Nutrition determinants of acute skeletal muscle loss in critically ill patients: A prospective observational cohort study

BACKGROUND

Skeletal muscle loss is associated with adverse outcomes in critically ill patients and risk factors of acute skeletal muscle loss are not well described. This study aims to determine the factors associated with acute skeletal muscle loss in critically ill patients.

METHODS

This prospective observational cohort study was conducted with patients who were expected to stay in the intensive care unit (ICU) for at least a week. Rectus femoris cross-sectional area (RFCSA) measurements were performed within 48 h of ICU admission and on study day 7. The percentage change in RFCSA and variables associated with this change were evaluated by univariate and multivariate regression analysis.

RESULTS

Over a 12-month period, 518 patients were assessed for eligibility and 44 critically ill patients with a mean age of 59.3 ± 10.9 years were enrolled; 52.3% of them were female. There were significant reductions in RFCSA (16.8 ± 16.5%; P < 0.001). The mean amounts of protein and energy consumed compared with those prescribed were 67.0 ± 28.8% and 71.5 ± 38.3%, respectively. Multivariate regression analysis revealed that frailty was independently associated with acute skeletal muscle loss after adjusting for confounding factors in our cohort of patients.

CONCLUSION

Frailty status before ICU admission is associated with acute skeletal muscle loss and may be important for identifying critically ill patients at high risk of muscle wasting.

Nutritional status changes in the treatment of substance use disorder: Relationship with substance craving

Tailored nutrition counseling enhances the efficacy of routine treatment for substance (alcohol/drugs) use disorders (SUDs). For this purpose, it is important to understand the current nutritional status of addicts and the changes in their nutritional status during the treatment process. Furthermore, the consumption of sweets to manage substance cravings is common among people with SUDs, but the evidence for the effectiveness of this practice is limited and conflicting. We therefore hypothesized SUD treatment would be associated with increases in appetite, nutrient intake, and anthropometric measurements in addicts, and that these changes, including changes in sweet consumption, would not be associated with decreased substance craving. Data for this prospective observational study were collected from 38 adult male patients who completed 21 days of inpatient SUD treatment. During the treatment, the participants' levels of appetite (P < 1.0 × 10-4), the frequency of main meals (P < 1.0 × 10-4), intake of macro- and micronutrients (P < .05 for each), and anthropometric measurements (P ≤ 5.9 × 10-4), significantly increased. Furthermore, it was found that the patients had a significant increase in sweets craving (P < 1.0 × 10-4) and sweets consumption (P = 1.2 × 10-3) during treatment. However, there was no significant difference between the individuals whose craving decreased and those whose craving did not decrease at the end of the treatment (P > .05 for both). The findings suggest the need to offer dietary counseling to individuals undergoing inpatient SUD treatment, given the substantial changes in nutritional status, and that increased consumption of sweets is not an effective strategy to reduce substance craving.

The caffeine dilemma: unraveling the intricate relationship between caffeine use disorder, caffeine withdrawal symptoms and mental well-being in adults

OBJECTIVE

This study aimed to explore the relationship between caffeine use disorder (CUD), caffeine withdrawal symptoms and the prevalence of depression, anxiety and stress (DASS) in adults.

DESIGN

The study utilised a cross-sectional design to assess the relationships between CUD, caffeine withdrawal symptoms and DASS.

SETTING

Participants' CUD was evaluated through the Caffeine Use Disorder Questionnaire (CUDQ), while the Depression Anxiety Stress Scale-21 (DASS-21) measured DASS levels. Caffeine withdrawal symptoms and total caffeine intake were calculated based on self-reported consumption of caffeine-rich products.

PARTICIPANTS

The study involved 618 participants with an average age of 27·8 (sd 7·8) years.

RESULTS

Participants consumed an average of 461·21 (sd 11·09) mg/d of caffeine, showing a positive correlation between CUD and total caffeine intake. The risk of CUD increased alongside levels of DASS. Individuals with caffeine withdrawal symptoms had higher CUDQ and DASS scores. A multiple linear regression model revealed significant associations between total caffeine intake (P < 0·001) and DASS-21 score (P < 0·001) with CUDQ score.

CONCLUSIONS

The study concluded that caffeine, while recognised for its potential health benefits, also exhibits properties that may lead to addiction. The development of caffeine use disorder and cessation of caffeine intake can increase DASS levels in adults, indicating the need for awareness and appropriate interventions in public health nutrition.

Nutritional Status and Feeding Problems in Pediatric Specific Learning Disability

This cross-sectional study aims to determine the feeding problems and nutritional status of children diagnosed with specific learning disability (SLD), which is one of the neurodevelopmental disorders. Sociodemographic information, anthropometric measurements, and food consumption records of 76 children (38 boys and 38 girls) diagnosed with SLD were obtained by applying a questionnaire. The Behavioral Pediatrics Feeding Assessment Scale was used to determine the feeding problems of children. About 31.6% of children with SLD are overweight and obese. Feeding behavioral problems were found in 39.5% of the children with SLD. Binary logistic regression analysis showed a significantly higher frequency of feeding behavior problems in children with SLD: (1) lower body mass index (adjusted odds ratio [AOR]: 0.841, 95% confidence interval [CI]: 0.722-0.979), (2) lower tri-ponderal mass index (AOR: 0.738, 95% CI: 0.585-0.933), (3) lower upper middle arm circumference (AOR: 0.772, 95% CI: 0.649-0.918),and (4) lower triceps skinfold thickness (TSFT) (AOR: 0.890, 95% CI: 0.808-0.980). In this study, feeding behavior problems are common in children diagnosed with SLD. Therefore, identifying feeding behavior problems in children diagnosed with SLD and developing solutions specific to the problem are important for gaining healthy eating habits throughout life.

WITHDRAWN: Do individuals living in Turkey accept artificial meat?

This article was withdrawn from Meat Science at the request of the authors above who had failed to include all authors and after the excluded authors had raised this issue. The paper contained methodology that was developed by the excluded authors without fully acknowledging this fact or allowing these authors to contribute to the paper. The Publisher apologizes for any inconvenience this may cause, but also wants to remind authors about observing ethical conduct in the execution of studies and their subsequent reporting. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

An in vitro Approach to Protective Effect of Lactoferrin on Acrylamide-induced Oxidative Damage

Acrylamide is a compound that occurs with high temperature during food processing and causes oxidative damage. Recently, the importance of antioxidative components is increasing to prevent oxidative damage. Lactoferrin is an antioxidant protein mainly found in milk. Therefore, the aim of this study is to determine the dose-dependent protective effects of lactoferrin on oxidative damage caused by acrylamide. In this study, HepG2 cell lines were treated with lactoferrin doses (0, 25, 50, 100µM) and half maximal inhibitory concentration of acrylamide. After 24 hours malondialdehyde, superoxide dismutase, catalase and glutathione reductase levels were measured. Acrylamide significantly increased malondialdehyde levels in HepG2 cells compared to the control group; however, catalase, superoxide dismutase and glutathione reductace significantly reduced. On the other hand, added lactoferrin doses (50-100µM) significantly reduced lipid peroxidation levels. Besides, it was found that glutathione reductase, catalase and superoxide dismutase levels significantly increased. As a result, the protective effect of lactoferrin against the oxidative damage caused by acrylamide in HepG2 cells was determined. This effect is thought to be due to the antioxidant capacity of lactoferrin. In this context, it is recommended that more studies are carried out on the mechanism of action of lactoferrin on oxidative stress caused by acrylamide.

Food-related quality of life in inflammatory bowel disease: measuring the validity and reliability of the Turkish version of FR-QOL-29

Purpose

Food-related quality of life is considerably impaired in patients with inflammatory bowel disease (IBD) and should be widely measured in research and clinical practice. This study aims to translate the FR-QoL-29 instrument to the Turkish language and evaluate its validity and reliability in Turkish patients with IBD.

Methods

The FR-QoL-29 was forwards and backwards translated into Turkish and the validity and reliability of the FR-QoL-29-Turkish measured at two tertiary hospitals in Ankara, Turkey. Participants completed four questionnaires regarding: sociodemographic; clinical (disease type and activity), and nutritional characteristics (MUST) together with FR-QoL-29-Turkish. In addition, 30 patients repeated the questionnaires after two weeks. collected. Pearson correlation coefficients and Cronbach α were used to assess reliability and validity (p < 0.05).

Results

A total of 180 participants with IBD (78 Crohn’s disease, 102 ulcerative colitis), with a mean age of 45.9 ± 12.5 years, were included. Bartlett's sphericity test was statistically significant (p < 0.001), meeting the prerequisite for factor analysis, and the adequacy of the sample size for factor analysis was confirmed by a high Kaiser–Meyer–Olkin (KMO = 0.92). Validity was confirmed by factor loadings ranging from 0.310 to 0.858. Item-total score correlations ranged from 0.258 to 0.837 and Cronbach’s α coefficient was 0.96 for the whole questionnaire indicating high internal consistency.

Conclusions

FR-QoL-29-Turkish is a valid and reliable measure of food-related quality of life in IBD patients with Turkish language. The FR-QoL-29-Turkish gives a comprehensive overview of the main aspects of food quality of life and can be used as a useful tool in both research and clinical practice.

Maternal micronutrient status and its association with sociodemographic, maternal, and dietary factors in a cross-sectional study

AIM

Maternal serum micronutrient status can have a significant impact on short- and long-term outcomes for mother and offspring. The aim of this study was to examine the associations of maternal serum folate, ferritin, and vitamin B₁₂ status with maternal and dietary factors.

METHODS

This observational cross-sectional study was carried out with 165 healthy pregnant women at least 18 years of age with a singleton pregnancy. Maternal nutrient intake was determined by 24-hour dietary recall method and supplement records. Multivariable analyses using stepwise linear regression models were performed to associations of dietary intakes and maternal serum status.

RESULTS

There was a difference between the lowest and highest quartile of maternal serum folate, ferritin, and vitamin B₁₂ status and maternal characteristics and dietary, and total intakes of nutrients (p < 0.05). Multivariable stepwise linear regression analysis showed the predictors of serum folate status were dietary folate equivalent, dietary folate, total vitamin B₆ and iron intake. Primer predictors of serum ferritin and vitamin B₁₂ status were dietary protein intake (p < 0.05).

CONCLUSION

Our findings support existing recommendations that folic acid supplementation should be prescribed to achieve optimal serum folate status during pregnancy. However, dietary protein intake is important to provide optimal maternal serum vitamin B₁₂ and ferritin status.

The relationships between leptin levels in maternal serum and breast milk of mothers and term infants

BACKGROUND

Leptin in breast milk play a significant role in metabolic programming.

OBJECTIVE

The aim of this study to evaluate the relationship between leptin levels in maternal serum and breast milk, and certain anthropometric measurements of infants and mothers.

METHODS

This study was conducted with 65 females and term infants. Anthropometric measurements of the mothers and the infants were obtained on the first, third, and sixth months, and leptin levels in maternal serum and breast milk were measured.

RESULTS

In this study, leptin levels in breast milk were positively correlated with leptin levels in maternal serum while the leptin levels in breast milk were lower than the serum leptin levels. It was also determined that mothers' body weights, BMI values, waist and hip circumferences were increased in a statistically significant way in terms of the months (p < .001). It was discovered that all the anthropometric measurements of the mothers were positively correlated with leptin levels in breast milk and maternal serum in all the months (p < .001). Furthermore, it was determined that the body weights of the infants in certain months were negatively correlated with leptin levels in breast milk and maternal serum while the lengths of the infants were positively correlated with leptin levels in breast milk and maternal serum (p < .05).

CONCLUSIONS

This study was determined that leptin levels in breast milk and maternal serum were related to anthropometric measurements of both mothers and infants. Future studies with larger populations are needed to understand the long-term consequences of leptin metabolism comprehensively.Key messagesThis study was determined that breast milk leptin level and maternal serum leptin level demonstrated a positive correlation, and breast milk leptin level was lower than maternal serum leptin level.Mothers' anthropometric measurements were positively correlated with leptin levels in breast milk and maternal serum in all the months.There was mostly a negative correlation between breast milk leptin level and infant body weight.

Validity and reliability of Turkish version of the Food-Mood Questionnaire for university students

OBJECTIVE

This study aims to evaluate the validity and reliability of the Turkish version of the Food-Mood Questionnaire (FMQ) for university students.

DESIGN

The original questionnaire developed by Begdache et al. (2019) was modified and translated into Turkish. The content validation ratio (CVR) and the content validity index (CVI) were used for content validity assessment. The construct validity was assessed by exploratory factor analysis and confirmatory factor analysis (CFA) on data collected on university students who completed the survey online. Pearson's correlation coefficients and Cronbach's α were used to assess reliability and validity (P < 0·05).

SETTING

This study was conducted at five different universities in Turkey.

PARTICIPANTS

A total of 251 (67 males and 184 females) undergraduate students participated in the study. Of these, seventy-five students completed a pre- and post-test assessment.

RESULTS

In the current study, 251 university students with a mean age of 21·9 ± 4·1 years participated. The mean CVR and CVI were 0·96 and 0·98, respectively. Factor loadings ranged from 0·341 to 0·863, and item total score correlations ranged from 0·142 to 0·749. Cronbach's α coefficient was 0·633 for the whole scale. Five factors were extracted that had a good fit in CFA (χ2/DF = 1·37, root mean error of approximation: 0·039, goodness-of-fit index: 0·911 and comparative fit index: 0·933).

CONCLUSIONS

The Turkish FMQ is a valid and a reliable tool for university students. FMQ can be used by clinicians or researchers to examine the mental distress and dietary patterns of university students. Further testing of the FMQ is required for validation in the general population.

Validation of the Turkish Version of the Caffeine Use Disorder Questionnaire in an Adult Population

The aim of this study was to examine the reliability and validity of the Turkish version of the Caffeine Use Disorder Questionnaire (CUDQ) in an adult population. In this instrument validation study, a total of 310 individuals (253 female, 57 males), with a mean age of 25.96 ± 6.29 years were included. The questionnaire consisted of 4 parts, comprising the sociodemographic characteristics, CUDQ, caffeine withdrawal symptoms, and caffeine consumption. For the evaluation of the data, confirmatory factor analysis (CFA), descriptive statistics, and the t test were used. In the reliability analysis, the Cronbach alpha internal consistency coefficient was 0.86, and the intraclass correlation coefficient was 0.83 for CUDQ. The CMIN/df was 0.54, and the model generally fits well to the structure (RMSEA = 0.08, CFI = 1, NFI = 1, GFI = 0.99, AGFI = 0.99, TLI = 1, NNFI = 1, RFI = 0.98). The findings suggested that the CUDQ has validity of structure, internal consistency, and construct validity for assessing Caffeine Use Disorder the tendency in the Turkish adult population.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00688-8.

A cross-sectional evaluation of the relationship between social jetlag and diet quality

The aim of this study was to compare anthropometric measures of obesity and sleep qualities in individuals with/without social jetlag (SJL). In addition, it was aimed to compare the energy, macronutrient intake and diet qualities of individuals with/without SJL during school and non-school days. This study comprised 710 university students with mean age 21.58 ± 1.41 years. The presence of SJL was acknowledged if there was a difference of more than 1 hour between the middle of sleep time on school day and on non-school day. While the physical activity levels (PALs) of the individuals were determined with a 24-hour physical activity record, measurements such as waist circumference, neck circumference and body mass index were recorded for anthropometric measurements. Pittsburgh Sleep Quality Index was used to determine the sleep quality of the individuals. Energy, macronutrients intake, and diet quality were calculated from the 24-h dietary recall of the individuals, and recorded for the school days and non-school days. In this study, 76% of the individuals (n = 542) were determined as exposed to SJL. Although there was no significant difference in their PALs, individuals with SJL had a higher waist (p < .05) and neck (p < .05) circumference, as well as higher body mass index (p < .05). Individuals with SJL were found to have significantly poor sleep quality (OR:1.109, p < .031) and sleep latency (OR:1.130, p < .001) after adjustment for confounding factors. When compared to school days, in the individuals with SJL, energy (p < .001), fat (p < .001), saturated fatty acids (SFA) (p < .001), and mono unsaturated fatty acids (MUFA) (p < .001) were significantly increased; however, fiber intake (p < .001) was significantly reduced on non-school days. Although there was no significant difference in the diet quality scores between the groups on the school days, the diet quality of the individuals without SJL on non-school days was increased significantly (p < .05). In conclusion, SJL was associated with sleep loss, increased body mass index, and lowered diet quality in university students.

Do sleep quality and caffeine consumption mediate the relationship between late chronotype and body mass index?

AIM

To determine the role of sleep quality and caffeinated beverage consumption in the effect of late chronotype on body mass index (BMI).

MATERIALS AND METHODS

The study consisted of a total of 661 healthy university students with a mean age of 21.4 ± 1.38 years. Within the scope of the study, The Morningness-Eveningness Questionnaire (MEQ) was used to determine the chronotypes of individuals, the Pittsburgh Sleep Quality Index (PSQI) was used to determine sleep quality, and a 24 h physical activity record was taken to determine physical activity levels. The caffeine intake of the individuals was determined using a food frequency questionnaire for the intake of caffeinated food and beverages. The role of mediators in the effect of late chronotype on BMI was evaluated via multiple mediation analysis.

RESULTS

In this study, evening-type individuals had higher daily caffeine intake, worse sleep quality (P < 0.001), and higher BMI (P < 0.05). When the effect of mediators was taken into account, the negative relationship between the chronotype score and BMI was maintained (β = -0.109, 95% CI (-0.194, -0.021), P < 0.05). Decreased sleep quality had a mediated effect in this relationship [β = -0.208, 95% CI (-0.275, -0.119)], and caffeinated beverage consumption was found to have no mediator function (β = 0.040 95% CI (-0.050, 0.108), P > 0.05).

CONCLUSION

To conclude, eveningness chronotype had an effect on higher levels of caffeinated beverage consumption, lower sleep quality, and increased BMI. Chronotype, sleep quality, and caffeinated beverage consumption should be taken into account in studies examining the relationship between circadian rhythm and obesity.

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.

Is iodized salt efficient to overcome iodine deficiency in pregnants?

Objective:

Iodine is a trace element that synthesizes thyroid hormones necessary for optimal human growth and development. The relationship between dietary iodine intake and spot urinary iodine excretion in pregnant women has not been previously evaluated in Trabzon city, which is an endemic area of iodine deficiency in the Black Sea region of Turkey. This study aimed to evaluate the relationship between dietary iodine intake and urine iodine excretion in pregnant women.

Materials and Methods:

This study enrolled 150 pregnant women aged between 19 and 45 years who applied to Clinic of Gynecology and Obstetrics in Trabzon. Spot urine specimens were taken, and dietary iodine intake data were collected using a food frequency questionnaire (FFQ) and 24-hours dietary recall (24-h DR) method.

Results:

The median urinary iodine concentration (UIC) in the general specimen was 100.6 μg/L. Of the pregnant women, 80.0% had insufficient and 20.0% had sufficient iodine levels, according to UIC. Although total iodine-rich food intake determined by FFQ was sufficient in 20.7% (n=31) of participants, 24-h DR iodine intake was sufficient only 10.7% (n=16). A significant association between urinary iodine excretion and iodine intake was observed in both 24-h DR and FFQ intake estimates (p<0.05). The iodine intake values obtained in both 24-h DR and FFQ and the iodized salt effect were correlated with UIC in all models (p<0.05). Even though 96.0% of pregnant women used iodized salt, its effect on UIC was 15.2%.

Conclusion:

Both methods indicate that the iodine intake of pregnant women might be insufficient in Trabzon area. Also, although iodized salt use is high in pregnant women in Trabzon, it is not enough to prevent iodine deficiency.

Adolescent Obesity and Its Association with Diet Quality and Cardiovascular Risk Factors

Objective: This study aimed to evaluate the adolescent obesity and its association with Mediterranean Diet Quality Index (KIDMED) and cardiovascular risk factors in adolescents. Method: This cross sectional study included 95 adolescents aged between 10 and 18 who visited a Primary Health Service Center in Turkey. Participants' biochemical parameters, anthropometric measurements and blood pressures were measured. The level of adherence to Mediterranean Diet was evaluated by a clinical questionnaire, the Mediterranean Diet Quality Index for children and adolescents (KIDMED). Results: Overweight adolescents had significantly higher systolic blood pressure, diastolic blood pressure, total cholesterol, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, hemoglobin A1c, C-reactive protein, alanine aminotransferase, than normal-weight adolescents. Overweight/obese subjects also had significantly lower HDL cholesterol than normal-weight subjects. Results indicated that 60.0% of the adolescents had a low quality diet, 34.7% had a mid-quality/needs-improvement diet, and 5.3% had an optimal quality diet. No association was found between diet quality and obesity and cardiovascular risk factors. Conclusion: Overweight and obese children are strongly associated with multiple cardiovascular risk factors. To avoid health problems arising from obesity, adolescents should refer to global solutions. Mediterranean diet is a good measure against adverse cardiovascular risk factors in adolescence.