Health Star Rating of Nonalcoholic, Packaged, and Ready-to-Drink Beverages in Türkiye: A Decision Tree Model Study.

This study aimed to compare the nutritional quality of beverages sold in Türkiye according to their labeling profiles. A total of 304 nonalcoholic beverages sold in supermarkets and online markets with the highest market capacity in Türkiye were included. Milk and dairy products, sports drinks, and beverages for children were excluded. The health star rating (HSR) was used to assess the nutritional quality of beverages. The nutritional quality of beverages was evaluated using a decision tree model according to the HSR score based on the variables presented on the beverage label. Moreover, confusion matrix tests were used to test the model's accuracy. The mean HSR score of beverages was 2.6±1.9, of which 30.2% were in the healthy category (HSR≥3.5). Fermented and 100% fruit juice beverages had the highest mean HSR scores. According to the decision tree model of the training set, the predictors of HSR quality score, in order of importance, were as follows: added sugar (46%), sweetener (28%), additives (19%), fructose-glucose syrup (4%), and caffeine (3%). In the test set, the accuracy rate and F1 score were 0.90 and 0.82, respectively, suggesting that the prediction performance of our model had the perfect fit. According to the HSR classification, most beverages were found to be unhealthy. Thus, they increase the risk of the development of obesity and other diseases because of their easy consumption. The decision tree learning algorithm could guide the population to choose healthy beverages based on their labeling information.

Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: a double-blind, placebo-controlled randomized clinical trial.

It has recently been observed that microorganisms in the gut can regulate brain processes through the gut microbiota-brain axis, affecting pain, depression, and sleep quality. Consequently, prebiotics and probiotics may potentially improve physical, psychological, and cognitive states in those with fibromyalgia syndrome (FMS) who have an altered microbiota balance. In a randomised, double-blind, placebo-controlled clinical trial to determine the effects of probiotic and prebiotic treatments on pain, sleep, quality of life, and psychological distress (depression and anxiety) in FMS, 53 female participants with FMS were randomised to receive either: 1) 4 × 1010 CFUs per day for the 18 patients in the probiotics group; 2) 10 g dose inulin per day for the 17 patients in the prebiotic group; or 3) a placebo for 8 weeks for the 18 patients in this group. The mean ages of the groups were similar and there was no significant difference between the groups. The impact of FMS on pain, sleep quality, quality of life, anxiety, and depressive symptoms were measured at baseline, 4 weeks, and 8 weeks post-intervention. Probiotic supplementation significantly decreased the Beck Depression Index (BDI), Beck Anxiety Index (BAI), and Pittsburgh Sleep Quality Index (PSQI) scores compared to baseline, while prebiotic supplementation only significantly decreased PSQI scores. Moreover, participants who received probiotic treatment presented a significantly reduced Visual Analogue Scale (VAS) score compared with those who received placebo treatment, after the interventions. Probiotic supplementation significantly improved sleep quality, depression, anxiety, and pain scores compared to those at baseline in FMS patients, while prebiotic supplementation significantly improved pain scores and sleep quality. The potential benefits of using probiotics for treatment management in FMS patients is supported by the results of the current study and might provide an important strategy to combat FMS-associated diseases.

Comparison between laser and transobturator tape therapy in the treatment of stress urinary incontinence and role of overweight in treatment: a prospective observational study.

INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence (SUI) is treated with transobturator tape (TOT) sling procedures, but problems arise with artificial mesh in certain instances. Hence, non-invasive laser therapy may be useful under such circumstances. The current study was aimed at comparing the effects of these two treatments and at checking their applicability in various body mass index (BMI) groups. METHODS: Seventy-nine patients, who were clinically diagnosed with SUI, were divided into two groups, those who preferred TOT and those who preferred the transvaginal fractional micro-ablative CO2 laser system. The SUI symptoms and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) scores of the patients were determined before and at the 12th month after the treatment. General linear model, Stuart-Maxwell, and Bonferroni correction for pairwise comparison analyses were performed to compare the efficacy of the treatment type. RESULTS: The ICIQ-SF score decreased by 56.8% for laser therapy and 43.5% for TOT therapy (mean ± SE = 5.97 ± 0.16 and 5.09 ± 0.14 respectively). Laser therapy had a better effect on ICIQ-SF than TOT therapy (η2p: 0.176, ptime*group < 0.001). Regardless of the types of treatment, the ICIQ-SF scores of healthy-weight participants decreased more than those of overweight participants (η2p:0.050, ptime*group = 0.045). In the TOT group, healthy-weight participants were more than twice as likely to recover fully from SUI symptoms as overweight participants, 1 year after the treatment. In the laser group, the majority of healthy-weight participants (88.8%) did not report any SUI symptoms after the treatment. CONCLUSIONS: The efficacy of laser therapy for urinary incontinence was confirmed. Furthermore, it was observed that being overweight may be a risk factor for the failure of laser therapy.

Body awareness mediates the relationship between body mass index and lipid profiles in adolescents.

Aim: The purposes of this study were to 1) investigate the relationship between body awareness and anthropometric measurements and lipid profile in adolescents, 2) determine the potential mediating effect of body awareness due to body mass index (BMI) on lipid profiles. Materials and methods: The study was carried out with 272 volunteer adolescents between the ages of 10-18 who applied to a private nutrition and counseling clinic. Anthropometric measurements of the participants were evaluated including body height body weight, waist and neck, and mid-upper arm circumference. The lipid profile including total cholesterol, high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholestero (LDL-c) and triglyceride was analyzed. A body awareness questionnaire (BAQ), a seven-point Likert-type questionnaire consisting of 18 statements, was administered and questionnaire is interpreted on the total score, and the higher score reflects better body sensitivity. Correlation analysis, linear regression analysis, and path analysis were performed. Results: Body awareness scores were negatively associated with all anthropometric measurements, namely, BMI, body weight and fat percentage waist and neck and mid-upper arm circumference (all p < 0.05). Body awareness was found to have a negative linear regression relationship with lipid profiles except than HDL-c. The results of path analysis showed that the direct effect of lipid profiles in relation to BMI and the indirect effect of BAQ was statistically significant. This result indicates that body awareness partial mediated the relationship between BMI and lipid profiles. Conclusion: The research results suggested that increased body awareness is associated body awareness with a lower risk and a decreased body awareness is associated with a higher risk of developing obesity and dyslipidemia.

Children-Dietary Inflammatory Index (C-DII), cardiometabolic risk, and inflammation in adolescents: a cross-sectional study.

OBJECTIVES: There is limited evidence about the inflammatory potential of diet and cardiometabolic risk in children. The aim of this study was to evaluate the association between the Children's Dietary Inflammatory Index (C-DII) with cardiometabolic risk factors in Turkish adolescents from 10 to 17 years. METHODS: Participants aged 10-17 years, who completed a 24-h dietary recall, from which C-DII scores were calculated, were include in this cross-sectional study. Lipid profile, glycemic parameters, high-sensitivity C-reactive protein (hs-CRP), liver enzymes, thyroid-stimulating hormone (TSH), and uric acid were analyzed in blood samples. Sociodemographic characteristics and sedentary behavior were assessed using a semi-structured questionnaire. We compared the distributions of anthropometric, biochemical, and blood pressure measurement levels associated with cardiometabolic risk factors by the median of C-DII with linear regression. RESULTS: The mean sample C-DII was -0.16 ± 2.31 and ranged from -3.22 to +4.09. Higher median C-DII scores, indicating a more pro-inflammatory diet among children, were associated with higher blood pressure and body mass index (BMI). However, the C-DII was modestly directly associated with fasting insulin, fasting blood glucose, and waist circumference. The area under the receiver operating curve of C-DII in predicting hs-CRP was found to be quite high (0.864, 95% CI: 0.795-0.933). CONCLUSIONS: Consuming a pro-inflammatory diet in adolescence was associated with alterations in cardiometabolic risk factors, especially with systolic blood pressure, diastolic blood pressure, and BMI.

Association between birth interval and wasting in children under 5 years of age in Ethiopia: a systematic review and meta-analysis protocol.

INTRODUCTION: According to the UNICEF, WHO and World Bank joint estimation, 1 in every 13 children suffered from wasting globally. The highest burden of undernutrition recorded in Asia and Africa. Wasting remains a considerable public health problem in Ethiopia despite the introduction of exhaustive nutritional programmes. As reported in the literature, the prevalence of wasting in Ethiopia has remained high over the last four decades. In Ethiopia, more than one-third of child deaths are associated with malnutrition. The current nutritional interventions implemented in Ethiopia need to be evidence based. For this purpose, systematic review is preferable as it can present a more reliable and precise estimate than individual studies. The aim of this review is to assess the pooled prevalence of wasting and its association with birth interval in Ethiopia. METHODOLOGY: Studies published after 20 January 2012 will be retrieved from databases, mainly PubMed/Medline, Scopus, Embase, CINAHL and HINARI. The articles retrieved from databases will be selected after reading the title, abstract and full text. Three reviewers will independently assess the quality of each study using both the Joanna Briggs Institute and Ottawa Scale critical appraisal checklists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain scientific strength. Funnel plots, Egger's test and Begg's test will be used to deal with publication bias, and I2, forest plots and Cochrane's Q square statistics will be used for heterogeneity. Potential causes of heterogeneity will be explored through sensitivity and subgroup analyses. Because heterogeneity among studies is inevitable, given the wide geographical area and variety of study designs, the Der-Simonian and Laird random-effects model will be used. The presence of a statistical association between birth interval and wasting will be declared if the p value is <0.05 with the 95% CI. ETHICS AND DISSEMINATION: Ethical issues will not be applicable to this review and meta-analysis. This review and meta-analysis will report the pooled prevalence of wasting and its association with birth interval in Ethiopia. Effort will be made to publish the findings in a peer-reviewed journal such as the Ethiopian Journal of Health and Development, and the findings will be presented at national conferences. A hard copy will also be sent to Woldia University and Debre Berhan University.

Low Economic Class Might Predispose Children under Five Years of Age to Stunting in Ethiopia: Updates of Systematic Review and Meta-Analysis.

BACKGROUND: Malnutrition is major public health problem worldwide, particularly in developing countries including Ethiopia. In 2016, out of 667 million children under five years of age, 159 million were stunted worldwide. The prevalence of stunting has been decreasing greatly from 58% in 2000 to 44% in 2011 and 38% in 2016 in Ethiopia. However, the prevalence of stunting is still high and considered as public health problem for the country. The aim of this systematic review and meta-analysis is to assess the prevalence of stunting and its associations with wealth index among children under five years of age in Ethiopia. Methodology. The databases searched were MEDLINE, Scopus, HINARI, and grey literature studies. The studies' qualities were assessed by two reviewers independently, and any controversy was handled by other reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist. The JBI checklist was used in assessing the risk of bias and method of measurement for both outcome and independent variables. Especially, the study design, study participants, definition of stunting, statistical methods used to identify the associations, results/data presentations, and odds ratios (ORs) with confidence intervals (CIs) were assessed. In the statistical analysis, the funnel plot, Egger's test, and Begg's test were used to assess publication bias. The I 2 statistic, forest plot, and Cochran's Q-test were used to deal with heterogeneity. RESULTS: In this review, 35 studies were included to assess the pooled prevalence of stunting. Similarly, 16 studies were used to assess the estimated effect sizes of wealth index on stunting. In this meta-analysis, the pooled prevalence of stunting was 41.5% among children under five years of age, despite its considerable heterogeneity (I 2 = 97.6%, p < 0.001, Q = 1461.93). However, no publication bias was detected (Egger's test p=0.26 and Begg's test p=0.87). Children from households with a medium or low/poor wealth index had higher odds of stunting (AOR: 1.33, 95% CI 1.07, 1.65 or AOR: 1.92, 95% CI 1.46, 2.54, respectively) compared to children from households with a high/rich wealth index. Both of the estimated effect sizes of low and medium wealth indexes had substantial heterogeneity (I 2 = 63.8%, p < 0.001, Q = 44.21 and I 2 = 78.3%, p < 0.001, Q = 73.73) respectively). In estimating the effect, there was no publication bias (small-studies effect) (Egger and Begg's test, p > 0.05). CONCLUSIONS: The pooled prevalence of stunting was great. In the subgroup analysis, the Amhara region had the highest prevalence of stunting, followed by the Oromia and Tigray regions, respectively. Low economic status was associated with stunting in Ethiopia. This relationship was found to be statistically more accurate in Oromia and Amhara regions. The government should emphasize community-based nutrition programs by scaling up more in these regions, just like the Seqota Declaration.

Evaluating the Relationship between Inflammatory Load of a Diet and Depression in Young Adults.

The aim of this study is to investigate the relationship between dietary inflammatory index (DII) and depression. The study was carried out with 134 female university students staying in dormitory. The data were collected using questionnaire form. The questionnaire contains socio-demographic information, physical activity, anthropometric measurements, depression scale, and the 3-day food intake record. The DII score was calculated based on the food intake record form. It was found that 56 of the participants did not have any depression symptoms. The participants' mean DII scores were 0.76 ± 0.59 and they were found to have a pro-inflammatory dietary pattern. The third-tertile depression score was 56.3 ± 8.6, which was statistically higher than the others (p < 0.05). Upon modeling, a significant association between high DII scores and increased odds of incidence DepS was observed (odds ratio (OR) = 2.90; 95% CI = 1.51-5.98). Finally there is a need to conduct cohort studies to identify DII scores of the individuals in our country, investigate the relationship between these scores and depression, and establish a cause and effect relationship.