Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12-15-yearolds (n 487; Young Hearts (YH)1) and again in the same individuals at 20-25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the 'healthy' DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the 'sweet tooth' DP were found to have increased LDL concentrations, systolic blood pressure, and diastolic blood pressure and decreased HDL concentrations, the 'drinker/social' DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the 'Western' DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods.

Studies of individual nutrients or foods have revealed much about dietary influences on bone. Multiple food or nutrient approaches, such as dietary pattern analysis, could offer further insight but research is limited and largely confined to older adults. We examined the relationship between dietary patterns, obtained by a posteriori and a priori methods, and bone mineral status (BMS; collective term for bone mineral content (BMC) and bone mineral density (BMD)) in young adults (20-25 years; n 489). Diet was assessed by 7 d diet history and BMD and BMC were determined at the lumbar spine and femoral neck (FN). A posteriori dietary patterns were derived using principal component analysis (PCA) and three a priori dietary quality scores were applied (dietary diversity score (DDS), nutritional risk score and Mediterranean diet score). For the PCA-derived dietary patterns, women in the top compared to the bottom fifth of the 'Nuts and Meat' pattern had greater FN BMD by 0·074 g/cm 2 (P¼0·049) and FN BMC by 0·40 g (P¼ 0·034) after adjustment for confounders. Similarly, men in the top compared to the bottom fifth of the 'Refined' pattern had lower FN BMC by 0·41 g (P¼ 0·049). For the a priori DDS, women in the top compared to the bottom third had lower FN BMD by 0·05 g/cm 2 after adjustments (P¼0·052), but no other relationships with BMS were identified. In conclusion, adherence to a 'Nuts and Meat' dietary pattern may be associated with greater BMS in young women and a 'Refined' dietary pattern may be detrimental for bone health in young men.

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The most extensive research in bone health has focused on Ca and/or vitamin D, with beneficial effects also shown from other nutrients and dietary components such as K, Mg, vitamin K and fruit and vegetable intake. Given these findings and the complexity of bone structure, it is likely that a wide range of nutrients are needed for its maintenance. Dietary pattern analysis is now widely used in nutritional epidemiology. Such approaches are said to better reflect the complex interactions between nutrients or foods that are not adequately accounted for when examining isolated nutrients (1) . The aim of the present study was to examine the relationship between bone mineral status and dietary patterns in young adults who participated in the Young Hearts (YH) Project, Northern Ireland.The YH Project is a longitudinal observational study initially designed to investigate coronary risk factors in 12-15-year olds (2) . The current findings are based on Young Hearts 3 (YH3) (3) , a follow-up study carried out between 1997 and 1999 (48.2% response rate; n = 489, 51 % male) when the participants were aged 20-25 years old. Ethical approval was obtained from the Research Ethics Committee, Queen's University Belfast, and written informed consent was obtained from all participants. Bone mineral density (BMD) and bone mineral content (BMC) were measured at lumbar spine (L2-L4) and femoral neck by dual-energy X-ray absorptiometry (DXA). Diet was assessed using a 7-d diet history and analysed using a computerised dietary analysis programme. To perform the dietary pattern analysis, the individual foods and food ingredients from the diet histories were aggregated into 31 food groups based on food types and macronutrient content, and examined using principal component analysis (PCA). Associations between dietary patterns (categorised into quintiles) and bone mineral status were assessed using multivariate linear regression, adjusting for the confounding factors BMI, age, smoking status, physical activity and mean energy intake.PCA was conducted separately for men and women, but produced four similar dietary patterns and were named according to the food groups which loaded most highly in each: (1) healthy, (2) traditional, (3) refined and (4) social for men and women. Women who adhered most closely to a refined dietary pattern had significantly greater femoral neck BMD (P = 0.041) and BMC (P = 0.022) after adjusting for confounding factors. In contrast, men who adhered most closely to this dietary pattern had significantly lower femoral neck BMC (P = 0.036) following adjustments. However, femoral neck BMC was significantly greater in men (P = 0.031) who closely followed a social dietary pattern; this finding was not observed in women.Little is known about the relationship between PCA-derived dietary patterns and bone health. This research indicates that dietary patterns with high factor loadings for red meat, meat dishes, poultry, vegetables and nuts may be associated with greater bone mineral status in young adults. An exploration of...

MCI patients need to be made more aware of the importance of lifestyle for cognition. EM such as those developed here, which are specifically tailored for this population would be valuable for HP who, currently, appear reticent in initiating lifestyle-related discussions. Following further evaluation, the EM could be used in health promotion activities targeting MCI patients.