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Abstract Diabetic retinopathy is a commonly observed cause of blindness and is a common problem in individuals with diabetes. Recent investigations have showed the capability of serum α-Klotho and FGF 23 in mitigating the effects of diabetic retinopathy. This study aimed to discover the correlation between FGF 23, α-Klotho, and diabetic retinopathy in type 1 diabetics. This case–control study included 63 diabetic patients and 66 healthy controls. Following an overnight duration of fasting, morning blood samples were taken from both the patient and the control groups. The serum concentrations of α-Klotho and FGF 23 were quantified. An experienced ophthalmologist inspected the retinopathy. All participants in this study have moderate non-proliferative retinopathy. A p value under 0.05 was considered statistically significant. The mean α-Klotho level for retinopathic diabetic patients was 501.7 ± 172.2 pg/mL and 579.6 ± 312.1 pg/mL for non-retinopathic diabetic patients. In comparison, α-Klotho level of the control group was 523.2 ± 265.4 pg/mL (p = 0.531). The mean of FGF 23 level did not demonstrate a significant difference (p = 0.259). The mean FGF 23 level were 75.7 ± 14.0 pg/mL, 74.0 ± 14.8 pg/mL and 79.3 ± 14.4 pg/mL in groups, respectively. In conclusion, there was no significant difference in FGF 23 and α-Klotho levels between type 1 diabetics with and without retinopathy when compared to the control group.

Diabetes is a major risk factor for cardiovascular disease. Despite recommendations and available therapeutic options, patients with diabetes do not always reach the recommended lipid levels. In this study, our aim was to compare the real world lipid profile of type 2 diabetes patients with guideline recommendations for dyslipidemia. Four hundred and sixty eight consecutive patients referred to Outpatient Diabetes Clinic of Istanbul Medeniyet University were recruited. Patient anthropometric measurements (height, weight, waist circumference), biochemical test results (LDL cholesterol (LDL-c), triglycerides, HDL cholesterol, HbA1c) and treatment modalities were recorded. Patients were stratified into cardiovascular risk categories according to the risk factors and their treatment dose was compared to the recommendations. Among 468 patients, 56 (12%) patients had coronary heart disease (CHD). Thirty-four percent of these patients were not on statin treatment (n=19) and their mean LDL-c level was 114±29 mg/dL (2.9±0.75 mmol/L). Nineteen percent of these patients were on high intensity statin treatment (atorvastatin 40-80 mg, rosuvastatin 20 mg). Only four patients with CHD had LDL-c levels

Objective: This study aims to evaluate the nutritional status of patients with stage 3 and 4 diabetic nephropathy (DN; DN-3 and DN-4) and to explain the effect of DN stages on the prognosis of protein-energy wasting (PEW)., Methods: Data from demographic characteristics, anthropometric measurements, biochemical findings, food consumption records, and the Subjective Global Assessment (SGA) screening tool of 49 patients (25 DN-3; 24 DN-4) who were followed at the nephrology department were collected. The criteria of the International Society of Renal Nutrition and Metabolism (ISRNM) were used to determine PEW., Results: 56% of DN-3 and 66.7% of DN-4 have been diagnosed with diabetes for over 15 years. The groups differed in total body weight, body-muscle weight, creatinine, microalbuminuria, and eGFR values (p<0.05). Protein (g/kg) intake was only different between the groups (p<0.05). 18.4% of patients had SGA-B score, and 26.5% had PEW., Conclusion: Our study provides a general impression about the presence of PEW in DN patients not receiving dialysis in Turkiye. In patients with DN-3 and DN-4, daily energy and macronutrient intakes are adequate by recommendation. According to ISRNM criteria, the prevalence of PEW increased with advancing disease stage. PEW was observed to be more effective than SGA in assessing malnutrition., Competing Interests: No conflict of interest was declared by the authors.

Given the increasing popularity of CrossFit ® as a high-intensity functional training program and the potential benefits of citrulline malate (CM) in enhancing exercise performance through its role as a precursor to L-arginine and nitric oxide production, this study aimed to investigate the acute effects of CM supplementation on CrossFit ® performance and cardiovascular function. Using a randomized, double-blind, placebo-controlled, cross-over design, 21 recreationally active participants (mean age 22.2 ± 2.6 years, mean body weight 75.9 ± 10.4 kg) with CrossFit ® experience completed the "Cindy" workout under CM and placebo conditions. Participants consumed 4.4 g of CM or a placebo 60 min before the workout, and the performance was measured by the number of rounds completed. Secondary outcomes included heart rate response, time spent in different heart rate intensity zones, and post-exercise recovery time. The results indicated no significant difference in the number of rounds completed between the CM and placebo conditions (13.5 ± 5.2 vs. 13.8 ± 6.7 rounds, respectively; p = 0.587). However, the time spent in zone 4 (80-90% of HR max) was significantly increased in the CM condition (527 ± 395 s vs. 453 ± 334 s; p = 0.017), suggesting a potential benefit for aerobic capacity and anaerobic threshold. No significant differences in post-exercise recovery time were observed (6.6 ± 4.7 h vs. 6.9 ± 4.7 h; p = 0.475). This study highlights the need for further research with larger sample sizes, both genders, and different CM dosages to clarify these findings and better understand CM's role in enhancing athletic performance.

Objective  Obstructive sleep apnea syndrome (OSAS) is characterized by episodic cessations of breathing due to upper airway obstruction during sleep, which may cause disturbances in dietary patterns resulting from appetite-related hormonal changes. The aim of the present study was to investigate the relationship between OSAS and nutritional and dietary patterns. Materials and Methods  A total of 20 female and 53 male OSAS patients aged > 30 years were enrolled. Demographic data, as well as data on smoking and alcohol habits, were noted, anthropometric measures were made, and a questionnaire regarding chronic diseases including OSAS and four questionnaires on recent food intake frequency and content of nutrition were filled out. The content of nutrition was noted under seven categories: meat, legumes, milk and dairy products, fruits and vegetables, bread and cereals, fat and carbohydrates, and beverages. Results  The severity of OSAS (assessed by the apnea-hypopnea index. AHI) was positively correlated with the body mass index (BMI), the circumferences of the waist, chest, and buttocks, and, in males, with the circumference of the neck as well. There was no correlation between the AHI and nutritional habits in terms of the frequency of meals or snacks, the scores on the Snoring, Tiredness, Observed Apnea, and High Blood Pressure-Body Mass Index, Age, Neck Circumference, and Gender (STOP-BANG) Questionnaire and the corresponding macro- and micronutrients. Worsening apnea scores led to increased intake of macronutrients of carbohydrate and protein and micronutrients of niacin and pyridoxine ( p  < 0.05), and decreased intake of fat ( p  < 0.05). Conclusion  The present study demonstrated an association between OSAS severity and recent food intake, manifested in increased intake of carbohydrates, niacin, and pyridoxine, and decreased fat intake., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Ethnopharmacological Relevance: Cornus mas L. (Cornelian cherry, CM) fruits have been utilized for decades in numerous European and Asian countries as traditional cuisine and folk medicine. CM has antioxidant, anti-diabetic, anti-inflammatory, anti-obesity, and hypolipidemic activities due to its rich bioactive compounds, and CM fruits and other parts have been used for the prevention and treatment of a diverse variety of diseases in folk medicine. Obesity, insulin resistance, and inflammation are strongly associated with metabolic-associated fatty liver disease (MAFLD), therefore, CM may be hope for MAFLD patients., Aim of the Study: The study aimed to evaluate the effect of lyophilized CM fruit powder with/without diet therapy on biochemical parameters and anthropometric measurements in patients with MAFLD., Materials and Methods: This randomized clinical trial was conducted on 87 patients with MAFLD and 21 healthy individuals. Patients were randomly assigned into 4 groups: group-1 receiving 30 g/d lyophilized CM fruit powder plus diet therapy, group-2 receiving only diet therapy, group-3 receiving only 30 g/d lyophilized CM fruit powder, and group-4 had not undertaken any pharmacological treatment and diet therapy or lyophilized CM fruit powder for 8 weeks. Biochemical parameters, and anthropometric measurements at baseline and after the intervention were taken., Results: After 8 weeks of intervention, a significant decrease in body weight, body mass index, body fat mass, waist and hip circumferences, fasting blood glucose, insulin, hbA1c, liver enzymes, total triglycerides, low-density lipoprotein, total cholesterol were found in group-1, 2 and 3., Conclusion: Lyophilized CM fruit powder in addition to diet therapy and only diet therapy had a positive and similar effect on anthropometric measurements and biochemical parameters in MAFLD patients. Furthermore, only lyophilized CM fruit powder improved glycemic parameters. Therefore, lyophilized CM fruit powder may be beneficial for adult patients with MAFLD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: The interest in the effect of gut microbiota on athlete health has increased in recent years. Available data indicate a relationship between gut microbiota composition and physical activity, suggesting that changes in the microbiota may contribute to the host's physical performance. Studies show that leaky gut syndrome is highly correlated with upper respiratory infections and gastrointestinal disorders in endurance sports. This study aims to reveal the relationship between microbiota profiles, and the nutritional status of football players who perform endurance exercises., Methods: Twenty male professional football players playing in one of the Turkish Football Federation Second League clubs participated in the study. Fecal samples were collected and stored at -86 °C, and the fecal microbiota was analyzed through 16s rRNA gene sequencing. The body composition of the football players was measured using a bioelectrical impedance analyzer. In addition, the 3-day food intake of the participants was recorded with the help of a dietitian., Results: In the microbiota of football players, four phyla, 10 genera, and four species with densities above 1% were found. Body fat percentage was observed to be negatively correlated with the species of Faecalibacterium prausnitzii and Bacteroides vulgatus and the genus of Faecalibacterium (P<0.05). Considering the nutritional status, the fat intake was found to be positively correlated with Actinobacteria and Blautia coccoides; energy and fiber intake with Prevotella and Prevotella copri (P<0.05). In addition, there was a negative correlation between carbohydrate intake and Faecalibacterium (P<0.05)., Conclusions: Our study is the first to reveal the microbiota profile of professional Turkish football players. It was found that football players' nutritional status and anthropometric measurements of are significantly related to phylum, genus and species ranks in the microbiota. These results support the bidirectional interaction between microbiota and sports. The relationship between microbiota and sports health/performance is thought to be further clarified with future studies.

The aim of this study was to determine the effect on the anthropometric and biochemical parameters for women with insulin resistance when lyophilized dried cornelian cherry ( Cornus mas L., CM) was added to medical nutrition therapy (MNT). The study was conducted with 84 women aged 18-45, who had been diagnosed with insulin resistance. Participants were randomized into four groups: MNT + 20 g lyophilized dried CM group (DCm, n  = 22), MNT group (D, n  = 21), only 20 g lyophilized dried CM group (Cm, n  = 21), and the control group (C, n  = 20). All participants were followed for 12 weeks. While pre- and post-intervention biochemical parameters were recorded from patient files, anthropometric measurements and food consumption records were taken every 15 days. Pre-intervention groups were homogeneously distributed. Post-intervention, among the groups, all anthropometric measurements were similar between the DCm and D, while the percentage of decrease in insulin resistance-related parameters was approximately two times greater in DCm than in D ( p  < .05). When the Cm and C were compared, it was found that all post-intervention anthropometric measurements were similar, but the percentage of decrease in fasting blood glucose, fasting insulin, and HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) values were greater in C ( p  < .05). In this study, it was concluded that CM consumption resulted with a decrease in insulin resistance-related biochemical parameters independent of body weight change. Nevertheless, MNT has positive effects on women with insulin resistance, and adding lyophilized dried CM to MNT improves insulin resistance-related parameters and may be beneficial for preventing the development of diabetes., Competing Interests: The authors declare that they do not have any conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Metabolic-associated fatty liver disease (MAFLD) affects nearly one quarter of the world's adult population creating large health loads and economic loads in society with no approved pharmacotherapy found yet. The number of studies showing the effect of nutrition on fibrosis accompanying MAFLD are insufficient. This study was planned with the aim of investigating the effect of nutritional treatment on liver injury., Methods: This research is a prospective, non-medication interventional study completed with 39 participants chosen from MAFLD patients with fibrosis. Post-treatment lasted three months, patients had liver stiffness measurements (LSM), anthropometric measurements and biochemical tests repeated., Results: In pre- and post-treatment, there were statistically significant correlations found between LSM with serum gamma glutamyl transferase (GGT) values, and between controlled attenuation parameter (CAP) with Body Mass Index (BMI) and fat mass (P<0.05). Post-treatment, statistically significant improvements were determined in the anthropometric measurements and biochemical findings. Moreover, post-treatment LSM and CAP values showed significant positive correlation compared to pretreatment (P<0.05)., Conclusions: This study found dietary interventions have an important place within the scope of fibrosis treatment. Preparation and application of medical nutrition treatment suitable for the clinical features of patients and completing correct lifestyle changes has an ameliorating effect on disease prognosis. There is a need for advanced studies with larger sample groups to further enlighten this topic.

Kidney patients are restricted from sodium, potassium, phosphorus, and protein. In thisstudy, new recipes have been developed in order to prevent the decrease in appetite, to control the loss of liquid electrolytes due to vomiting, to help patients feel better by improving their morale, to facilitate their adaptation to the diet. Eight selected foods were prepared by modified for reducing sodium, potassium, and phosphorus (repeating 2 times) and by standard recipes (repeating two times). Eight foods and 16 recipes were obtained. Sodium, potassium, phosphorus, and protein contents were measured after the process. Sodium, potassium, and phosphorus contents were analyzed with the ICP-MS method. Protein content was analyzed with the Kjeldahl nitrogen determination method. Applied cooking methods led to a decrease in sodium, potassium, phosphorus, and protein levels in the modified foods. The highest loss rate (65.3%) was observed in proteins in apple halva. The lowest loss (21.5%) was determined in the potassium in the banana cake. These cooking methods can be useful for enriching the meals of kidney patients.

Background & Aims: Malnutrition is one of the most important factors affecting the prognosis of inpatients. The aim of this study is to determine the malnutrition risk of hospitalized patients and to examine the relationship between the presence of malnutrition and other parameters., Methods: The study included 162 inpatients over the age of 25 who were staying in the hospital's internal medicine service for 7 days or more and who volunteered to participate in the study. A demographic-information questionnaire, consisting of 5 sections, a 24-h food recall record, NRS-2002, NRI and Beck Depression Inventory was given to patients during bedside interviews. After obtaining the necessary permission, the anthropometric measurements and biochemical parameter values of the patients were taken from their files. All statistical analyzes were performed by researchers with the SPSS package program., Results: Of 162 patients (48.8% female, 51.2% male), 24.7% were at risk for malnutrition according to NRS-2002 and 66.7% of the patients were not depressive, based on the Beck Depression Inventory scale. The malnutrition risk was higher (60.0%) in patients who had been hospitalized for more than 15 days (p = 0.010). The majority of those with malnutrition had no problems preventing them from eating (32.5%), were found to be not depressive (52.5%) and were in the normal range of body mass index (57.5%) (p = 0.002, p = 0.034, p = 0.001; respectively). Nutrient intake was lower in patients with a higher malnutrition risk, but the difference was insignificant (p > 0.05). Albumin levels (p = 0.028) and total protein levels (p = 0.015) were significantly lower in patients who were at risk of malnutrition. While overweight patients showed higher levels of serum albumin (p < 0.001), CRP levels were found to be lower in overweight patients (p < 0.001)., Conclusions: It was found that the majority of patients with malnutrition were in the normal range for BMI. Nutritional intake and biochemical parameters should be followed closely in patients who are at risk of malnutrition. Depression can be a cause for insufficient nutrition and should be evaluated, particularly in patients whose length of hospital stay is greater than 7 days., Competing Interests: Declaration of competing interest None of the authors have any conflict of interest related to the authorship of this article., (Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background & Aims: Nutrition is one of the most important environmental factors affecting the formation of osteopenia. The purpose of this study was to investigate the effects of dietary changes on bone formation and bone resorption markers of postmenopausal women with vertebral osteopenia., Methods: In this study, 108 women with postmenopausal vertebral osteopenia were included. Patients were observed for a month to identify their regular nutritional status. Before intervention, blood and urine samples were taken from all patients. Then, 2-day food consumption records were taken and the patients were divided into 4 groups. Different types of diets (opposite of their regular diets) were prepared for these groups (1: control, 2: reduced-carbohydrate, 3: reduced-protein, 4: reduced-sodium) and followed for 3 months. At the end of follow-ups, blood and urine samples were taken again and changes in osteocalcin (OC) and N-terminal telopeptide (NTX) levels were examined., Results: According to biochemical analysis, there was a significant decrease (p < 0,001) in OC levels in reduced protein group and an increase (p > 0,05) in reduced carbohydrate group. When NTX levels were assessed, a significant decrease (p < 0.001) in the reduced carbohydrate group and a significant increase in the reduced protein group (p < 0.05) were found., Conclusion: Our findings show that reduced carbohydrate diet protected whereas, reduced protein diet negatively affected bone health. Osteopenic individuals were thought to be able to improve bone health and their quality of life by early dietary intervention., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

The aim of this cross-sectional study is to evaluate the effect of nutrition education on nutritional knowledge levels of pregnant women. The study was undertaken on a sample of pregnant women (i = 743) attending health centers in Istanbul for prenatal care. Nutrition knowledge scores were significantly higher in posttest (23.0) than pretest (16.0) after receiving nutrition education (p < .001). Significant differences in pretest (p < .05) but not posttest (p > .05) scores were found for factors, such as education level, work status, and the number of pregnancies; significant differences in both test scores were found for age and nutrition information (p < .05). In conclusion, pregnant women need to be given adequate and appropriate nutrition education for maternal and child health according to sociodemographic characteristics.

Objective: To validate the original food frequency questionnaire in Turkish adult population., Methods: The cross-sectional study was conducted in June and December 2008 and 2009, and comprised adults of either gender aged 30-70 years. All subjects were Caucasians and were native Turkish speakers. The food frequency questionnaire containing 229 most frequently consumed foods under 7 topics was used for data collection. It was completed twice and the 24-hour dietary recall four times in a year. In order to assess the validity of the questionnaire, Pearson correlation, attenuation coefficient, measures of agreement between the two methods, weighted kappa statistics and Bland-Altman plots were employed. SPSS 16 was used for statistical analysis., Results: Of the 120 subjects in the study, 71(59%) were males and 49(41%) were females with an overall mean age of 50.16±9.76 years. The correlation of estimated nutrient intake between the food frequency questionnaire and 24-hour dietary recall varied between 0.200 and 0.468, energy-adjusted regression was between 0.044 and 0.611 and attenuation coefficients of regression were between 0.339 and 0.658 for the selected macro and micro nutrients. Bland-Altman plots showed an acceptable agreement between the two methods. When nutrient intake was categorised in quartiles, proportions of the same or adjacent quartiles were 98.3%, 98.4%, 98.3%, 96.7% and 95% for energy, fat, protein, carbohydrates and fibre, respectively., Conclusions: The first food frequency questionnaire developed in Turkish language was an adequate and valid tool to assess the nutritional habits of the local population.

Objectives: This study aimed to examine the relation between eating habits and a high body mass index (BMI) in first-year freshman university students and included 2525 freshman university students 18 to 22 years old from a Turkish population., Methods: İn this study, 48% of the students were men. They were asked to complete a questionnaire on their dietary habits including the frequency of their consumption of individual food items, demographic data, and smoking habit., Results: The effects of eating habits on increased BMI (≥25) were analyzed. Of 2259 subjects included in the analyses, 322 were overweight or obese and 1937 had normal and thin BMI (<25). Multivariate analyses identified male gender, recent weight change, and high number of meals as independent predictors of obesity/overweight. Frequent consumptions of beer, alcoholic drinks other than beer and wine (e.g., spirits including whisky, gin, raki, vodka), coffee, tea, coke, red meat, variety meat, and eggs were associated with a significantly higher risk of obesity/overweight, whereas frequent consumption of snacks was associated with a low risk., Conclusions: Findings of further studies, possibly taking into consideration the absolute quantities of consumption along with cultural and local issues, would guide the adoption of healthier feeding behaviors in this particular age group.