Investigation of the Psychometric Properties of the Comprehensive Feeding Practices Questionnaire in Turkish Parents.

OBJECTIVE: The Comprehensive Feeding Practices Questionnaire (CFPQ) measures parental attitudes toward feeding practices that directly influence children's eating habits. This study aims to determine the reliability and validity of the Turkish adaptation of the CFPQ developed by Musher-Eizenman et al. DESIGN: Validity and reliability analyses were conducted for the T-CFPQ. In addition to reliability analyses and partial correlations between scale dimensions, correlations between scale dimensions according to mothers' BMI and children's BMI z-scores were also examined. SETTING: Parents with children aged 18 months to 8 years living in the community. PARTICIPANTS: The study sample consisted of 274 parents with children aged 18 months to 8 years who agreed to participate in the online survey. RESULTS: In this study, 47 items and 12-factor structure describing feeding practices were supported by CFA. Although most of the dimensions of the T-CFPQ showed significant correlations with each other, the highest correlation was found between the encourage balance/variety and the dimension of modeling and teaching nutrition (r=0.53; 0.50) (p<0.05). There was a negative correlation between the child's BMI z-score and the pressure to eat dimension (r=-0.173; p<0.01) and a positive correlation between the restriction for weight dimension (r =0.339; p<0.01). Maternal BMI was negatively associated with the involvement dimension (r=-0.121; p<0.05) and positively associated with the restriction for weight dimension (r=0.154; p<0.01). CONCLUSIONS: The findings revealed that the T-CFPQ is a valid and reliable measurement tool that can be applied to obtain the necessary information for evaluating nutritional interactions between parent and child.

Chronotype is associated with Mediterranean dietary adherence and environmental footprints.

This cross-sectional study was carried out to determine the relationship between nutrition according to chronotype and the Mediterranean diet and environmental footprints. "Morningness Eveningness Questionnaire" was used to determine the chronotype classification, and "Mediterranean Diet Adherence Screener" was used to evaluate adherence to the Mediterranean diet. In addition, the food consumption record of the participants was taken and the carbon and water footprints were calculated. A total of 472 adults with a mean age of 22.7 ± 5.0 years participated in the study. Accordingly, 61.0% of the participants were morning type, 15.7% were intermediate type, and 23.3% were evening type. Individuals with higher chronotype values (morning) tended to be more adherent to the Mediterranean diet and had lower environmental (carbon and water) footprints (p < 0.05). The results of this study; showed that diet according to chronotype affects adherence to the Mediterranean diet and environmental footprints.

Assessment of eating disorders and depression in postpartum women.

OBJECTIVE: To determine the prevalence of eating disorders and orthorexia in postpartum women and examine the relationship with postpartum depression. STUDY DESIGN: Included in this study were 227 postpartum women. The Eating Attitude Test-26 (EAT-26) was used to determine the risk of eating disorders in the women, followed by the Orthorexia 11 Scale (ORTO-11) to identify orthorexia, and the Edinburgh Postpartum Depression Scale (EPDS) to identify postpartum depression. RESULTS: 63 of the women (27.8%) exhibited an orthorexic tendency, which was also related to eating disorders and postpartum depression. Each one-point increase in the EAT-26 score led to a decrease of 0.32 points in the ORTO-11 score. Similarly, each one-point increase in the EPDS score caused a reduction of 0.18 points in the ORTO-11 score. The ORTO-11 score increased by 0.26 points per each live birth. CONCLUSION: An obsessive focus on healthful nutrition may result in the impairment of health and numerous adverse psychological and physiological outcomes in the future. Healthy eating habits should be maintained to improve the quality of life without causing an obsession with healthy eating.

Evaluation of malnutrition and screening tools in hospitalized children.

BACKGROUND & AIMS: Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. METHODS: A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. RESULTS: A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than -2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p < 0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p < 0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p > 0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. CONCLUSIONS: Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Comparing the effects of dietary sugars on cognitive performance and reaction time: A randomized, placebo- controlled and double-blind experimental trial.

The aim of the study was to compare the effects of acute intake dietary sugars on cognitive performance and reaction time. This study was, randomized, placebo-controlled, double-blind experimental design, conducted with 75 healthy adults. At the beginning of the study, the participants (36 male, 39 female; 21.6 ± 1.3 years of age; body mass index: 21.59 ± 1.94 kg/m2) were randomly divided into equal five groups (n:15) (glucose (10 g), fructose (10 g), sucrose (10 g), saccharin (0.24 g), placebo), and received dietary sugars dissolved in 200 mL of water. Cognitive performance was determined with Cancelation Test, and the Simple Response Time and Ruler Drop Tests were used in order to response and reaction time of participants, respectively. General score of cognitive performance (0.93 ± 0.1), reaction (295 ± 20 ms), and response (204 ms) were highest in glucose and lowest in placebo (0.63 ± 0.1; 368 ± 22 ms; 251 ms, respectively) (p < .001). Saccharin groups had a higher reaction (312 ± 22 ms) and response (216 ms) time score compared to consumed fructose (316 ± 39; 227 ms), sucrose (354 ± 26; 246 ms), and placebo (368 ± 22; 251 ms) groups, respectively (p < .001). These findings show that differences in the absorption pattern and sweetness levels of sugar types may have different effects on cognitive performance and reaction time.

Is there any Relationship between Acne Vulgaris and Diet Inflammatory Index in Women? / ¿Existe alguna relación entre el acné vulgar y el índice inflamatorio de la dieta en mujeres?

Background: Acne vulgaris (AV) is a chronic inflammatorydisease that can be seen at any stage of life. Diet is thoughtto be effective in AV formation. The dietary inflammatory in-dex (DII) determines how inflammatory a diet is. We hypoth-esized that DII is associated with AV and a biochemical pa-rameter in women. Methods: In the study performed on 68 women (34 casesand 34 controls) between the ages of 19-35 at Erciyes University Faculty of Medicine Dermatology Polyclinic, AVseverity was determined by the responsible dermatologist andblood samples were taken from the individuals. Three-dayfood consumption records from women were used in the DIIcalculation. DII scores were divided into tertiles according towomen with and without AV. The socio-demographic information and anthropometric measurements of the women wererecorded face-to-face with a questionnaire. Results: Cases had higher DII scores than controls. WhenDII scores were divided into tertiles, the most proinflammatory group was found to be tertile 3+. It was determined thatthe women in the most proinflammatory group had higherbody weight and body mass index (BMI) values compared toother tertiles. Conclusion: The study’s results suggest that as the DIIscore increases, the diet has a pro-inflammatory effect associated with AV. Including sufficient anti-inflammatory foods in their diets to decrease DII of individuals will help prevent AVformation and/or reduce lesions.(AU)

Introducción: El acné vulgaris (AV) es una enfermedad inflamatoria crónica que puede aparecer en cualquier etapa de la vida. Se cree que la dieta es efectiva en la formación del AV. El índice inflamatorio dietético (DII) determina cuán inflamatoria es una dieta. Hipotetizamos que el DII está asociado con AV y un parámetro bioquímico en mujeres. Métodos: El estudio incluyó a 34 mujeres con casos y 34 mujeres sanas como control que acudieron a un hospital. Un dermatólogo responsable determinó la gravedad del AV y se recopilaron muestras de sangre de las personas. El DII se calculó utilizando registros de consumo de alimentos de tres días de mujeres. El DII se ajustó según los terciles en mujeres con y sin AV. El investigador responsable utilizó el enfoque de entrevista cara a cara para registrar la información sociodemográfica y las medidas antropométricas de las mujeres. Resultados: Los casos tenían puntuaciones DII más altas que los controles. Cuando se dividieron en terciles, el grupo con la puntuación DII más alta y el grupo más proinflamatorio fueron las mujeres en el grupo tercil 3+ (4,93 ± 1,37). Se encontró que aquellos en el grupo más proinflamatorio tenían más sobrepeso (58,27 ± 6,63 kg), y el índice de masa corporal (IMC) (21,94 ± 2,80 kg/m2) era mayor. Conclusión: Los resultados del estudio sugieren que a medida que aumenta la puntuación DII, la dieta tiene un efecto proinflamatorio asociado con el AV. Incluir suficientes alimentos antiinflamatorios en su dieta para disminuir el DII de las personas ayudará a prevenir la formación de AV y/o reducir las lesiones.(AU)

Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence.

Aim; This study was planned and conducted to examine the change in food consumption and nutritional supplement use during the COVID-19 pandemic according to individuals' status of anxiety and Mediterranean diet adherence. Methods; This prospective, cross-sectional research was completed online with the participation of 949 people (66.4% women). The Mediterranean Diet Adherence Screener Scale (MEDAS) and Coronavirus Anxiety Scale (CAS) were applied. After this section of the questionnaire was completed, the participants were tasked with answering questions regarding changes in food consumption and use of nutritional supplements during the pandemic. Results; While 50.8% of the participants had low adherence to the Mediterranean diet, 18.2% were considered to have a high adherence. It was observed that legume (p = 0.001), milk and dairy (p = 0.01), and fruit (p < 0.001) consumption of participants with high adherence to the Mediterranean diet increased during the pandemic, and packaged food (p < 0.001) consumption decreased. The increase in the consumption of fruit (p < 0.001) and vegetables (p = 0.018) were significantly higher in the group with anxiety. Age, sex, educational status, positive COVID-19 test, place of residence, CAS score and MEDAS score affect the use of dietary supplements according to binary logistic regression (R2 = 0.106 p < 0.001). The three most commonly used supplements were identified as vitamins C, D and B12. Conclusions: These results can shed light on how to prepare for possible future pandemics when it comes to dealing with anxiety through diet.

Adaptation of Food Craving Inventory to Turkish culture: a validity and reliability study.

INTRODUCTION: The Food Craving Inventory is a 28-item self-report measure of specific food cravings. The inventory consists of 4 factors: high fats, sweets, carbohydrates/starches and fast-food fats. PURPOSE: This study was carried out to evaluate the Turkish validity and reliability of the Food Craving Inventory, and to determine the psychometric properties and factor structure of the Turkish version. METHODS: The sample of the study consists of 621 individuals between the ages of 19-50 who voluntarily agree to participate in online survey. Validity and reliability analyses were performed for the Turkish version of Food Craving Inventory (FCI-TR). Confirmatory factor analysis was performed to evaluate the factor structure of the Turkish version of FCI. RESULTS: Confirmatory factor analysis yielded a four-factor structure as "sweets," "high-fats," "carbohydrates/starches" and "fast food fats". The Cronbach-alpha coefficient for the total score was 0.84; subfactors were calculated as 0.74 for "sweets", 0.64 for "high-fat foods", 0.65 for "carbohydrates/starches", and 0.66 for "fast-food fats". The scores of the FCI-TR factors and its total score significantly correlated with the sub-factors of Three Factor Eating Questionnaire (TFEQ). A significant correlation was found between body mass index (BMI) and high fats and fast-food fats factor score. Also total and factor scores of the FCI-TR were different between BMI groups. CONCLUSIONS: This study demonstrates that the Turkish version of the FCI is a valid and reliable tool to measure food cravings in the Turkish population. FCI is also correlated with sub-factors of TFEQ.

This study was carried out to adapt the Food Craving Inventory to Turkish. The English version of inventory consists of 4 sub-factors that measure cravings for high-fat foods, carbohydrates/starches, sweets, and fast food fats, and creates a total score. The sample of the study consists of 621 individuals between the ages of 19­50 who voluntarily agree to participate in an online survey. This study revealed that FCI-TR is a valid instrument of specific food cravings in the Turkish adult population. Turkish version of the FCI also consist of 4 sub-factors. Women experienced more food craving for sweets than men. While the most craved food by women was chocolate, men scored significantly higher on bread than women. In addition, a relationship was found between food craving and body weight.

Transitioning of protein substitutes in patients with phenylketonuria: evaluation of current practice.

BACKGROUND: In children with phenylketonuria (PKU), transitioning protein substitutes at the appropriate developmental age is essential to help with their long-term acceptance and ease of administration. We assessed the parental experiences in transitioning from a second stage to third stage liquid or powdered protein substitute in patients with PKU. RESULTS: Sixteen interviews (23 open-ended questions) were carried out with parents/caregivers of children with PKU (8 females, 50%) with a median age of 8 years (range 5-11 years), continuously treated with diet, and on a third stage protein substitute. Parents/caregivers identified common facilitators and barriers during the third stage protein substitute transition process. The main facilitators were: child and parent motivation, parent knowledge of the transition process, a role model with PKU, low volume and easy preparation of the third stage protein substitute (liquid/powder), anticipation of increasing child independence, lower parent workload, attractive packaging, better taste and smell, school and teacher support, dietetic plans and guidance, PKU social events, child educational materials and written resources. The main barriers were child aversion to new protein substitutes, poor child behaviour, child aged > 5 years, parental fear of change, the necessity for  parental time and persistence, loss of parental control, high product volume, different taste, smell, and texture of new protein substitutes, and peer bullying. CONCLUSION: A stepwise, supportive approach is necessary when transitioning from second to third stage protein substitutes in PKU. Future studies are needed to develop guidance to assist parents/caregivers, health professionals, and teachers during the transition process.

The Effect of Bigorexia Nervosa on Eating Attitudes and Physical Activity: A Study on University Students.

Purpose: This study aims to examine the relationship between physical activity, eating attitude, and bigorexia nervosa among university students. Method: A questionnaire form consisting of sociodemographic characteristics, eating habits, the Eating Attitude Scale (EAT-40), the International Physical Activity Questionnaire (IPAQ), and the Muscle Appearance Satisfaction Scale (MASS) was conducted on undergraduate students at Üsküdar University. Results: There were 1006 students who participated in this study with a mean age of 22.58 ± 2.87 years. The median "muscle appearance satisfaction" score of the obese students was statistically higher than the normal weight and underweight students. The median score for "Obesity Anxiety" was statistically higher in underweight students than in obese ones. A one-unit increase in IPAQ scores was related to an elevation of 24.9% in the MASS and a decrease of 17.9% in the EAT-40 scores, while a one-unit increase in MASS scores was related to a reduction of 12.5% in the EAT-40 scores. Conclusion: Eating attitude is associated with bigorexia nervosa, and as MASS scores increase, EAT-40 scores decrease and as IPAQ scores increase, and EAT-40 scores decrease. In other words, as physical activity increases, muscle strength satisfaction elevates, and in parallel with this increase, a positive eating attitude improves.

Physical Growth of Patients with Hereditary Tyrosinaemia Type I: A Single-Centre Retrospective Study.

In a retrospective review, we aimed to assess long-term growth in 17 patients (n = 11 males) with hereditary tyrosinaemia type I (HTI). Median age at assessment was 15.6 years (5.7-26.6 years) and median age at diagnosis was 1 month (range: 0-16 months), with 35% (n = 6/17) symptomatic on presentation. From the age of 8 years, there was a noticeable change in median height, weight, and body-mass-index [BMI]-z-scores. Median height-for-age z-scores were consistently ≤ -1 (IQR -1.6, -0.5) during the first 8 years of life but increased with age. Weight-for-age z-scores ranged between -1 to 0 (IQR -1.2, 0.1) in the first 8 years; then increased to > 0.5 (IQR -0.3, 1.3) by age 16 years, and BMI-for-age z-scores ranged from 0 to 1 (IQR -0.7, 1.3) up to 8 years, and >1 (IQR -0.2, 1.9) until 16 years. The percentage of overweight and obesity was lowest in children aged < 5 years, and consistently > 40% in patients aged between 7 to 16 years. The prescribed total protein intake was associated with improved height growth (p < 0.01). Impaired growth in early life improved with age achieving normal population standards. Further studies are needed to investigate factors that influence growth outcome in HTI patients.

Relationship between eating disorders and internet and smartphone addiction in college students.

PURPOSE: This study was planned and conducted to determine the relation between eating behavior disorder and smartphones and the internet in college students. METHODS: This research was performed on a total of 437 college students, including 116 males and 321 females. A questionnaire questioning the general characteristics (age, sex, department, socioeconomic status, skipping meal, number of main meals and snacks in a day, sleeping duration, doing physical activity, height, and body weight) of students was used. In addition, Eating Attitude Test-40 (EAT-40), Young's Internet Addiction Scale, and Smartphone Addiction Scale were used to measure eating behavior disorders, internet addiction, and smartphone addiction, respectively. Height and body weight were measured in accordance with the method. RESULTS: 12.6% of the students participating in the study were at risk for eating disorders. Female students had higher EAT-40 scores than male students. 13% of students had potential internet addiction. According to Pearson chi-square test, the prevalence of potential internet addiction (36.4%) in students with eating disorder was higher than those without eating disorder (9.7%) (p < 0.05). Pearson correlation analyses displayed that Smartphone Addiction Test score associated positively with EAT-40 score (r = 0.277) and Internet Addiction Test score (r = 0.665) and students' body mass index (BMI) (r = 0.121). In addition to these, students' duration of staying on the internet correlated with their BMI (r = 0.137). Males had a higher rate of potential internet addiction than females (22.4% in males and 9.7% in females, respectively) (p < 0.05). CONCLUSION: The present results suggest that students' duration of using the internet affects smartphone addiction and internet addiction, both of which influence eating behavior disorder. In addition, both smartphone and internet addiction and eating behavior disorder correlated positively and significantly with overweight. LEVEL OF EVIDENCE: Level V: cross-sectional descriptive study.

Is there prejudice against obese persons among health professionals? A sample of student nurses and registered nurses.

PURPOSE: The aim of this study was to assess whether there is prejudice toward obese persons among student nurses and registered nurses. DESIGN AND METHOD: A total of 379 participants were included (190 student nurses, 189 registered nurses). The Fat Phobia Scale and Belief About Obese Persons Scale were used to determine the prejudice. FINDINGS: Registered nurses were found to have more negative prejudices toward obese persons than those of student nurses. These prejudices were determined to be influenced by the nurses' body mass index and having an obese person in the family. PRACTICAL IMPLICATIONS: Both groups had negative prejudices toward obese persons, there was a higher level of prejudice among the registered nurses. These prejudices can have a negative impact on healthcare practices.

Associations between Poor Sleep Quality, Obesity, and the Anthropometric Measurements of Women in Turkey.

Recent studies have shown that poor sleep quality is significantly associated with obesity. The aim of this study is to examine the association of sleep quality with obesity and specific anthropometric measurements. A total of 105 women aged 20-55 years with no chronic diseases participated in this study. They filled out the Pittsburgh Sleep Quality Index (PSQI), their anthropometric measurements were taken, and their dietary data were collected with a food frequency questionnaire (FFQ). There was no significant relationship between sleep quality and BMI, waist circumference, triceps skinfold thicknesses, body fat ratio (%), and body fat mass (p > .05), but high bread consumption was significantly associated with poor sleep quality (p < .05). The women with poor sleep quality consumed significantly more bread, but not other foods, than the women with good sleep quality. Sleep quality can thus be related to eating habits.

Determination of Dietary Status as a Risk Factor of Cardiovascular Heart Disease in Turkish Elderly People.

This study was performed to determine the status of diet as a risk factor of cardiovascular heart disease in a group of Turkish elderly people. We performed a cross-sectional study using the data of voluntary participants aged between 65-74 years old. Participants completed 3-day diet records. Of participants, 64.1% of the men and 62.2% of the women reported their daily dietary fat intake as being > 30% of total energy (p > .05). More than 20% of these elderly respondents' daily intakes of vitamin E, vitamin B6, vitamin B12, and folate were found to be under the recommended values. As a result, the total fat intake of these elderly people was found to be high; while their intake of fiber and vitamin B6, vitamin B12 were found to be low, compared to American Heart Association recommendations. In conclusion, it is recommended that developing sufficient and balanced diets may decrease cardiovascular risk factors.