Investigation of psychometric properties of Turkish version of nursing students' attitudes and beliefs towards Childhood Obesity Scale.

AIM: This study aimed to evaluate the Turkish psychometric properties of The Attitudes and Beliefs of Nursing Students Towards the Childhood Overweight Scale. METHODS: The study was conducted with 219 nursing students. The data were obtained with the 'Information Form' and the 'Attitudes and Beliefs of Nursing Students Towards Childhood Overweight. Strengthening the Reporting of Observational Studies in Epidemiology guidelines was implemented in the study. RESULT: Original scale was created using the Attitudes Towards Obese Person Scale (ATOP) and the Beliefs About Obese Persons Scale (BAOP). ATOP consists of 13 items and two sub-dimensions (self-concept, social relationships) in a 5-point Likert type that evaluates nursing students' attitudes towards childhood obesity. BAOP is 5-point Likert-type and consists of 6 items that evaluate nursing students' beliefs on childhood obesity. When the item-total score correlations were examined in the study, two items showing a negative correlation in the "ATOP" were removed. Cronbach's alpha was 0.80 for the ATOP and 0.83 for the BAOP. In the exploratory EFA and confirmatory CFA factor analyses, the factor loading of all items was >0.40 for both scales. CONCLUSION: It was determined that Turkish psychometric properties of the Nursing Students' Attitudes and Beliefs towards Childhood Obesity Scales were valid and reliable.

The Relationship Between Myostatin, Inflammatory Markers, and Sarcopenia in Patients With Chronic Kidney Disease.

OBJECTIVE: To determine the prevalence of sarcopenia in patients with chronic kidney disease (CKD), investigate the relationship of the serum myostatin level with sarcopenia and inflammatory markers. METHODS: The study was conducted with four patient groups: renal transplantation (TX), stage 3-5 non-dialysis-dependent CKD (NDD-CKD), hemodialysis (HD), and peritoneal dialysis (PD). Laboratory parameters, serum myostatin, C-reactive protein, and interleukin-6 levels were studied. Body composition was estimated using a multifrequency bioimpedance analysis. Handgrip strength (HGS) was evaluated with a handgrip dynamometer. The HGS and appendicular skeletal muscle index measurements were used to determine sarcopenia presence. RESULTS: The study included 130 patients (72 [55%] male patients). The patient distribution in groups was as follows: 37 in HD, 28 in PD, 37 in renal TX, and 28 in NDD-CKD. The highest level of myostatin was measured in the HD group, and the lowest in the TX group (P < .001). The HGS measurement in the PD group was significantly lower than that in the TX group (P = .025). The myostatin was negatively correlated with HGS, albumin, estimated glomerular filtration rate, and Kt/Vurea. However, myostatin had no correlation with inflammatory markers or appendicular skeletal muscle index. Sarcopenia was present in 37 (29%) patients: 15 (40%) in the HD group, nine (32%) in NDD-CKD, seven (25%) in PD, and six (16%) in TX. When the patients with and without sarcopenia were compared, only myostatin was higher in the former (P = .045). As a result of multivariate analysis, myostatin was the only independent factor which predicts sarcopenia (odds ratio: 1.002, 95% confidence interval: 1.001-1.005, P = .048). CONCLUSION: To prevent devastating events associated with sarcopenia in patients with CKD, renal transplantation seems to be the best treatment solution. For the early recognition of sarcopenia, the measurement of the serum myostatin level may be a promising diagnostic approach.

A Comparison of the Indirect Calorimetry and Different Energy Equations for the Determination of Resting Energy Expenditure of Patients With Renal Transplantation.

OBJECTIVE: We aimed to evaluate the agreement between the resting energy expenditure (REE) obtained by indirect calorimetry and eight prediction equations in adult patients with renal transplantation and a newly developed REE prediction equation for use in patients with renal transplantation in the clinic. METHODS: A total of 51 patients (30 males and 21 females) were involved in the study. The REE was measured by indirect calorimetry and compared with the previous prediction equations. The agreement was assessed by the interclass correlation coefficient and by Bland-Altman plot analysis. RESULTS: No significant difference was found in terms of age and body mass index between the genders. Differences between the predicted and measured REEs were maximum in the Bernstein equation (-478 kcal) and minimum in the Cunningham equation (-69 kcal). It was found that underprediction values varied from 27.5% (chronic kidney disease equation) to 98.0% (Bernstein equation). The highest overprediction value was found in the Schofield equation (17.7%). The Cunningham equation and the new equation had the lowest root mean square error (265 kcal/day). In this study, fat-free mass (FFM) was found to be the most significant variable in multiple regression analysis (r2: 0.55). The new specific equation based on FFM was generated as 424.2 + 24.7∗FFM (kg). Besides that, it was found that the new equation and Cunningham equation were distributed randomly according to Bland-Altman analysis. A supplementary new equation based on available anthropometric measurements was developed as -1996.8 + 19.1∗height (cm) + 7.2∗body weight (kg). CONCLUSION: This study showed that most of the predictive equations significantly underestimated REE. In patients with renal transplantation, if the REE is not measurable by indirect calorimetry, the use of the proposed equations will be more accurate.

Relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness: A cross-sectional study from Turkey.

OBJECTIVES: This study aimed to evaluate the relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness in adults. METHODS: This descriptive and cross-sectional study was conducted with 1797 adults ages 19-65 y. Demographic characteristics, anthropometric measurements, adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness were ascertained through a questionnaire. RESULTS: The mean age of the individuals was 27.5 ± 11.76 y, and 50.5% of the participants were adherent to the Mediterranean diet. A statistically significant difference was found between individuals who did and did not adhere to the Mediterranean diet in terms of age, income status, total score and subscores on the Sustainable and Healthy Eating Behaviors Scale, and subscores for information on climate change causes (P < 0.05). A statistically significant positive correlation was found between the Mediterranean Diet Adherence Scale (MEDAS) total score, the Sustainable and Healthy Eating Behaviors Scale total score and subscores, and the Climate Change Awareness Scale total score and subscores (P < 0.05). It was determined that sex, education level, and income status affected the Climate Change Awareness Scale total score (P < 0.05). It was determined that age, income status, the Sustainable and Healthy Eating Behaviors Scale total score, and the Climate Change Awareness Scale total score affected the MEDAS total score (P < 0.05). Also, it was determined that age, sex, education level, MEDAS total score, and Climate Change Awareness Scale total score affected the Sustainable and Healthy Eating Behaviors Scale total score (P < 0.05). CONCLUSIONS: This study showed a significant effect of climate change awareness on sustainable and healthy eating behaviors and adherence to the Mediterranean diet.

Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults.

BACKGROUND: Malnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults. METHODS: This cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed. RESULTS: The mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085). CONCLUSIONS: The SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.

Evaluation of food insecurity and its association with food consumption and some variables among college students.

BACKGROUND: Students are an important group threatened by food insecurity. Food insecurity among college students is one of the research topics that is attracting attention worldwide, and interest in this topic is growing by the day. Food insecurity has a negative impact on students' biological, mental and social health. This study aimed to determine the prevalence of food insecurity and correlate it with frequency of food consumption and some variables among undergraduate students. METHODS: This descriptive-analytical study was conducted with 1149 university students at Akdeniz University, Antalya, Turkey. The demographic characteristics of the individuals (gender, age, living situation, income status, and health information), anthropometric measurements (body weight and height), nutritional habits, frequency of food consumption, and Household Food Insecurity Access Scale (HFIAS) were questioned. Statistical Package for the Social Sciences (SPSS) software was used for statistical analyses. RESULTS: It was found that 13.1% of the students have mild, 13.0% moderate, and 9.4% severe food insecurity. The rate of individuals with and without food security differs according to gender, living situation, and income status (p < 0.05). There was a statistically significant correlations between the food insecurity score and age (p = 0.047), the number of main meals (p < 0.001) and snacks (0.007), and consumption frequency of certain foods (p < 0.05). CONCLUSIONS: The prevalance of students facing food insecurity was high. Individuals with food insecurity have a lower frequency of healthy food consumption than individuals with food security. Steps should be taken to ensure nutritional security among undergraduate students, who are the young adult population.