Evaluation of Healthy Eating Index and Children's Diet Inflammatory Index according to asthma severity group.

BACKGROUND: Diet may contribute to better asthma control in children by impacting the immune and inflammatory pathophysiology. Therefore, this study aimed to investigate differences in nutrient intake, Children's Dietary Inflammatory Index (C-DII), and dietary quality according to asthma severity. MATERIALS AND METHODS: Asthma severity, dietary inflammatory status, and diet quality were assessed in a sample of 202 children with asthma (55.6% males, aged 5-18 years) attending a pediatric allergy outpatient clinic. Asthma severity was evaluated according to the Global Initiative for Asthma criteria and categorized as mild, moderate, or severe. The Children's Dietary Inflammatory Index (C-DII) and Healthy Eating Index (HEI-2010) were calculated based on information collected by the 24-h dietary recall method. Dietary quality was categorized as poor, moderate, or good diet according to HEI-2010. RESULTS: The mean age of the participants was 9.6 ± 3.2 years. Children with severe asthma were younger on average (p < 0.05). Children with mild asthma had significantly higher fiber and iron intake than those with moderate asthma (p < 0.05). C-DII values did not differ significantly according to asthma severity (p > 0.05). Dietary quality was evaluated as moderate in 89.1% of the participants and also showed no difference based on asthma severity. CONCLUSIONS: These findings suggest that inflammatory status and diet quality may not affect asthma severity in children, highlighting the influence of various genetic and environmental factors on the association between diet and asthma severity. More comprehensive and longitudinal studies are needed to investigate the mechanisms linking diet and asthma.

Validity and reliability of Turkish version of the Adult Eating Behaviour Questionnaire for adult participants.

OBJECTIVE: The aim of this study is to assess the validity and reliability of the Adult Eating Behaviour Questionnaire (AEBQ-TR) for adults. DESIGN: Hunot et al. (2016) developed the original questionnaire, which was modified and translated into Turkish. On data collected from adults, construct validity was assessed using exploratory factor analysis and confirmatory factor analysis. Pearson's and Cronbach's correlation coefficients were used to evaluate reliability and validity (P < 0·05). SETTING: This research was carried out in Ankara, Turkey. PARTICIPANTS: A total of 311 adults from Ankara (148 men and 163 women) took part in the study. Seventy-two of these adults take the retest. RESULTS: In the present study, 311 adults with a mean age of 29·3 ± 11·3 years participated. Factor loadings ranged from 0·404 to 0·907. In general, food approach and food avoidance scales showed a positive correlation within themselves. According to the results of confirmatory factor analysis and goodness-of-fit indicators, the seven-factor model showed a better model fit in the Turkish data (chi-square/degrees of freedom = 2·137, root mean error of approximation: 0·061, comparative fit index: 0·884, and normed fit index: 0·850). Higher BMI was associated with higher Emotional Over-eating, higher Enjoyment of the Food, lower Food Satiety and lower Emotional Under-eating. CONCLUSIONS: The Turkish AEBQ is a valid and reliable tool for 20- to 65-year adults to determine appetitive properties related to the aetiology of weight change and especially obesity risk. Besides, AEBQ testing is required for validation in early and late adulthood.

Nutritional literacy levels of university academic and administrative staff: A cross-sectional study from Turkey.

AIM: This study aimed to evaluate the nutritional literacy levels of university academic and administrative staff. METHODS: Data were collected with a questionnaire including sociodemographic variables, some eating habits, and the Nutritional Literacy Assessment Tool of Adults. A total of 413 individuals, 211 women (51.1%) and 202 men (48.9%), aged 23-64 (mean: 37.41 ± 10.04 years), were included in the study. The data obtained were evaluated with the SPSS 25.0 statistical package program. RESULTS: It was found that the nutritional literacy level of 18.15% of the participants is at the borderline, 81.85 are sufficient. Women's nutrition literacy scores are significantly higher than men's (p = 0.034). A significant relationship was found between nutritional literacy, socioeconomic status, and some eating habits (p < 0.05). The average daily water consumption of individuals with sufficient nutritional literacy is statistically significantly higher than those with borderline nutritional literacy (p < 0.001). It was determined that individuals with borderline nutritional literacy skipped meals more frequently (p < 0.05). CONCLUSION: The present study suggests that nutritional literacy may be effective in developing healthy eating behaviors. The study's results can guide the determination of methods that will improve nutritional literacy and increase awareness in the future.

Inflammation level in type 2 diabetes is associated with dietary advanced glycation end products, Mediterranean diet adherence and oxidative balance score: A pathway analysis.

AIMS: The aim of this study was to evaluate the effects of dietary advanced glycation end products (dAGE) intake, Mediterranean diet adherence screener (MEDAS), and oxidative balance score (OBS) on inflammation among individuals with type 2 diabetes. METHODS: The study was conducted with 96 adults (aged between 32 and 64 years) with type 2 diabetes. The average daily dAGE intakes, energy and macronutrient intakes of the participants were taken with the three-day food consumption recording method. OBS and MEDAS score was used. At the same time, routine blood lipids, HbA1c, fasting blood glucose and inflammation marker C-reactive protein (CRP) were measured. RESULTS: Dietary AGE intake was associated with fasting blood glucose, HbA1c, CRP and blood pressures (p < 0.01). The relationship between OBS and dAGE intake was significant (ß = -0.36; 95 % Cl = -0.500, -0.220; p < 0.001). MEDAS has a negative and statistically significant effect on dAGE intake (ß = -0.56; 95 % Cl = -0.696, -0.444; p < 0.001). There was a significant and positive effect of dAGE on CRP when other variables (MEDAS, OBS) affecting dAGE were also included in the analysis (ß = 0.79; 95 % CI = 0.664, 0.917; p < 0.001). CONCLUSIONS: Our findings may have important implications for explaining the development of inflammation in type 2 diabetes patients with high dAGE intake.

Vitamin D Deficiency During the First Trimester of Pregnancy and the Risk of Developing Gestational Diabetes Mellitus.

OBJECTIVE: To investigate the relationships among various factors that affect serum vitamin D levels and vitamin D in the first trimester and the risk of developing gestational diabetes mellitus (GDM). DESIGN: A prospective cohort design. SETTING: The family health center of Ankara, Turkey. PARTICIPANTS: Out of 889 pregnant women who participated in the study in the first trimester (6-13 weeks gestation), 814 participated in GDM screening in the second trimester (24-28 weeks gestation). METHODS: We determined serum vitamin D levels, demographic data, various biochemical and anthropometric parameters, and factors that affect vitamin D synthesis of participants in the first trimester and used logistic regression analysis to analyze the effects of the associations among vitamin D deficiency and the other variables on the occurrence of GDM. RESULTS: Vitamin D deficiency in the first trimester was present in 425 (82.5%) participants. In the second trimester, 198 participants (24.3%) were diagnosed with GDM through oral glucose tolerance test screening. We detected GDM in the second trimester in 5.7% of participants who had vitamin D deficiency in the first trimester. Even after adjustment for vitamin D intake, clothing style, and duration of exposure to the sun, the risk of GDM was significantly greater in participants who were vitamin D deficient than those who were not deficient. The risk of GDM among women with vitamin D deficiency was sustained or increased significantly after we adjusted for age, parity, prepregnancy body mass index, history of diabetes, triglyceride levels, vitamin D intake, clothing style, and length of sun exposure, OR = 10.60, p < .001, 95% confidence interval [2.82, 39.76]. CONCLUSIONS: Our results suggest that vitamin D deficiency in the first trimester may significantly increase the risk of developing GDM.

The effect of orthorexia nervosa on food label reading habits among university students.

PURPOSE: This observational cross-sectional study aimed to evaluate university students' food label reading habits with and without orthorexia nervosa (ON) tendency. METHODS: Data were collected online with a questionnaire. The questionnaire form included sociodemographic variables, the ORTO-11 scale, the reading frequency of some components on the food label, and the evaluation of some opinions about the food label. The obtained data were evaluated with SPSS 25.0 statistical package program and GraphPad Prism program. RESULTS: A total of 674 university students (mean age: 21.03 ± 2.43 years), 537 women (79.7%) and 137 men (20.3%) were included in the study. It was determined that individuals with ON tendency read some nutrients, content information, serving size, health information, instructions for use, additives and brand more frequently compared to individuals without ON tendency (p < 0.05). At the same time, it was determined that individuals with ON tendency were more likely to agree with the idea that reading food labels is important for a healthy diet, compared to individuals with normal eating behavior (p < 0.001). CONCLUSION: The study findings show that individuals with ON tendency have a higher habits of reading food labels compared to individuals with normal eating behavior. To reach a decision on this issue and to determine the diagnostic criteria for ON, future studies should be conducted on different groups and samples with higher participation, as well as studies using different screening tools to determine the tendency for ON. LEVEL OF EVIDENCE: V, Cross-sectional descriptive study.

Is high adaptation to the Mediterranean diet effective in increasing ecological footprint awareness? A cross-sectional study from Turkey.

BACKGROUND: The effect of diet type on sustainable environment is known. It is important to understand the adaptation of individuals with high ecological footprint awareness to the Mediterranean type diet, especially under the assumption that the Mediterranean diet will reduce the ecological footprint. In the study, it is aimed to examine the relationship between the level of adherence to the Mediterranean diet and Ecological Footprint awareness of adults. RESULTS: The sample of the study consisted of 395 individuals with a mean age of 26.2 ± 8.7 years: 293 females (74.2%) and 102 males (25.8%). As the Mediterranean Diet Adherence Scale (MDAS) score of individuals increased, the Ecological Footprint Awareness Scale score also increased. Similarly, a positive correlation was found between the participants' MDAS score and the awareness of food (r = 0.157; P = 0.002), energy (r = 0.133; P = 0.008), waste (r = 0.149; P = 0.003) and water consumption (r = 0.101; P = 0.045), which are sub-factors of the Ecological Footprint Awareness Scale. CONCLUSION: As far as is known, this cross-sectional study is one of the first studies on compliance with the Mediterranean diet and awareness of the ecological footprint. The findings of the study show that as individuals' compliance with the Mediterranean diet increases, their awareness of their ecological footprint will also increase. To reach a conclusion on this issue, future studies should evaluate the relationship between adherence to the Mediterranean diet and awareness of food-environmental impact on different samples. © 2021 Society of Chemical Industry.

Effects of black tea consumption and caffeine intake on depression risk in black tea consumers.

BACKGROUND: The aim of this study was to compare black tea consumption and caffeine intake with depression status. SUBJECTS AND METHODS: This study was conducted on 491 adults (M:169, F:322). The average daily caffeine intake of individuals was calculated using the amounts of caffeinated beverages they consumed daily and the caffeine contents of these beverages. The participants' depression status was determined using the Beck Depression Inventory (BDI). All of the research data were evaluated using STATA. RESULTS: According to BDI scores, 30.1% of participants had depression. Black tea was consumed by all of the participants and also had the highest consumption level of 620.1±90.4mL and the mean caffeine intake of the participants was 629.5±418.8 mg. Multivariate regression analyses showed that consuming more than 1 cup was protective against depression up to 4 cups. Moreover, a 450-600 mg caffeine intake also reduces the risk of depression than lower or higher intake levels. CONCLUSION: Our study suggests that black tea consumption up to 4 cups and caffeine intake between 450-600 mg can help protect against depression. Further studies are needed to better understand the protective effects of black tea and caffeine on depression.

Compliance of mothers' breastfeeding and complementary feeding practices with WHO recommendations in Turkey.

BACKGROUND/OBJECTIVES: This study aimed to evaluate how breastfeeding and complementary nutrition practices of mothers of 0-24-month-old children comply with the World Health Organization (WHO) recommendations for infant and young child feeding and to compare the results with selected demographic parameters related to the mother and child. SUBJECTS/METHODS: The research sample comprised mothers (n = 250) with children less than 2 years old. Data were obtained via questionnaire and were analyzed using SPSS 20.0 package program. The Pearson χ2 or Fisher's exact tests were used for assessing relationships between categorical variables. The one-sample t-test was used for comparisons with reference values. RESULTS: Most mothers (97.2%) breastfed their babies immediately after birth. The mean time to breastfeeding after delivery was 47.8 ± 14.8 minutes, and 40.8% of the mothers complied with the WHO recommendation. Furthermore, 59.8% of the mothers exclusively breastfed their children for 6 months (mean 5.2 ± 1.5 months). The mean duration to the start of providing complementary food was 5.8 ± 0.6 months, and 76.1% of mothers who complied with the WHO recommendation. Only 12.3% of mothers breastfed their children for at least 12 months (mean 7.7 ± 3.3 months). On average, mothers gave cow milk to their children for the first time at 10.1 ± 1.7 months and honey at 11.8 ± 2.3 months. The mothers' rates of compliance with the WHO recommendations on cow milk and honey feeding were 32.0% and 71.6%, respectively. The rate of mothers who complied with the WHO minimum meal frequency recommendation was 88.3%. CONCLUSIONS: We suggest that the WHO recommendations on this subject will be realized more fully by emphasizing the importance of the positive effects of breastfeeding until the age of 2 years and of a timely start of complementary food provision. Such changes will affect child health over the long term.

Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems?

Autism spectrum disorder [ASD] is characterized by deficits in communication and social interactions combined with repetitive and restricted patterns of behaviors. Bidirectional changes in brain-gut microbiota are known to be responsible for the pathophysiology of many brain-related disorders, such as autism, as well as well-known gastrointestinal diseases, including gut disorders. Imbalance in the composition of gut microbiota is frequently observed in individuals with ASD. It is therefore believed that this imbalance is significant in the frequent occurrence of gastrointestinal symptoms. The integrity of the intestinal barrier and the blood-brain barrier [BBB] in individuals with ASD is affected. Incompletely digested peptides, toxins, and proinflammatory cytokines cross the BBB by entering the bloodstream and reach the central nervous system. As a result of the accumulation of these elements, brain function is adversely affected. It is hypothesized that incompletely digested peptides acting as opioid agonists reduce pain sensitivity and increase the severity of autism-specific behaviors. However, it is not known exactly how opioid peptides trigger ASD symptoms after they reach the brain. Diet therapies, especially elimination diets, are considered to be an alternative treatment to prevent this condition. Gluten-free casein-free [GFCF] diet is an elimination diet that involves the removal of certain proteins from the normal diet, such as gluten and casein. However, studies that demonstrate the beneficial effects of the GFCF diet on ASD patients and explain its mechanism is limited, which supports the opioid theory. This review aims to investigate the gastrointestinal and behavioral problems that are frequently observed in ASD, the possible action mechanisms of GFCF diets, and the efficacy of these elimination diets.

Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study.

Objectives Metabolic syndrome (MS) is a fatal endocrinopathy that begins with insulin resistance (IR) and causes abdominal obesity, glucose intolerance, or systemic disorders. This study was aimed to determine the cut-off values for the triglyceride (TG)/high-density lipoprotein cholesterol (TG/HDL-C) ratio, the TG glucose (TyG) index and homeostasis model assessment (HOMA-IR) for the diagnosis of MS in obese adolescents, and to compare which of the three indexes would offer a more accurate approach to diagnosis. Methods The study population comprised 1,171 obese adolescents (639 females and 532 males aged 10-16 years, Body Mass Index (BMI)>=95th percentile). Indirect measures of IR screening for MS were the TG/HDL ratio, TyG index, and HOMA-IR. The cut-off values of the TG/HDL ratio, TyG index, and HOMA-IR were obtained from receiver operation characteristic (ROC) curves. Results HOMA-IR had a significant positive correlation with the TyG index (r=0.352, p<0.001) and TG/HDL-C (r=0.291, p<.001). The TyG index and TG/HDL-C showed a strong positive correlation (r=0.901, p<0.001). The TG/HDL-C ratio showed a larger ROC Area under Curve (AUC=0.849) than HOMA-IR index (AUC=0.689), but as a predictor similar to TyG index (AUC=0.833) when screening for MS. The cut-off values for MS were as follows: TG/HDL-C ratio>2.16 (sensitivity: 88.8%; specificity: 49.7%), TyG index>8.50 (sensitivity: 85.6%; specificity: 57.0%) and HOMA-IR>2.52 (sensitivity: 83.2%; specificity: 40.4%). Conclusions Both the TyG index and TG/HDL-C ratio are better markers than HOMA-IR to determine the risk of metabolic syndrome according to IDF criteria. Besides, the TyG index and TG/HDL-C ratio have similar differentiating powers to determine this risk in obese Turkish adolescents.

Relationship between dietary caffeine intake and blood pressure in adults.

The aim of this study was to determine the consumption frequency of caffeinated foods and beverages and daily caffeine consumption amounts, and examine relation between caffeine and blood pressure (BP). A cross sectional door-to-door interview was conducted with 1329 volunteers between the ages of 20 and 60 (mean ages 29.9 ± 10.8 years) and based in Ankara/Turkey. The rate of individuals whose BPs were above 140/90 mmHg was 13.5%. The median caffeine consumption was 150.0 ± 122.06 mg. Although no significant correlation was found between total caffeine intake and diastolic blood pressure (DBP) of individuals, a positive correlation was observed between daily total caffeine and systolic blood pressure (SBP) (p < .05). Also, when analyzed factors that could be associated with DBP and SBP, BMI had effect in the model formed for both types of BP (p < .05). While smoking status associated with SBP (p = .002), gender and waist circumference related to DBP (p < .05) As a result relationship between caffeine intake and BP was affected other factors.

Beneficial Effect of the Nutritional Support in Children Who Underwent Hematopoietic Stem Cell Transplant.

OBJECTIVES: The aim of this study was to evaluate nutritional status in children who underwent hematopoietic stem cell transplant compared with a healthy control group. A secondary aim was to utilize mid-upper arm circumference as a measure of nutritional status in these groups of children. MATERIALS AND METHODS: Our study group included 40 children (18 girls, 22 boys) with mean age of 9.2 ± 4.6 years (range, 2-17 y) who underwent hematopoietic stem cell transplant. Our control group consisted of 20 healthy children (9 girls, 11 boys). The children were evaluated at admission to the hospital and followed regularly 3, 6, 9, and 12 months after discharge from the hospital. RESULTS: In the study group, 27 of 40 patients (67.5%) received nutritional support during hematopoietic stem cell transplant, with 15 patients (56%) receiving enteral nutrition, 6 (22%) receiving total parenteral nutrition, and 6 (22%) receiving enteral and total parenteral nutrition. Chronic malnutrition rate in the study group was 47.5% on admission to the hospital, with the control group having a rate of 20%. One year after transplant, the rate decreased to 20% in the study group and 5% in the control group. The mid-upper arm circumference was lower in children in the study group versus the control group at the beginning of the study (P < .05). However, there were no significant differences in mid-upper arm circumference measurements between groups at follow-up examinations (P > .05). During follow-up, all anthropometric measurements increased significantly in both groups. CONCLUSIONS: Monitoring nutritional status and initiating appropriate nutritional support improved the success of hematopoietic stem cell transplant and provided a more comfortable process during the transplant period. Furthermore, mid-upper arm circumference is a more sensitive, useful, and safer parameter that can be used to measure nutritional status of children who undergo hematopoietic stem cell transplant.