Nutrition in heart failure [Kalp Yetersizliginde Beslenme]

Heart failure is defined as decreased ability of heart due to various reasons. It's seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilemma. Since one of the main reasons of heart failure is cardiovascular diseases, in first phase, the patient may be obese. In the later phases, cachexia may show up. It was shown that cachexia is associated with mortality. Within this period, patients should not be over-fed and the patient should pass from catabolic state to anabolic state slowly. If the gastrointestinal track is functional oral/enteral feeding must be preferred. Multi vitamin and mineral supportsmay be beneficial, which may replace the increased loss, increase anti-inflammatory response and be anti-oxidants. Large, controlled and well-designed studies must be conducted in order to evaluate the benefits of nutritional practices such as nutritional assessment, enteral feeding and nutrient supports in heart failure patients

Obesity prevalence in the elderly and the association between obesity and cardiovascular risks [Yaşlilarda obezi·te sikligi ve obezi·teni·n kardi·yovasküler ri·sklerle i·li·şki·si·]

Introduction: Obesity prevalence is increasing among the elderly and obesity is association with diseases. The aim of this study was to determine obesity/ abdominal obesity prevalence according to four different anthropometric indices, and the effect of obesity on cardiovascular (CV) risk in the elderly. Materials and Method: This cross-sectional study involved 2,502 elderly participants, 65 years and older, who were parts of Balcova's Heart Project. The dependent variable was CV risk factors; the independent variable was obesity. Obesity measures were Body Mass Index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). Data were analyzed using t-test, Chi-square, Pearson's correlation and Logistic regression analyses. Results: The prevalence of obesity according to body mass index was 48.7%, WC: 52.4%, WHpR: 65.2%, and WHtR: 93.7%. High levels of all of anthropometric measurements were risk factors for diabetes, hypertension and metabolic syndrome. All measurements, except for BMI in women, were risk factors for dyslipidemia in both sexes. WHtR and WHpR in men and WC and WHpR in women were predictors of Framingham risk scores. In women, WHtR had more predictive value for CV risk, except for the Framingham risk score; in men WHtR had more predictive value than all other risks. Conclusion: In both genders, obesity (determined with anthropometric measurements) is associated with CV risks. However, abdominal obesity (WHtR and WC) is more effective than BMI in determining CV risk

Food addiction and obesity [Gıda bağımlılığı ve şişmanlık gıda bağımlılığı ve şişmanlık]

The aim of this review is to discuss the concept of food addiction and its association with obesity. The DSM-5, published in May 2013, defines substance related and addictive disorders as clinical disorders indicated by inappropriate substance use within the last 12 months that meets at least two of the following 11 criteria: impaired control (4 criteria), social impairment (3 criteria), risky use (2 criteria) and pharmacological response (tolerance and withdrawal, 2 criteria). An important novelty in the DSM-5 is that, even though it is not induced by a chemical agent, a behavioral disorder, gambling, is classified as an addiction. Eating and sex, instincts that are essential for survival and wellbeing, are also called natural rewards. Dopamine, a reward neurotransmitter, regulates pleasurable and motivating responses to food intake. Repeated stimulation of these reward pathways, as in substance abuse, weakens control over food intake and causes compulsive food consumption. Imaging studies have shown that obese people have impairments in the dopaminergic pathways that regulate their control and reward systems. Studies indicate that even in post-prandial satiety, obese people show reward response to hyper-palatable foods. Thus, food addicts' efforts to lose weight are frustrated by addiction, and they have difficulty in adopting healthy nutritional habits. Studies of food addiction have proliferated recently around the world, but very few have been conducted in Turkey. Community-based studies of food addiction should be conducted to determine its prevalence. Obese people who are also addicted to food should be treated with multiple treatment methods. © 2016, Ege University Press. All Rights Reserved

A factor that can yield to eating attitude disorders in university students: Self-esteem

Objective: To determine prevalence of eating attitude disorder (EAD) and the effect of self-esteem on EAD in female university students. Study Design: In this cross-sectional study, female university students were included. The dependent variable was EAD determined by Eating Attitude Test-40. Socio-demographic characteristics, body perception, obesity, self-compassion and self-esteem were independent variables. Logistic regression (LR) models have been established to determine the associated factors of EAD. p 0.05 was considered significant. Results: EAD were found in 3.3% (n = 20) of the participants (n = 600). 44.5% had low and medium self-esteem and %13.4 were overweight (body mass index (BMI) ≥ 25.0). According to LR models, after adjusted for age, increased self-esteem score (decreased self-esteem) (OR:1.8, 95%CI:1.063–3.303) and practicing popular diet (OR:12.6, 95%CI:4.439–35.904) increased the risk of EAD significantly. Conclusion: EAD were less than expected in this group of university students. Self-esteem is an important factor affecting EAD. Students with EAD may be recommended to get psychological support as well as nutritional counseling. © 2021 Taylor ; Francis Group, LLC.We would like to thank our senior students Ayşenur Özturan, Betül Karabaş, Burcu Yılmaz and Kübra Kaplan for their valuable contribution to the planning of the research and the data collection process. This study was not funded

Prevalence of food insecurity and malnutrition, factors related to malnutrition in the elderly: A community-based, cross-sectional study from Turkey

Background and aim: Malnutrition is an important cause of mortality and morbidity in the elderly. The objectives of this study were to determine the malnutrition and food insecurity prevalence in the elderly in the Balcova District of Izmir and to evaluate the risk factors leading to malnutrition