The potential of the Mediterranean diet to improve metabolic control and body composition in youths with Type 1 Diabetes Mellitus.

BACKGROUND: A chronic autoimmune disease with an increasing incidence rate, type 1 diabetes mellitus (T1DM) is typified by the degeneration of the pancreatic beta cells. Diabetes management is significantly impacted by nutrition. Although it has been demonstrated that following the Mediterranean diet (MD) improves metabolic control with type 2 diabetes in children and adults, its effects on children with T1DM have not received much attention. OBJECTIVE: Therefore, the purpose of this study was to assess whether adherence to Mediterranean diet is associated with better metabolic control and body composition in youths with Type 1 Diabetes Mellitus. The study recruited T1DM patients aged 6-18 years at Istanbul University Cerrahpasa Medical Faculty Hospital's Pediatric Endocrinology and Diabetes Outpatient Clinic for follow-up. METHODS: In addition to demographic variables, some anthropometric measurements, body composition and biochemical parameters such as: Trygliceride(TG), Total cholesterol (TC), High density lipoprotein cholesterol (HDL-C), Low density lipoprotein cholesterol (LDL-C), (Aspartate aminotransferase) AST, Alanine transaminase (ALT) and glycated hemoglobin (HbA1c) was analyzed. The time in range (TIR) is a value obtained from continuous glucose monitoring. KIDMED was used to assess the participants' adherence with the MD. RESULTS: Good adherence to the MD resulted in much larger height SDS than poor adherence. Poor adherence to MD resulted in higher body fat than moderate and good adherence. There is positivite correlation between TIR and KIDMED score. Adherence to MD is negatively associated with HbA1c. The regression anaylsis showed that a one-point rise in the KIDMED score would result in a 0.314-unit reduction in the HbA1c value (p < 0.01). CONCLUSIONS: In conclusion, this study found that adhering to MD led to improved anthropometric measurements, biochemistry, and diabetes outcomes. Awareness among children, adolescents with T1DM, and their parents about the benefits of MD compliance for glycemic and metabolic control should be raised.

Food insecurity, Mediterranean diet adherence, and psychosocial health among university students in Türkiye.

The aim was to examine the relationship between food insecurity and adherence to the Mediterranean diet, academic achievement, depression, anxiety, and stress among university students. This cross-sectional study was conducted with 2039 university students studying in Türkiye. Sixty-eight point two per cent of the students were food insecure. Food security (FS) scores were negatively associated with adherence to the MD and academic achievement, and positively associated with depression, anxiety, and stress scores. A 1-unit increase in FS score resulted in a statistically significant increase of 0.458, 0.468, and 0.400 units in depression, anxiety, and stress scores, respectively, and a significant decrease of 0.140 units in the MD adherence screener score. Food insecurity among university students in Türkiye is very common, and students with food insecurity have low adherence to the MD and low academic achievement and high depression, anxiety, and stress scores. Financial support as well as financial and food literacy provided to students play an important role in managing food insecurity.

Turkish Version of the New Instrument for Orthorexia Nervosa-Test of Orthorexia Nervosa (TON-17): A Validity and Reliability Study.

This study aimed to adapt the Test of Orthorexia Nervosa- (TON-17) into Turkish and verify its validity and reliability. The study included 539 adults with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed, along with a confirmatory factor analysis to test its construct validity. The time-invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test the relationships between the scale and Eating Attitudes Test-26 and Obsessive Beliefs Questionnaire-9. Analyses were conducted using SPSS Version 28 and the AMOS-24 software. The Cronbach's α internal consistency coefficient of the total scale was found to be 0.82, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.68 for the "control of food quality", 0.64 for the "fixation on health and a healthy diet", and 0.73 for the "disorder symptoms". In addition, the test-retest reliability was found to be 0.87 for the total scale, suggesting excellent reliability. Most of the fit indices (CMIN/df, RMSEA, AGFI, NFI, and TLI) of the scale were acceptable, and the GFI indicated a good model fit. This study shows that the Turkish version of TON-17, which is a new tool with a three-factor structure to evaluate orthorexia, is a valid and reliable scale.

Relationship of perceived depression, stress, anxiety levels and hedonic hunger.

BACKGROUND: This study was designed to explore relationship of perceived depression, anxiety and stress (DAS) levels and hedonic hunger in adults. METHODS: A cross-sectional survey included questions about some socio-demographic characteristics, Power of Food Scale (PFS-Tr) and Depression Anxiety Stress Scales (DASS-21) was sent via an online platform. Self-reported weight and height were also questioned. A total of 4112 adult volunteers between the ages of 18-65 years participated in this study. 72.3% of them were female. RESULTS: The prevalence of moderate to extremely severe depression, anxiety, and stress was reported as 31%, 34% and 13% respectively. Hedonic hunger and perceived DAS levels were higher in females (p < 0.001). Hedonic hunger was positively correlated with perceived DAS (p < 0.001). While body mass index (BMI) was positively associated with PFS-Tr total score, food available and food present; negatively associated with food tasted. Body mass index was negatively correlated with perceived DAS. Hedonic hunger and perceived DAS levels decreased with increasing age. Females were more prone to both hedonic hunger and perceived DAS. About one in three participants reported moderate to extremely severe levels of depression and anxiety. Greater perceived DAS levels are associated with hedonic hunger. Underweight individuals had higher levels of perceived DAS. CONCLUSION: To our knowledge, this is the first study to examine the prevalence and predictors of perceived DAS levels and hedonic hunger in the Turkish adult population. The findings of the study suggest that the predictors such as age, sex and BMI are a part of psychological well-being and hedonic hunger.

The effect of social media use on orthorexia nervosa: a sample from Turkey.

Introduction: Objectives: the current study evaluated the orthorexic tendencies of social media users and the factors affecting these tendencies. Methods: a total of 2526 adult participants (696 male and 1830 female, 28.4 ± 10.3 years) completed a questionnaire that includes personal information, the Orthorexia Nervosa Scale (ORTO-11), the Social Media and Eating Behavior Scale (SMEB), and the International Physical Activity Questionnaire Short Form (IPAQ). Body mass index (BMI) was calculated from the reported weight and height of the participants. Independent-sample t-tests or chi-square tests were computed to evaluate various information of the participants according to the ON tendency. A binary logistic regression analysis was used to identify risk factors. Results: according to ORTO-11, 56.1 % of the participants had a tendency to ON, and the trend to ON increased with age and BMI (p < 0.05). People without ON tendency spent more time (172.2 ± 119.9 min/day) on social media. Participants who followed webpages with healthy nutrition and sport-exercise recommendations had an increased ON risk when compared to those who did not follow those pages (p < 0.05). In addition, although there was a significant difference between participants in physical activity level according to the ON tendency, this relationship was not significant in the regression model (p > 0.05). Conclusion: this study indicates that increasing social media usage, especially web pages that include health and nutrition recommendations, may boost the tendency to ON. Thus, raising awareness of social media may be beneficial to people who have a tendency to ON.

Introducción: Objetivos: el presente estudio evaluó las tendencias ortoréxicas de los usuarios de las redes sociales y los factores que afectan a estas tendencias. Métodos: un total de 2526 participantes adultos (696 hombres y 1830 mujeres, 28,4 ± 10,3 años de edad) completaron un cuestionario que incluye información personal, la escala de ortorexia nerviosa (ORTO-11), la escala de redes sociales y conducta alimentaria (SMEB) y el cuestionario internacional de actividad física en formato corto (IPAQ). El índice de masa corporal (IMC) se calculó a partir del peso y la estatura declarados por los participantes. Se realizaron pruebas t o pruebas del chi cuadrado de muestras independientes para evaluar la diversa información de los participantes según la tendencia a la ortorexia nerviosa. Se utilizó un análisis de regresión logística binaria para identificar los factores de riesgo. Resultados: según el ORTO-11, el 56,1 % de los participantes tenían tendencia a la ortorexia nerviosa y esta tendencia aumentaba con la edad y el IMC (p < 0,05). Las personas sin tendencia a la ortorexia nerviosa dedicaban más tiempo (172,2 ± 119,9 min/día) a las redes sociales. Los participantes que seguían páginas web con recomendaciones sobre alimentación saludable y deporte/ejercicios tenían un mayor riesgo de ortorexia nerviosa que los que no seguían esas páginas (p < 0,05). Además, aunque había una diferencia significativa entre los niveles de actividad física de los participantes según la tendencia a la ortorexia nerviosa, esta relación no era significativa en el modelo de regresión (p > 0,05). Conclusión: este estudio indica que el incremento del uso de las redes sociales, especialmente de las páginas web que incluyen recomendaciones sobre salud y alimentación, podría favorecer la tendencia a la ortorexia nerviosa. Por lo tanto, concienciar a las personas con tendencia a la ortorexia nerviosa sobre las redes sociales puede tener un efecto beneficioso.

Emotional and intuitive eating: an emerging approach to eating behaviours related to obesity.

Emotional and intuitive eating are associated with obesity. In the present study, it was aimed to evaluate the relationship between intuitive eating and emotional eating behaviours in adults with anthropometric measurements of obesity-related disease risk and gender. Body weight, body mass index (BMI), waist, hip and neck circumferences were taken. Emotional Eater Questionnaire and Intuitive Eating Scale-2 were used for the assessment of eating behaviour. A total of 3742 adult individuals (56⋅8 % (n 2125) female and (n 1617) male) were participated voluntarily. The total score and subscales of EEQ were higher in females than males (P < 0⋅001). The scores of the IES-2 subscales and the total score were higher in males than females (P < 0⋅05). In metabolic risk classification according to waist and neck circumference, EEQ scale scores (except type of food) were higher in the metabolic risk group, while IES-2 (except body-food congruence in neck circumference) scores were higher in the non-risk group (P < 0⋅05). While there was a positive correlation between EEQ and body weight, BMI, waist circumference, waist-height ratio, a negative correlation was found between age and waist-hip ratio. There was a negative correlation between IES-2 and body weight, BMI, waist-height ratio, waist-hip ratio. In addition, a negative correlation was found between IES-2 and EEQ. Intuitive eating and emotional eating differ by gender. Anthropometric measures and metabolic disease risk is associated with emotional eating and intuitive eating. Interventions to increase intuitive and decreasing emotional eating behaviour can be effective in preventing both obesity and obesity-related diseases.

Validity and reliability of the Turkish version of the Eating Disorder Examination Questionnaire (EDE-Q-13): short-form of EDE-Q.

BACKGROUND: The Eating Disorder Examination Questionnaire (EDE-Q) is a frequently used scale to evaluate eating behaviors and attitudes. In recent years, its use has increased due to the fact that the use of short forms is more practical. The aim of this study was to validate the short Turkish form of the Eating Disorder Examination Questionnaire (EDE-Q) including 13 items. METHODS: The study included 924 adults at a mean age of 30.3 ± 10.93 years. EDEQ-13 was translated and adapted to Turkish according to the Beaton Guidelines. The Eating Attitudes Test-26 (EAT-26), the Satisfaction with Life Scale (SWLS), and the Body Appreciation Scale (BAS) were used to analyze their relationships to EDE-Q-13. RESULTS: In this study, the rate of the total variance explained by the factors of EDE-Q-13 according to the Explanatory Factor Analysis (EFA) results of the scale was 83.54%. The Cronbach's alpha value of the scale was 0.89, and the Cronbach's alpha values of the 5 subscales were calculated in the range of 0.75-0.94. The criterion validity analysis showed an acceptable correlation between EDE-Q-13 and EAT-26, SWLS, and BAS. The confirmatory factor analysis (CFA) revealed that the model had fit values that were acceptable or good. CONCLUSION: Both EFA and CFA results showed that it is appropriate to use the Turkish EDE-Q-13. EDE-Q-13 was significantly correlated with eating disturbances, body appreciation, and life satisfaction. In conclusion, the Turkish version of EDE-Q-13 possesses high levels of validity and reliability.

The rate of eating disorders has been increasing in recent years. Although there are many scales in the evaluation of eating disorders, one of the most frequently used scales is the Eating Disorder Examination Questionnaire (EDE-Q). In recent years, its use has increased due to the fact that the use of short forms is more practical. The aim of this study was to validate the short Turkish form of EDE-Q. The study included 924 adults. Our results showed that it is appropriate to use the Turkish EDE-Q-13. EDE-Q-13 was significantly correlated with eating disturbances, body appreciation, and life satisfaction. In conclusion, the Turkish version of EDE-Q-13 possesses high levels of validity and reliability.

The effects of vitamin D supplemantation on prognosis in patients with mild obstructive sleep apnea syndrome

Background/aim: The aim of this study was to investigate the effect of vitamin D on the disease prognosis and biochemical parameters in patients with mild obstructive sleep apnea syndrome (OSAS). Materials and methods: Nineteen adult male individuals (18­65 years) who were diagnosed with mild OSAS after polysomnography and had low vitamin D levels were included in the study. Each week, patients took 50.000 IU Vitamin D3 supplementation for 8 weeks. Polysomnography, biochemical parameters FBG (fasting blood glucose), lipid profile (TG, TC, LDL-C, HDL-C, VLDL-C), calcium, phosphorus, parathormone, calcitonin, serum 25(OH)D, insulin, CRP, TNF-α, IL-6, and IL-10 of patients were evaluated at the beginning of study and at the end of the study. All assessments, including polysomnography, were repeated after 8 weeks. Results: Serum vitamin D levels were initially 19.5 ± 5.01 ng/mL and increased to 41.8 ± 10.51 ng/mL (p < 0.001) at the end of the study. FBG, TC and HOMA-IR of the patients were significantly decreased (p < 0.05). CRP, TNF-α, IL-6, and IL-10 levels were also correlated with serum vitamin D levels (p < 0.05). There was a significant decrease in number of obstructive apneas, apneas a nd hypopneas, apnea index, hypopnea index, and apnea hypopnea index of the patients (p < 0.05). Conclusion: As a result, it is thought that vitamin D supplementation may have a positive effect on the disease prognosis of mild OSAS.

Validation of the Turkish version of the power of food scale in adult population.

PURPOSE: The Power of Food Scale (PFS) is a tool for measuring the hedonic impact of food environments rich in palatable foods. The purpose of this study was to validate the Turkish version of PFS (PFS-Tr) in a large adult population. METHODS: Data were obtained from 505 Turkish adults aged between 19 and 64 years. The PFS-Tr and Dutch Eating Behavior Questionnaire (DEBQ) were completed by all participants. RESULTS: PFS-Tr compared with the original English version of PFS, items 5 and 13, which showed the highest error covariance under the food available factor. To provide general criteria, items 5 and 13 were removed. After these two items were removed, the Cronbach's alpha coefficient was 0.922 for PFS-Tr and Cronbach's alpha values for "food available", "food present", and "food taste" were found to be 0.849, 0.797, and 0.82, respectively. Besides, the Cronbach's alpha coefficient was 0.93 for DEBQ. In addition, a linear association was found between BMI and mean score of PFS-Tr with a model fit (R2 = 0.02) and PFS-Tr was positively correlated with DEBQ (r 0.497 p < 0.001). CONCLUSION: This is the first study that validates and reports the Turkish version of PFS and the results of our study show that PFS-Tr is a valid and reliable tool for determining the tendency for the hedonic hunger in Turkish adult population. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.