Relationships among alexithymia, psychological distress, and disordered eating behaviors in adolescents.

This cross-sectional study aimed to evaluate the relations between psychological distress, alexithymia, disordered eating behaviors (DEBs), and body mass index (BMI) and to assess if psychological stress would mediate the influence of alexithymia on DEBs in adolescents. A total of 1609 high school students (58.9% females) aged 14-18 years were included in the study. Data were collected using a self-administered questionnaire. DEBs including emotional eating, cognitive restraint, and uncontrolled eating were assessed with the Three-Factor Eating Questionnaire, psychological distress was assessed with the Depression Anxiety Stress Scale and alexithymia was assessed with the Toronto Alexithymia Scale. Anthropometric measurements were performed. Psychological distress was found to be positively associated with alexithymia, emotional eating, uncontrolled eating, and cognitive restraint (p < 0.01). Both direct and indirect effects of alexithymia on emotional eating and uncontrolled eating were significant. Psychological distress partially mediated the relationship between alexithymia and uncontrolled eating (ß = 0.05) and emotional eating (ß = 0.04), while it fully mediated the relationship between alexithymia and cognitive restraint (ß = 0.05). BMI z score was not correlated with alexithymia and psychological distress. Emotional eating (ß = 0.16) and cognitive restraint (ß = 0.34), but not uncontrolled eating, significantly were associated with BMI z score. This study demonstrated that alexithymia and psychological distress are positively associated with DEBs in adolescents. It also showed that psychological distress plays a mediating role between alexithymia and DEBs. Moreover, it showed that emotional eating and cognitive restraint are positively associated with the BMI z score. These results suggest that interventions aimed at improving adolescents' psychological well-being and their ability to identify and describe their emotions may reduce DEBs in adolescents, thereby preventing obesity in adolescents.

Nutrition literacy status and its association with adherence to the Mediterranean diet, anthropometric parameters and lifestyle behaviours among early adolescents.

OBJECTIVE: To evaluate nutrition literacy status and its association with adherence to the Mediterranean diet (MD), anthropometric parameters and lifestyle behaviours among early adolescents. DESIGN: This is a cross-sectional study. Nutrition literacy was evaluated using the 'Adolescent Nutrition Literacy Scale'. Dietary intake was assessed by 24-h food recall. The 'Mediterranean Diet Quality Index' was used to evaluate adolescents' adherence to the MD. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Body weight, height, waist, hip and neck circumference were measured. SETTING: Four secondary schools in Izmir, Türkiye. PARTICIPANTS: The study included 1074 secondary school students. RESULTS: Adolescents' nutrition literacy was at a moderate level. Nutrition literacy scores were significantly lower in those who skip main meals. Adolescents with high nutrition literacy had higher intakes of fibre, protein, protein, Ca, K, Mg, P, vitamin C, folate and Fe intake than those with low and moderate nutrition literacy (P < 0·05). According to IPAQ, active adolescents had higher nutrition literacy scores than inactive adolescents. There was no significant difference in BMI and anthropometric measurements of the adolescents according to their nutrition literacy level. Linear regression analysis showed that each unit increase in nutrition literacy increased adherence to the MD by 0·286 points (ß = 0·286) and decreased total screen time by 0·182 points (ß = -0·182). CONCLUSIONS: These findings showed that nutrition literacy among early adolescents was not optimal, and a higher nutrition literacy score was significantly associated with higher MD adherence, and healthy eating habits and lifestyle behaviours.

Dietary acid load in children with chronic kidney disease: its association with nutritional status and health-related quality of life.

BACKGROUND: This study aimed to determine the dietary acid load of children with chronic kidney disease (CKD) and to evaluate the relationship between dietary acid load, nutritional status, and health-related quality of life (HRQOL). METHOD: A total of 67 children aged 3-18 years with a diagnosis of CKD stages II-V were included in the study. Anthropometric measurements (body weight, height, mid-upper arm circumference, waist, and neck circumference) and 3-day food consumption records were taken to evaluate the nutritional status. The net endogenous acid production (NEAP) score was calculated to determine the dietary acid load. "Pediatric Inventory of Quality of Life (PedsQL)" was used to assess the participants' HRQOL. RESULTS: The mean NEAP was 59.2 ± 18.96 mEq/day. Stunted and malnourished children had significantly higher NEAP than those who were not (p < 0.05). There were no significant differences in terms of HRQOL scores according to NEAP groups. The multivariate logistic regression analysis showed that waist circumference (OR: 0.890, 95% CI: 0.794-0.997), serum albumin (OR: 0.252, 95% CI: 0.068-0.929), and glomerular filtration rate (GFR) (OR: 0.985, 95% CI: 0.970-1.000) were negatively associated with high NEAP. CONCLUSION: This study shows that a diet shifted in an acidic direction in children with CKD and a higher dietary acid load are associated with lower serum albumin, GFR, and waist circumference, but not HRQOL. These results suggest that dietary acid load might affect nutritional status and CKD progression in children with CKD. Future studies with larger samples are needed to confirm these results and to understand underlying mechanisms. A higher resolution version of the Graphical abstract is available as Supplementary information.

Functional Constipation in Elderly and Related Determinant Risk Factors: Malnutrition and Dietary Intake.

AIM: The objective of this study was to evaluate the relationship between FC and physical activity, dietary intake and malnutrition in the elderly. METHOD: A cross-sectional study was conducted on 883 adults aged >65 years from nursing homes and community health centers in Turkey. Constipation status was evaluated according to Rome IV criteria and Bristol Stool Form Scale. Dietary intake was assessed using a food consumption record (24-hour food recall). The dietary energy and nutrients were analyzed using the "Nutrition Information Systems Package Program". The nutritional status of participants was evaluated using the Mini-Nutritional Assessment (MNA) test. The International Physical Activity Questionnaire (IPAQ, short form) was used to assess physical activity status. RESULTS: Among the 883 participants, 29.6% were classified into the FC group (32.2% of females, 25.8% of males). The FC group had significantly lower total energy, fluid, water, protein, carbohydrate, magnesium, zinc, phosphorus, potassium, soluble fiber, insoluble fiber, total fiber, and fiber (g)/1000 kcal intake than the non-FC group (p < 0.05). The multivariate logistic regression analysis showed that total dietary fiber intake was significantly associated with a lower prevalence of FC (OR: 0.98, 95% Cl: 0.96-0.99). According to MNA, participants at risk of malnutrition (OR: 5.21, 95% Cl: 3.09-9.77) and malnourished participants (OR: 3.03, 95% Cl: 1.62-5.68) had a greater likelihood of FC compared with normal participants. Participants in the middle lower quartile of water intake (OR: 0.63, 95% CI: 0.42-0.95) had a decreased likelihood of FC compared with participants in the lowest quartile. CONCLUSION: FC is a common gastrointestinal disorder among the elderly in Turkey. Low dietary fiber intake, low water intake and malnutrition were important risk factors associated with FC in the elderly.

The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents.

AIM: This study was planned to determine the relationship between social media addiction and orthorexia nervosa (ON), eating attitude and body image among adolescents. METHOD: This cross-sectional study was conducted with 1232 high school-going adolescents. Data were collected using the Social Media Addiction Scale for Adolescents, Eating Attitude Test-26 (EAT-26), Body Image Scale (BIS) and ORTO-11 questionnaire. RESULTS: Social media addiction levels were higher in girls than in boys (p < 0.05). Multiple linear regression analysis showed that a better body image was associated with lower social media addiction scores (ß = - 0.268, p < 0.001). Social media addiction was significantly associated with a greater risk of eating behavior disorders (OR: 1.07, 95% Cl: 1.04-1.10) and ON tendency (OR: 1.02, 95% Cl = 1.00-1.04). Adolescents who stated that they always or often read nutrition-related posts on social media had an increased likelihood of eating behavior disorder risk (OR: 6.77, 95% CI: 3.84-11.94) and ON tendency (OR: 5.49, 95% CI: 3.39-8.88). CONCLUSION: This study demonstrated that social media addiction was associated with a higher eating behavior disorder risk, ON tendency and lower body image. Moreover, frequent reading of posts about nutrition on social media was positively associated with ON tendency and eating behavior risk. These results highlight that adolescents should be educated about social media use and its content to minimize the negative effects of constant exposure to unrealistic body images and nutrition-related misinformation and reduce the risk of eating disorders and ON among adolescents. Level of evidence Level V, cross-sectional descriptive study.

Evaluation of perceived depression, anxiety, stress levels and emotional eating behaviours and their predictors among adults during the COVID-19 pandemic.

OBJECTIVE: This study aimed to (1) evaluate the prevalence and predictors of perceived depression, anxiety, stress (DAS) levels and emotional eating behaviours and (2) determine the correlations between DAS levels and emotional eating behaviours during the pandemic. DESIGN: An online cross-sectional study included questions about demographic and anthropometric characteristics, dietary habits, Emotional Appetite Questionnaire (EMAQ) and Depression Anxiety Stress Scales. The snowball sampling method was used. SETTING: Türkiye. PARTICIPANTS: The study population was 2002 adults aged ≥18 years. RESULT: The mean age was 27·1 ± 9·52 years (72·1 % females and 27·9 % males). The prevalence of moderate to severe DAS was reported as 27·8 %, 30·5 % and 30·7 %, respectively. Skipping meals (OR = 1·32, 95 % CI (1·14, 1·49)) was associated with depression. Weight gain (OR = 1·43, 95 % CI (1·19, 1·66); OR = 1·30, 95 % CI (1·14, 1·49); OR = 1·39, 95 % CI (1·14, 1·64)), weight loss (OR = 1·45, 95 % CI (1·20, 1·70); OR = 1·37, 95 % CI (1·11, 1·62); OR = 1·46, 95 % CI (1·20, 1·72)), exercising at least 150 min/week (OR = 0·64, 95 % CI (0·46, 0·83); OR = 0·73, 95 % CI (0·55, 0·92); OR = 0·83, 95 % CI (0·63, 1·02)), and maintaining an adequate and balanced diet (OR = 0·52, 95 % CI (0·33, 0·71); OR = 0·53, 95 % CI (0·34, 0·73); OR = 0·63, 95 % CI (-0·15, 0·35)) were associated with DAS, respectively. BMI (r = 0·169, P < 0·001), weight (r = 0·152, P < 0·001), number of snacks (r = 0·102, P = 0·011), depression (r = 0·060, P = 0·007), anxiety (r = 0·061, P = 0·006) and stress (r = 0·073, P = 0·001) levels were positively correlated with EMAQ-negative scores. CONCLUSION: Approximately one out of every three participants reported moderate to severe DAS levels. Emotional eating was significantly correlated with perceived DAS. The predictors obtained in the study suggest that a healthy diet and lifestyle behaviours are part of psychological well-being and emotional eating.

Nutritional status and adherence to the mediterranean diet in children with epilepsy.

INTRODUCTION: The objective of this study was to determine the nutritional status of children diagnosed with epilepsy and to evaluate adherence to the Mediterranean diet. METHODS: This cross-sectional study was carried out with a total of 85 children aged 2-18 years and their parents who attended the outpatient paediatric neurology clinic of a university hospital. Socio-demographic, dietary, biochemical, lifestyle, and anthropometric data were collected. Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Quality Index (KIDMED). RESULTS: Of the total children, 22.3% were classified as high adherers to the Mediterranean diet (55.4% moderate and 22.3% poor). According to BMI for age, 15.3% of the children were overweight, and 15.3% were obese. The ratio of energy from fat intake was found to be high. The mean dietary iron and sodium intakes of children with a high level of adherence to the Mediterranean diet were higher than those with moderate and low levels (p < 0.05). The mean dietary cholesterol intake of those with low adherence to the Mediterranean diet (322.70 ± 166.63 mg) was found to be higher than those with high (237.43 ± 163.46 mg) and moderate (194.23 ± 182.71 mg) adherence (p < 0.05). A positive and statistically significant relationship was found between the children's KIDMED index score and carbohydrate, fibre, soluble fibre, iron, potassium, calcium and magnesium values (p < 0.05). There was no relationship between the children's KIDMED index scores and the number of seizures and anthropometric measurements (p > 0.05). CONCLUSION: Majority of children diagnosed with epilepsy had moderate adherence to the Mediterranean diet, and that the KIDMED index might be used in the evaluation of healthy eating habits in children diagnosed with epilepsy.