescents aged 12–19 years, from the US National Health and Nutrition Examination Study were used to examine the relationship between dietary zinc intake and myopia. Data from 304 subjects of similar age from the Korean National Health and Nutrition Examination Study were used to examine the association between serum zinc levels and myopia using multivariate logistic regression.

43% (NHANES) and 84% (KNHANES) of subjects were found to be myopic. Mean dietary intake of zinc was lower among myopes relative to non-myopes, but not significantly. In multivariate logistic regression, dietary zinc was not significantly associated with myopia. Among Korean subjects mean serum zinc was found to be higher in non-myopes v. myopes (p = 0.809). Multiple logistic regression did not show any significant relationship between serum zinc and myopia, after adjustment for confounders.

In contrast to previous studies, no relationship was found between lower dietary zinc intake or lower serum zinc, and myopia. Currently the BOND Zinc Expert Panel recommend plasma zinc concentration to assess zinc status, despite its extreme sensitivity to both internal and external factors like; inflammation, fasting, pregnancy, oral contraception and diurnal rhythm. Biological samples are very easily contaminated, meaning strict quality controls and procedures are required. These factors severely impact reliability, and thus, comparison between studies is challenging, particularly in the case of contrasting findings.As zinc is a vital micronutrient and an estimated one-third of the population are affected by zinc deficiency. A reliable biomarker of status is important, for clinical and research needs.

The rupture of atherosclerotic plaques is the prerequisite for adverse cardiovascular events. Calcification morphology plays a critical role in plaque stability, therefore accurate calcification classification is essential for favourable patient management. Blood biomarkers may be a worthwhile approach to stratify patients based on calcification phenotype. Vitamin K-dependent Matrix γ-carboxyglutamate (Gla) protein (MGP) is a potent inhibitor of vascular calcification. Recent studies have demonstrated the potential utility of circulating non-functional MGP (dp-ucMGP) measurements to determine arterial stiffness and calcification levels. The objective of this study was to examine the relationship between circulating dp-ucMGP and calcification phenotype within symptomatic atherosclerotic lesions. Consenting patients undergoing standard endarterectomy procedures were recruited (n = 29). Fasting venous blood was collected preoperatively. Circulating plasma levels of dp-ucMGP were quantified using the inaKtif MGP (dp-ucMGP) iSYS kit. A bicinchoninic acid assay was used to standardise the total protein content present in each sample. High-resolution micro-CT imaging was conducted on the excised atherosclerotic specimens postoperatively. ImageJ post-processing was used to accurately quantify the calcification volume (≥ 130 Hounsfield Units) and determine the total number of calcified particles (3D objects counter plugin). Thirteen carotid (average age 71 years, 9 male) and fourteen peripheral lower limb (average age 65 years, 12 male) patients were examined. One patient had a carotid and a peripheral lower limb plaque (age 79, male). Peripheral lower limb specimens have larger volumes of calcification and higher numbers of calcified particles than carotid samples (472 ± 310 vs 85 ± 113mm3, p < 0.0005; 13919 ± 16034 vs 3476 ± 6208, p = 0.061.) While a higher dp-ucMGP value was noted in carotid than peripheral lower limb patients (214 ± 52 vs 169 ± 36pmol/L, p = 0.014) there was no correlation between circulating dp-ucMGP and calcification volume or number of calcified particles (rs = -0.329 and rs = 0.046). Previous research also found that peripheral lower limb lesions contain higher volumes of calcification than carotid lesions. There is currently no published data on calcified particle comparisons. Patients with symptomatic carotid disease are assumed to have a degree of peripheral arterial disease, this could explain the higher levels of circulating dp-ucMGP in carotid patients. The current study did not examine the dietary patterns of individuals with regards to Vitamin K intake or analyse other areas of the vasculature for additional calcification. This may interfere with dp-ucMGP measurements. This study serves as a preliminary investigation into the potential of dp-ucMGP as a blood based biomarker to distinguish between symptomatic atherosclerotic calcification phenotypes.

Online dietary assessment tools can reduce administrative costs and facilitate repeated dietary assessment during follow-up in large-scale prospective studies. We developed an online 24-h recall (myfood24) with automated estimation of associated nutrient intake, and assessed validity against reference recovery, predictive and concentration biomarkers. Validity of the online tool was then compared with that of traditional interviewer-administered multiple-pass 24-h recalls and presented as the expected attenuation of any diet-disease associations estimated with the tool.

Metabolically stable adults were recruited and completed the new online dietary recall, a traditional interviewer-based multiple-pass recall and provided samples of blood and urine for a range of reference biomarkers. Longer-term dietary intake was estimated from up to three recalls taken two weeks apart. Estimated intakes of protein, total sugars, potassium and sodium were compared with urinary biomarker concentrations. Estimated energy intake was compared with energy expenditure measured by three-plane accelerometry and open-circuit indirect calorimetry. Validity against these biomarkers was also compared to that estimated for traditional interviewer-administered multiple-pass 24-hour recalls.

At least one biomarker sample was received from each of 212 participants. Compared to reference biomarkers, both the online 24-hour recall and interviewer-based recall led to attenuation of diet-disease associations. The online tool resulted in attenuation factors of around 0.2–0.3 which could have important effects on estimated risks. For example, if the true relative risk of a diet-disease association was 2.0, an attenuation factor of 0.3 would reduce the relative risk to 1.23. Ranking using intakes against repeated biomarkers as an estimate of truth, resulted in higher attenuation factors of approximately 0.3–0.4, with a smaller impact on risk estimates. Attenuation improved substantially on repeated application of the tool. Validity of the interviewer-based recall found similar attenuation factors, but it was more administratively burdensome and expensive to implement. The online tool typically provided 10–20% lower nutrient estimates compared to the interviewer-administered tool.

Our findings show that, whilst results from both automated online and traditional interviewer-based dietary recalls are attenuated compared to objective biomarker measures, the myfood24 online 24-hour recall is comparable to the more time-consuming and costly traditional interviewer-based 24-hour recall across a wide range of measures. The less burdensome implementation of the online tool, with automated nutrient coding and easy replication over a longer time period with associated gains in precision, makes it well-placed for repeated use in large-scale prospective studies.

Both obesity and type 2 diabetes mellitus have been associated with excessive free sugar consumption. Increasingly, LCS are used to replace free sugar to reduce the energy density of the diet, whilst maintaining diet palatability. However, while experimental data suggest a beneficial effect of LCS on weight management and glycaemic control, data from free-living populations are contradictory and primarily use reported intakes of low-calorie sweetened beverages as a marker of overall LCS consumption. Therefore, a dietary assessment tool that reliably assesses overall LCS consumption and is applicable in large-scale epidemiological studies is desirable. This study aimed to validate an LCS-focused food frequency questionnaire (FFQ) for assessing habitual dietary intake of the LCS using the method of triads. Healthy adults were recruited at Ulster University, Coleraine (n = 120). A 65-item FFQ and a 4-day food diary (FD) were used to assess dietary intake of LCS with amounts based on maximum permitted levels for foods and beverages as per EU legislation. A novel urinary biomarker approach, developed by this research group, was used to objectively assess consumption of 5 commonly used LCS(1). The method of triads was used to validate the FFQ by evaluating the correlations between the FFQ, FD and the urinary biomarkers (reference method). A total of 110 participants (51 males, 59 females) completed all analyses. Median (IQR) total LCS consumption estimated from the FFQ, FD and urinary biomarker was 116.8 (24.9–303.3) mg/d, 27.8 (0.0–247.3) mg/d and 5.0 (0.6–34.9) mg/d respectively. Moderate correlations were observed between the FD and urinary biomarker (r = 0.471; P < 0.001) and between the FFQ and FD (r = 0.471; P < 0.001). There was a low correlation between the FFQ and urinary biomarker (r = 0.291; P < 0.001). Using the method of triads, the overall validity co-efficient for the FFQ was moderate (0.54). These preliminary results indicate potential for this LCS-focused FFQ as a method of assessing LCS consumption in free-living populations. However, as maximum permitted levels of LCS in foods and beverages were used to estimate LCS consumption from the FFQ and FD, they are likely to significantly overestimate actual LCS intakes as compared to the more reliable biomarker approach. Therefore, the FFQ ability to categorise individuals into low-, medium- and high LCS consumers will be tested. Further analysis is ongoing to assess the completeness of urine collections using PABA analysis and will also focus on individual LCS intake.

Electronic- and mobile-health applications (Apps) are considered as potentially powerful means to improve the nutrition behaviour of users. In the design of App messages, “tailoring” can be used as it is found to be effective in affecting health behaviour outcomes including nutrition. Tailoring entails matching message content to characteristics of a message receiver. However, research provides some indications that message characteristics other than content could be related to the effectiveness of tailored communication (e.g. frequency). Furthermore, there are different approaches on how to execute tailoring. Two of such approaches are personalization and customization. With personalization, the preferences of a new App user are selected by a computer-tailoring-system based on the preferences of App users with similar characteristics. With customization, a new App user actively sets the preferences himself.

The aim of this research was to take a first step in investigating whether personalization and customization are suitable to tailor preferences for non-content message characteristics in the context of nutrition. Based on literature study and interviews with a number of dietitians (n = 3) a selection of personal characteristics and non-content message characteristics was made, and applied in the setup of a survey targeting respondents (n = 37) with an interest in changing their dietary habits. The (Dutch) online survey was designed with the idea of asking respondents to enact setting up a new account with a mobile health App. So, respondents were asked to imagine that they were going to create an App account (NB they were told that it was a fictional account), and were asked to fill in some items regarding several personal characteristics. Next, respondents were asked to choose between setting preferences for the non-content message characteristics themselves (= customization) and setting preferences for non-content message characteristics of persons similar to themselves (e.g. gender and age) by the App (= personalization). Of the 37 survey respondents, most respondents (73%, n = 27) preferred customization in order to set their preferences in contrast to approximately a quarter of the respondents (27%, n = 10) that preferred personalization.

In conclusion, this research found that at this moment the preferences of message receivers could be best tailored via customization due to a) great diversity in personal characteristics and preferences and b) a majority of the respondents that preferred customization over personalization. Nonetheless, it seems additionally worthwhile to further explore relations between personal characteristics and preferences to enable personalization as approximately a quarter of the respondents preferred this approach.

Reports in the recent literature indicate that consumption of phytochemicals (e.g. plant polyphenols) has been associated with a wide range of health benefits. Fennel (Foeniculum vulgare Mill.) is common Mediterranean plant that has been widely used as medicinal and aromatic herb. Numerous studies reported the use of fennel extracts (plant or seed) due to its diversity of phenolic compounds to whom inhibitory effects against several diseases are prescribed. Hence, phenolic compounds isolated from fennel are of the great interest for the use in food, chemical and pharmaceutical industries.

In order to obtain the highest quality of the fennel extracts, the selection of an effective extraction procedure is required. Nowadays, innovative extraction techniques have been introduced for isolation of bioactive compounds from plant material, among which pressurized liquid extraction (PLE) was reported as automated extraction procedure that combines effects of elevated temperature and pressure to increase the efficiency of the extraction process. Improved efficiency is also achieved by selecting the right solvent and by optimizing processing conditions (temperature, static time, cycle number).

Thus, PLE was applied for the extraction of phenolic compounds from fennel seeds. The effects of exhaustive extraction (acetone followed by methanol) as well as extraction temperatures (75 and 100 °C), static time (5 and 10 min) and cycle number (1,2,3) on the phenolic compounds concentrations were evaluated. A total of 27 phenolic compounds were identified and characterized by UPLC-ESI-MS/MS whereas 6 different categories are distinguished: (1) simple phenolic acid derivatives, (2) hydroxycinnamoylquinic acid derivatives, (3) flavonoid diglycosides, (4) flavonoid O-rhamnoglucosides, (5) flavonoid glucuronides and (6) flavonoid glycosides. Phenolic compounds were identified by comparing retention time and m/z values obtained by MS and MS/MS with the mass spectra from corresponding standards whereas the quantification was made on the basis of their peak areas and comparison with calibration curve obtained with the corresponding standards. Obtained results indicated that hydroxycinnamoylquinic acid derivatives (10 compounds) and flavonoid glucuronides (3 compounds) were found as the most abundant phenolics in acetone and methanol extracts, respectively. Statistical analysis showed that optimized PLE conditions for the most effective extraction of phenolic compounds were as follows: 100 °C/10 min/3 cycles for acetone and 100 °C/5 min/3 cycles for methanol extracts. In conclusion, PLE might be considered as a rapid and effective extraction procedure that could be useful in production of fennel seeds extracts.

Food Based Dietary Guidelines (FBDG) are dietary recommendations described in terms of amounts of foods that should be consumed. They are designed to support healthy eating through simple messaging and indicate how to achieve a nutritionally adequate diet. However, assessing compliance with FBDG targets can be difficult. The quantity of food either being consumed or prescribed and the amount of that food that constitutes a serving are needed to calculate the contribution of the food towards a food group target. The aim of this study was to define the serving weight of foods, guided by definitions from Irish FBDG, to the McCance and Widdowson Composition of Foods Integrated Dataset 2015 (CoFID). This will enable the automatic assessment of compliance to FBDG using Nutritics nutrition analysis software. Foods from CoFID were categorised into six food groups as defined by Ireland's FBDG. Quantified servings from the Irish FBDG were matched to foods. Calculation criteria were developed to establish a serving size for remaining foods within each food group. For fats and oils, as well as raw fruits and vegetables, household measurements were converted to grams, using Food Portion Sizes from the Food Standards Agency. Quantities for cooked fruits and vegetables were calculated using weight-change factors published by Bognar. For the breads, cereals and potatoes group a serving size was calculated using the midpoint for the calorie bands in this group, as defined by the Food Safety Authority of Ireland. For the dairy group, a serving size was determined by calculating the quantity needed to provide 250 mg of calcium. This was in line with achieving the total daily recommended amount of calcium from the dairy group from 3 servings. For meat, fish and alternatives (MFA), serving sizes were developed using the recommended amount of protein per body weight reference value for males and females. For foods high in fat, sugar and salt, serving sizes were defined using 100kcal as the recommended amount of energy provided for snacks. Out of 3,291 foods, 1,980 were grouped into 6 food groups. Quantified servings were available for 694 foods in 3 food groups. Calculated serving sizes were developed for the remaining 1,276 foods. The quantity of each food that constitutes a serving will be integrated into Nutritics to automatically assess compliance to FBDG. This will enable Health Care and Food Industry Professionals to deliver informed advice on meeting population health targets.

Adipose tissue is an endocrine organ involved in a variety of regulatory functions beyond simple fat storage. Excessive fat accumulation in the visceral tissue has been related to obesity associated comorbidities and manifestations such as hypertension, hyperglycaemia, hypercholesterolemia, and inflammatory processes. In the later stages of life, there is a shift of fat distribution from subcutaneous to visceral depots, which is associated to the development of several age-related diseases. Epigenetics has been described as a potential contributor in aging processes, being also associated with diseases and fat deposition that progress with age. The aim of this research was to investigate the relationships between aging, epigenetic processes and visceral adipose tissue.

The study population included 269 adult subjects recruited in the University of Navarra, Spain. Methylation data was assessed by Infinium MethylationEPIC beadchip from Illumina. Epigenetic age acceleration was calculated using the method GrimAge (AgeAccGrim), available in the website DNA methylation Age Calculator (https://dnamage.genetics.ucla.edu/home). Anthropometric, biochemical and blood pressure measurements were assessed following standardized methods. Body composition measurements by DXA were also carried out.

Statistically significant correlations were found between age acceleration and waist circumference, some DXA-measured variables (lean mass, trunk fat mass, android fat mass, visceral adipose tissue mass), glucose, HDL-cholesterol, triglycerides levels and C-reactive protein. Linear regression models showed that visceral adipose tissue mass and HDL-cholesterol were conjointly influencing the epigenetic age acceleration. In addition, a mediation by HDL-cholesterol in the relationship between AgeAccGrim and visceral adipose tissue mass was found.

Collectively, these findings demonstrated that visceral adiposity and dyslipidaemia are associated with accelerated aging effects, contributing to understand the development of age-related diseases.

Obesity associates with plethora of dysfunctions including changes in the brain structures, like hippocampus which is particularly susceptible to metabolic or inflammatory alterations. The is a need to expand knowledge about the obesity related brain changes in order to enable development of new therapeutic interventions, that would support not only weight loss but also could help to restore the after-effects of obesity in the brain. In the present report we evaluated the hippocampal efficiency of obese rats. In order to induce obesity 4 weeks old male rats were fed with a chow that mimics human western diet for 12 weeks (model of diet induced obesity). Then the cognitive functions (water maze), neurogenesis (BrdU detection) and global proteomic changes (MS/MS analysis) were analyzed in separate cohorts of animals. Obese rats had worsen cognitive flexibility than normal rats, but the spatial learning and long term memory were unaffected. The number of BrdU/NeuN positive cells was lowered in obese animals suggesting decreased hippocampal neurogenesis. The analysis of proteins revealed that about 120 proteins significantly differed between hippocampi of obese and normal rats. Neuronal calcium sensor 1 (NCS-1) which participates in mechanisms involving synaptic plasticity and acquisition of spatial memory was decreased in obese rats. Neuromodulin and vinculin, required for synaptic plasticity also decreased in these animals. Impaired neurogenesis was associated with decreased level of: receptor-type tyrosine-protein phosphatase zeta and cytoplasmic dynein 1 light intermediate chain 2, which play crucial roles in controlling axonal growth and neuronal migration. Altogether the data show that proteomic changes related to obesity associate with impaired hippocampal functioning. The same set of experiments was performed on the additional cohort of obese animals subsequent to weight loss to examine if the observed brain changes persist if obesity is reversed. This research is supported by Nutricia Foundation, grant no. RG 1/2017.

It has become evident that chronic low-grade inflammation associated with excess adipose tissue plays an important role in the etiology of insulin resistance and other obesity related metabolic disturbances. Weight loss intervention focusing on anti-inflammatory dietary modification might help to attenuate and eventually reverse these disturbances. In this random case-control nutrition intervention study we hypothesized that obese patients will improve their inflammatory and metabolic status together with body composition following anti-inflammatory diet during 24 weeks. Body composition parameters of 42 obese patients, who completed the study, were determined by bioelectrical impedance analysis (Seca®, mBCA 515 Medical Body Composition Analyzer). Their inflammatory status was assessed with high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with HOMA index. The inflammatory potential of their diet was assessed by the Dietary Inflammatory Index (DII®), based on 37 food parameters which derived from 123-item food frequency questionnaire. A positive DII® designates a diet with pro-inflammatory potential, while negative DII® designates a diet with anti-inflammatory potential. Data and z-scores were analyzed with Statistica v13.3 (StatSoft Inc., Tulsa, USA) for baseline and study end parameters differences. Obtained results have shown that, at the end of study, the patients significantly reduced their body weight (-3.3 %, p < 0.001), BMI (-3.2 %, p < 0.001), waist circumference (-1.9 %, p < 0.001), total (-3.3 %, p < 0.001) and visceral body fat (-10.4 %, p < 0.001), total (-3.1 %, p < 0.001) and extracellular water (-2.9 %, p < 0.001). The patients also significantly reduced hs-CRP (-37.7 %, p = 0.0025). Although we observed noteworthy -10.7 % reduction of HOMA index, this finding did not reach statistical significance (p = 0.862). The inflammatory potential of patients’ diet changed significantly from -0.45 to -1.73 on average (p < 0.001). With presented dietary intervention study it could be concluded that the change of the diet toward more anti-inflammatory milieu had significant influence on body weight, total and visceral body fat reduction. Consequently, those changes could have been involved in observed significant improvement of their inflammatory status. However, mild reduction of insulin resistance and rather small study group pointed out the need for further studies with more comprehensive dietary intervention.

The composition of diet plays a vital role in maintaining health and may alter the human microbiota. The main focus to date has been on the association between diet and gut microbiota and only few studies have investigated the correlation between diet and the saliva microbiota. Our aim was to investigate whether eating habits and meal patterns are associated with the saliva microbiota. In this study, we included 842 adolescents aged 11–14 years from the Finnish Health in Teens (Fin-HIT) study cohort. Adolescents answered a web-based questionnaire, including information on eating habits, breakfast and dinner patterns at school. Questions related to diet were adapted to the age group. Previously three major eating habits were identified: healthy, unhealthy and fruit and vegetable avoiders. Saliva microbiota profiles were produced by 16S (V3-V4) sequencing on the Illumina HiSeq platform. We found that the regular breakfast eaters had a higher diversity than the irregular breakfast eaters (Shannon index mean 2.27 vs. 2.21, ANCOVA; p-value = 0.026 and inverse Simpsońs index mean 6.21 vs. 5.70, ANCOVA; p-value = 0.004 adjusted for gender, age, language, body mass index (BMI) categories, and sequencing depth). No associations were found between microbiota and eating habit groups, and between microbiota and dinner pattern groups. Microbial composition differed between the regular breakfast and irregular breakfast eaters (Bray-Curtis dissimilarity index, PERMANOVA; p = 0.021), but not between eating habit groups or dinner pattern groups. A high abundance of Prevotella was identified in the fruit and vegetable avoideŕs, irregular breakfast and irregular dinner eaters. Our results indicate that having an irregular breakfast may shape the saliva microbiota diversity. Prevotella may be an indicator of avoiding veggies and skipping meals.

Many previous studies supported that shift of dietary choice is necessary to reduce environmental impact and achieve a healthy diet. However, inconsistent results have been shown for the association between the environmental impact of diet and its nutritional adequacy. The aim of this study was to investigate the association between environmental indicator including greenhouse gas emissions (GHGE) and energy use (EU) and diet quality using several diet quality scores among Japanese. Dietary data were obtained from a cross-sectional study including 392 healthy adults (196 women and 196 men, aged 20–69 y) living in 20 areas of 47 prefectures, in which four non-consecutive-day diet record was collected from February to March in 2013. Diet-related GHGE and EU were estimated using the Global Link Input-Output model. Diet quality was assessed with the adherence to the Japanese Food Guide Spinning Top (JFG score), its modified version (modified JFG score), Nutrient-rich Dietary index (NRD9.3.), the Mediterranean diet score (MDS) and the Dietary Approaches to Stop Hypertension (DASH) score. Participants were categorized into sex-specific tertiles according to energy-adjusted GHGE or EU then mixed for the analysis. Using the PROC GLM procedure, linear regression models were constructed to examine the association of environmental indicators with diet quality and intakes of foods and nutrition. Diet-related GHGE and EU were positively associated with NRF.9.3 score and MDS. Diet-related EU was also positively associated with DASH score. However, there was no significant association observed in either JFG score or the modified JFG score with both diet-related GHGE and EU. Diet-related GHGE and EU were both negatively associated with intakes of well-milled rice, fats and oils, and sugar-sweetened beverage, and positively associated with intakes of vegetables, mushroom, fish and seafood, tea and coffee and seasoning, protein, and several micronutrients. A positive association between GHGE or EU, and NRF.9.3 or MSD was seemed to be due to higher intake of vegetables, fish and seafood, meat, vitamin A, iron, potassium in high GHGE or EU group than low GHGE or EU group. The results suggested that achieving low GHGE or EU diet might not lead to higher nutritional quality among Japanese. On the other hand, it may be possible that diet quality scores used in this study could not appropriately evaluate nutritional adequacy of the diet for the Japanese population as previously suggested.

The Central Statistics Office (CSO) in Ireland report that 62% of adults were overweight or obese in 2017(1). In 2019, the latest data from the national longitudinal study “Growing Up in Ireland” showed that 15% of five-year olds were overweight and 5% were obese(2). According to WHO projections, Ireland may have the highest prevalence of overweight and obesity in Europe by 2030(3). The International Agency for Research on Cancer (IARC) state there is sufficient evidence for a cancer preventative effect of the absence of excess body fatness for 13 different cancer sites(4). Recent USA based research showed that the risk of developing an obesity-related cancer seems to be increasing in a stepwise manner in successively younger birth cohorts(5), therefore we aimed to investigate trends in the age of obesity related cancer diagnosis.

National Cancer Registry Ireland (NCRI) data was obtained for 25 to 84 year olds between 1997 and 2016 for several cancer types and 5-year intervals were constructed to categorise age (25–29, 30–34 etc.) and year of diagnosis (1997–2001, 2002–2006 etc.). An age-period-cohort model was fitted to each cancer type, resulting in estimated temporal trends in incidence (expressed as annual percent change (APC) per year) and significance of the trend across age groups was tested using a Wald test(5).

Analysis of NCRI data reflect significantly increasing incidence of colorectal cancer with decreasing age in Ireland (n = 40703, p = 0.00). Despite the limitation of low numbers for several cancer sites in younger age groups, similar trends were observed for a number of cancer types including thyroid and cervical cancer (p < 0.05). Although other factors (such as early detection) may contribute to these observations, addressing the large increase in incidence of obesity and colorectal cancer among young adults is essential. Research to identify exposure to modifiable risk factors, including nutrition and physical activity, throughout life in Ireland is necessary to examine potential determinants of such trends.

Global diabetes prevalence is projected to rise from 382 million in 2013 to 592 million in 2030 with type 2 diabetes (T2D) accounting for 90–95% of cases(1,2). Approximately 4.7 million people in the UK had diabetes in 2018, this is estimated to rise to over 5 million by 2025(2) costing the NHS £15.1bn by 2035(3).

Low-fat vegan (LFV) diets are associated with improvements in T2D biomarkers(4) however, to date no systematic review has evaluated the effectiveness of LFV diets in prevention and management of T2D. The aim of this study was to assess effects of LFV diets on T2D biomarkers in controlled trials for those with, or at risk of developing T2D.

The review followed the PRISMA checklist for systematic reviews and used Cochrane Collaboration search strategies, which support the identification of randomised controlled trials (RCT's)(5). Searches were conducted and titles and abstracts screened for relevance by two independent review authors (AW or KEL). Studies that evaluated a LFV diet to reduce the risk of, or manage T2D using controlled trials were included with publication range from January 2003 to June 2018.

Search criteria identified 130 articles, which reduced to 21 upon abstract and title screening. Further application of inclusion/exclusion criteria led to identification of six key studies. Four studies were RCT's, and two were cluster-controlled trials at corporate sites, one of which was randomised. In three of the studies participants were previously diagnosed with T2D, in two of the studies participants had a BMI ≥ 25 kg/m2 and/or were previously diagnosed with T2D, and one study had participants with BMI between 28 and 40 kg/m2. Four studies had a control group (non-intervention) two of which had a conventional diabetes diet (American Dietetic Association(6)) as a comparison group. Mean study length was 28.3 weeks; ranging from 16–74 weeks. An intention-to-treat and medication adjusted analysis was carried out; significant effects for BMI, body weight, HbA1c, fasting plasma glucose, LDL, HDL and total cholesterol were reported in most of the studies.

Results from this systematic review demonstrate that a LFV diet is an effective alternative therapy to improve T2D biomarkers in those with, or at elevated risk of developing the disease. The LFV diet showed consistent positive effects on T2D biomarkers. Its effects are comparable to conventional T2D diets and energy restrictive diets, despite absence of restrictions on energy intake or portion sizes.