Application of the infant and young child feeding index and the evaluation of its relationship with nutritional status in 6-24 months children / Aplicação do índice de alimentação de lactentes e crianças pequenas e avaliação de sua relação com o estado nutricional de crianças de 6 a 24 meses

ABSTRACT Objective To evaluate the complementary feeding practices of mothers in infant and child nutrition using Infant and Young Child Feeding Indicator and Infant and Child Feeding Index and to determine their relationship with nutritional status. Methods Study data were collected through an online questionnaire administered to 141 parents on healthy 6-24 month infants/children. Complementary feeding practices for infants/children were evaluated in line with the Infant and Child Feeding Index and Infant and Young Child Feeding Indicator. In the evaluation of growth, weight for age z-scores, length for age z-scores, and weight for length z-scores of infants/children were calculated with the World Health Organization Anthro program. Results 74.5% of 141 infants and children (71 boys, 70 girls) evaluated in the study are breastfed. The prevalence of stunting, wasted, and underweight was determined as 6.4%, 0.7%, and 4.3%, respectively. When evaluated using Infant and Young Child Feeding Indicator, it was determined that 82.3% of children met the minimum meal frequency, 80.9% met the minimum dietary diversity, and 67.4% met the minimum acceptable diet. Regarding Infant and Child Feeding Index evaluations of the children, while there was no difference between 9-11 and 12-24 month age groups, the mean Infant and Child Feeding Index score in the 6-8 month group was significantly lower than the other age groups (p=0.000). The Infant and Child Feeding Index scores used to evaluate complementary feeding practices in our study were found to be high in most infants/children. No clear relationship was found between stunting and minimum acceptable diet, minimum dietary diversity or minimum meal frequency, which are indicators of both Infant and Child Feeding Index scores and World Health Organization, Infant and Young Child Feeding Indicator. Conclusion The Infant and Child Feeding Index scores used to evaluate complementary feeding practices in our study were high in most infants/children. In addition, the high rates of MMF, minimum dietary diversity, and minimum acceptable diet coverage in evaluating infants/children in terms of World Health Organization indicators show that they have appropriate complementary feeding practices. However, study found no clear relationship between stunting and minimum acceptable diet, minimum dietary diversity or MMF, which are indicators of both Infant and Child Feeding Index I scores and WHO Infant and Young Child Feeding Indicator. It was concluded that World Health Organization Infant and Young Child Feeding Indicator indicators may be better than length for age z-scores in the weight for length z-scores explanation.

RESUMO Objetivo Avaliar as práticas de alimentação complementar das mães na nutrição de lactentes e crianças utilizando o Indicador de Alimentação de Lactentes e Crianças Pequenas e o Índice de Alimentação de Lactentes e Crianças e determinar sua relação com o estado nutricional. Métodos Os dados do estudo foram coletados por meio de um questionário online administrado a 141 pais de bebês/crianças saudáveis de 6 a 24 meses. As práticas de alimentação complementar de lactentes/crianças foram avaliadas de acordo com o Índice de Alimentação de Lactentes e Crianças e o Indicador de Alimentação de Lactentes e Crianças Pequenas. Na avaliação do crescimento, os escores z de peso para idade, escores z de comprimento para idade e escores z de peso para comprimento de bebês/crianças foram calculados com o programa Organização Mundial da Saúde Anthro. Resultados Quando avaliadas por meio do Indicador de Alimentação de Lactentes e Crianças Pequenas, constatou-se que 82,3% das crianças atendiam à frequência mínima de refeições, 80,9% atingiam a diversidade alimentar mínima e 67,4% atingiam a dieta mínima aceitável. Em relação às avaliações do Índice de Alimentação de Lactentes e Crianças das crianças, embora não tenha havido diferença entre as faixas etárias de 9 a 11 e 12 a 24 meses, a pontuação média do Índice de Alimentação de Lactentes e Crianças no grupo de 6 a 8 meses foi significativamente menor do que nas outras faixas etárias (p=0,000). Os escores do Índice de Alimentação de Lactentes e Crianças utilizados para avaliar as práticas de alimentação complementar em nosso estudo foram elevados na maioria dos bebês/crianças. Não foi encontrada nenhuma relação clara entre o atraso no crescimento e a dieta mínima aceitável, diversidade alimentar mínima ou frequência mínima de refeição ,que são indicadores tanto das pontuações do Índice de Alimentação de Lactentes e Crianças como do Indicador de Alimentação de Lactentes e Crianças Pequenas da Organização Mundial da Saúde. Conclusão Escores altos do Índice de Alimentação de Lactentes e Crianças na maioria dos bebês/crianças são um bom indicador de Indicador de Alimentação de Lactentes e Crianças Pequenas nessa população. No entanto, nenhuma relação clara foi encontrada entre o déficit de estatura e os escores do Índice de Alimentação de Lactentes e Crianças e do Indicador de Alimentação de Lactentes e Crianças Pequenas neste estudo.

Evaluation of sustainable and healthy eating behaviors and adherence to the planetary health diet index in Turkish adults: a cross-sectional study.

Aim: The Planetary Health Diet Index (PHDI) is a relatively new index, and studies about its relationship with eating behaviors, nutritional status, and obesity in adults are very limited. For this reason, in this study, sustainable healthy eating behaviors of individuals and compliance of their diets with PHDI were evaluated. Methods: This cross-sectional study was conducted with 1,112 adults (70.1% women and 29.9% men with mean age = 28.7 years, SE = 9.47). Study data were obtained with the face-to-face interview method via a questionnaire including sociodemographic characteristics, anthropometric measurements, the Sustainable and Healthy Eating (SHE) Behaviors Scale, and 24-h dietary recall. PHDI was evaluated for adherence to EAT-Lancet Commission recommendations. Results: The average PHDI total score was 41.5 points. Higher SHE Behaviors Scale and PHDI scores were observed in participants with a duration of education above 8 years (p < 0.05). Those with lower SHE Behaviors Scale and PHDI scores were more likely to be obese (p < 0.001). The total PHDI score was positively associated with fiber, vitamin E, potassium, and folate, and negatively associated with pyridoxine and calcium (p < 0.05). The total SHE Behaviors Scale score was positively associated with carbohydrates, fiber, and potassium and negatively associated with pyridoxine, calcium, and energy (p < 0.05). A one-unit increase in SHE Behaviors Scale total score resulted in a 5,530 unit (95%CI: 4.652; 6.407) increase in PHDI total score and a one-unit increase in duration of education (years) resulted in a 0.660 unit (95%CI: 0.403; 0.918) increase in PHDI total score. Furthermore, a one-unit increase in Body Mass Index (BMI) (kg/m2) resulted in a - 0.218 unit (95%CI: -0.424; -0.013) decrease in PHDI total score. Conclusion: The participants' PHDI index scores were low; therefore, the adherence to the EAT-Lancet recommendation was low which might be associated with obesity. Clinical studies evaluating the effects of adherence to sustainable diets on adequate and balanced nutrition and health outcomes are recommended.

Evaluation of the Turkey Nutrition and Health Surveys according to the mediterranean adequacy index and sustainability through water footprints.

OBJECTIVE: Sustainable diet is one of the main factors that support food security, and the Mediterranean diet (MD) one of the sustainable diet models associated with low ecological impact and optimum health results has come to the fore. It was aimed to compare the results of the 2010 and 2017 Turkey Nutrition and Health Studies (TNHS) according to the Mediterranean Adequacy Index (MAI) and in order to evaluate the environmental impact of the current nutritional status in Turkey through water footprints (WF). DESIGN: The MAI score was calculated using the published results of the 2010 and 2017 TNHS, and the WF have been calculated as indicators of environmental impact. SETTING: Turkey. PARTICIPANTS: There are no participants. RESULTS: In the TNHS, there was an increase in the amount of energy provided by foods non-MD in 2017 compared to 2010, with a decrease in the total MAI score. The group with the lowest adherence to the MD in both years was the adult group (MAI20102·74 and MAI20172·31), while the group with the highest adherence was the adolescent group (MAI20103·21 and MAI20172·53). The MAI scores of females were higher than those of males in both years. The males aged 19-64 years had the largest (841 m3/year) WF and the females aged 65+ years had the smallest (483 m3/year). The food group that contributed the most to WF was meat and meat products (21·0-35·0 %). CONCLUSIONS: Adherence to the MD has decreased due to the increase in the consumption of the Western-type diet in Turkey.

Children's eating attitudes test (ChEAT): validation and reliability in Turkish children.

OBJECTIVES: This study aims to examine the validity and reliability of the children's eating attitudes test (ChEAT) in Turkish children. METHODS: The participants were 331 children (137 boys and 194 girls, ages 8-15). Data was collected through face-to-face interviews using a questionnaire containing socio-demographic characteristics, the ChEAT, and the children's eating behaviour questionnaire (CEBQ). Exploratory factor analysis (EFA) was performed to determine the factor structure of the Turkish version of the ChEAT. Additionally, the reliability was examined in terms of internal consistency and test-retest reliability. All statistical analyses were performed using Mplus Trial Version and SPSS 11.5 (SPSS, Chicago, IL, USA). RESULTS: According to the goodness-of-fit statistic, a three-factor solution was appropriate and compatible with clinical considerations. The three factors explained 50.1% of the variance. Cronbach's alpha coefficient was 0.75 for ChEAT-26, 0.67 for "Preoccupation with thinness and food", 0.63 for "Social pressure to eat", and 0.71 for "Dieting". Furthermore, the test-retest reliability was 0.72, 0.62, 0.59, and 0.59 respectively. Statistically significant correlations between the ChEAT and CEBQ were found (p < 0.05). "Preoccupation with thinness and food" was significantly higher in obese children (p < 0.05), while "Social pressure to eat" was lower (p < 0.001). Sex, grade, BMI, parental education in addition to working status affected the ChEAT-26 scores. CONCLUSIONS: The present study has provided preliminary evidence for the validity and reliability of a Turkish version of the ChEAT.

Early diagnosis and intervention of abnormal eating attitudes are crucial to minimizing adverse physical as well as psychological health outcomes such as obesity or being underweight for children with eating disorders. Since eating disorders occur early, screening for nutritional attitudes along with behaviors is crucial. The Children's Eating Attitudes Test (ChEAT) was developed by Maloney et al. to evaluate eating attitudes and behaviors in children. This study aimed to adapt the ChEAT-26 to Turkish and evaluate its validity and reliability. The present study has provided preliminary evidence for the validity and reliability of a Turkish version of the ChEAT. High scores on ChEAT-26 indicate the severity of the eating disorder.

Time-restricted eating (16/8) and energy-restricted diet: effects on diet quality, body composition and biochemical parameters in healthy overweight females.

BACKGROUND: Time-restricted eating (TRE) is a current popular dietary strategy for noncommunicable diseases. However, studies demonstrated contradictory results for it and in all dietary strategies, diet quality is an the important part of the well-being. Our study aimed to investigate the effect of TRE and energy-restricted diet (ERD) on the nutritional status and diet quality of individuals. METHODS: This pilot study was completed 23 healthy overweight female. Anthropometric and body composition measurements of individuals were taken. The energy expenditure was measured using indirect calorimetry. Blood pressure and heart rate measurements were made. Biochemical parameters were evaluated and food consumption were taken. The quality of dietary intake was assessed using the Healthy Eating Index (HEI) -2015. The physical activity levels of the individuals were estimated using the physical activity record. The Statistical Package for the Social Sciences (version 22.0) software was used for all analyses. A p-value of less than 0.05 was considered to be statistically significant. RESULTS: After 8 weeks of intervention, while no change was observed in the diet quality of the individuals in the TRE group (p > 0.05), a significant increase was found in the diet quality score of the individuals in the ERD group (p < 0.05). There was a 3.2% and 5.5% decrease in body weight of individuals in the TRE and ERD groups, respectively (p < 0.05). While no significant change was observed in the body fat percentage of individuals in the TRE group (p > 0.05), a 7.1% decrease was observed in the ERD group (p < 0.05). A statistically significant decrease was found in the total cholesterol (3.7%) in the ERD group, and in the total cholesterol (6.7%) and low density lipoprotein cholesterol (LDL-C) (6.5%) in the TRE group. In addition, a statistically significant increase was found in adiponectin (77.3%) and total antioxidant status (TAS) (13.2%) in the ERD group. CONCLUSION: Energy-restricted diet yielded better results in weight loss and improvement of body composition and diet quality compared to TRE. Also, a decrease in total cholesterol level was found in the ERD group. However, more studies should be done with longer follow-ups and high sample sizes are very important in terms of creating public health-based recommendations.

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.

Relationships between serum and dietary magnesium, calcium, and metabolic parameters in women with type 2 diabetes mellitus.

BACKGROUND & AIMS: Magnesium and calcium are essential minerals in several enzymatic activities that modulate essential biological functions. Hypomagnesemia occurs in patients with type 2 diabetes mellitus (T2DM), especially those with poor metabolic control. Dietary magnesium and calcium intake play a protective role in the development of T2DM. This research aimed to investigate the association of dietary and serum magnesium and calcium with metabolic control parameters in diabetic women. METHODS: This case-control study was conducted on 80 women, including 40 patients diagnosed with T2DM and 40 healthy controls aged 35-60 years. Some anthropometric measurements of the individuals were taken, and their body mass index was calculated. In addition, some biochemical parameters, serum magnesium, and calcium were analyzed. A validated 96-item quantitative food frequency questionnaire was used to obtain dietary magnesium and calcium intake data. RESULTS: Serum magnesium levels were lower in subjects with diabetes than in controls, and there was a similar incidence of hypomagnesemia in T2DM patients and controls, but not statistically significant (p > 0.05). In T2DM patients, there was a statistically significant inverse association between HbA1c and serum magnesium (p < 0.05). Dietary magnesium intake was inversely associated with HOMA-IR scores (p < 0.05) but had a positive association with serum magnesium levels in patients with T2DM (p < 0.05). There were no significant differences in the calcium/magnesium ratio between T2DM patients and healthy controls (p > 0.05). In a multiple linear regression analysis, dietary magnesium intake and HbA1c were found to be significantly related to altered serum magnesium in T2DM patients. CONCLUSION: The present findings suggest that lower serum magnesium levels were associated with higher HbA1c levels in subjects with T2DM. Increased dietary magnesium intake in T2DM may enhance HOMA-IR scores and serum magnesium levels.

Validity and reliability of food frequency questionnaire used in age-related eye disease studies in Turkish adults.

The present study aimed to perform the validity and reliability study of the Food Frequency Questionnaire (FFQ) on the frequency of foods rich in antioxidant nutrients and used in Age-Related Eye Diseases (AREDs). In the first interview of the study, the first application of FFQ was carried out, and blank forms of Dietary Records (DRs) were given. For the validity of the FFQ, a total of 12 d (3 days * 4 weeks) of DR were taken. For the reliability of the FFQ, a test-retest application was made with an interval of 4 weeks. The daily intake means of antioxidant nutrients, omega 3 and total antioxidant capacity data obtained from both the FFQ and DR were calculated, and the concordance between the two methods was evaluated with the Pearson Correlation Coefficient (PCC) and Bland-Altman graphs. The present study was carried out at Ege University Izmir/Turkey, Department of Ophthalmology, Retina Unit. The study was conducted with individuals aged ≥50 years who suffered from Age-Related Macular Degeneration (n 100, 72⋅0 ± 8⋅03 years). The values obtained from the test-retest applications for FFQ reliability were the same. The nutrient intake means obtained from the FFQ were similar or significantly higher than DR (P < 0⋅05). In the Bland-Altman graphical approach, the nutrient data were within the limits of agreement, and the PCCs between the two methods were moderately related. Considered together, this FFQ is a suitable tool for determining the dietary intakes of antioxidant nutrients in the Turkish population.

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.

Validity and Reliability of the Turkish Version of the Sustainable and Healthy Eating Behaviors Scale.

This study was conducted to determine the validity and reliability of the Turkish version of the Sustainable and Healthy Eating (SHE) Behaviors Scale. The original scale included 8 factors and 34 items related to the SHE behaviors of adults. The research was carried out in three stages with a total of 586 participants aged 19 to 50 years. The Cronbach alpha coefficient was used to evaluate internal consistency reliability and the test-retest method was applied. Exploratory factor analysis (EFA) was performed to determine the factor structure. The model obtained with EFA was evaluated with confirmatory factor analysis (CFA). The Cronbach alpha coefficient of the scale was found to be excellent at 0.912, and the intra-class correlation coefficient was found to be good at 0.832 using the test-retest method. Considering the suitability of the data for factor analysis, the KMO coefficient was 0.859, and the significance level of the Bartlett test of sphericity was less than 0.05 (χ2=3.803,25; p<0.05). As a result of EFA, the items of the scale were found to be distributed in 7 factor dimensions. The factor loadings of the items were between 0.516 and 0.890, and the factors explained 67% of the variance. Considering the fit indices obtained as a result of the analysis of this model with CFA, it was seen that the model had an acceptable fit (χ2/sd=2.593, CFI=0.915, Tucker-Lewis index=0.902, SRMR=0.0754, and RMSEA=0.067). In conclusion, the Turkish version of the SHE Behaviors Scale has credible reliability and construct validity to assess the sustainable and healthy eating behaviors of the Turkish adult population.

Screening for malnutrition with malnutrition inflammation score and geriatric nutritional risk index in hemodialysis patients.

BACKGROUND AND AIMS: Screening malnutrition, which is the most common complication in hemodialysis patients, is extremely important for these patients. Malnutrition inflammation score (MIS) and geriatric nutritional risk index (GNRI) are malnutrition screening tests used in hemodialysis patients in recent years. The purposes of this study are to evaluate the nutritional status of hemodialysis patients with different screening tests and to determine the cutoff values for this disease-specific MIS and GNRI. METHODS: The study was conducted with 194 adult patients including 98 males and 96 females whose mean age was 53.1 ± 10.96. Subjective global assessment (SGA) and MIS tests were applied, and the GNRI value was calculated for screening malnutrition. MIS and GNRI cutoff values were obtained by adopting the SGA scores as a standard and drawing a receiver operating characteristic curve. The tatistical Package for the Social Sciences-22.0 package program was used in the analysis. RESULTS: According to SGA, 70.7% of the patients were nourished, 21.1% were mildly-moderately malnourished, and 8.2% were found to be severely malnourished. The optimal cutoff value predicted for malnutrition was 6.5 points (94.7% sensitivity and 98.5% specificity) for MIS and 86.0 points (64.9% sensitivity and 62.8% specificity) for GNRI. Based on these cutoff values, 28.9% of the patients were determined to be malnourished according to MIS and 45.4% according to GNRI. CONCLUSION: In conclusion, screening tests are very important in the early identification of malnutrition in hemodialysis patients. This study was conducted to evaluate the malnutrition of hemodialysis patients with different screening tests. At the end of the study, the availability of MIS was found to be high in detecting malnutrition in hemodialysis patients because of its high accuracy and sensitivity of MIS. The cutoff points we identified for both MIS and GNRI are thought to facilitate the determination of malnutrition.

Effects of Diurnal Ramadan Intermittent Fasting on Cardiometabolic Risk Factors and Sleep Quality in Healthy Turkish Adults.

This study aimed to evaluate the effect of diurnal Ramadan fasting on cardiometabolic risk factors (blood glucose, lipid profile, inflammatory cytokines) and sleep quality in healthy Turkish adults. This prospective observational study was conducted with a total of 32 individuals (12 males, 20 females) who were aged between 19-32 years and fasted for 25 or more continuous days in Ankara, Turkey between 1 Ramadan 1442 and 30 Ramadan 1442. Individuals applied fasting for 16 hours in the spring season. Blood samples were taken after at least 8 hours of fasting, anthropometric measurements were taken and sleep quality was assessed using The Pittsburgh Sleep Quality Index (PSQI) at the beginning and the end of Ramadan. There was a significant decrease in body mass index (BMI), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels during Ramadan fasting (p < .005). There were no changes in lipid profiles and sleep quality. There was a significant increase in fasting blood glucose levels (p < .05); however, this change is within normal limits. There was also a significant relationship between BMI and CRP, IL-6, and TNF-α levels (p < .05). The diurnal Ramadan fasting did not affect lipid profiles and sleep quality in healthy Turkish subjects. However, decreased BMI and inflammatory cytokine levels were observed at the end of Ramadan fasting. More studies are needed to clarify the role of Ramadan fasting in healthy populations.

Nutritional Targets in Cow's Milk Protein Allergy: A Comprehensive Review.

PURPOSE OF REVIEW: Cow's milk protein allergy (CMPA) is known as the most common food allergy in the first year of life. For this purpose, in our review, the regulation of maternal and infant nutrition, and the risks and the issues to be considered in terms of nutrition are discussed from the perspective of a dietitian. RECENT FINDINGS: Therefore, understanding the epidemiology, symptoms, diagnostic criteria, and appropriate treatment of cow's milk protein allergy is crucial for the multidisciplinary team of physicians, dietitians, and nurses working in the clinic. It has been reported that tolerance develops in approximately 50% of infants affected by cow's milk protein in the first year of life. Although CMPA is generally thought to clear up between 1 and 2 years of age, there is insufficient evidence to determine an optimal time to reintroduce cow's milk protein to the diet. Because the elimination diet recommended in the treatment of children with CMPA, adequate protein and calcium intake of the mother and/or baby in the diet should be evaluated. Studies focusing on metabolic bone turnover in children with food allergies are limited. In general, low calcium intake is associated with reduced bone formation in children with CMPA. Therefore, bone health should be focused on and appropriate strategies should be developed in children with CMPA. Unnecessary elimination of milk and its products, which are an important part of nutrition, should be prevented and nutrient deficiencies and growth status should be monitored by dietitians especially working in the field of pediatric nutrition.

Turkish version of the 'Three-Factor Eating Questionnaire-51' for obese individuals: a validity and reliability study.

OBJECTIVES: Obesity is a serious public health issue. Investigating the eating behaviour of individuals plays an important role in preventing obesity. Therefore, the purpose of the current study is to adapt the long and first version of the 'Three-Factor Eating Questionnaire' (TFEQ), a scale that examines the eating behaviour of individuals, to Turkish culture and to carry out its validity and reliability study. DESIGN: The data were collected using data collection forms, and anthropometric measurements of the individuals were made by the researchers. The data collection form included several parameters: socio-demographic characteristics, the TFEQ scale, whose validity and reliability analysis is conducted here, and the Dutch Eating Behaviour Questionnaire (DEBQ) which was used as a parallel form. SETTING: The Obesity Clinic at Ege University in Izmir. PARTICIPANTS: The study group consisted of obese adult individuals (n 257). RESULTS: It was seen that constructing the questionnaire with twenty-seven items and four sub-dimensions provides better information about Turkish obese individuals. Factor loadings ranged from 0·421 to 0·846, and item total score correlations ranged from 0·214 to 0·558. Cronbach's α coefficient was found to be 0·639 for the whole scale. A positive, strong and statistically significant correlation was detected between TFEQ and DEBQ, which was used as a parallel form (r = 0·519, P < 0·001). CONCLUSION: In Turkey, the long version of the TFEQ scale was found valid and reliable for obese adult individuals. TFEQ can be used by clinicians or researchers to study the eating behaviour of obese individuals.

Factors affecting emotional eating and eating palatable food in adults.

BACKGROUND/OBJECTIVES: The aim of this study was to determine the relationship among emotional eating behavior, tendency to eat palatable foods, and several risk factors. SUBJECTS/METHODS: This study was carried out on 2,434 persons (1,736 women and 698 men) aged between 19 and 64 years. A questionnaire form was used as a data collection tool, which consisted of items for the socio-demographic characteristics, anthropometric measurements, Emotional Appetite Questionnaire (EMAQ), and the Palatable Eating Motives Scale (PEMS). RESULTS: A positive significant correlation was observed between the BMI groups and the negative emotions, negative situations, and negative total scores of EMAQ (P < 0.01). The regression results on negative subscales showed that a one unit increase in BMI resulted in a 0.293 unit increase in negative situations scores, a 0.626 unit increase in negative emotions scores, and a 0.919 unit increase in negative total EMAQ scores. When the BMI groups and PEMS subscale scores were examined, a significant relationship was found in the social motives, rewarding, and conformity subscales (P < 0.01). A one unit increase in BMI increased the coping motives scores by 0.077 units. CONCLUSIONS: The emotional states have a significant effect on the eating behavior. On the other hand, an increase in eating attacks was observed, particularly in people who were under the effect of a negative emotion or situation. Nevertheless, there were some limitations of the study in terms of quantitative determination of the effects of this eating behavior depending on the BMI.

Increased Obesity Awareness and Adherence to Healthy Lifestyle-Diet Reduce Metabolic Syndrome Risk in Overweight Children.

Objective: Obesity is a common epidemic issue in all over the world. In order to prevent obesity it is essential to know about obesity and its detrimental consequences. This study aimed to evaluate children's awareness about obesity and to determine the associations between level of awareness, healthy lifestyle, dietary habits and risk factors for metabolic syndrome.Methods: Two hundred and thirty-six overweight children (119 boys and 117 girls) aged 10-14 years were enrolled to the study. Anthropometric and biochemical measurements were taken and metabolic syndrome (MetS) definition were done according to the International Diabetes Federation (IDF) consensus and divided into two groups as MetS (+) and MetS (-). Obesity awareness scale (OBA) and Adapted Healthy Lifestyle-Diet Index for Turkey (HLD-TR) were performed.Results: Among children, the prevalence of having MetS was found as 26.3%. Obesity awareness and HLD-TR index sores were lower in MetS (+) group than MetS (-) group. Metabolic syndrome related biochemical parameters and anthropometric measurements were associated with obesity awareness level of the children. The binary logistic regression model shows that a one-unit increase in the OBA index score increases the odd of not having MetS for 1.12 times after adjustments for age, gender, body mass index, and HLD-TR index score.Conclusions: Increased awareness about obesity among children will help to reduce the risk of metabolic syndrome, type 2 diabetes and atherosclerotic cardiovascular diseases in the future.

Association of Mediterranean diet and anthropometric measures with quality of life in coronary artery disease patients.

INTRODUCTION: Introduction: the Mediterranean diet (MD) and ideal body weight are associated with a reduction in the risk of chronic diseases, but their association with health-related quality of life (HRQL) is not clear. Objective: the aim of this study was to assess the association between adherence to MD and the HRQL and anthropometric measurements in coronary artery disease patients. Methods: this cross-sectional study was carried out in 55 women and 84 men who were diagnosed with coronary artery disease by a physician. Anthropometric indices were measured, MD adherence was evaluated with a 14-item questionnaire and the 36-Item Short Form Health Survey (SF-36) was used for HRQL. Results: mean age in males was 63.0 ± 9.7 years and mean age in females was 63.1 ± 10.1 years. Prevalence of overweight and obesity was 53.5% and 40.5%, respectively, in men and 14.5% and 83.6%, respectively, in women. Adherence to the MD was assessed and the median values were found statistically higher in male patients (p < 0.05). A significant positive correlation was found between MD and all physical component summary (PCS, its subscale) and most mental component summary (MCS) (except emotional role, social health subscale) (p < 0.05). Inverse significant associations were found between BMI, waist circumference, waist/height ratio, percent of body fat and both PCS and MCS (including most subscales). Conclusion: adoption of healthy dietary habits (adherence to the Mediterranean diet) by the participants and optimal anthropometric measurements may be considered as a possible contributor to HRQL.

INTRODUCCIÓN: Introducción: la dieta mediterránea (DM) y el peso corporal ideal se asocian con una reducción en el riesgo de enfermedades crónicas, pero su asociación con la calidad de vida relacionada con la salud (CVRS) no está clara. Objetivo: el objetivo de este estudio fue evaluar la asociación entre la adherencia a la DM y la CVRS y las mediciones antropométricas en pacientes con enfermedad arterial coronaria. Métodos: este estudio transversal se llevó a cabo en 55 mujeres y 84 hombres que fueron diagnosticados con enfermedad de las arterias coronarias por un médico. Se midieron los índices antropométricos, se evaluó la adherencia a la DM con un cuestionario de 14 ítems y se utilizó el cuestionario de salud SF-36 para la CVRS. Resultados: la edad media de los hombres fue de 63,0 ± 9,7 y la edad media de las mujeres fue de 63,1 ± 10,1. La prevalencia de sobrepeso y obesidad fue del 53,5% y 40,5%, respectivamente, en hombres y del 14,5% y 83,6%, respectivamente, en mujeres. Se evaluó la adherencia a la DM y los valores de la mediana fueron estadísticamente más altos en los pacientes varones (p < 0,05). Se encontró una correlación positiva significativa (p < 0,05) entre la DM y el resumen general del componente físico (PCS, subescala) y la mayor parte del resumen del componente mental (MCS), excepto el subpeso emocional y la subescala de salud social. Hubo una correlación negativa entre el IMC, la circunferencia de la cintura, la relación cintura/estatura, el porcentaje de grasa corporal y PCS y MCS (incluida la mayoría de las subescalas). Conclusión: la adopción de hábitos alimentarios saludables (adherencia a la dieta mediterránea) por parte de los participantes y las mediciones antropométricas óptimas pueden considerarse como un posible contribuyente a la CVRS.

Association of Mediterranean diet and anthropometric measures with quality of life in coronary artery disease patients / Asociación de la dieta mediterránea y las medidas antropométricas con la calidad de vida en pacientes con enfermedad arterial coronaria

Introduction: the Mediterranean diet (MD) and ideal body weight are associated with a reduction in the risk of chronic diseases, but their association with health-related quality of life (HRQL) is not clear. Objective: the aim of this study was to assess the association between adherence to MD and the HRQL and anthropometric measurements in coronary artery disease patients. Methods: this cross-sectional study was carried out in 55 women and 84 men who were diagnosed with coronary artery disease by a physician. Anthropometric indices were measured, MD adherence was evaluated with a 14-item questionnaire and the 36-Item Short Form Health Survey (SF-36) was used for HRQL. Results: mean age in males was 63.0 ± 9.7 years and mean age in females was 63.1 ± 10.1 years. Prevalence of overweight and obesity was 53.5% and 40.5%, respectively, in men and 14.5% and 83.6%, respectively, in women. Adherence to the MD was assessed and the median values were found statistically higher in male patients (p < 0.05). A significant positive correlation was found between MD and all physical component summary (PCS, its subscale) and most mental component summary (MCS) (except emotional role, social health subscale) (p < 0.05). Inverse significant associations were found between BMI, waist circumference, waist/height ratio, percent of body fat and both PCS and MCS (including most subscales). Conclusion: adoption of healthy dietary habits (adherence to the Mediterranean diet) by the participants and optimal anthropometric measurements may be considered as a possible contributor to HRQL

Introducción: la dieta mediterránea (DM) y el peso corporal ideal se asocian con una reducción en el riesgo de enfermedades crónicas, pero su asociación con la calidad de vida relacionada con la salud (CVRS) no está clara. Objetivo: el objetivo de este estudio fue evaluar la asociación entre la adherencia a la DM y la CVRS y las mediciones antropométricas en pacientes con enfermedad arterial coronaria. Métodos: este estudio transversal se llevó a cabo en 55 mujeres y 84 hombres que fueron diagnosticados con enfermedad de las arterias coronarias por un médico. Se midieron los índices antropométricos, se evaluó la adherencia a la DM con un cuestionario de 14 ítems y se utilizó el cuestionario de salud SF-36 para la CVRS. Resultados: la edad media de los hombres fue de 63,0 ± 9,7 y la edad media de las mujeres fue de 63,1 ± 10,1. La prevalencia de sobrepeso y obesidad fue del 53,5% y 40,5%, respectivamente, en hombres y del 14,5% y 83,6%, respectivamente, en mujeres. Se evaluó la adherencia a la DM y los valores de la mediana fueron estadísticamente más altos en los pacientes varones (p < 0,05). Se encontró una correlación positiva significativa (p < 0,05) entre la DM y el resumen general del componente físico (PCS, subescala) y la mayor parte del resumen del componente mental (MCS), excepto el subpeso emocional y la subescala de salud social. Hubo una correlación negativa entre el IMC, la circunferencia de la cintura, la relación cintura/estatura, el porcentaje de grasa corporal y PCS y MCS (incluida la mayoría de las subescalas). Conclusión: la adopción de hábitos alimentarios saludables (adherencia a la dieta mediterránea) por parte de los participantes y las mediciones antropométricas óptimas pueden considerarse como un posible contribuyente a la CVRS

School Teachers' Awareness about National Obesity Prevention Programs in Turkey.

Nutritional programs are one of the most important public health policies in order to prevent obesity. School teachers are role models for students and their nutrition knowledge about these policies can affect children's dietary habits. The aim of this observational descriptive study was to evaluate the school teachers' awareness about nutrition programs for the prevention of obesity of the Ministry of Education in Turkey. It was conducted to 87,070 classroom teachers working at state schools from all the cities of Turkey. Data collection was obtained with a plain web-based survey, and national nutrition programs (Nutrition-Friendly School Program, White-Flag Protocol, and circular letter on foods can be sold in school canteens) were questioned. Mean age of teachers was 38.3 ± 9.30 years and 50.4% of them were male. It was determined that only 66.2% of the teachers know whether their school is nutrition-friendly. Frequency of knowing "White-Flag" Protocol was 80.1%. Present study showed that educational programs about nutrition policies are required in order to increase knowledge among school teachers and thus, prevent childhood obesity.