Is Obesity Associated with Lower Mini Mental Test Scores among Elderly? A Cross Sectional Study.

OBJECTIVES: Obesity leads to many chronic diseases and its association with cognitive impairment is controversial. The objective was to investigate the association between obesity, anthropometric measurements and cognitive functions of elderly. METHODS: Planned cross-sectionally, community-dwelling Cypriots (aged ≥ 50 years) without any neurological disorders, were included. Cognitive impairment evaluated by Mini Mental State Examination (MMSE) was the dependent variable. Socio-demographic variables, anthropometric measurements and obesity were the independent variables. The data was collected via face-to-face interview. Logistic regression models were constituted to determine the association of anthropometric measurements, obesity and dementia. RESULTS: The mean age of participants (n = 541) was 60.0 ± 8.7 for women (n = 377) and 61.5 ± 6.0 years for men (n = 164). According to MMSE, 26.0% of women and 11.0% of men had mild-dementia, and the rest scored normal. After adjusted for age and sex, each unit increase in BMI (OR: 1.045, 95%CI: 1.008-1.091), Waist to height ratio (WHtR; OR: 1.030, 95%CI: 1.006-1.055) and Mid upper arm circumference (MUAC; OR: 1.077, 95%CI: 1.016-1.141) increases the risk of mild-dementia. When education, employment and smoking were included in the models, significance of anthropometric measurements was diminished and only sex and education were remained significant for all. CONCLUSION: After controlled for age and sex, increment in anthropometric measurements increased the risk of dementia but when education was taken into consideration, this significant association was diminished showing that sex and education is more predominant in a heterogeneous group in means of education. Thus, for heterogeneous groups it might be better to revise MMSE. To determine the association between obesity and dementia cohort studies with longer follow-up duration with larger samples are needed.

Efficacy of krill oil versus fish oil on obesity-related parameters and lipid gene expression in rats: randomized controlled study.

BACKROUND: This study aimed to determine the effects of LC n-3 PUFA supplementation on the prevention and treatment of obesity and obesity-related diseases, and to compare the efficiency of different LC n-3 PUFA sources via biochemical and genetic mechanisms in rats. METHODS: Male Wistar rats were randomized into four study groups, and fed with a standard diet, High Fat Diet (HFD), HFD+%2.5 Fish Oil (FO-HFD) or HFD+%2.5 Krill Oil (KO-HFD) for eight weeks. Food consumption, weight gain, serum glucose, insulin, ghrelin and leptin concentrations, lipid profile, liver fatty acid composition, and FADS1 and FADS2 mRNA gene expression levels were measured. RESULTS: Weight gain in each HFD group was significantly higher than control group (p < 0.001), without any differences among them (p < 0.05). LC n-3 PUFAs modified lipid profile, but not glucose tolerance. Serum leptin levels were significantly higher in HFD groups than in the control group, however, no difference in serum ghrelin levels was observed among the groups. Liver n-3 fatty acid desaturation activity was higher (p = 0.74), and liver total lipid content was lower (p = 0.86) in KO-HFD compared to FO-HFD. FADS1 gene expression was highest in the HFD group (p < 0.001) while FADS2 gene expression was highest in the FO-HFD group (p < 0.001). CONCLUSION: LC n-3 PUFAs, especially krill oil, had moderate effects on lipid profile, but limited effects on obesity related parameters, suggesting different effects of different sources on gene expression levels. Further randomized controlled trials are needed to determine the efficacy of different LC n-3 PUFA sources in the prevention and treatment of obesity in humans.

The Nutrition and Health Communication Education Program and For Accurate Science Project of Sabri Ülker Foundation: Initiatives from Turkey.

In recent decades interest in food and health issues has not ceased to increase globally. Consumers typically obtain information on issues related to food, nutrition, and health via a wide variety of media channels, including TV, radio, newspapers, internet, and social media. Unfortunately, the messages that reach consumers through these different channels can be conflicting, inaccurate, or confusing. The "For Accurate Science Platform" of the Sabri Ülker Food Research Foundation aims to disseminate current and reliable information to the public about health and nutrition. Since 2017, the Sabri Ülker Food Research Foundation has also organized a 2-day education program, entitled the "Nutrition and Health Education Program," with the aim of educating and providing a better understanding of nutrition science and science communication to participants from the media and influencers who are interested in area of nutrition and health. This program is also accredited by the Society of Nutrition and Food Science (SNFS) as an international nutrition communication training program. This year the theme of the program was "Popular Diets: Health Effects and Effective Communication." Popular diets is one of the most frequent topics in nutrition communication, sought by millions of people, and where the available information is not always evidence based. A recent meta-analysis by the British Medical Journal on the role of food in weight management found that no dietary method has been shown to achieve superior results in terms of long-term weight maintenance. Many popular diets limit food groups and/or nutrients to achieve faster results. However, these limitations might cause vitamin and mineral deficiencies and lead to hidden hunger in the short and long term. Thus, inaccurate and non-scientific news about popular diets can negatively affect the worldwide burden of hidden hunger.

Turkish version of the Yale Food Addiction Scale: preliminary results of factorial structure, reliability, and construct validity.

BACKGROUND: Yale Food Addiction Scale (YFAS) was established to identify individuals exhibiting signs of addiction towards certain types of food. This study aimed to develop a Turkish version of the Yale Food Addiction Scale and test its psychometric properties. METHODS: The backward translation techniques were used to develop Turkish versions of the YFAS, and its reproducibility was assessed. Turkish version of the YFAS was administered to a total of 1033 participants (439 men and 594 women), aged 19-65 years. Exploratory factor analysis and confirmatory factor analysis were used to examine the factorial structure of the tool. Construct validity was assessed by principal component factor analysis with varimax rotation. Reliabilities were estimated with Cronbach's alpha coefficient. The criterion-related validity was tested by the administration of Eating Attitude Test-26 (EAT-26) to all participants. RESULTS: The primary factor loadings for seven items were ranged between 0.45 and 0.79, and no items cross-loaded onto other factors. The fit indices showed that eight items of the YFAS were a good representation of the item responses and each item loaded significantly on the specified factor (p < 0.001 for each). YFAS subscales had a high internal consistency and test-retest reliability. The criterion-related validity of the tool showed a positive relationship with scales of the EAT-26. CONCLUSION: Current study suggested that the Turkish version of the YFAS is a reliable, valid, and useful tool for assessing the signs of food addiction in a non-clinical sample.

Promoting a Healthy Diet in Young Adults: The Role of Nutrition Labelling.

The use of the nutrition facts label has been associated with healthy eating behaviors for adults. However, the relationship between nutrition facts label use and overall diet quality is not well known in young adults, a vulnerable group that acquire lifelong eating behaviors during this period of life. This study aimed to assess if the use of information on the nutrition facts label is associated with a higher diet quality in young adults. In this cross-sectional study, 958 university students aged 18⁻34 years were recruited. Nutrition facts label use was recorded. Dietary intake was assessed using 24-h dietary recall. Healthy Eating Index-2005 (HEI-2005) scores were calculated. HEI-2005 score was significantly associated with using nutrition facts label (p < 0.001). The mean total HEI-2005 score was 60.7 ± 10.11, 62.4 ± 11.43 and 67.1 ± 12.23 respectively for never, sometimes and everytime users of nutrition facts label (p < 0.001). Sub-group scores of HEI-2005 for total fruits, whole fruits, total vegetables, whole grains, milk, oils, saturated fat, and calories from solid fat, alcohol and added sugar (SoFAAS) were significantly higher in regular nutrition facts label users (p < 0.05, for each). This study showed that young adults who regularly use the nutrition facts label have a higher diet quality.

How does food addiction influence dietary intake profile?

This study aimed to investigate whether there was any difference in eating pattern, abnormal eating behaviour, obesity and the number of food addiction symptoms according to food addiction presence. A total sample of 851 healthy subjects living in Ankara (n = 360 male, n = 491 female) aged 19-65 years were included in this cross-sectional survey. Data on demographic information, 24-hour dietary recalls, Yale Food Addiction Scale (YFAS), Eating Attitudes Test-26 (EAT-26), and anthropometric measurements were collected through face-to-face interviews. Overall, 11.4% of participants were identified as "food addicted" (F: 13.0%; M: 9.2%). Subjects meeting criteria for 'food addiction' had higher body mass index (35.1% were obese and 3.1% were underweight), compared to subjects without food addiction (13.1% were obese and 10.2% were underweight) (p<0.05). Abnormal eating attitudes estimated with EAT-26 were determined as 45.5% in males, 37.5% in females and 40.2% in total, among subjects with food addiction. Daily energy, protein and fat intakes were significantly higher in food addicted females, compared to non-addicted females (p<0.05). Participants with food addiction reported significantly more problems with foods, which contain high amounts of fat and sugar, compared to the participants without food addiction. Food addiction behaviour should be considered as a part of efforts towards reducing food related problems involving obesity.

Dietary intake of patients with moderate to severe COPD in relation to fat-free mass index: a cross-sectional study.

BACKGROUND: Fat-free mass (FFM) depletion has been shown to be a better predictor of mortality than BMI in chronic obstructive pulmonary disease (COPD) patients. The specific aim of the current study was to assess the nutritional status of stable COPD patients in relation to fat free mass index profiles. METHODS: We investigated 65 male moderate-to-severe stable COPD patients. A self-reported questionnaire was applied about general characteristics and smoking history. Nutritional intake was assessed by using a 54-item quantitative food frequency questionnaire. Weight, height, mid-upper arm circumference (MUAC), waist circumference (WC), handgrip strength and body composition measurements were taken by a trained dietitian. The data were analyzed with SPSS 15.0 software. RESULTS: The mean age of the patients was 62.1 ± 8.9 years. Among all of the patients 13.8% was underweight (BMI < 21 kg/m(2)) and 18.5% had a low fat-free mass index (FFMI < 16 kg/m(2)). The percentages of the patients who did not meet the daily recommended intakes (RNI) were highest for magnesium (93.8%) and calcium (92.3%). Mean daily consumptions of milk-yogurt, red meat and fruits were significantly low in the low FFMI group compared to normal FFMI group (for all; p < 0.05). Patients with normal FFMI had significantly higher weight, height, WC, MUAC, handgrip strength, fat and fat-free mass than the patients with low FFMI (for all; p < 0.05). CONCLUSIONS: Dieticians should be aware of COPD patients with low FFMI in order to evaluate the nutritional intake and therefore plan nutritional strategies to improve prognosis of the disease.

Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation.

BACKGROUND: Increased levels of reactive oxygen species during and after surgery may affect inflammatory response, post-operative adhesion molecule formation, and hemodynamic stability. The glutathione redox cycle is an important regulator in oxidative stress and its reduced forms scavenge free radicals. N-acetyl cysteine, a precursor of reduced glutathione, is considered as a potentially therapeutic wide spectrum agent in clinical practice. We therefore examined whether N-acetyl cysteine improves some biochemical parameters in cancer patients undergoing major abdominal surgery. METHODS: Thirty-three patients diagnosed with pancreas, stomach, rectum, colon malignancies, and undergoing major abdominal surgery at Ankara Numune Training and Research Hospital were randomly divided into two groups; control (CON) and N-acetyl cysteine (NAC). The NAC group had 1,200 mg N-acetyl cysteine starting two days before the operation day, in addition to isonitrogenous and isocaloric total parenteral nutrition of 1.2 g/kg protein, 25 kcal/kg, and 60:40 carbohydrate/fat ratio. Blood and urine samples were drawn two days before the operation, on operation day, and on the first, third, and fifth days post-operation. RESULTS: Plasma malondialdehyde was significantly lower in the NAC group (P < 0.001). N-acetyl cysteine treatment did not affect plasma levels of vitamin A, C or E. The NAC group exhibited a higher ratio of reduced glutathione to oxidised glutathione (P = 0.019). Urinary nitrate level was also significantly lower in the NAC group (P = 0.016). CONCLUSION: The study demonstrated the clinical importance of N-acetyl cysteine supplementation on antioxidant parameters in abdominal surgery patients. In these patients N-acetyl cysteine and vitamin administration can be considered as an effective method for improvement of oxidative status.

The cholesterol lowering efficacy of plant stanol ester yoghurt in a Turkish population: a double-blind, placebo-controlled trial.

BACKGROUND: We evaluated the cholesterol lowering efficacy of low-fat spoonable yoghurt with 1.9 g/d plant stanols as esters on plasma lipid profiles of Turkish subjects with mild to moderate hypercholesterolemia. METHODS: Using a randomised, double-blind, placebo-controlled study design, intervention (n = 35) and control (n = 35) groups consumed either 115 g low-fat yoghurt with 1.9 g/d plant stanols as esters or placebo yoghurt, respectively, for 4 weeks. Seventy subjects with untreated mild to moderate hypercholesterolemia (aged 23-65 years) were recruited. Changes in the lipid profile, including lipoproteins, apolipoproteins, and triglycerides, and anthropometric measurements were monitored at screening, baseline, and at the end of the second, third, and fourth weeks of intervention. The general linear model repeated measures procedure was used to test differences in the repeated continuous variables between study groups. RESULTS: Serum total cholesterol (4.6%), LDL cholesterol (6.3%), and non-HDL cholesterol (6.2%) concentrations were reduced significantly from baseline in the plant stanol group compared to the control group (p = 0.007, p = 0.005 and p = 0.005, respectively). A variation in the response of serum total and LDL cholesterol between the subjects in plant stanol group was obtained. No clinically significant change in anthropometrical measurements was observed during the intervention. CONCLUSIONS: The spoonable low-fat yoghurt with 1.9 g/d plant stanols as esters lowered total, LDL, and non-HDL cholesterol levels in Turkish subjects with mild to moderate hypercholesterolemia. Nevertheless variation in baseline cholesterol levels, genetic predisposition of the subjects and compliance may contribute to a large individual variability.

Consumer understanding and use of food and nutrition labeling in Turkey.

OBJECTIVES: To determine patterns of food and nutrition labels use by Turkish consumers, and examine constraints on the use of this information. DESIGN: Cross-sectional survey. SETTING: Twenty-six regions of Turkey. PARTICIPANTS: Consumers (n = 1,536), aged 12-56 years. VARIABLES MEASURED: Level of interest in food and nutrition labels, the perceived sources of information about nutrition, the performance of the food industry at labeling, and sociodemographic factors. ANALYSIS: Descriptive statistics and χ(2) statistics. RESULTS: The uses of food labels and nutrition labels were reported, respectively, by 76.5% and 72.4% of participants. Nutrition label use was significantly associated with sex, age, marital status, educational level, and socioeconomic status (P < .001 for all variables). Barriers to the use of nutrition labels included: the lack of understanding of terms, symbols, and values; poor presentation of the information; and concerns about the accuracy of the information. Consumers who wished to use nutrition labels to make healthful choices demanded a standardized location and format for the labels, as well as simplified information conveyed with comprehensible terms and statements. CONCLUSIONS AND IMPLICATIONS: New strategies to encourage the effective consumer use of food and nutrition labels should include educational programs and revision of the label format.

Serum antioxidant vitamin levels in patients with coronary heart disease.

The aim of this study was to investigate anthropometric measurements, body composition, and serum antioxidant vitamin levels in men with coronary heart disease (CHD). Thirty-five men with CHD and 31 men without CHD, aged 40 - 65 years, were included this study. Dietary records and anthropometric measurements of each participant were recorded by researchers and serum antioxidant vitamin levels and lipid profiles were analyzed. Fat mass (FM) and the percentage of fat mass (FM%) in men with CHD was higher than in men without CHD (p < 0.05). Lipid profiles were found to be similar in both groups, with the exception of high-density lipoprotein cholesterol (HDL-C). Men with CHD had lower HDL-C levels than men without CHD (p < 0.05). When the antioxidant vitamin intake of participants was investigated, vitamin E intake in men without CHD was found to be less than in men with CHD (p < 0.05). However, serum vitamin A, vitamin E, and vitamin C levels in men with CHD were found to be lower than in men without CHD (p < 0.05). Based on the results of this study, we propose that high FM, low HDL-C, and low serum antioxidant vitamin levels could be important risk factors for CHD.

Lipoprotein oxidation, plasma total antioxidant capacity and homocysteine level in patients with multiple sclerosis.

Free radical-mediated peroxidation of biological molecules, especially of lipids, is implicated in the pathogenesis of a number of diseases like multiple sclerosis. Low concentration of antioxidant vitamins: beta carotene, retinol, alpha tocopherol and ascorbic acid have been observed in serum or cerebrospinal fluid of multiple sclerosis patients. On the basis of these observations, we studied the potential lipoprotein oxidation and total antioxidant capacity in the pathogenesis of multiple sclerosis. Lipoprotein oxidizability for plasma in vitro, serum levels of autoantibodies against oxidized low-density lipoproteins, plasma total homocysteine levels with vitamin B12 and folate, and plasma total antioxidant capacity were measured in twenty four patients with multiple sclerosis and twenty four healthy sex- and age-matched person as control. In multiple sclerosis patients during an attack, a significant increase in both in vitro lipid oxidizability for plasma and in the levels of autoantibodies against oxidized low-density lipoproteins, and a strong decrease in plasma total antioxidant capacity were detected. Plasma total homocysteine levels were significantly higher in multiple sclerosis patients whose plasma vitamin B12 and folate levels were lower but not statistically significant, than controls. The present study indicates that lipoprotein oxidation may be important factor in the course of multiple sclerosis and in vitro measurements of plasma oxidation kinetics as an indication for lipoprotein oxidation might be useful as an additional tool for the clinical diagnosis of multiple sclerosis.

Serum levels of antioxidant vitamins and lipid peroxidation in multiple sclerosis.

We determined serum levels of ascorbic acid, betacarotene, retinol and alpha tocopherol and lipid peroxidation (as estimated by thiobarbituric acid reacting substances (TBARS) generation) in 24 multiple sclerosis (MS) patients and 24 healthy sex- and age-matched person as control. The levels of four antioxidant vitamins were significantly lower in MS patients compared to controls (p < 0.05). TBARS levels were significantly higher in the patients of MS compared to the controls (p = 0.001). In MS patients, the levels of beta-carotene, alpha tocopherol and ascorbic acid correlated significantly with each other (r2 = 0.689 - 0.779). It appeared that there was inverse correlation between the serum levels of ascorbic acid or beta-carotene, but not of alpha tocopherol or retinol, and TBARS levels in MS. The present study indicates that antioxidant vitamins (alpha tocopherol, beta-carotene, retinol and ascorbic acid) are decreased in sera of MS patients during an attack, and that this decrease may well be dependent on the increased oxidative burden as reflected by lipid peroxidation products. The role of antioxidant vitamin supplementation in prevention and/or treatment of MS remains to be explored.