Evaluation of the relationship between the Mediterranean diet adherence and sleep quality in adults.

PURPOSE: To investigate the association between Mediterranean diet adherence (MDA) and sleep quality in adults. METHODS: This cross-sectional research was conducted among adults aged 19-64 years in Ankara, Türkiye. Data on demographics, education, lifestyle, and physical activity habits were collected. Mediterranean diet adherence was assessed with the Mediterranean Diet Adherence Screener (MEDAS). Healthy eating attitudes were evaluated with the Attitude Scale for Healthy Nutrition (ASHN). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Data were gathered using an online format. RESULTS: Among 1031 participants enrolled (74% women), mean age was 28.6 ± 8.3 years. Median age increased with MDA (p = 0.001). As individuals' MDA increased, ASHN total and subgroup scores also increased significantly (p < 0.001). The total sleep duration of the participants with low MDA was significantly lower than the other groups (p = 0.003). Pittsburgh Sleep Quality Index score and MEDAS (ß = - 0.222, p < 0.001), ASHN (ß = - 0.043, p < 0.001) and ASHN subgroups (ß = (- 0.086) - (- 0.031)) were found to have a weakly signficant negative relation. CONCLUSIONS: The findings suggest that healthy eating attitudes and nutritional behavior in accordance with the Mediterranean diet are associated with sleep quality.

Frequently Asked Questions and Evidence-Based Answers on Medical Nutritional Therapy in Children with Type 1 Diabetes for Health Care Professionals

Medical nutrition therapy is a cornerstone in type 1 diabetes management and is based on the principles of healthy eating. The recommendations presented are valid for all children and their families. A number of frequently asked questions will be addressed in this article. Although carbohydrates are the main nutrient that affects postprandial blood glucose in individuals with type 1 diabetes, intake of carbohydrates (type and amount), protein and fat content of the meal, and glycemic index affect the postprandial glycemic response. In recent years, the relative increase in studies about Ramadan fasting for individuals with type 1 diabetes has indicated that health professionals should be informed about this issue. The difficulties in nutritional management of preschool children should be solved with a professional approach. The increasing frequency of celiac disease in people with type 1 diabetes and an increasing interest in a gluten-free diet for non-celiac reasons (popular diet trends for weight loss or healthy eating) further complicate diabetes management. This review provides evidence-based approaches to frequently encountered problems on medical nutrition therapy in children and adolescents with type 1 diabetes.

Effect of emotional eating and social media on nutritional behavior and obesity in university students who were receiving distance education due to the COVID-19 pandemic.

Aim: This study aimed to evaluate the effects of emotional eating and social media on nutritional behavior and obesity in university students receiving distance education during the pandemic. Subject and methods: This cross-sectional study was performed with 1000 undergraduate students who were receiving distance education due to COVID-19 in Türkiye. Data were collected using an online questionnaire that included demographic information, height, body weight, eating habits, the Scale of Effects of Social Media on Eating Behavior (SESMEB), and the Emotional Eating Scale (EES). A p value less than 0.05 was considered as statistically significant for statistical tests. Results: During the distance education period, more than half of both male and female students (61.7%; 58.2%) changed their meal pattern, 31.7% of them started to consume their main meals more regularly, and 31.2% of them began to skip their main meals. Of the participants, 52.6% spent more than 2 hours a day on social media. The female students who spend more than 2 hours a day on social media have higher SESMEB and EES scores than those who spend 2 hours or less a day (p < 0.01). The score SESMEB is positively weakly correlated with body mass index (BMI) (rho 0.132, p < 0.01) and positively moderately associated with the EES score (rho 0.334, p < 0.01). The interaction between the SESMEB and EES scores increases the risk of overweight/obesity (odds ratio (OR) 1.002, p = 0.009). Conclusion: For the students who received distance education, social media affects eating behavior, BMI, and emotional eating. Additionally, these effects may increase the risk of overweight/obesity.

Effect of saccharin, a non-nutritive sweeteners, on insulin and blood glucose levels in healthy young men: A crossover trial.

BACKGROUND AND AIMS: Artificial sweeteners used instead of sugar were considered as the best alternatives that have no endocrine effects. However, it has recently been suggested that artificial sweeteners may cause impaired metabolic parameters. The hypothesis of the study was there is an association between acute saccharin consumption and both glycemia and insulin response in young healthy adult men. METHODS: 9 healthy adult males were included in this study. This study randomly provided participants with preloads as (a)300 ml of water, or 300 ml of water sweetened with (b)75 g of sucrose, (c)240 mg of saccharine (adjusted to the sweetness of 75 g of sucrose) 1 h before a standard breakfast. RESULTS: Compared to mean blood glucose and serum insulin after test drinks consumption, there was only one difference between sucrose and saccharin trials in the 15th minute (117.0 ± 18.70, 95.4 ± 5.64 mg/dl respectively, p < 0.05). At the 60th minute, insulin secretion (0.80 ± 0.27 pg/dl) after the sucrose trial was found significantly higher than the saccharin trial (0.53 ± 0.09 pg/dl) and water (0.49 ± 0.06 pg/dl) (p < 0.05). Although at all intervals (except 90th minute), the mean insulin is higher after the saccharin trial compared to the water trial, these were non-statistically significant differences (p > 0.05). CONCLUSIONS: Consequently, it was determined that saccharin had no glycemic effect. However, for the effect on serum insulin to be clarified, the long-term effects should be investigated.

Recommendations for Clinical Decision-making in Children with Type 1 Diabetes and Celiac Disease: Type 1 Diabetes and Celiac Disease Joint Working Group Report

It is well-known that in children with type 1 diabetes (T1D), the frequency of Celiac disease (CD) is increased due to mechanisms which are not fully elucidated but include autoimmune injury as well as shared genetic predisposition. Although histopathologic examination is the gold standard for diagnosis, avoiding unnecessary endoscopy is crucial. Therefore, for both clinicians and patients' families, the diagnosis of CD remains challenging. In light of this, a joint working group, the Type 1 Diabetes and Celiac Disease Joint Working Group, was convened, with the aim of reporting institutional data and reviewing current international guidelines, in order to provide a framework for clinicians. Several controversial issues were discussed: For CD screening in children with T1D, regardless of age, it is recommended to measure tissue transglutaminase-immunoglobulin A (tTG-IgA) and/or endomysial-IgA antibody due to their high sensitivity and specificity. However, the decision-making process based on tTG-IgA titer in children with T1D is still debated, since tTG-IgA titers may fluctuate in children with T1D. Moreover, seronegativity may occur spontaneously. The authors' own data showed that most of the cases who have biopsy-proven CD had tTG-IgA levels 7-10 times above the upper limit. The decision for endoscopy based solely on tTG-IgA levels should be avoided, except in cases where tTG-IgA levels are seven times and above the upper limit. A closer collaboration should be built between divisions of pediatric endocrinology and gastroenterology in terms of screening, diagnosis and follow-up of children with T1D and suspicious CD.

Children's Power of Food Scale: Turkish validity and reliability study.

OBJECTIVE: The aim of the present study was to validate the Turkish version of the Children's Power of Food Scale (C-PFS-T) after translation of the original version. DESIGN: The data were collected via face-to-face interviews using the C-PFS-T and a socio-demographic information form. BMI was calculated by dividing body weight by the square of the height. After the adaptation of the scale to Turkish language, validity and reliability analysis were conducted for the C-PFS-T. SETTING: Gülhane Training and Research Hospital Department of Child Health and Diseases Nutrition and Diet Unit in Ankara. PARTICIPANTS: This research was conducted with volunteer children and adolescents between the ages of 9 and 16 years (n 268). RESULTS: It was concluded that the 15-item C-PFS-T was collected under three factors as in the original version of the child version. Cronbach's α coefficient was found to be 0·878 for the scale. The confirmatory factor analysis results showed the acceptability and applicability of adapting the version of the C-PFS-T in terms of χ2/df (= 3·816), adjusted goodness-of-fit index (AGFI = 0·931), root mean square error of approximation (RMSEA = 0·082) and goodness-of-fit index (GFI = 0·852) fit indices. C-PFS-T total score's median value of obese group wasn't substantially different from normal weight group.Conclusions:It was concluded that the Turkish version of the C-PFS, which provides an assessment of the hedonic hunger status of children and adolescents with fifteen items and threesubdimensions, has sufficient reliability and validity to be applied to these subjects.

Development of the scale of effects of social media on eating behaviour: a study of validity and reliability.

OBJECTIVES: The aim of the current study is to develop a valid and reliable instrument with psychometric qualities to measure effect of social media usage on eating behaviour in university students. DESIGN: A thirty-eight-item draft scale developed by the researchers. After content validity, twenty-two items are remained and was used to collect the data. In the analysis of the data, confirmatory factor analyses were performed to test construct validity. For the reliability of the scale, Cronbach alpha coefficient was calculated for the whole of the scale. SETTING: The participants attended from various departments of different universities in Ankara. PARTICIPANTS: The scale was administered to the study group consisting of 247 university students. RESULTS: Four items that had total correlation value less than 0·40 were removed from scale. The reliability coefficient of the whole eighteen-item scale was found to be 0·928. CONCLUSIONS: It has been shown that the scale developed as a result of the validity and reliability analyses performed for the scale is a valid and reliable measurement tool and can be used in studies.

Investigating the nutritional value of foods targeting children.

PURPOSE: This study aimed to investigate the nutritional values of some low-nutrition packaged foods widely sold in supermarkets and encouraged for consumption. METHODS: The study used 435 packaged foods from six hypermarkets with high sale capacities in Ankara to analyze their contents of energy/total fat/saturated fat/carbohydrate/sugar/salt based on label information. RESULTS: Among the products in the scope of the study, the highest values were found in chocolates for fat (33.0 ± 4.28/100 g) and sugar (45.6 ± 5.95/100 g), wafers for saturated fat (19.2 ± 3.89/100 g), and crackers for sodium (0.9 ± 0.23/100 g). Among the 435 packaged foods investigated in the study, the products exceeded the limits designated in the health codes declared by the Turkish Food Codex Labeling Directive in 83.4% of the instances in terms of sugar, 93.7% of the instances in terms of total fat, 92.4% of the instances in terms of saturated fat, and 70.3% of the instances in terms of sodium. CONCLUSION: Energy/fat/sugar/salt contents were high in the packaged products that are especially targeted for children for higher consumption. Children's frequent and excessive consumption of these products contribute to the prevalence of childhood obesity and increase in related health risks. LEVEL OF EVIDENCE: Level V, descriptive study.

A new insight into food addiction in childhood obesity.

Uncontrolled eating behavior in obese subjects is very similar to behavior in food addiction, suggesting a relationship. This study was designed to evaluate the relationship between childhood obesity and food addiction and to determine the frequency of food addiction among obese children and adolescents. The study included 100 overweight and obese children. Food addiction was evaluated by the Yale Food Addiction Scale (YFAS). The cutoff value for food addiction was defined as the presence of 3 or more symptoms. Participants were between 10 and 18 years of age; 63% were girls. Of the participants, 71% had food addiction. The most addictive foods were chocolate, ice cream, carbonated beverages, French fries, white bread, rice, candy, chips and pasta, in decreasing order of frequency. Experiencing a frequent feeling of hunger was associated with a 2.2-fold increase in food addiction risk, while consumption of French fries ≥1-2 times per week was associated with a 2.3-fold increase in risk (p<0.05). The high YFAS scores in obese and overweight adolescents suggest that food addiction plays an important role in childhood obesity. Evaluation of food addiction in more detail may open a new perspective on the prevention and treatment of obesity.

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.

No relationship between vitamin D status and insulin resistance in a group of high school students.

OBJECTIVE: To investigate the effects of vitamin D deficiency on both insulin resistance and risk of metabolic syndrome in children. METHODS: The study group consisted of 301 children and adolescents with a mean age of 14.2 ± 1.8 years. Serum 25-hydroxyvitamin D [25(OH)D] levels and insulin resistance indices were evaluated. According to serum 25(OH)D levels, the subjects were classified in 3 groups. Those with levels ≤ 10 ng/mL were labeled as the vitamin D deficient group (group A), those with levels of 10-20 ng/mL as the vitamin D insufficient group (group B) and those with ≥ 20 ng/mL as having normal vitamin D levels (group C). Metabolic syndrome was defined according to the International Diabetes Federation consensus. The participants with and without metabolic syndrome were compared in terms of 25(OH)D levels. RESULTS: Mean 25(OH)D level of the total group was 18.2 ± 9.3 (2.8-72.0) ng/mL. Distribution of individuals according to their vitamin D levels showed that 11.6% were in group A, 53.5% in group B, and 34.9% in group C. The proportions of boys and girls in these categories were 22.9% and 77.1% in group A, 36.6% and 63.4% in group B, 54.3% and 45.7% in group C, respectively. There were no significant differences in 25(OH)D levels in the individuals with and without impaired fasting glucose or impaired glucose tolerance. No relationship was observed between insulin resistance/sensitivity indices and vitamin D status (p > 0.05). Metabolic syndrome was diagnosed in 12.3% (n = 37) of the children. There was also no difference in mean 25(OH)D levels between individuals who had and those who did not have the metabolic syndrome. CONCLUSION: In our study, no correlations were found between insulin measurements during oral glucose tolerance test and vitamin D deficiency. Nonetheless, more extended studies including vitamin D supplementation and evaluating insulin sensitivity via clamp technique are needed to further elucidate this relationship.