Illuminating insights: Exploring the effect of 16/8 intermittent fasting on serum cytokine levels in overweight adults.

BACKGROUND: The immune system's pivotal role extends to numerous diseases, and maintaining a balance between dietary and consumed energy is vital for preventing chronic illnesses and increasing life expectancy. Intermittent fasting (IF), a dietary approach typically implemented through time restrictions, exerts positive effects on the immune system and shows promising outcomes in managing various diseases. OBJECTIVES: To evaluate the effectiveness of IF on the immune system with a wide cytokine panel. MATERIAL AND METHODS: A total of 21 volunteers with body mass index (BMI) between 25 and 30 were included in the study. Fasting was applied for 16 h in a day to the volunteers, and they were free to consume food for the rest of the day. The weight, BMI, interleukin (IL)-1ß, interferon (IFN)-α2, IFN-γ, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 values were measured using flow cytometry and compared before and after 21 days follow-up. RESULTS: The mean age of study participants was 37.76 ±8.06 years and weight loss of the volunteers was 3.35 percentile compared to the values obtained before fasting. The pro-inflammatory cytokines decreased, while anti-inflammatory cytokines increased after fasting; there was a significant difference in TNF-α, MCP-1, IL-6, IL-8, and IL-33 values. Also, IL-1ß, IL-8 and IL-12p70 had moderately positive, IL-33 had strongly negative, and IL-10 had moderately negative correlation with the BMI change over time. CONCLUSIONS: Intermittent fasting has positive effects on obesity-induced inflammation and promotes decrease in proinflammatory cytokines and increase in IL-33 values, which is known to have a protective effect on fat-associated inflammation.

Psychometric properties and factor structure of the diabetes eating problem survey- revised (DEPS-R) among adults with type 1 diabetes mellitus.

BACKGROUND AND OBJECTIVE: Although many studies on the Diabetes Eating Problem Survey-Revised (DEPS-R) in adolescents with type 1 diabetes mellitus (T1D), the number of studies validating this questionnaire in adults with T1D is limited. Therefore, this study aimed to examine the factor structure of the Turkish version of the DEPS-R in adults with T1D and internal consistency and construct validity. METHODS: A total of 100 patients with T1D, ages 18-50 years, completed the DEPS-R and EDE-Q. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 6-item Turkish version of DEPS-R. RESULTS: The Cronbach's alpha coefficient of the DEPS-R Turkish version was 0.77, suggesting good internal consistency. The median (IQ) DEPS-R score was 15.0 (13.0) among all participants. DEPS-R score was significantly correlated with BMI (r = 0.210; p < 0.05) and EDE-Q (r = 0.586; p < 0.01). There was no correlation between the HbA1c values of participants and neither EDE-Q nor DEPS-R scores. The confirmatory factor analysis results show that the three-factor model was a good fit. CONCLUSION: A short, self-administered diabetes-specific screening tool for disordered eating behavior is recommended be used routinely in the clinical care of adults with T1D, and Turkish version of DEPS-R has acceptable internal consistency and construct validity in adults with T1D. LEVEL OF EVIDENCE: Level V, descriptive study. CLINICALTRIALS: gov registration number NCT05346679/ 21.04.2022 (retrospectively registered).

Electrochemical skin conductances values and clinical factors affecting sudomotor dysfunction in patients with prediabetes, type 1 diabetes, and type 2 diabetes: A single center experience.

BACKGROUND AND AIM: Sudomotor dysfunction is linked to small fibers damage. We investigated sudomotor dysfunction in a large group of participants with diabetes, prediabetes, and nondiabetic healthy subjects. This study aimed to complete knowledge on sudomotor dysfunction in this population, especially regarding the threshold values for the electrochemical skin conductance (ESC) and factors affecting it. MATERIALS AND METHODS: A total of 690 volunteers in four groups were included in the study (type 1 [T1DG]: n = 80, 61.3% women; type 2 diabetes [T2DG]: n = 438, 63.5% women; prediabetes [Pre-DG]: n = 88, 80.7% women; healthy control [HC-G]: n = 84, 67.5% women). All subjects were investigated for clinical diabetic peripheral polyneuropathy and sudomotor dysfunction. The characteristics of participants obtained from outpatient records were evaluated. We used the Sudoscan device to measure ESC which was normalized for BMI, to improve the discriminative capability of the method. RESULTS: Diabetic polyneuropathy was found in 17.5% of T1DG, 27.4% of T1DG, and 10.2% of Pre-DG. The mean ESC/BMI was lower in subgroups with diabetic polyneuropathy than those without. Mean ESC/BMI was lowest in T2DG and highest in HC-G but comparable in T1DG and Pre-DG. We accepted the "mean ESC/BMI-1 SD" in the HC-G as the threshold for sudomotor dysfunction. Accordingly, the prevalence of sudomotor dysfunction was 18.8%, 44.3%, 59.1%, and 15% in T1DG, T2DG, Pre-DG, and HC-G, respectively. In T2DG, sudomotor dysfunction was found in 66.7% of persons with retinopathy, of which 56.3% had clinical diabetic polyneuropathy. The prevalence of sudomotor dysfunction in subjects with peripheral artery disease, chronic kidney disease, cardiovascular disease, and hypertension was 46.7%, 47.4%, 43.4%, and 50%, respectively, and 42.9%, 38.9%, 45.5%, and 37.3% of whom in the same order detected with clinical diabetic polyneuropathy. Considering the entire group, a logistic regression model demonstrated that the variables associated with SMD were: retinopathy (OR: 2.969; 95% CI: 1.723, 5.114), female gender (OR: 1.952; 95% CI: 1.287, 2.962), and e-GFR (OR: 0.989; 95% CI: 0.981, 0.998). Since the rate of complications was very low in T1DG, excluding this group, a new model similarly revealed that retinopathy and female gender were associated with SMD, however, the association with e-GFR was disappeared. CONCLUSION: The prevalence of sudomotor dysfunction is high when established peripheral polyneuropathy was present in diabetes. Even though, sudomotor dysfunction can also occur before clinical polyneuropathy in both types of diabetes (T1DG: 18.8%, T2DG 44.3%), prediabetes (59.1%), and nondiabetic healthy subjects (15%). The variables associated with sudomotor dysfunction were retinopathy and female sex. Normalization of ESC for BMI would be a beneficial approach. However, before this method is included in the routine screening programs for diabetic polyneuropathy, large-scale and prospective studies are required to reach a consensus on the pathological threshold values.

Telemedicine as a Motivational Tool to Optimize Metabolic Control in Patients with Diabetes in Turkey: A Prospective, Randomized, Controlled TeleDiab Trial.

Introduction: Telemedicine is a follow-up system that can improve the quality of management and cost-effectiveness of rapidly increasing diabetes patients. Methods: Two hundred adult patients with diabetes were enrolled in this prospective, randomized study. Consecutive patients were divided equally into two groups. Both groups received routine care visits quarterly. TeleDiab group also sent self-monitoring of blood glucose data and received short message service over the transmission system for 12 months. After the study was completed, all patients continued their routine care visits, and their data were evaluated for another 12 months. Six years after the initial study, patients were contacted by phone during the Covid-19 lockdown, and their status was assessed. Results: At the end of the study, glycemic control, kidney function, and lipid parameters of the TeleDiab group were statistically significantly better than the Usual Care group. There was no significant change in the weights of the patients. It was observed that this state of wellbeing continued both at the end of the second year and during the Covid-19 lockdown. Individuals with type 2 diabetes were found to benefit more from telemedicine. Discussion: It has been beneficial to guide patients with applications such as TeleDiab in diseases such as diabetes that require lifelong follow-up. On the other hand, the importance of telemedicine programs in the management of chronic diseases in the current pandemic conditions has come to the fore even more. Telemedicine is an effective motivational tool to ensure optimal control not only of glycemic but also of kidney and lipid parameters.

Evaluation of Osmaniye Korkut Ata University Students’ Eating Behaviors During the Quarantine Period during the COVID-19 Pandemic Period

Introduction: This study was conducted in order to evaluate the effects of stress on eating behavior in cases of uncertainty experienced during the COVID-19 quarantine period. Methods: Three hundred-eighty-six university students participated in the study. Demographic (age, gender) data, anthropometric (body weight, height) measurements and the faculty of education information were recorded. The Dutch Eating Behavior Questionnaire (DEBQ) was used to evaluatethe eating behaviors of the participants. The body weight (BW), body mass index (BMI), body weight gain and DEBQ score of the participants before and after the quarantine applied during the COVID-19 pandemic period were recorded and compared. Results: In the study, 203 (52.6%) of the participants were women, 183 (47.4%) were men; The average age was21.9 ± 1.7 years. A significant increase was observed in the BW and BMI of the participants in the post-quarantine period compared to pre-quarantine period (p=0.00). During the quarantine period, a significant increase was found in the mean scores of the three subscales of DEBQ, “Restricted, Emotional and External eating”, compared to the pre-quarantine averages (p=0.00). Discussion: The act of eating is the simplest and the most important need for survival, which is maintained from birth to death. When the majority of individuals feel under stress, they tend to change their eating behavior, furthermore, there is evidence that an estimated 80% of the people change their calorie intake by increasing or decreasing their food consumption. Conclusions: Stress-related eating behavior change, triggers the formation of repetitive stress as it may negatively affect the health of the individual. Realizing and accepting the situation in the earliest possible time makes it easy to cope with this period both physically and psychologically. (AU)

May Nesfatin-1 be a Biomarker in Acute Mesenteric Ischemia?

OBJECTIVE: To investigate the diagnostic value of nesfatin-1 in cases of intestinal ischemia and ischemia/reperfusion. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Experimental Animals Laboratory of Bezmialem University, in June 2018. METHODOLOGY: Twenty-one healthy male Sprague Dawley rats were randomly divided into three groups of 7 rats each. In group 1: 1-hour intestinal ischemia followed by 5-hour reperfusion was performed. In group 2: rats were subjected to 6-hour intestinal ischemia. In group 3: rats underwent laparotomy and closure without performing any further procedure. Changes in leukocyte count, amylase, blood sugar, LDH, SGOT, CRP, and nesfatin-1 levels were determined. For histopathological examination, a small intestinal sample was taken and preserved in 10% formaldehyde. RESULTS: Nesfatin-1 value in group 2 was significantly higher than that in group 1 and group 3 (p=0.005, and p <0.001 respectively). Nesfatin-1 value in group 1 was significantly higher than that in group 3. A significant (r = 0.864/p <0.001) positive correlation was observed between nesfatin-1 value and pathology score. The pathology score of group 2 was significantly higher than that of group 1 and group 3 (p <0.001). CONCLUSION: Serum nesfatin-1 can be a biomarker in acute mesenteric ischemia.

The Role of Nutrition in Women with Benign Cyclic Mastalgia: A Case-Control Study.

OBJECTIVE: Smoking, caffeine, oral contraception, and exercise are the most cited factors for premenstrual mastalgia in the literature, but remain controversial. In this study, we aimed to investigate the most often proposed nutritional factors for cyclic breast pain. MATERIALS AND METHODS: Patients who met the criteria for participation in the mastalgia or control group were included in this case-control study. The age, body mass index, educational status, duration of breast pain, visual analog scale (VAS) pain score (0 to 10), number of births, use of oral contraception, exercise habits, drinking coffee, tea, alcohol and water, smoking history, and eating fast food and dessert were examined using a questionnaire. RESULTS: The mean age of mastalgia (n=256) and control (n=200) patients were 35.9±11.0 and 36.6±10.6 years, respectively. In the mastalgia group, the mean duration of cyclic breast pain time was 22.8±33.0 months and mean the VAS score 4.0±2.1. Body mass index and the mean number of births were higher in the mastalgia group than control group (p<0.005). There were no differences in smoking, oral contraceptive use, and drinking alcohol and tea (p>0.005). Compared to the mastalgia group, the control group ate more fast food and desserts, drank more water and coffee, and exercised less (p<0.005). CONCLUSION: The causes of mastalgia remain controversial. Our data supports some of the published studies, but not others. We propose that nutritional factors contribute less to the risk of mastalgia than is generally thought.