Potential associations between alterations in gut microbiome and obesity-related traits after the bariatric surgery.

BACKGROUND: This study aimed to examine the effects of both obesity and bariatric surgery on gut microbiome, dietary intake, as well as metabolic and inflammatory parameters. METHODS: All participants (15 with morbid obesity who had bariatric surgery, 8 with morbid obesity and 11 non-obese) were followed up for a 6-month period with interviews at baseline (M0), at the end of 3 (M3) and 6 months (M6). Dietary assessment was done, and blood and faecal samples were collected. RESULTS: Dietary energy and nutrient intakes as well as serum glucose levels, total cholesterol, low-density lipoprotein (LDL)-cholesterol and high sensitivity C-reactive protein (hs-CRP) levels decreased after surgery (p < 0.05, for each). Participants with morbid obesity had higher levels of Firmicutes and lower levels of Bacteroidetes at M0 compared to non-obese participants. The abundances of Bacteroidetes increased (p = 0.02), whereas that of Firmicutes decreased (p > 0.05) after the surgery, leading to a significant decrease in Firmicutes/Bacteroidetes ratio (p = 0.01). At sub-phylum level, the abundances of Lactobacillus and Bifidobacterium decreased, whereas those of Akkermansia increased after the surgery (p < 0.01, for each). Although participants who were morbidly obese had a distinct profile according to ß-diversity indices at M0, it became similar with the profile of non-obese participants (p > 0.05) at M3 and M6. Similarly, α-diversity indices were lower in subjects with morbid obesity at M0, but became similar to levels in non-obese controls at M6. CONCLUSION: This study confirmed that bariatric surgery has substantial impacts on gut microbiome's composition and diversity, as well as anthropometrical measurements and biochemical parameters, which were associated with the alterations in dietary intake patterns.

Acute and short-term effects of Lactobacillus paracasei subsp. paracasei 431 and inulin intake on appetite control and dietary intake: A two-phases randomized, double blind, placebo-controlled study.

This study aims to examine the acute and short-term effects of prebiotics, probiotics, and their combination on appetite, energy intake and satiety related hormones in two phases. The first phase was a randomized, double blind, placebo controlled crossover study. Prebiotic (16 g inulin), probiotic (Lactobacillus paracasei subsp. paracasei 431 (L. casei 431) (>106 cfu/ml), synbiotic (their combination) and control (16 g maltodextrin) dairy drinks were consumed by 16 healthy men with a standard breakfast on four separate test days, and the following satiety responses and ad libitum food intake at lunch and over 24 h were assessed. In the second phase, the effects of 21 days of synbiotic (n = 10) or control (n = 11) drink consumption on appetite sensation, energy intake, serum glucose, insulin, peptide YY, ghrelin, obestatin and adiponectin concentration were assessed in a randomized double-blind placebo-controlled design. In the first phase, energy intake values during ad libitum lunch were the lowest in the prebiotic drink, followed by probiotic, synbiotic and control drinks, respectively (p = 0.017); also the rest of the day and 24-h dietary energy intake was lower by prebiotic and probiotic drinks compared to the control drink (p < 0.05 for each). For short-term effects, no significant difference in anthropometric measurements, hunger-satiety scores and serum glucose, insulin, PYY, ghrelin, obestatin and adiponectin concentrations were recorded. Despite the potential of prebiotics and probiotics to reduce energy intake, further studies are required for a better understanding of their role in satiety related mechanisms.

FTO gene-lifestyle interactions on serum adiponectin concentrations and central obesity in a Turkish population.

The aim of the study was to investigate whether lifestyle factors modify the association between fat mass and obesity-associated (FTO) gene single nucleotide polymorphisms (SNPs) and obesity in a Turkish population. The study included 400 unrelated individuals, aged 24-50 years recruited in a hospital setting. Dietary intake and physical activity were assessed using 24-hour dietary recall and self-report questionnaire, respectively. A genetic risk score (GRS) was developed using FTO SNPs, rs9939609 and rs10163409. Body mass index and fat mass index were significantly associated with FTO SNP rs9939609 (p = 0.001 and p = 0.002, respectively) and GRS (p = 0.002 and p = 0.003, respectively). The interactions between SNP rs9939609 and physical activity on adiponectin concentrations, and SNP rs10163409 and dietary protein intake on increased waist circumference were statistically significant (Pinteraction = 0.027 and Pinteraction = 0.044, respectively). Our study has demonstrated that the association between FTO SNPs and central obesity might be modified by lifestyle factors in this Turkish population.

Is Ramadan fasting correlated with disordered eating behaviours in adolescents?

This study aimed to examine the cross-sectional relationship between Ramadan fasting as a spiritual factor with prolonged hunger and disordered eating behaviors. The study was conducted in June 2016 (11th-29th days of Ramadan) and consisted of 238 fasting and 49 non-fasting adolescents. Risk of disordered eating was evaluated using the Eating Attitudes Test-26 (EAT-26) and Three Factor Eating Questionnaire-R18 (TFEQ-R18). Body image dissatisfaction was rated with Stunkard's Figure Rating Scale (FRS). Nutritional status was assessed using a 24-hour dietary recall. There was no significant difference between energy intake, EAT-26 and TFEQ-R18 scores (except the emotional eating sub-scores) between the groups. FRS revealed that the comparisons of their "ideal" and self were not significantly different between the groups whereas the gap between the figures they think healthy and closest to self was significantly higher amongst non-fasting adolescents. Two-hundred and two (97.5%) adolescents reported fasting for religious purposes whereas only 8 (3.4%) for losing weight. The EAT-26 total scores were in the pathological range in 39 (16.8%) adolescents who fasted for religious purposes. This study suggests that motivation of adolescents to fast during Ramadan was due to spiritual decisions rather than weight control or other factors and Ramadan fasting was not correlated with disordered eating behaviors or body image dissatisfaction.

Formation of advanced glycation endproducts in foods during cooking process and underlying mechanisms: a comprehensive review of experimental studies.

Advanced glycation endproducts (AGE) are a group of complex and heterogeneous molecules, sharing some common characteristics such as covalent cross-link formation among proteins, the effect of transforming the colour of food products into yellow-brown colours and fluorescence formation. AGE are linked to many diseases including diabetes, renal diseases, CVD, liver diseases, neuro-degenerative and eye disorders, female reproductive dysfunction, and even cancer. AGE are formed endogenously but are also provided from exogenous sources including diet and tobacco. Western diet, rich in processed and/or heat-treated foods, fat and sugar, increases the exposure to AGE. The foods that contain high levels of fat and protein are generally rich in terms of AGE, and are also prone to AGE formation during cooking compared with carbohydrate-rich foods such as vegetables, fruits, legumes and whole grains. The present article aimed to review the literature about the effects of different cooking methods and conditions on the AGE content of food and AGE formation mechanisms using a comprehensive approach.

Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation.

BACKGROUND: Increased levels of reactive oxygen species during and after surgery may affect inflammatory response, post-operative adhesion molecule formation, and hemodynamic stability. The glutathione redox cycle is an important regulator in oxidative stress and its reduced forms scavenge free radicals. N-acetyl cysteine, a precursor of reduced glutathione, is considered as a potentially therapeutic wide spectrum agent in clinical practice. We therefore examined whether N-acetyl cysteine improves some biochemical parameters in cancer patients undergoing major abdominal surgery. METHODS: Thirty-three patients diagnosed with pancreas, stomach, rectum, colon malignancies, and undergoing major abdominal surgery at Ankara Numune Training and Research Hospital were randomly divided into two groups; control (CON) and N-acetyl cysteine (NAC). The NAC group had 1,200 mg N-acetyl cysteine starting two days before the operation day, in addition to isonitrogenous and isocaloric total parenteral nutrition of 1.2 g/kg protein, 25 kcal/kg, and 60:40 carbohydrate/fat ratio. Blood and urine samples were drawn two days before the operation, on operation day, and on the first, third, and fifth days post-operation. RESULTS: Plasma malondialdehyde was significantly lower in the NAC group (P < 0.001). N-acetyl cysteine treatment did not affect plasma levels of vitamin A, C or E. The NAC group exhibited a higher ratio of reduced glutathione to oxidised glutathione (P = 0.019). Urinary nitrate level was also significantly lower in the NAC group (P = 0.016). CONCLUSION: The study demonstrated the clinical importance of N-acetyl cysteine supplementation on antioxidant parameters in abdominal surgery patients. In these patients N-acetyl cysteine and vitamin administration can be considered as an effective method for improvement of oxidative status.

Dietary Total Polyphenol, Flavonoid, and Lignan Intakes Are Associated with Obesity and Diabetes-Related Traits: A Case-Control Study.

Purpose: Dietary phytochemicals have been under examination as adjuvants for the prevention and treatment of obesity and diabetes. This study aimed at examining the potential associations of dietary "Phytochemical Index" (PI) and polyphenol intake with obesity and diabetes-related parameters. Materials and Methods: The case-control study involved 331 participants (156 overweight/obese and 175 normal weight), aged 18-50 years. Dietary intake was assessed using the 24-hr dietary recall method, and the PI score was calculated as the percentage of energy intake provided by phytochemical-rich foods. Polyphenol intakes were calculated using Phenol-Explorer and U.S. Department of Agriculture databases. Anthropometrical measurements were taken, serum glucose, insulin, and lipid profiles were analyzed, homeostatic model assessment for insulin resistance (HOMA-IR) was calculated, and blood pressure was measured. Linear regression analyses were used to examine the potential associations. Results: Participants with higher PI scores had higher total and some sub-classes polyphenol intakes compared with lower ones (P < 0.05, for each). Dietary PI score was not associated with any of the anthropometrical measurements; however, total polyphenol and flavonoids intakes were inversely associated with body mass index (ß = -0.269, P = 0.049; ß = -0.262, P = 0.048; respectively), waist circumference (ß = -0.127, P = 0.021; ß = -0.130, P = 0.016; respectively), and waist-to-hip ratio (ß = -20.724, P = 0.032; ß = -22.199, P = 0.018; respectively) after adjusting for potential confounders. Either dietary PI score or total and sub-class polyphenol intakes were not associated with a better metabolic profile, except for the lignan intake, which was inversely associated with HOMA-IR (ß = -0.048, P = 0.011). Conclusions: Higher dietary polyphenol intake may have potential in the prevention of obesity and diabetes, and validated practical tools are essential for the assessment of polyphenol intake in clinical practice.

The cholesterol lowering efficacy of plant stanol ester yoghurt in a Turkish population: a double-blind, placebo-controlled trial.

BACKGROUND: We evaluated the cholesterol lowering efficacy of low-fat spoonable yoghurt with 1.9 g/d plant stanols as esters on plasma lipid profiles of Turkish subjects with mild to moderate hypercholesterolemia. METHODS: Using a randomised, double-blind, placebo-controlled study design, intervention (n = 35) and control (n = 35) groups consumed either 115 g low-fat yoghurt with 1.9 g/d plant stanols as esters or placebo yoghurt, respectively, for 4 weeks. Seventy subjects with untreated mild to moderate hypercholesterolemia (aged 23-65 years) were recruited. Changes in the lipid profile, including lipoproteins, apolipoproteins, and triglycerides, and anthropometric measurements were monitored at screening, baseline, and at the end of the second, third, and fourth weeks of intervention. The general linear model repeated measures procedure was used to test differences in the repeated continuous variables between study groups. RESULTS: Serum total cholesterol (4.6%), LDL cholesterol (6.3%), and non-HDL cholesterol (6.2%) concentrations were reduced significantly from baseline in the plant stanol group compared to the control group (p = 0.007, p = 0.005 and p = 0.005, respectively). A variation in the response of serum total and LDL cholesterol between the subjects in plant stanol group was obtained. No clinically significant change in anthropometrical measurements was observed during the intervention. CONCLUSIONS: The spoonable low-fat yoghurt with 1.9 g/d plant stanols as esters lowered total, LDL, and non-HDL cholesterol levels in Turkish subjects with mild to moderate hypercholesterolemia. Nevertheless variation in baseline cholesterol levels, genetic predisposition of the subjects and compliance may contribute to a large individual variability.

The Triglycerides-Glucose Index Shows a Stronger Correlation with Serum Adiponectin Levels than Homeostasis Model Assessment of Insulin Resistance and Quantitative Insulin Sensitivity Check Index.

Purpose: To evaluate the association between diverse surrogate markers of insulin resistance and adiponectin concentrations. Methods: Four hundred healthy participants were included. Two different cohorts were formed according to the body mass index (BMI) values. Group 1 (n = 200) consisted of individuals with normal BMI values (18.50-24.99 kg/m2), whereas in Group 2 (n = 200) there were overweight or obese individuals (BMI ≥25.00 kg/m2). Homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and triglycerides-glucose index (TyG) were calculated. Serum adiponectin levels were measured by ELISA. A correlation analysis was performed to assess the association between serum adiponectin and HOMA-IR, QUICKI, and TyG. Results: Participants in Group 2 were older (age in years: Group 1, 33.3 ± 6.8 vs. Group 2, 36.4 ± 7.0, P < 0.001). There was no gender difference between groups. Overweight or obese participants had higher BMI, waist circumference, fat mass, fat ratio, fasting plasma glucose, fasting plasma insulin, triglycerides, total cholesterol, and low-density lipoprotein cholesterol values, whereas high-density lipoprotein cholesterol was higher in participants with normal BMI measures. Overweight or obese subjects were more insulin resistant (higher TyG index and HOMA-IR) and less insulin sensitive (lower QUICKI), P < 0.001 for all. Serum adiponectin levels were lower in Group 2 (serum adiponectin in ng/mL: Group 1, 11,880 ± 6838 vs. Group 2, 9115 ± 5766, P < 0.001). The correlation between TyG index and adiponectin was stronger than the correlation between QUICKI and adiponectin, and HOMA-IR and adiponectin (r for TyG and adiponectin -0.408, r for QUICKI and adiponectin 0.394, r for HOMA-IR and adiponectin -0.268, respectively, P < 0.001 for all correlations). Conclusions: TyG has a stronger association with adiponectin than HOMA-IR and QUICKI.

Development and validation of a comprehensive food frequency questionnaire that assesses the dietary intake related with dental health in children: A pilot study.

BACKGROUND AND AIMS: This study aimed to develop a validated and reliable food frequency questionnaire (FFQ) that assess dietary intake related with dental health in children. METHODS: Children, two-to-nine-years old, who consulted to a paediatric dental clinic for any reason, were recruited to complete the FFQ and 24-h recall, inquired oral hygiene habits, performed oral examinations, recorded dmft(s)/DMFT(S) index, and taken anthropometric measurements. The statistical methods used for validation were Wilcoxon signed rank test, Spearman ranked correlations, weighted kappa statistic and Bland-Altman graphs were drawn. Besides, intraclass and spearman correlation coefficients calculated for the reliability. RESULTS: A total of 120 children participated in to the first stage of the study while 70 participants completed the 4-month period. The Spearman correlation coefficient and weighted kappa values confirmed that the FFQ had moderate validation against the food records for lactose, calcium and phosphorus. Dietary fat, fibre, lactose, calcium, potassium, fluoride, magnesium, phosphorus and zinc intakes were negatively and statistically significantly correlated with DMFT and DMFS according to both FFQ and 24-h (p < 0.05, for each). Furthermore, a positive correlation between DMFT/S and dietary carbohydrate, starch, polysaccharide and sucrose intakes was obtained. CONCLUSIONS: These results provide the preliminary evidence for the moderated reliability and validity of the FFQ; the higher DMFT and DMFS scores might be linked to lower dietary intakes of fat, fibre, lactose, calcium, potassium, fluorine, magnesium, phosphorus and zinc; and probably higher dietary intakes of carbohydrate, starch, polysaccharide and sucrose in children.

YouTube: Is It a Reliable Source of Nutrition Information on COVID-19 Pandemic?

Data on the nutrition-related misinformation about COVID-19 are limited. This study analysed the quality and accuracy of the nutrition information available on YouTube about current COVID-19 pandemic as well as assessed the content of the videos. YouTube was searched using the terms "nutrition and COVID-19" in Turkish on 1 February 2021. Videos were filtered according to relevancy, and the first 280 videos were analysed. A total of 218 videos were reviewed and classified as "misleading" or "relevant" depending on the information provided. The transparency, utility, reliability, and accuracy of video contents were assessed. The videos attracted a cumulative 6,258,694 views. There were 178 (81.7%) fully relevant and 40 (18.3%) misleading videos. Approximately 80% of the videos shared by health professionals were relevant videos. Government organisations only shared relevant videos. Relevant videos had higher reliability, accuracy, and quality than misleading videos. The nutrition-related content of COVID-19 videos is suboptimal on YouTube. As the COVID-19 pandemic worsens, and nutrition could improve immunity, health professionals and educational and government organisations need to engage more in the spread of nutrition-related COVID-19 information to Internet platforms based on nutrition guidelines and the latest scientific evidence. This will be a practical and immediately implementable public health strategy to effectively spread the right information.

Probiotic kefir consumption improves serum apolipoprotein A1 levels in metabolic syndrome patients: a randomized controlled clinical trial.

Metabolic syndrome has become a major health hazard of the modern world. Studies investigating the effects of traditional fermented foods on metabolic syndrome are limited. We hypothesized that regular kefir consumption could improve the anthropometrical measurements, glycemic control, lipid profile, blood pressure, and inflammatory status in patients with metabolic syndrome. Sixty-two participants were randomly assigned to receive either 180 mL/d probiotic kefir or unfermented milk for 12 weeks. Dietary intake, anthropometrical measurements, biochemical status, and blood pressure were assessed at baseline and the end of weeks 4, 8, and 12. Serum apolipoprotein A1 concentration increased by 3.4% in the kefir group, whereas it decreased by 2.4% in the milk group in 12 weeks (P = .03). A subgroup analysis for participants with low-density lipoprotein cholesterol (LDL-C) levels >130 mg/dL showed that serum LDL-C and apolipoprotein B concentrations (7.6% and 5.4%, respectively) significantly decreased with kefir consumption compared with the baseline values at the 12th week (P < .05), but not compared with milk consumption (P > .05). Both milk and kefir consumption was associated with lower systolic and diastolic blood pressure compared with the baseline (P < .05). The 12-weeks of kefir administration also decreased serum tumor necrosis factor-α, interleukin 6, interleukin 10, interferon-gamma, and homocysteine concentrations significantly (P < .05). In conclusion, regular dairy consumption as part of a well-balanced diet can provide favorable effects in the management of metabolic syndrome, and probiotic kefir may deserve a special interest among dairy products. This trial was registered at clinicaltrials.gov (NCT03966846).

Interaction between Dietary Fat Intake and Metabolic Genetic Risk Score on 25-Hydroxyvitamin D Concentrations in a Turkish Adult Population.

Previous studies have pointed out a link between vitamin D status and metabolic traits, however, consistent evidence has not been provided yet. This cross-sectional study has used a nutrigenetic approach to investigate the interaction between metabolic-genetic risk score (GRS) and dietary intake on serum 25-hydroxyvitamin D [25(OH)D] concentrations in 396 unrelated Turkish adults, aged 24-50 years. Serum 25(OH)D concentration was significantly lower in those with a metabolic-GRS ≥ 1 risk allele than those with a metabolic-GRS < 1 risk allele (p = 0.020). A significant interaction between metabolic-GRS and dietary fat intake (energy%) on serum 25(OH)D levels was identified (Pinteraction = 0.040). Participants carrying a metabolic-GRS ≥ 1 risk allele and consuming a high fat diet (≥38% of energy = 122.3 ± 52.51 g/day) had significantly lower serum 25(OH)D concentration (p = 0.006) in comparison to those consuming a low-fat diet (<38% of energy = 82.5 ± 37.36 g/d). In conclusion, our study suggests a novel interaction between metabolic-GRS and dietary fat intake on serum 25(OH)D level, which emphasises that following the current dietary fat intake recommendation (<35% total fat) could be important in reducing the prevalence of vitamin D deficiency in this Turkish population. Nevertheless, further larger studies are needed to verify this interaction, before implementing personalized dietary recommendations for the maintenance of optimal vitamin D status.

Home visits in phenylketonuria: a 12-month longitudinal study.

This study aimed to evaluate the effect of dietary education given to the caregivers of children with phenylketonuria (PKU) in their home environment on children's blood phenylalanine (Phe) levels. Thirty-six children with PKU, aged 2-12 years, were recruited. Each caregiver was visited on three separate occasions and given a detailed dietary education. Fasting morning skin puncture blood samples were collected on Newborn Screening Blood Test filter paper for Phe analysis at baseline and 1, 4, 12, 24, and 48 weeks after the home visits. The mean baseline blood Phe level (365 +/- 232 micromol/L) significantly decreased with home visits at the 1st week (314 +/- 226 micromol/L) (p < 0.05). Four weeks after the home visits, the median blood Phe level was still lower than baseline, but the difference was not statistically significant (p > 0.05). The mean blood Phe levels significantly increased at the end of the 12th, 24th and 48th weeks (329 +/- 230 micromol/L; 447 +/- 189 micromol/L and 486 +/- 261 micromol/L, respectively) (p < 0.05). A well-controlled blood Phe level can be achieved with intense, regular and continuing education programs, which include regular home visits.

Efficacy of krill oil versus fish oil on obesity-related parameters and lipid gene expression in rats: randomized controlled study.

BACKROUND: This study aimed to determine the effects of LC n-3 PUFA supplementation on the prevention and treatment of obesity and obesity-related diseases, and to compare the efficiency of different LC n-3 PUFA sources via biochemical and genetic mechanisms in rats. METHODS: Male Wistar rats were randomized into four study groups, and fed with a standard diet, High Fat Diet (HFD), HFD+%2.5 Fish Oil (FO-HFD) or HFD+%2.5 Krill Oil (KO-HFD) for eight weeks. Food consumption, weight gain, serum glucose, insulin, ghrelin and leptin concentrations, lipid profile, liver fatty acid composition, and FADS1 and FADS2 mRNA gene expression levels were measured. RESULTS: Weight gain in each HFD group was significantly higher than control group (p < 0.001), without any differences among them (p < 0.05). LC n-3 PUFAs modified lipid profile, but not glucose tolerance. Serum leptin levels were significantly higher in HFD groups than in the control group, however, no difference in serum ghrelin levels was observed among the groups. Liver n-3 fatty acid desaturation activity was higher (p = 0.74), and liver total lipid content was lower (p = 0.86) in KO-HFD compared to FO-HFD. FADS1 gene expression was highest in the HFD group (p < 0.001) while FADS2 gene expression was highest in the FO-HFD group (p < 0.001). CONCLUSION: LC n-3 PUFAs, especially krill oil, had moderate effects on lipid profile, but limited effects on obesity related parameters, suggesting different effects of different sources on gene expression levels. Further randomized controlled trials are needed to determine the efficacy of different LC n-3 PUFA sources in the prevention and treatment of obesity in humans.

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.

Diet quality in adolescents with premenstrual syndrome: A cross-sectional study.

AIM: Premenstrual syndrome (PMS) is a complex of symptoms that can seriously affect the quality of life in women. It has been suggested that the nutritional status of adult women may influence the presence and/or severity of PMS symptoms. However, little is known about this association in adolescents. The present study aimed to examine the relationship between diet quality and the presence/severity of PMS symptoms in adolescents. METHODS: A case-control study of 272 female students, aged 13-18 years, was conducted in a high school. PMS was diagnosed and the symptoms were recorded using Premenstrual Syndrome Scale (PMSS)-2006 in 2 consecutive months. Dietary intake was assessed with 24-hour-dietary intake recall method and Healthy Eating Index-2010 (HEI-2010) score was calculated as an indicator of diet quality. Anthropometric measurements, including body weight, height, waist circumference and hip circumference were taken. RESULTS: PMS was diagnosed in 56.9% of the study sample. The mean HEI-2010 score was significantly lower in the PMS group (47.5 ± 23.95) when compared to the control group (53.5 ± 20.98), P = 0.034. The PMS symptoms, anxiety (P = 0.009), depressive feelings (P = 0.016) and changes in sleeping pattern (P = 0.000) were associated with lower diet quality scores in the PMS group. No significant difference in anthropometric measurements was observed between the groups. CONCLUSIONS: The present study suggested that adolescents with a high-quality diet might experience depressive feelings, anxiety or changes in sleeping less when compared to those with a low quality diet. Therefore, the causal relationship between diet quality and presence/severity of PMS should be investigated in further studies.

Usability Study of a Novel Tool: The Virtual Cafeteria in Nutrition Education.

OBJECTIVE: This study aimed to evaluate the usability of the virtual cafeteria (VC) and determine its suitability for further studies in portion size education and rehabilitation of nutrition. METHODS: The study was conducted with 73 participants (aged 18-40 years). The VC, where the participants performed the task of assembling a meal, was created as a virtual reality simulation of a buffet-style cafeteria (94 food and 10 beverage items). The participants were asked to complete the System Usability Scale, which regards ≥70 points as acceptable, and to give comments about the VC. RESULTS: The mean System Usability Scale score was 79.4 ± 12.71 (range, 22.2-97.2). Approximately 68% of the participants described positive qualities for the VC. The participants with technical background reported the VC as more usable (96%) than the others (74%) (χ2 = 5,378; df = 1, P = 0.025). CONCLUSIONS AND IMPLICATIONS: Offered as a novel tool for education and rehabilitation of nutrition, the VC was confirmed to feature good usability.

A comprehensive evaluation of the enzymatic and nonenzymatic antioxidant systems in childhood asthma.

BACKGROUND: Even though there is ample evidence on the oxidative stress in asthma, there is limited information on the antioxidant defense systems. OBJECTIVES: To conduct a comprehensive evaluation of various components of both enzymatic and nonenzymatic antioxidants in a large group of children with asthma. METHODS: A total of 164 children with mild asthma and 173 healthy children were included in the study. Levels of the enzymes glutathione peroxidase and superoxide dismutase were measured by using ELISA, whereas reduced glutathione, ascorbic acid, alpha-tocopherol, lycopene, beta-carotene, amino acids participating in glutathione synthesis, and amino acids susceptible to oxidation were measured by HPLC. All comparisons were adjusted for atopy, body mass index, smoke exposure, and pet ownership. RESULTS: Levels of the enzymes glutathione peroxidase and superoxide dismutase and of the nonenzymatic components of the antioxidant system including reduced glutathione, ascorbic acid, alpha-tocopherol, lycopene, and beta-carotene were significantly lower in children with asthma compared with healthy controls (P < .001 for each). Of the amino acids contributing to glutathione synthesis, glycine and glutamine were significantly lower in children with asthma (P < .001). The majority of the amino acid susceptible to oxidative stress displayed lower levels in children with asthma (P < .05). CONCLUSION: Childhood asthma is associated with significant decreases in various components of both enzymatic and nonenzymatic antioxidant defenses.

Turkish version of the Yale Food Addiction Scale: preliminary results of factorial structure, reliability, and construct validity.

BACKGROUND: Yale Food Addiction Scale (YFAS) was established to identify individuals exhibiting signs of addiction towards certain types of food. This study aimed to develop a Turkish version of the Yale Food Addiction Scale and test its psychometric properties. METHODS: The backward translation techniques were used to develop Turkish versions of the YFAS, and its reproducibility was assessed. Turkish version of the YFAS was administered to a total of 1033 participants (439 men and 594 women), aged 19-65 years. Exploratory factor analysis and confirmatory factor analysis were used to examine the factorial structure of the tool. Construct validity was assessed by principal component factor analysis with varimax rotation. Reliabilities were estimated with Cronbach's alpha coefficient. The criterion-related validity was tested by the administration of Eating Attitude Test-26 (EAT-26) to all participants. RESULTS: The primary factor loadings for seven items were ranged between 0.45 and 0.79, and no items cross-loaded onto other factors. The fit indices showed that eight items of the YFAS were a good representation of the item responses and each item loaded significantly on the specified factor (p < 0.001 for each). YFAS subscales had a high internal consistency and test-retest reliability. The criterion-related validity of the tool showed a positive relationship with scales of the EAT-26. CONCLUSION: Current study suggested that the Turkish version of the YFAS is a reliable, valid, and useful tool for assessing the signs of food addiction in a non-clinical sample.