The relationship between the quantity and type of macronutrients in diet and frailty in older outpatients.

BACKGROUND AND AIM: The aim of this study is to determine the relationship between the quantity and type of macronutrients in the diet and frailty. MATERIAL AND METHODS: A total of 106 patients were included in the study. Exclusion criteria included patients with pacemakers, edema, advanced dementia, acute infectious and inflammatory disease, and those using oral or enteral nutritional supplements. Frailty was assessed using the Fried Frailty Phenotype. Three-day dietary records were taken, 2 days on weekdays and 1 day on weekends. The Nutrition Information System (BeBis) 8.2 full version program was used to analyze the average energy and nutrient values of the consumed foods. Insufficient protein and energy intake were defined as taking less than 1 or 1.2 g/kg/day for protein and less than 30 kcal/kg/day for energy, respectively. RESULTS: The mean age of the participants was 74.3 (± 6.75), and 68.9% (n = 73) of them were women. 26.4% (n = 28) of the patients were classified as frail. There was no difference between the energy consumption of < 30 kcal/kg/day in the frail and non-frail groups. Protein consumption of less than 1.2 g/kg/day had a significant relationship with frailty. There was no significant difference between the consumed plant/animal protein ratio and frailty, but plant protein, polyunsaturated fatty acids, and fiber intake were significantly lower in frail patients. Decreased consumption of polyunsaturated fatty acids (PUFAs), advanced age, and increased number of medications were identified as independently associated factors with frailty. CONCLUSION: This study found that frailty was associated with less than 1.2 g/kg/day protein consumption, lower fiber, and PUFA consumption.

Roles of citrus fruits on energy expenditure, body weight management, and metabolic biomarkers: a comprehensive review.

Citrus fruits are widely consumed for their nutritional and health benefits. They belong to the Rutaceae and have many varieties, such as sweet orange (Citrus sinensis), which is the most popular. Citrus fruits are rich in water (>80%), dietary fiber, and vitamins. They also contain bioactive components, which may modulate energy metabolism and lipid oxidation through various mechanisms. These mechanisms include stimulating ß3-adrenergic receptors, increasing mitochondrial biogenesis and thermogenesis, activating AMP kinase and peroxisome proliferator-activated receptor-gamma coactivator-1α pathways, inhibiting lipogenesis and lipid accumulation, and inducing browning of white adipose tissue. This review summarizes the mechanisms and outcomes of citrus fruits and their metabolites on energy metabolism and body weight in different experimental models. The literature was searched for in vitro and in vivo animal and human studies that investigated the effects of citrus consumption on energy expenditure, thermogenesis, adipogenesis, and lipid accumulation. Citrus fruits and their metabolites have shown promising effects on energy metabolism and lipid oxidation in in vitro and in vivo animal studies. However, the evidence from human studies is limited and inconsistent. Possible reasons for the discrepancy are briefly discussed, and knowledge gaps and research needs are identified for future studies. Citrus fruits may have beneficial effects on energy metabolism and body weight, but more rigorous and well-designed human trials are needed to confirm their efficacy and safety.

Validation of predictive equations for resting energy expenditure in children and adolescents with different body mass indexes.

BACKGROUND: Accurate estimation of resting energy expenditure (REE) in children and adolescents is important to establish estimated energy requirements. The objective of this study was to assess the validity of existing equations in literature and a newly developed equation in estimating REE in children and adolescents. METHODS: 275 participants (148 boys, 127 girls) aged 6-18 years included in the study were classified as normal-weighted, overweight, obese based on BMI z-scores for age according to WHO-2007 growth curves for 5-19 years of age. REEs were measured using an indirect calorimeter, with various equations, and a newly established equation [REE = 505.412+(24.383*FFM);Adjusted R2 = 0.649] were compared with REE measured using Bland-Altman and further validation parameters. RESULTS: When the predicted REEs were compared with the measured REEs, the highest prediction accuracy was achieved using the new Eq. (64.8%) and IOM (63.8%) for normal-weight participants, Müller FFM and new Eq. (59.6%) for overweight participants and Lazzer (44.9%) for obese participants. In normal and overweight participants, lowest root mean squared error (RMSE) values were acquired from Schmelzle's equation (respectively 136.2;159.9 kcal/d), and the highest values were found in Kim's Eq. (315.2; 295.2 kcal/d respectively). RMSE value of the new equation was 174.7 kcal/d for normal-weight children and adolescents, and 201.9 kcal/d for overweight ones. In obese participants, the lowest RMSE value was obtained from Schmelzle's Eq. (305.4 kcal/d) and the new Eq. (317.4 kcal/d), while the highest value was obtained from IOM Eq. (439.9 kcal/d). RMSE was higher in obese groups compared to the other BMI groups. CONCLUSION: Indirect-calorimeter is the most suitable method for REE measurement in especially obese children and adolescents. The new equation and Schmelzle's equation appear to be most accurate equations for normal and overweight children and adolescents.

Water Consumption: Effect on Energy Expenditure and Body Weight Management.

PURPOSE OF REVIEW: Water, which is of vital importance, has a critical role in maintaining the normal function of the body, and even mild dehydration can play a role in the development of various diseases. Therefore, it is of great importance to meet the recommended daily water consumption amounts. In addition to the numerous roles of water in metabolism, its effect on energy metabolism should not be overlooked. Water consumption can increase energy expenditure and be an additional tool for weight management. Therefore, the importance of water consumption, which is like a hidden component for treating of obesity, should be emphasized. This review was written to explain the possible mechanisms of water consumption in energy expenditure and body weight management. RECENT FINDINGS: Because water consumption is associated with sympathetic activity, which increases metabolic rate (thermogenesis) and daily energy expenditure, the increase in sympathetic activity caused by water consumption is an important and unrecognized component of daily energy expenditure. In addition to the concept of water-based thermogenesis, water, which is a potential improvement factor in body composition, also plays an auxiliary role in body weight loss with both less energy intake and increased fat oxidation. From this perspective, water consumption may have critical importance in the fight against increasing obesity worldwide. Considering its effect on energy metabolism in various ways, it becomes necessary to focus more on the importance of water on human health. (Created by BioRender.com).

Association between adherence to the Mediterranean diet with anthropometric measurements and nutritional status in adolescents / Asociación entre la adherencia a la dieta mediterránea y las medidas antropométricas y el estado nutricional en adolescentes

Background: adolescence is a critical period for developing healthy eating habits. It is crucial to evaluate and encourage adherence to the Mediterranean diet, a sustainable and healthy diet model in this age group. Objective: this study aimed to evaluate the relationship between adherence to the Mediterranean diet and anthropometric measurements and nutritional status in Turkish adolescents. Material and methods: the demographic characteristics, health information, nutritional habits, physical activity status, and 24-hour dietary recall of the adolescents were obtained with a questionnaire. Adherence to Mediterranean diet was evaluated with the Mediterranean-Style Dietary Pattern Score (MSDPS). Results: a total of 1,137 adolescents (mean age 14.0 ± 1.37 years) were included; 30.2 % of the boys and 39.5 % of the girls were overweight/obese. The median (interquartile range) value of the MSDPS was 10.7 (7.7), and this value was 11.0 (7.6) for the boys and 10.6 (7.4) for the girls (p > 0.05). The levels of protein, fiber, vitamin A, vitamin C, folate, vitamin B12, iron, magnesium, zinc, and potassium intake increased with adherence to Mediterranean diet (p < 0.001). Age, parental education level, body mass index (BMI), waist circumference, and skipping meals affected MSDPS. Conclusion: adolescents’ adherence to the Mediterranean diet was low and correlated with some anthropometric measures. Increasing adherence to the Mediterranean diet may contribute to preventing obesity and adequate and balanced nutrition in adolescents. (AU)

Introducción: la adolescencia es un periodo crítico para el desarrollo de hábitos alimentarios saludables. Es fundamental evaluar y fomentar la adherencia a la dieta mediterránea, un modelo de alimentación sostenible y saludable en este grupo de edad. Objetivo: este estudio tuvo como objetivo evaluar la relación entre la adherencia a la dieta mediterránea y las medidas antropométricas y el estado nutricional en adolescentes turcos. Material y métodos: las características demográficas, la información de salud, los hábitos nutricionales, el estado de actividad física y el recuerdo dietético de 24 horas de los adolescentes se obtuvieron mediante un cuestionario. La adherencia a la dieta mediterránea se evaluó con el Mediterranean-Style Dietary Pattern Score (MSDPS). Resultados: se incluyó un total de 1.137 adolescentes (edad media 14,0 ± 1,37 años). El 30,2 % de los niños y el 39,5 % de las niñas tenían sobrepeso/obesidad. El valor de la mediana (rango intercuartílico) del MSDPS fue de 10,7 (7,7), siendo este valor de 11,0 (7,6) para los niños y de 10,6 (7,4) para las niñas (p > 0,05). Los niveles de ingesta de proteína, fibra, vitamina A, vitamina C, folato, vitamina B12, hierro, magnesio, zinc y potasio aumentaron con la adherencia a la dieta mediterránea (p < 0,001). La edad, el nivel de educación de los padres, el índice de masa corporal (IMC), la circunferencia de la cintura y la omisión de comidas afectaron al MSDPS. Conclusión: la adherencia a la dieta mediterránea de los adolescentes fue baja y se correlacionó con algunas medidas antropométricas. El aumento de la adherencia a la dieta mediterránea puede contribuir a la prevención de la obesidad y a una nutrición adecuada y equilibrada en los adolescentes. (AU)

Association between adherence to the Mediterranean diet with anthropometric measurements and nutritional status in adolescents.

Introduction: Background: adolescence is a critical period for developing healthy eating habits. It is crucial to evaluate and encourage adherence to the Mediterranean diet, a sustainable and healthy diet model in this age group. Objective: this study aimed to evaluate the relationship between adherence to the Mediterranean diet and anthropometric measurements and nutritional status in Turkish adolescents. Material and methods: the demographic characteristics, health information, nutritional habits, physical activity status, and 24-hour dietary recall of the adolescents were obtained with a questionnaire. Adherence to Mediterranean diet was evaluated with the Mediterranean-Style Dietary Pattern Score (MSDPS). Results: a total of 1,137 adolescents (mean age 14.0 ± 1.37 years) were included; 30.2 % of the boys and 39.5 % of the girls were overweight/obese. The median (interquartile range) value of the MSDPS was 10.7 (7.7), and this value was 11.0 (7.6) for the boys and 10.6 (7.4) for the girls (p > 0.05). The levels of protein, fiber, vitamin A, vitamin C, folate, vitamin B12, iron, magnesium, zinc, and potassium intake increased with adherence to Mediterranean diet (p < 0.001). Age, parental education level, body mass index (BMI), waist circumference, and skipping meals affected MSDPS. Conclusion: adolescents' adherence to the Mediterranean diet was low and correlated with some anthropometric measures. Increasing adherence to the Mediterranean diet may contribute to preventing obesity and adequate and balanced nutrition in adolescents.

Introducción: Introducción: la adolescencia es un periodo crítico para el desarrollo de hábitos alimentarios saludables. Es fundamental evaluar y fomentar la adherencia a la dieta mediterránea, un modelo de alimentación sostenible y saludable en este grupo de edad. Objetivo: este estudio tuvo como objetivo evaluar la relación entre la adherencia a la dieta mediterránea y las medidas antropométricas y el estado nutricional en adolescentes turcos. Material y métodos: las características demográficas, la información de salud, los hábitos nutricionales, el estado de actividad física y el recuerdo dietético de 24 horas de los adolescentes se obtuvieron mediante un cuestionario. La adherencia a la dieta mediterránea se evaluó con el Mediterranean-Style Dietary Pattern Score (MSDPS). Resultados: se incluyó un total de 1.137 adolescentes (edad media 14,0 ± 1,37 años). El 30,2 % de los niños y el 39,5 % de las niñas tenían sobrepeso/obesidad. El valor de la mediana (rango intercuartílico) del MSDPS fue de 10,7 (7,7), siendo este valor de 11,0 (7,6) para los niños y de 10,6 (7,4) para las niñas (p > 0,05). Los niveles de ingesta de proteína, fibra, vitamina A, vitamina C, folato, vitamina B12, hierro, magnesio, zinc y potasio aumentaron con la adherencia a la dieta mediterránea (p < 0,001). La edad, el nivel de educación de los padres, el índice de masa corporal (IMC), la circunferencia de la cintura y la omisión de comidas afectaron al MSDPS. Conclusión: la adherencia a la dieta mediterránea de los adolescentes fue baja y se correlacionó con algunas medidas antropométricas. El aumento de la adherencia a la dieta mediterránea puede contribuir a la prevención de la obesidad y a una nutrición adecuada y equilibrada en los adolescentes.

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.

The Effect on Inflammation of Adherence to the Mediterranean Diet in Polycystic Ovary Syndrome.

PURPOSE OF REVIEW: Polycystic ovary syndrome (PCOS), which is common in women of reproductive age worldwide, is a syndrome that reduces the lifelong quality of life and poses a significant risk for various diseases. PCOS is a combination of symptoms of hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology (PCOM). In PCOS, which is characterized by chronic low-grade inflammation, some inflammatory cytokines are increased. This review aimed to explain possible mechanisms of inflammation in PCOS and the effects of Mediterranean diet components on reducing this inflammation. RECENT FINDINGS: Although the exact mechanisms of inflammation in PCOS are not yet fully known, it is stated that it is mediated by obesity, insulin resistance, and high androgen concentration. This inflammatory state negatively impacts the risk of future health problems and the quality of life of PCOS. Therefore, strategies to reduce inflammation are thought to be important. Dietary adjustments have important effects in reducing this inflammation and preventing disease. At this point, the Mediterranean diet, which has been proven to have a protective effect against many diseases, draws attention. Among the components of the Mediterranean diet, especially omega-3, antioxidants and dietary fiber may contribute to the reduction of inflammation through different mechanisms. PCOS is characterized by chronic low-grade inflammation, which increases women's risk of health problems, both now and in the future. Reducing inflammation is therefore extremely important, and it can be achieved with adherence to the Mediterranean diet. Inflammation pathways and the effect of the components of the Mediterranean diet in PCOS. AGE, advanced glycation end products; NF-κB, nuclear factor kappa-B. Obesity, insulin resistance, and hyperandrogenism may cause inflammation in PCOS through different mechanisms. Antioxidants, omega-3, and dietary fiber, which are the main components of the Mediterranean diet, may be effective in reducing this inflammation in PCOS. (Created with BioRender.com).

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.

Effects of Red Pepper, Ginger, and Turmeric on Energy Metabolism: Review of Current Knowledge.

Context: Energy metabolism is the main determinant of obesity etiology. Consumption of some spices, such as red pepper, ginger, and turmeric, can be considered to be an environmental factor affecting energy metabolism. Objective: This review aimed to examine the effects of red pepper, ginger, and turmeric on weight control, weight loss, and energy metabolism. Design: The research team performed a narrative review by searching the Google scholar, Scopus, PubMed, ResearchGate, Web of Science, and Science Direct databases. The search used the keywords red pepper, ginger, and turmeric in combination with energy metabolism, energy expenditure, energy balance, thermogenesis, anti-obesity, weight management, weight control, weight loss, metabolic rate, and oxygen consumption, without considering any time limitation. Setting: This study has been carried out in Ankara / Turkey. Results: Red pepper, ginger, and turmeric affect energy metabolism through various mechanisms. Dietary red pepper and its pungent principle capsaicin affects satiety and has a promising thermogenic influence. Ginger has positive effects on weight control, obesity prevention, and energy metabolism. In addition, curcumin inhibits the conversion of preadipocytes to mature adipocytes. Conclusions: Red pepper, ginger, and turmeric affect energy metabolism using mechanisms related to thermal effect, BMR, total energy expenditure, oxygen consumption, and lipid oxidation. These spices haven't been assigned appropriate doses and periods of use, and no definite judgments can be made on their use. Therefore, it's necessary to conduct further randomized controlled research to reach absolute conclusions and determine by which mechanisms these spices show this effect on energy metabolism.

Effects of High-dose Folic Acid Supplementation on Maternal/Child Health Outcomes: Gestational Diabetes Mellitus in Pregnancy and Insulin Resistance in Offspring.

OBJECTIVES: The purpose of this study was to evaluate the effects of maternal high folic acid (FA) supplementation during pregnancy on glucose intolerance in dams and insulin resistance in offspring. METHODS: Wistar female rats (n=18) were mated and randomly divided into 3 groups: a control group and 2 experimental groups. Three different feeding protocols were administered during pregnancy: control group, 2 mg/kg FA (recommended level FA supplementation); experimental 1 group, 5 mg/kg FA (tolerable upper intake level of FA supplementation [ULFolS]); and experimental 2 group, 40 mg/kg FA (high FA supplementation [HfolS]). All dams were fed the same FA content diet (2 mg/kg FA) during the lactation period. An oral glucose tolerance test was performed on day 16 of pregnancy. After the lactation period, body weight and food intake of 36 pups were monitored. Dams were euthanized at the end of the lactation period and half of the pups were euthanized at the end of week 7 and the others at the end of week 12. Serum FA, homocysteine, vitamin B12, insulin, glucose, interleukin-6, tumor necrosis factor-alpha, glycated hemoglobin (A1C), and adiponectin levels of mothers and pups were evaluated. The homeostatic model of insulin resistance (HOMA-IR) was used to determine insulin resistance in dams and offspring. RESULTS: According to glucose tolerance test results of dams, blood glucose values at minutes 0, 60, 90, and 120 for the HFolS group were significantly higher compared with the control group (p<0.05). The A1C level in HFolS dams was significantly higher than in the control group (p<0.05). The mean birthweight of the pups in the HFolS group was significantly higher than that of control pups (p<0.05). HOMA-IR values for control and HFolS offspring were similar at weeks 7 and 12 and higher than in ULFolS offspring (p>0.05). CONCLUSIONS: It was determined that high doses of FA exposure during pregnancy might be effective in the development of glucose intolerance in dams and insulin resistance in offspring in this study.

Evaluation of personal water footprint components in Turkey: factors associated with obesity and food consumption.

This study aimed to evaluate the personal water footprint individuals, and was conducted with 3431 individuals Ibetween 18-95 years. A questionnaire form included questions about demographic characteristics, anthropometric measurements, and food consumption was applied. The "Extended Water Footprint Calculator" was used to evaluate the personal water footprint, and various questions were asked to determine the components of food consumption, domestic water, and industrial water use. The average age of the participants was 34.6 ± 13.93 years. The total water footprint of the male was significantly higher than the female. The total water footprint of individuals between the ages of 41-64 was higher than other age groups, and also obese individuals had the highest total water footprint (p < 0.05). Meat and meat products contributed the most to the total water footprint. Having a normal body weight and adopting more sustainable dietary patterns should be emphasized because of their impacts on the environment and health.

Association between ecological footprint awareness and health literacy in adults: a population-based study from Turkey.

This study aimed to determine the relationship between health literacy and ecological footprint which is an indicator of sustainability and environmental impact and to examine the factors that may affect them. It was found that 20.3% of individuals have inadequate, 43.7% problematic, 26.1% sufficient and 10.0% excellent health literacy levels. There were differences in age, education level and BMI classification according to Ecological Footprint Awareness Scale score quartiles and health literacy levels (p < 0.05). It was determined that age and Turkey Health Literacy Scale score had effect on ecological footprint awareness. Individuals with a high level of health literacy have a high awareness of their ecological footprint. The increase in people's health literacy levels and ecological footprint awareness with age can be interpreted as the increase in people's education and knowledge levels and their awareness levels against the protection of nature and the environment.

Prevalence of Obesity/Abdominal Obesity and Related Factors in Pediatric ALL Survivors.

OBJECTIVE: Obesity has been increasingly recognized in pediatric acute lymphoblastic leukemia (ALL) survivors. The aim of the current study was to determine the prevelance and related factors of obesity/abdominal obesity and evaluate the association between nutrition and overweight/obesity after cancer treatment in pediatric ALL survivors. METHOD: An observational retrospective cohort study was performed among 67 volunteers (aged 5-15). Participants completed 3 consecutive days (2 weekdays and 1 weekend day) recording food consumption and physical activity simultaneously. Weight, height, and waist circumference measurements were performed in remission period, and retrospective data were obtained from patient records. We examined data at three periods: diagnosis, end of treatment, and remission. Subjects were classified into four groups according to body mass index for age z score (BAZ): underweight, normal weight, overweight, and obese. Abdominal obesity was defined waist-to-height ratio ≥ 0.5. RESULTS: Prevalence of overweight, obesity, and abdominal obesity were 25.3%, 23.9%, 38.8%, respectively in remission. BAZ at diagnosis and at treatment completion, dietary energy intake, and physical activity were associated with an increased risk of being overweight/obese in remission (p < .05). Gender, age at diagnosis, cranial radiotherapy, and treatment risk category were not significant (p > .05). CONCLUSIONS: As in obesity, abdominal obesity was found an important problem in pediatric ALL survivors. Therefore, nutritional targets are needed to prevent obesity. Survivors should be closely monitored in terms of nutritional status during and after treatment and informed about and supported for healthy lifestyle (balanced and adequate nutrition, increase in physical activity).

Effect of Intermittent Fasting (18/6) on Energy Expenditure, Nutritional Status, and Body Composition in Healthy Adults.

OBJECTIVE: This study was aimed at evaluating the effect of intermittent fasting of Ramadan on resting energy expenditure (REE), body composition, and nutritional status. METHODS: The study was conducted on a total of 27 adults (16 females, 11 males) who were fasting (18 h) in the Ramadan month (May 6-June 3) of 2019. REE was measured using the indirect calorimeter. Dietary energy and nutrient intakes were evaluated by 3-day food records in baseline and post-Ramadan. Body composition and some metabolic parameters were analyzed simultaneously with REE measurements. All measurements were performed two times at baseline, and post-Ramadan. RESULTS: Body weight (-2.9% vs. -1.4%), body mass index (BMI) (-3.1% vs. -2.1%), fat-free mass (-2.7% vs. -1.4%), and hydration status were decreased in both males and females after the Ramadan fasting (p < 0.05). REEs (kcal/d) of the participants were 1708.1 ± 262.50 kcal/d and 1596.5 ± 302.27 kcal/d at baseline and post-Ramadan, respectively (6.5%) (p < 0.05). This decrease in REE (kcal/d) in females was greater than that in males (-8.1% vs. -4.6%). However, no statistically significant difference was found in sleep duration (h), physical activity levels, dietary energy and nutrient intakes, and blood pressures (mm Hg) of both genders compared to baseline (p > 0.05). CONCLUSION: Intermittent circadian fasting may lead to a decreased energy expenditure and a change in fat-free mass in healthy individuals, and this effect is interpreted as gender-dependent.

An Evaluation of Awareness, Knowledge, and Use of Folic Acid and Dietary Folate Intake among Non-Pregnant Women of Childbearing Age and Pregnant Women: A Cross-Sectional Study from Turkey.

This study was carried out to evaluate awareness, knowledge, and use of folic acid and dietary folate intake among non-pregnant women of childbearing age and pregnant women. A cross-sectional study was completed with 1442 women (1106 non-pregnant and 336 pregnant) in Ankara, Turkey. The individuals' awareness, knowledge, and use of folic acid were questioned and food consumption were taken. More than two-thirds of the non-pregnant and pregnant women had heard of folic acid (77.2% and 89.0%, respectively). The pregnant women (53.9%) knew more that folic acid should be used before conception in order to prevent congenital anomalies than non-pregnant women (41.4%). It was found that 70.2% of the pregnant women and only 15.1% of the non-pregnant women used folic acid supplementation. The pregnant women (1368.4 mcg; 330.4 mcg) significantly had higher folic acid and dietary folate intake than non-pregnant women (29.6 mcg; 289.3 mcg) (p < .01). Despite many public health campaigns, awareness, knowledge, and appropriate use of folic acid are still inadequate and not at the desired level in women of childbearing age.

Determining the factors affecting energy metabolism and energy requirement in cancer patients.

Cancer is the second most common cause of death worldwide. It is a generic name for a large group of diseases that can affect any part of the body. Cancer affects both energy intake through the diet and the total energy expenditure (TEE) through the changes in energy metabolism, resulting in negative or positive energy balance. Determining daily energy requirement is very important in the regulation of the nutrition therapy in a cancer patients. Due to the difficulty in directly measuring the TEE, resting energy expenditure, which is the largest component of the TEE, is often used in the determination of the energy requirement. In this study, the effects of disease-specific factors such as tumor burden, inflammation, weight loss and cachexia on energy metabolism in cancer patients were investigated.

Risk Factors for Constipation in Adults: A Cross-Sectional Study.

Aim: The objective of this study was to determine associations between physical activity, dietary fiber intake, water and fluid intake, and constipation as well as other possible risk factors for constipation in adults.Method: A cross-sectional study was conducted in 4561 (1812 male and 2749 female) adults, aged between 18-65 years, living in Ankara, Turkey. Participants having three or fewer bowel movements per week were considered constipated. Dietary fiber and fluid intake data were ascertained from a 62-item food frequency questionnaire (FFQ). The International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to evaluate participant physical activity.Results: Of the total cohort, 16.6% were diagnosed with constipation (13.6% males, 18.5% females). Logistic regression analysis showed a significantly greater risk of constipation in participants with female gender, advancing age, being obese. Participants who were moderately active (OR: 0.77, 95% CI: 0.62-0.91) and active (OR: 0.74, 95% CI: 0.59-0.90) had a decreased likelihood of constipation, when compared with inactive participants (p < 0.05). Participants in the middle upper quartile for water intake (OR: 0.71, 95% CI: 0.57-0.88), had a decreased likelihood of constipation, when compared with participants in the lowest quartile. Participants in the middle upper quartile (OR: 0.74, 95% CI: 0.58-0.92) and the highest quartile for dietary fiber intake (OR: 0.66, 95% CI: 0.52-0.84), had a decreased likelihood of constipation, when compared with participants in the lowest quartile (p < 0.05).Conclusion: Constipation is common in the Turkish adult population. Insufficient physical activity, decreasing fiber and water intake, obesity, advancing age and female gender were associated with increased constipation risks. Combining regular physical activity and increasing fiber and water intake may protect from constipation, and relieve constipation symptoms.

Olive Leaf (Olea europaea L. folium): Potential Effects on Glycemia and Lipidemia.

BACKGROUND: Olive tree (Olea europaea, Oleaceae) leaves have been widely used in traditional herbal medicine to prevent and treat various diseases especially in Mediterranean countries. They contain several potentially bioactive compounds that may have hypoglycemic and hypolipidemic properties. SUMMARY: The literature has recently been attempting to define the relationship between olive leaf (Olea europaea L. folium) polyphenols and a number of health problems. Oleuropein, the basic phenolic compound of olive leaf and its extract, is responsible for the characteristic bitter taste and unique aroma of olive fruits. Furthermore, it is shown that oleuropein and its hydrolyzed products have many beneficial effects on human health because of its antioxidant characters. A number of studies report that olive leaf has potentially positive effects on the parameters related to diabetes and cardiovascular diseases by various mechanisms. Besides, toxicity studies suggest that olive leaf is generally safe even at high doses. Key messages: Although current results obtained until today seem promising, the studies in this subject are usually on cell culture and animal trials. Moreover, mostly the extract forms of olive leaves are used in the studies. More randomized controlled human clinical trials with extensive toxicity studies are needed to evaluate potential health effects and safety.

Evaluation of Nutritional Status and Allostatic Load in Adult Patients With Type 2 Diabetes.

OBJECTIVE: Diabetes is a chronic disease, affected by nutritional status, and characterized by dysregulations in several systems. Allostatic load is an index that evaluates the dysregulation of all physiological and metabolic systems. This study was conducted to determine the relationship between nutritional status and allostatic load in patients with type 2 diabetes mellitus (T2DM). METHODS: The study sample consisted of 30 males and 73 females between 20 and 55 years of age. Individuals had T2DM for 7.9±6.17 (mean ± standard deviation) years. World Health Organization criteria cutoffs were used to calculate allostatic load scores. Twelve parameters were questioned and an allostatic load score between 0 and 12 was obtained; values above the cutoff levels were assigned a value of 1, and values in the normal range were assigned a value of 0. RESULTS: Individuals with high allostatic load comprised a significant portion of the sample (79.6%) for both males and females (73.3% and 82.2%, respectively). Longer diabetes duration was associated with high allostatic load score (p<0.05). There was lower vegetable consumption and higher fruit consumption in the high-allostatic-load group compared with the low-allostatic-load group (p<0.05). However, fruit consumption was still lower than recommended levels in both groups. CONCLUSIONS: A significant number of individuals had high allostatic load scores in our study. A healthy diet plan in line with the recommendations may help to decrease the allostatic load scores by reducing body weight, waist/hip ratio, blood pressure and fasting blood glucose, and may prevent the negative effects of stress on metabolic processes in the long-term malnutrition in T2DM.