Effects of low fat diet on inflammatory parameters in individuals with obesity/overweight and non-alcoholic fatty liver disease: A cross-sectional study.

Nonalcoholic fatty liver disease (NAFLD) is considered one of the most important causes of chronic liver disorders in the world. Dietary pattern is a modifiable risk factor that represents the main target for the prevention and treatment of NAFLD. The aim of this cross-sectional study was to assess the impact of low-fat diet on anthropometric measurements, biochemical, and inflammatory parameters in individuals with obesity/overweight and NAFLD. A total of 108 individuals (n = 59 males and n = 49 females) aged between 19 and 65 years participated in the 12-week weight loss program. Dietary treatment plans including low-fat diets were randomly prescribed for each individual. Anthropometric measurements were collected by a trained dietitian at baseline and 12-week follow-up. Blood samples were collected for each individual at baseline and 3rd month for biochemical measurements and enzyme-linked immunosorbent assay analysis for tumor necrosis factor-α (TNF-α), interleukin (IL)-6, fibroblast growth factor-21 (FGF-21), chemerin, and irisin levels in plasma. At the end of the study, body weight, body mass index, body fat % body fat mass (kg) reduced significantly in females and males (P < .05). Moreover, reductions in waist, hip, and neck circumferences were significant in both groups. Changes in alanine aminotransferase and aspartate aminotransferase levels were significant in 3rd month. After 3 months, reductions in TNF-α, IL-6, and FGF-21 levels were significant in individuals with obesity/overweight and NAFLD. While no significant change in chemerin and irisin levels was found. These results show that low-fat diet over a 12-week period led to improvements in both anthropometric measurements and biochemical parameters in individuals with obesity/overweight and NAFLD.

The effect of perioperative immunonutritional support on nutritional and inflammatory status in patients undergoing lung cancer surgery: a prospective, randomized controlled study.

PURPOSE: Nutritional status is affected in patients who undergo lung cancer surgery (LCS). This study is aimed at investigating the effects of the use of immunonutritional support in the perioperative period on nutritional and inflammatory status in patients undergoing LCS. METHODS: A single-center, prospective, randomized controlled clinical trial was conducted with seventy patients planning to have LCS and randomized into treatment (TG) and control groups (CG). Immunonutritional support was given orally twice a day for ten days before the operation and five days after the operation in the treatment group. The nutritional status of the patients was screened with the Patient-Generated Subjective Global Assessment (PG-SGA); the Prognostic Nutrition Index (PNI) and the Systemic Inflammation Index (SII) were calculated. The physical activity status was assessed with the Eastern Cooperative Oncology Group Performance Status (ECOG-PS). RESULTS: Post-op nutritional status of the TG patients was better than the CG group (p = 0.009). Post-operative PG-SGA score was higher than preoperative PG-SGA score in both groups (p < 0.001). In the post-operative period, nutritional status (in terms of PG-SGA score category) in the patients in the TG was better than the CG (p = 0.046). In both groups, post-op ECOG score was higher than the pre-op ECOG score (p < 0.001). Post-op physical performance status was found to be better in the TG compared to the CG (p = 0.001). PNI level decreased statistically and significantly in the post-op period compared to the pre-op period, SII levels increased. CONCLUSION: Patients who will undergo LCS should be supported in terms of immunonutrition starting from the preoperative period.

Acceptability, Usability and Weight Loss Outcomes in a Randomized Cross-Over Study of Commercially Available Portion Size Tools in an Overweight South Asian Community.

South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardiovascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically designed tableware helps individuals to manage weight by controlling food portion sizes. Thirty-one (n = 31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess the efficacy, acceptance, and weight change of two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet diaries. Scores describing acceptance, ease of use, and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p = 0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, and perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group is warranted.

Assessment of the effect of hand dryers used in shopping malls on hand hygiene.

BACKGROUND: Hand drying is one of the most important factors affect hand hygiene. This study was conducted to investigate the effect of hand dryers used in the restrooms located on the food court floors in shopping malls in Turkey on hand hygiene. METHODS: Hands were washed for at least 20 seconds by following hygienic hand washing procedures of the World Health Organization. Swab samples were taken from the wet hands after hand washing, then from the dry hands, which were dried under the hand dryers and from the air blowing part of the hand dryers. Samples were cultured on agar plates that were directly exposed to the air-blowing part of the hand dryers. RESULTS: It was found that total coliform bacteria were 0.000 colony-forming unit (CFU)/petri in wet and dried hand, 3.437 CFU/petri in blown air and 5.250 CFU/petri in swab samples. Staphylococcus aureus was found to be 0.125, 64.125, 26.375, and 388.750 CFU/petri, respectively. Total bacteria count was found to be 0.687, 48.750, 35.625, and 595.000 CFU/petri, respectively. S. aureus and the total bacterial load were higher in the blower outlet of the hand dryers than washed hand, blown air and dried hand (P < .05). The bacteria count in the unfiltered hand dryers was higher than that in the filtered hand dryers (P < .05). CONCLUSIONS: Using hand dryers would negatively affect hand hygiene even if hands were washed following hygienic hand washing procedures.

Validation of MEDFICTS Dietary Assessment Questionnaire in Turkish Population.

OBJECTIVE: The purpose of this study was to assess the validity of MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, Snacks) questionnaire in Turkish population. DESIGN: MEDFICTS questionnaire is a brief dietary assessment tool developed as part of the National Cholesterol Education Program Adult Treatment Panel guidelines, and it measures the adherence to Step 1 and Step 2 diets that are recommended for the prevention and treatment of CVD. MEDFICTS questionnaire was administered with 3-d food record to compare overall dietary fat intake. SETTING: This study was conducted at the Hacettepe University (Ankara, Turkey) in 2017. PARTICIPANTS: Subjects were university students, recruited from several departments of Hacettepe University by trained dietitians. A total of 442 adults (249 females and 194 males) between the ages of 18 and 31 years participated in the study. Students with CVD were excluded. RESULTS: Total fat intake ratio was higher than the recommended level for both males and females (39·4 % and 39·9 %, respectively). Mean MEDCISTS score was 66·3 ± 27·24 points. Total energy, total fat, SFA and cholesterol intakes from 3-d food records within the different MEDFICTS diet groups significantly differed (P < 0·001 for all). Receiver operating characteristics curve analysis demonstrated that a cut-off point of 60 showed 80 % sensitivity and 65 % specificity. CONCLUSIONS: Our data indicate that the MEDFICTS questionnaire is moderately accurate; however, sensitivity analysis did not demonstrate the recommended 40 points as an optimal cut-off point for Turkish population.

Is sonic hedgehog expression in saliva related to taste sensitivity in adults?

Recent studies have demonstrated the critical role of the sonic hedgehog in the sensory perception of taste. Salivary sonic hedgehog stimulates taste bud stem cells, also acts as a taste bud growth factor, and contributes to the receptors' development and longevity in the taste buds. This study's objective was to investigate the possible relationship between taste sensitivity and sonic hedgehog expression in saliva in normal-weight and pre-obese/obese participants (totally 46 male (47.8%) and female (52.2%) aged 19-44 were recruited). Thresholds for the six tastes (sweet, salty, bitter, sour, umami and fat) were investigated using 3-Alternate Forced Choice Methodology. Saliva was collected with the draining method for sonic hedgehog expression analysis. The results indicated significantly higher thresholds for sweet, bitter and fat in pre-obese /obese adults than normal-weight adults (p<0.05). The sonic hedgehog expression was also lower in pre-obese /obese participants than normal-weight participants (p<0.05). Furthermore, sonic hedgehog expression was higher in hypersensitive participants than hyposensitive participants (p<0.05) only among normal-weight individuals, with no significant difference in sonic hedgehog expression level by taste sensitivity in pre-obese/obese individuals (p>0.05). Sonic hedgehog expression level was negatively correlated with body mass index, sweet, salty, bitter and fat taste threshold. The study results indicated that sonic hedgehog expression level acted on taste sensitivity in normal-weight participants, with greater expression in hypersensitive individuals than hyposensitive individuals.

Cross-Sectional Evaluation of Food Items Preferred by Adolescents under the Influence of Television Advertisements.

BACKGROUND: Food and beverage advertisements on television play a significant role in food preferences, especially among children and adolescents. This study aimed to evaluate foods and beverages advertised on television and purchased by adolescents or their families using the World Health Organization (WHO) nutrient profiling model. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study was performed on 2,699 students (1380 males and 1319 females) aged 11-16 in Ankara, Turkey, in 2015. Socio-demographic characteristics, television-viewing habits, and the tendency to purchase foods and beverages under the influence of TV advertisements were recorded. The body weight and height were measured by the researchers. All reported food and beverage items (n  =  284) were evaluated and classified as permitted or not permitted to advertise, according to the WHO nutrient profile model (2015). RESULTS: The majority (69.8%) of students were underweight/normal weight, whereas 13.3% and 16.9% were classified as overweight and obese, respectively. A total of 69.6% of adolescents declared that they were influenced by food advertisements, and 66.4% bought those foods. The most purchased products included cakes and sweet biscuits (63.8%), chocolate and confectionery (44.9%), savory snacks (39.6%), and soft drinks (25.4%). Only 8.5% of all the advertised products (n  =  284) were permitted to be advertised, according to the WHO nutrient profile model (2015). Dairy products, meat products, grains, fruits and vegetables, soup, and some traditional Turkish foods (e.g., cig kofte and Turkish pizza) were permitted. The permitted products were preferred by only 13.6% of the adolescents. CONCLUSIONS: Unhealthy foods are advertised on television for adolescents, and food advertisement management may be an essential strategy to provide healthy food choices.

Are food and drink available in online and physical supermarkets the same? A comparison of product availability, price, price promotions and nutritional information.

OBJECTIVE: Online supermarkets are increasingly used both by consumers and as a source of data on the food environment. We compared product availability, nutritional information, front-of-pack (FOP) labelling, price and price promotions for food and drink products between physical and online supermarkets. DESIGN: For physical stores, we collected data on price, price promotions, FOP nutrition labels and nutrition information from a random sample of food and drinks from six UK supermarkets. For online stores, we used foodDB, a research-ready dataset of over 14 million observations of food and drink products available in online supermarkets. SETTING: Six large supermarket stores located near Oxford, UK. PARTICIPANTS: General sample with 295 food and drink products, plus boost samples for both fruit and vegetables, and alcohol. RESULTS: In the general sample, 85 % (95 % CI 80, 90 %) of products found in physical stores could be matched with an online product. Nutritional information found in the two settings was almost identical, for example, concordance correlation coefficient for energy = 0·995 (95 % CI 0·993, 0·996). The presence of FOP labelling and price promotions differed between the two settings (Cohen's kappa = 0·56 (95 % CI 0·45, 0·66) and 0·40 (95 % CI 0·26, 0·55), respectively). Prices were similar between online and physical supermarkets (concordance correlation coefficient > 0·9 for all samples). CONCLUSIONS: Product availability, nutritional information and prices sourced online for these six retailers are good proxies of those found in physical stores. Price promotions and FOP labelling vary between the two settings. Further research should investigate whether this could impact on health inequalities.

Exploring the health status of older persons in Sub-Saharan Africa.

Sub-Saharan Africa (SSA) has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation, SSA is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases (NCD). The aim of this review is to highlight available research on the health status of older persons in SSA, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in SSA on older persons (aged 50 years and older) related to health indicators including nutritional status, NCD and HIV burden. While it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.

Nutritional habits in functional dyspepsia and its subgroups: a comparative study.

OBJECTIVE: Research data demonstrating nutritional habits of functional dyspepsia (FD) patients are very limited. This is the first study to evaluate nutritional habits in FD subgroups according to Rome III criteria. Our aim was to evaluate nutritional habits of FD patients and determine the food items that may provoke a dyspepsia symptom. METHODS: A total of 168 adults with FD and 135 healthy control subjects participated in the study. FD subjects were divided into epigastric pain syndrome (EP-FD), postprandial distress syndrome (PS-FD), mixed (MX-FD) subgroups according to Rome Criteria III. Subjects completed a questionnaire that included a short-form food frequency questionnaire. Furthermore, subjects were asked to list the food items that were causing a dyspepsia symptom. RESULTS: Functional dyspepsia subjects had a slightly higher BMI (26.1 ± 4.97 kg/m(2)) than control subjects (24.6 ± 4.08 kg/m(2)). The most common symptom triggering foods among all the FD groups were fried and fatty foods (27.1%), hot spices (26.4%), and carbonated drinks (21.8%). In FD subgroups, carbonated drinks were more likely to cause a symptom in PS-FD group (37.3%) than MX-FD (25.7%) and EP-FD (22.1%) groups. There was no difference in frequency of main meals and snacks among any of the groups. CONCLUSION: Fatty and spicy foods and carbonated drinks were the most common symptom triggering food items in FD group. In subgroups, carbonated drinks and legumes were more likely to cause a symptom in PS-FD. Removing these food items during the course of treatment might help alleviate the symptoms.

Energy expenditure and nutritional status of coal miners: A cross-sectional study.

The objectives of this study were to assess the nutritional status, daily energy intake, and daily energy expenditure of coal miners in Turkey. A total of 135 healthy coal miners (aged 19-64 years) were evaluated. Heart rates were measured using Polar watches, and the total energy expenditure was calculated using physical activity level formula and Hiilloskorpi equation. The average body mass index of the participants was 25.7 ± 3.98 kg/m2, and the average energy intake was 3,973.7 ± 420.85 kcal. According to Dietary Reference Intakes, the energy and nutrient intakes of the miners were adequate, except for the intake of vitamin D. The coal miners were found to be at moderate (43.0%), heavy (41.5%), and very heavy (13.3%) activity levels. Calculations of the energy expenditure at work were found to be 2,189.8 ± 376.19 to 2,788.8 ± 359.89 kcal per day. Further studies have to be conducted for developing national standards for each occupation.

Testing Two Nutrient Profiling Models of Labelled Foods and Beverages Marketed in Turkey.

AIM: The objective of this study was to evaluate the nutrient profile of labelled foods and also understand the application of two international nutrient profiling models of labelled foods and beverages. METHODS: WXYfm and NRF 9.3 nutrient profiling models were used to evaluate 3,171 labelled foods and beverages of 38 food categories and 500 different brands. RESULTS: According to the WXYfm model, pasta, grains and legumes and frozen foods had the best scores whereas oils had the worst scores. According to the NRF 9.3 model per 100 kcal, the best scores were obtained for frozen foods, grains and legumes and milk products whereas the confectionery foods had the worst scores. According to NRF 9.3 per serving size, grains and legumes had the best scores and flavoured milks had the worst scores. A comparison of WXYfm and NRF 9.3 nutrient profiling models ranked scores showed a high positive correlation (p=0.01). CONCLUSIONS: The two nutrient models evaluated yielded similar results. Further studies are needed to test other category specific nutrient profiling models in order to understand how different models behave.