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Öğe An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy(Routledge Journals, Taylor & Francis Ltd, 2024) Emir, Kubra Nur; Demirel, Birsen; Atasoy, Beste M.This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72(degrees). The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.Öğe Attitudes and preferences of consumers towards functional foods enriched with omega-3 fatty acids(Avrupa Bilim ve Teknoloji Dergisi, 2021-08) Demirel, BirsenABSTRACT: In recent years, increasing attention has focused on foods enriched with omega-3 fatty acids due to their positive effects on health.. Natural omega-3 fatty acid sources include aquaculture and plants such as walnut, flaxseed, and purslane. In view of the inadequate intake of omega-3 fatty acids in modern diets, several enriched functional foods have been developed on a large scale to improve nutrition. Several types of functional products have been progressively manufactured following the advent of novel food technologies. In the current study, consumer attitudes, knowledge and preferences of functional foods enriched with omega-3 were assessed in a survey including 819 participants in Istanbul, Turkey. The survey findings revealed that 72% of the participants consumed omega-3 fatty acids from natural sources, 17% used fish oil capsules, and only 11% preferred foods enriched with omega-3 fatty acids.Öğe Attitudes and Preferences of Consumers Towards Functional FoodsEnriched with Omega-3 Fatty Acids(2021) Bilsel, Alev Yüksel; Demirel, Birsen; Yeşilçubuk, Neşe ŞahinIn recent years, increasing attention has focused on foods enriched with omega-3 fatty acids due to their positive effects on health..Natural omega-3 fatty acid sources include aquaculture and plants such as walnut, flaxseed, and purslane. In view of the inadequateintake of omega-3 fatty acids in modern diets, several enriched functional foods have been developed on a large scale to improvenutrition. Several types of functional products have been progressively manufactured following the advent of novel food technologies.In the current study, consumer attitudes, knowledge and preferences of functional foods enriched with omega-3 were assessed in asurvey including 819 participants in Istanbul, Turkey. The survey findings revealed that 72% of the participants consumed omega-3fatty acids from natural sources, 17% used fish oil capsules, and only 11% preferred foods enriched with omega-3 fatty acids.Öğe Autism spectrum disorder and typically developing children: Comparison of eating behaviors and parents nutrition knowledge(Elsevier Sci Ltd, 2026) Hekimci, Demet Konak; Demirel, Birsen; Kilinc, Gul Eda; Ozturk, GultenBackground: This study aimed to determine difference between the eating behaviors of children with autism spectrum disorder (ASD) and typically developing children and nutritional knowledge of their parents. Method: This is a cross-sectional study that included typically developing children (n = 36) between the ages of 3 and 6 diagnosed with autism spectrum disorder (n = 33) and their parents (n = 69). Child Eating Behavior Questionnaire (CEBQ) was used, and the Nutrition Knowledge Level for Adults (NKLA) scale was used to assess parents' nutritional knowledge. To control for potential confounding effects in the analyses, demographic and anthropometric variables such as age, gender, height, weight and breastfeeding duration, as well as nutritional factors such as skipping main meals, amount of water consumption, bowel problems, picky eating behavior, problems during feeding, eating environment and who received the food were included as control variables. Results: Children with ASD exhibited lower snack consumption compared to typically developing children (p < 0.05). A higher percentage of children with ASD (69.7 %) experienced temper tantrums when unable to consume their preferred food compared to typically developing children (p < 0.05). The results of the CEBQ showed that children with ASD exhibited more emotional overeating behavior (p < 0.05). The parents of typically developing children had a higher level of education (p < 0.05). Parents of typically developing children scored higher than parents of autistic children on the rating question on the NKLA scale regarding the nutrition-health relationship (p < 0.05). Food frequency results showed that children with ASD consumed core food groups less frequently and had a higher daily intake of packaged products and beverages (p < 0.05). Conclusions: Children with autism spectrum disorder face more difficulties in nutrition than their typically developing peers. Considering the differences in the level of nutrition knowledge of parents, it would be beneficial to strengthen nutrition education programs especially for parents of children with ASD.Öğe Bariatrik Cerrahi Hastalarının Sağlıklı Yeme İndeksi ile Diyet Kalitelerinin Değerlendirilmesi(2023) Işık, Yasin; Demirel, Birsen; Erdem, Nihal Zekiye; Avuk, Hande SevenAmaç: Bu çalışmada, Sağlıklı Yeme İndeksi (SYİ) ile bariatrik cerrahi hastalarında diyet kalitelerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Araştırma Kasım 2018 – Mart 2019 tarihlerinde Sleeve Gastrektomili (SG), en az 3 ayını doldurmuş, toplam 44 (%75’i kadın, %25’i erkek) gönüllü birey üzerinde 40 sorudan oluşan anket formu ile yüz yüze görüşme yöntemiyle yapılmıştır. Bireylerin diyet kaliteleri Sağlıklı Yeme İndeksi-2010 ile değerlendirilmiştir. Bulgular: SYİ toplam puan ortalaması 62,15±6,13’tür ve cinsiyetler arasında farklılık görülmemiştir (p=0,586). SYİ alt gruplarına göre süt, protein ve sebze, meyve grubu yiyecekleri yüksek diyet kalitesinde ve tam tahıllı yiyecekleri ise düşük diyet kalitesinde tükettikleri saptanmıştır. Cerrahi sonrasında beslenme desteği alanların diyet kalitesinde toplam sebze puan ortancası, beslenme desteği almayanlardan daha yüksek; yağ asitleri puanı ise daha düşük bulunmuştur (p=0,038, p=0,019). Kadınların günlük enerji alım ortalaması 963,2±134 kkal, protein alımı 45,2±9,1 g iken erkeklerin sırasıyla 1049,8±121,5 kkal ve 53,5±5,3 g olarak bulunmuştur. Erkek bireylerin günlük protein alım miktarı kadınlardan istatistiksel olarak önemli fazla saptanmıştır (p=0,007). Her iki cinsiyette folat, D vitamini ve tiamin günlük alımının yetersiz olduğu saptanmıştır. Günlük kalsiyum, folat, sodyum alım düzeyinin erkeklerde; çinko alım düzeyinin ise kadınlarda daha fazla olduğu belirlenmiştir (p<0,05). SYİ’ye göre 1 hastanın da iyi diyet kalitesine ve 43 hastanın geliştirilmesi gereken diyet kalitesine sahip olduğu belirlenmiştir. Sonuç: Bariatrik cerrahi sonrası iyi diyet kalitesi besin öğesi yetersizliklerinin öngörülmesinde önemlidir. Bu araştırmada, sleeve gastrektomili hastaların diyet kalitelerinin kötü olmadığı ancak geliştirilmesi gerektiği saptanmıştır. Daha geniş popülasyonda sağlıklı yeme indeksiyle yürütülecek çalışmalar, bariatrik cerrahi hastalarında sağlıklı vücut ağırlığı kontrolü ve diyet kalitesinin iyileştirilmesinde fayda sağlayacaktır.Öğe Belediye Çalışanlarının İş Stresi Düzeylerinin Beslenme Durumu, Diyet Kalitesi ve Beden Kütle İndeksi Üzerine Etkisi(2024) Buz, Emine Hatun; Avuk, Hande Seven; Demirel, BirsenBu araştırmada, belediye çalışanlarının iş stres düzeylerinin beslenme durumu, diyet kalitesi ve beden kütle indeksi üzerindeki etkisini belirlemek amaçlanmıştır. Çalışma Zeytinburnu Belediyesi’nin farklı birimlerinde görevli, yaş ortalaması 29,60±7,90 yıl olan gönüllü 384 yetişkin birey ile Ocak 2022-Mayıs 2022 tarihleri arasında yürütülmüştür. Bireylerin sosyodemografik özellikleri, 24 saatlik besin tüketim kayıtları ve antropometrik o?lc?u?mleri, diyet kalitesini saptamaya yönelik Akdeniz Diyet Kalitesi İndeksi (KIDMED), iş stresini belirlemeye yönelik ise iş stresi ölçeği (İSÖ)’den oluşan anket formu yüz yüze görüşme yöntemiyle sorgulanmıştır. Çalışmaya katılan bireylerin %58,9’unun orta ve %39’unun yüksek düzeyde iş stresine sahip olduğu belirlenmiştir. Akdeniz diyeti kalite indeksi (KIDMED) ortalama 7,76±3,36 puandır. Kadın bireylerin KIDMED puan ortalamasının 7,59±3,00; erkek bireylerin puan ortalamasının 8,20±4,17 olduğu saptanmıştır (p=0,006). Kadın bireylerin BKİ ortalaması 21,57±3,28 kg/m2, erkek bireylerin ise 26,40±3,04 kg/m2’dir. Belediye çalışanlarının %10,4’ü zayıf, %56,8’i normal, %26,6 hafif şişman ve %6,3’ü obez olduğu belirlenmiştir. Bireylerin günlük enerji tüketimi kadınlarda 1624,30±485,03 kkal ve erkeklerde 1638,14±493,36 kkal’dir. İş stresi ölçeği ile KIDMED arasında pozitif yönde düşük düzeyde ilişki saptanmış; ancak, BKİ ile arasında anlamlı bir ilişki saptanmamıştır (r: 0,163, p=0,001; r:0,032, p=0,529). Bu araştırmanın sonucunda, belediye çalışanlarının iş stres düzeylerinin orta ve yüksek düzeyde olduğu; Akdeniz diyet kalitesi ile yüksek iş stres düzeyinin pozitif yönde, ancak düşük düzeyde ilişkili olduğu bulunmuştur.Öğe Beyaz ve Mavi Yakalı Sanayi Çalışanlarının Diyet Kalitesi, İş Stresi ve Kaygı Durumlarının Değerlendirilmesi(Manisa Celal Bayar University, 2024) Aras, Rabia; Demirel, Birsen; Avuk, Hande SevenAmaç: Bu çalışma, endüstriyel kuruluşlarda farklı pozisyonlarda çalışan bireylerin beslenme kalitesi, iş stresi ve kaygıları arasındaki ilişkiyi incelemek için yürütülmüştür. Gereç ve Yöntemler: İstanbul’da endüstrilerde çalışan, yaşları 18-65 arasında değişen toplam 132 gönüllü değerlendirildi. Çalışmada, iş stresi ve kaygı ölçümleri için İş Stresi Ölçeği ve Beck Anksiyete Envanteri, diyet kalitesi için ise Sağlıklı Yeme İndeksi-2015 (HEI-2015) kullanılarak 24 saatlik yemek kayıtları kullanılmıştır. Bulgular: Bu araştırmada beyaz yakalı çalışanların %48,9'u, mavi yakalı çalışanların ise %49,4'ü yüksek düzeyde iş stresi yaşadığı bulunmuştur (p>0,05). Beyaz yakalı çalışanların %48,9'unda, mavi yakalı çalışanların ise %39,1'inde kaygı tespit edilmiştir (p>0,05). Beyaz yakalı çalışanların %75,6'sının, mavi yakalı çalışanların ise %72,4'ünün beslenme kalitesi kötü bulunmuştur. Beck Anksiyete Envanteri ve HEI-2015 sonuçları ile iş stresi karşılaştırıldığında istatistiksel olarak anlamlı farklılıklar tespit edilmiştir (sırasıyla p=0,005 ve p=0,030). Mavi yakalı sanayi işçileri, beyaz yakalı işçilere (enerji 1979,1 kkal; karbonhidratlar 261,2±78,61 g/gün) kıyasla daha yüksek günlük enerji (2277,3 kkal) ve karbonhidrat (295,5±77,50 g/gün) alımı olduğu belirlenmiştir (p=0,015). İş stresini etkileyen dikkat çekici beslenme alışkanlıkları arasında atıştırmalıkların ve öğle yemeğinin atlanması yer almıştır (pÖğe Comparison of Three Nutritional Screening Tools to Predict Malnutrition Risk and Detect Distinctions Between Tools in Cancer Patients Receiving Radiochemotherapy(Routledge Journals, Taylor & Francis Ltd, 2018) Demirel, Birsen; Atasoy, Beste M.The aim of this study was to compare three screening tools for malnutrition in patients with head and neck cancers or central nervous system tumors (CNS) who are undergoing radio-chemotherapy. The study evaluated 124 adult cancer patients. The Subjective Global Assessment (SGA), Mini-Nutritional Assessment (MNA), and Nutritional Risk Screening 2002 (NRS-2002) were chosen to assess the risk of malnutrition. The prevalence of patients at nutritional risk was 31% with SGA, 31% with MNA and 23% with NRS-2002 in all patients. The agreement between SGA and MNA was substantial (k = 0.886, P<0.001); the agreement between SGA and NRS-2002 was moderate (k = 0.713, P<0.001); and the agreement between MNA and NRS-2002 was also moderate (k = 0.795, P<0.001). In subgroup analysis, SGA and MNA substantially (k = 0.973, P<0.001), SGA and NRS-2002 moderately (k =0.722, P<0.001), and MNA and NRS-2002 moderately (k =0.747, P<0.001) agreed in head and neck cancer patients. In CNS tumor patients, SGA and MNA slightly (k = 0.390, P = 0.005), SGA and NRS-2002 fairly (k = 0.457, P = 0.001), and MNA and NRS-2002 substantially (k = 0.878, P<0.001) agreed. The best agreement in tools was observed between SGA with MNA in all patients. Further studies in different tumor groups will enhance our understanding of current tools for malnutrition detection of radiotherapy patient.Öğe Environmental reflections of traditional and improved recipes: Assessing greenhouse gas and water footprints(Elsevier, 2025) Biliroglu, Cansu; Demirel, Birsen; Kilinc, Guel Eda; Acar, Yasemin; Sensoy, FundaThe concept of sustainability is expressed as to increase people's quality of life and reducing resource use and environmental impacts. The aim of this study was to determine the values of greenhouse gas emissions and water footprints of recipes with improved nutritional content specific to various Turkish cuisines. Thirty traditional recipes were improved in terms of nutritional content, and thirty improved new recipes were created. In this context, the carbon and water footprints of traditional and improved recipes were calculated, and the relationship between nutrients and greenhouse gas emissions and water footprints was analyzed. Compared to traditional recipes, improved recipes for meat dishes, pastries, herb dishes, vegetable dishes, and seafood recipes were found to have lower greenhouse gas emission values (p < 0.05), while the water footprint values of meat dishes, herb dishes, vegetable dishes and seafood recipes were found to be lower (p < 0.05). In traditional recipes, as the amount of energy, protein and fat increased, greenhouse gas values increased (p = 0.030 for energy; p = 0.001 for protein; p=<0.001 for fat), while in improved recipes, as the amount of protein and fat increased, greenhouse gas values increased (p = 0.001; p = 0.012). In addition, in traditional recipes, as the amount of protein and fat increased, the water footprint values also increased (p = 0.013; p = 0.007). In improved recipes, as the amount of protein increased, the water footprint values increased significantly (p = 0.008). It was determined that greenhouse gas emission values decreased by 14.55 % in improved meat dishes, 34.89 % in seafood, and 17.21 % in vegetable dishes, while water footprint values decreased by 15.55 %, 33.82 % and 52.26 % for meat, seafood, and vegetable dishes respectively. We believe that improving and reorganizing traditional cuisines of countries will have positive effects ecologically and health-wise, and will provide important contributions to future studies.Öğe Evaluation of Diet Quality, Work Stress and Anxiety Status of White and Blue Collar Industrial Workers(2024) Kahraman, Rabia Aras; Demirel, Birsen; Avuk, Hande SevenAims: This study examines the relationship between nutritional quality, work stress, and anxiety of individuals working in different positions in industrial organizations. Material and Methods: This study was conducted with a total of 132 volunteers, 45 white-collar and 87 blue- collar, between the agStress Scale and Beck Anxiety Inventory for work stress and anxiety measurements and the Healthy Eating Index- 2015 (HEI-2015) for diet quality, using 24-hour food records. Results: In this research, 48.9% of white-collar employees and 49.4% of blue-collar employees experience high levels of job stress (p>0.05). Anxiety was found in 48.9% of white-collar workers and 39.1% of blue-collar workers (p>0.05). The diet quality of 75.6% of white-collar workers and 72.4% of blue-collar workers was poor. Statistically significant differences were identified when comparing job stress with the Beck Anxiety Inventory and HEI-2015 results (p=0.005 and p=0.030, respectively). Blue-collar industrial workers reported higher daily energy intake (2277.3 kcal) and carbohydrates (295.5±77.50 g/day) compared to white-collar workers (energy 1979.1 kcal; carbohydrates 261.2±78.61 g/day), with significant differences in calorie and carbohydrate consumption (p=0.015). Noteworthy dietary habits influencing work stress included skipping snacks (p<0.001) and lunch (p<0.001). Work stress was found to exacerbate anxiety and negatively affect diet quality (p<0.05). No differences between blue and white-collar workers were observed in work stress, Beck anxiety, and HEI-2015 scale data (p>0.05). Conclusion: Work-related stress is pivotal in employees' physical and psychological well-being and diet quality. Developing strategies to enhance diet quality within organizations can aid in alleviating work stress and anxiety.Öğe Hospital Food Services, Patient Satisfaction and Malnutrition Risk Inpatients: A Pilot Study(Routledge Journals, Taylor & Francis Ltd, 2025) Sarac, Dilara Goksenin; Demirel, Birsen; Seven Avuk, Hande; Kevenk, Ahmet UgurObjective: Malnutrition is a preventable issue that complicates patient recovery and increases healthcare costs. This study evaluated inpatients' satisfaction with food services and its impact on malnutrition. Methods: This cross-sectional study included 310 patients (52.6% female, median age 42 years) hospitalized for at least seven days. The NRS-2002 screening test was administered within two days of admission and repeated on day seven, along with the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ). Results: The risk of malnutrition increased from 21.9% initially to 38.7% on the 7-day follow-up evaluation (p < 0.001). Higher ACHFPSQ scores were associated with a decreased malnutrition risk, with significant correlations found between food quality, meal service quality, staff/service issues, and lower malnutrition risk (p < 0.05). Very weak positive but statistically significant relationships were detected between the total scale score, body weight, and BMI (p < 0.05). The risk of malnutrition decreased as food quality (OR = 0.891; p < 0.001), meal service quality (OR = 0.915; p = 0.001), and staff/service issues scores (OR = 0.925; p = 0.010) increased. Conclusions: This study highlights the importance of hospital food service quality in preventing malnutrition among inpatients. [GRAPHICS]Öğe İnsan İmmün Yetmezlik Virüsü (HIV) ile enfekte çocuklarda beslenme(2023) Afacan, Fatma Öznur; Tipici, Beyza Eliuz; Demirel, BirsenEdinsel immün yetmezlik sendromu, insan immün yetmezlik virüsünün neden olduğu bağışıklık sistemini zayıflatan bir enfeksiyon hastalığıdır. Günümüzde insan immün yetmezlik virüsü ve edinsel immün yetmezlik sendromu çocuklar için önemli bir halk sağlığı sorunu olmaya devam etmektedir. Birleşmiş Milletler İnsan immün yetmezlik virüsü / Edinsel immün yetmezlik sendromu Ortak Programı 2020 yılı raporlarına göre, insan immün yetmezlik virüsü ile yaşayan çocukların yaklaşık yarısı antiretroviral tedavi alabilmekte ve pediatrik insan immün yetmezlik virüsü enfeksiyonunun tedavisi, kaynakları kısıtlı olan ülkelerde zorlu olmaya devam etmektedir. İnsan immün yetmezlik virüsü ile yaşayan çocuklarda anormal vücut yağ dağılımı, insülin direnci, kemik yoğunluğunda azalma ve lipodistrofi sendromu gibi komplikasyonlar görülebilmektedir. Malnütrisyon ise, hastalığın progresif ilerlemesinde hızlandırıcı bir etkendir ve erken ölüm riskinin artmasına, yaşam kalitesinin düşmesine neden olmaktadır. Dünya Sağlık Örgütü, insan immün yetmezlik virüsü ile yaşayan çocuklarda beslenme değerlendirmesi ve desteğinin önemli olduğunu bildirmektedir. Bununla beraber Beslenme ve Diyetetik Akademisi, tıbbi beslenme tedavisinin bu popülasyon için rutin bakıma entegrasyonunu desteklemekte ve insan immün yetmezlik virüsü ile yaşayan çocukları hedef alan bireyselleştirilmiş tıbbi beslenme tedavisini önermektedir. Bu derlemede insan immün yetmezlik virüsü ve edinsel immün yetmezlik sendromu ile yaşayan çocuklarda beslenme ile ilişkili klinik sorunlar, antiretroviral tedavinin yan etkileri ve tıbbi beslenme tedavisi hakkında güncel yaklaşımlar incelenmiştir.Öğe İnsan İmmün Yetmezlik Virüsü (HIV) ile enfekte çocuklarda beslenme(Mersin Üniversitesi, 2023) Afacan, Fatma Öznur; Tipici, Beyza Eliuz; Demirel, BirsenEdinsel immün yetmezlik sendromu, insan immün yetmezlik virüsünün neden olduğu bağışıklık sistemini zayıflatan bir enfeksiyon hastalığıdır. Günümüzde insan immün yetmezlik virüsü ve edinsel immün yetmezlik sendromu çocuklar için önemli bir halk sağlığı sorunu olmaya devam etmektedir. Birleşmiş Milletler İnsan immün yetmezlik virüsü / Edinsel immün yetmezlik sendromu Ortak Programı 2020 yılı raporlarına göre, insan immün yetmezlik virüsü ile yaşayan çocukların yaklaşık yarısı antiretroviral tedavi alabilmekte ve pediatrik insan immün yetmezlik virüsü enfeksiyonunun tedavisi, kaynakları kısıtlı olan ülkelerde zorlu olmaya devam etmektedir. İnsan immün yetmezlik virüsü ile yaşayan çocuklarda anormal vücut yağ dağılımı, insülin direnci, kemik yoğunluğunda azalma ve lipodistrofi sendromu gibi komplikasyonlar görülebilmektedir. Malnütrisyon ise, hastalığın progresif ilerlemesinde hızlandırıcı bir etkendir ve erken ölüm riskinin artmasına, yaşam kalitesinin düşmesine neden olmaktadır. Dünya Sağlık Örgütü, insan immün yetmezlik virüsü ile yaşayan çocuklarda beslenme değerlendirmesi ve desteğinin önemli olduğunu bildirmektedir. Bununla beraber Beslenme ve Diyetetik Akademisi, tıbbi beslenme tedavisinin bu popülasyon için rutin bakıma entegrasyonunu desteklemekte ve insan immün yetmezlik virüsü ile yaşayan çocukları hedef alan bireyselleştirilmiş tıbbi beslenme tedavisini önermektedir. Bu derlemede insan immün yetmezlik virüsü ve edinsel immün yetmezlik sendromu ile yaşayan çocuklarda beslenme ile ilişkili klinik sorunlar, antiretroviral tedavinin yan etkileri ve tıbbi beslenme tedavisi hakkında güncel yaklaşımlar incelenmiştir.Öğe Ketogenic diet as a successful early treatment modality for SCN2A mutation(Elsevier Science Bv, 2019) Turkdogan, Dilsad; Thomas, Gulten; Demirel, BirsenSCN2A mutations have been described in a very broad spectrum of clinical phenotypes including benign (familial) neonatal/ infantile seizures and early infantile epileptic encephalopathies (EIEE) as Ohtahara syndrome (OS), Dravet syndrome (DS), epilepsy of infancy with migrating focal seizures and West syndrome (WS). Treatment modalities for epilepsy caused by SCN2A mutations mainly consist of sodium channel blockers but ketogenic diet (KD) is also considered as an option of treatment for intractible seizures caused by SCN2A mutations. Because of the wide nature of the heterogeneity of mutations related to SCN2A gene, the clinical phenotypes vary in severity and treatment response to KD has been reported to be controversial. We present a patient diagnosed with OS associated with a novel SCN2A mutation (c.408G > A, p.Met136lle; OMIM (R): 182390) who had a complete resolution of seizures and EEG abnormalities with KD commenced at 39 days of age. As far as we are aware our case is the youngest patient with SCN2A mutation treated with KD with complete resolution of epilepsy at an early age and has been seizure free of antiepileptic medications for a long duration. (C) 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.Öğe Mucositis-Induced Pain due to Barrier Dysfunction may have a Direct Effect on Nutritional Status and Quality of Life in Head and Neck Cancer Patients Receiving Radiotherapy(Kare Publ., 2020) Atasoy, Beste M.; Kayhan, Kıvanç Bektaş; Demirel, Birsen; Akdeniz, EsraOBJECTIVE To maintain the barrier function against mucositis-induced pain and to improve the nutritional status and quality of life in head and neck cancer patients during radiotherapy. METHODS All patients (n=30) used oral gel to reduce mucositis-induced pain. Patients were examined weekly for the severity of mucositis, pain and nutritional status. The quality of life parameters was measured at the beginning and at the end of treatment. There was no restriction for pain killers against mucositis. RESULTS The only significant factor affecting the severity and frequency of mucositis was the cumulative radiation dose (p<0.001). Despite the regular use of oral gel, weight loss was observed in 65% of the patients. There was no difference concerning the severity of mucositis, cumulative radiation doses, or mean dose of oral mucosa between patients with no risk or at risk, according to SGA. However, self-assessment pain scores were significantly better in the well-nourished group (p=0.05 vs. 0.015) with better scores for dry mouth (p=0.043), social eating (p=0.006), swallowing difficulties (p=0.001) and communication (p=0.049). CONCLUSION Supporting the barrier function alone does not help to reduce the severity and frequency of mucositis, nor the oral pain in high doses. Mucositis-induced pain may have a direct effect on malnutrition risk and quality of life in head and neck cancer patients. Powerful strategies are required to manage pain due to mucositis during curative radiotherapy.Öğe Patient perspectives on dietitians’ role in nutrition management among cancer patients: Implications for proactive care and communication(2024) Ece, Melis Nur; Demirel, Birsen; Bayoğlu, Vedat; Mengüç, Meral Uluköylü; Atasoy, BesteObjective: This study aimed to determine patients’ perspectives regarding the role of dietitians in nutrition management. Methods: This study was conducted at our hospital’s oncology outpatient clinics. It used a questionnaire previously reported in the literature. One hundred sixty-two adult volunteers were included in this study. Patients’ knowledge of nutritional information, preferences for nutrition care, and perspectives on the dietitian’s role were measured. Descriptive statistics were used to describe the continuous variables. The degree of agreement was assessed using a 5-point Likert scale. Results: Nutritional care was a high priority for most volunteers (74.7%). Almost half of the patients expressed a need for dietitians to address their dietary challenges proactively. Most patients (64.2%) first met with a dietitian during ongoing treatment. They emphasized the need for frequent meetings and were willing to be referred to a dietitian earlier in their treatment. Conclusions: Most patients are referred to a dietitian after malnutrition, indicating the need for earlier intervention. Patients strongly desire improved communication among the healthcare team members regarding their nutritional concerns. Proactive nutritional management can reduce the incidence of malnutrition and enhance patient outcomes.Öğe PLASMA COENZYME Q10 LEVELS OF INDIVIDUALS WITH NEWLY DIAGNOSED TYPE 2 DIABETES AND DIABETES INDIVIDUALS WITH ADVANCED MICROALBUMINURIA: A COMPARATIVE STUDY(Nobel Ilac, 2024) Yildirim, Osman; Demirel, Birsen; Guendogan, Erdal; Avuk, Hande SevenObjective: Diabetes is a chronic disease that causes the development of microalbuminuria. CoQ10 deficiency is common in people with type 2 diabetes. This study aims to evaluate whether coenzyme Q10 (CoQ10) levels are a risk factor for diabetes and microalbuminuria in newly diagnosed diabetes and advanced microalbuminuria. Material and Method: The study was conducted with patients who came to the internal medicine outpatient clinic. Plasma CoQ10 and malondialdehyde (MDA) values of 90 people in total, including 30 people in each group, newly diagnosed Type 2 diabetes (Group D), diabetes mellitus with microalbuminuria (Group M), and the control group (Group C) were examined. Results: There was no difference between plasma CoQ10 and MDA levels of newly diagnosed type 2 diabetes patients and those with microalbuminuria (p>0.05). There was a negative correlation between CoQ10 and fasting glucose and HbA1c in all groups (p<0.05). A positive correlation was observed between CoQ10 and MDA (p<0.05). CoQ10 level of the control group was found to be higher than Group D and M (p<0.05); the difference between Group M and Group D was not significant (p>0.05). As a result of regression analysis, increasing the CoQ10 value was found to have a protective effect on the risk of diabetes (95 %CI: p=0.005). Conclusion: This study showed that individuals with low blood sugar and HbA1c had high CoQ10 levels. We think that CoQ10 can be considered a risk factor for diabetes, and further studies examining total CoQ10 and ubiquinol/ ubiquinone ratio would be beneficial.Öğe Quality and Nutritional Value of Functional Strawberry Marmalade Enriched with Chia Seed (Salvia hispanica L.)(WILEY-HINDAWI, 2019-08-14) Özbek, Tuğba; Şahin Yeşilçubuk, Neşe; Demirel, BirsenThe aim of the study was to develop and characterize marmalade having functional food ingredients such as omega-3 fatty acid, dietary fiber, protein, and antioxidants with the addition of chia seed (Salvia hispanica L.). During the development of marmalade formulations, sweetener type and chia content in the strawberry marmalade were decided by two-step sensory analysis. In the first step, four different formulas were prepared separately by using sorbitol, isomalt, commercial Stevie (TM) powder, and isomalt together with sorbitol. The control formula was prepared with sucrose (refined commercial sugar). In the first part of the study, sensorial parameters showed good acceptability for sorbitol. Thereafter, in the second step, marmalades were prepared with 2.5% and 5% (by weight) chia seed including sorbitol. According to sensory panels, sorbitol had the highest acceptance level and the chia seed content was chosen to be used as 5% in the formulations. Chia seed and sorbitol addition increased the phenolic content by 15.45% and the dietary fiber content by 168% and decreased the caloric value by 48% compared to the control prepared with sucrose and without chia seed. The final product had 1.5% omega-3 fatty acid and could be declared as "omega-3 source" in the label. The viscosity of chia-added marmalade was found to be slightly higher than the viscosity of control, even though there was no distinct difference between the two samples. The gel-like character was more dominant in chia-added strawberry marmalade compared to the control. The addition of chia at 5% may contribute to the crosslinking without formation of a gel structure.Öğe Sosyal Medyadaki Beslenme ile İlgili Paylaşımların Yetişkin Bireylerin Yeme Tutum ve Davranışlarına Etkisi(2021) Demirel, Birsen; Sipahi, SimgeAmaç: Bu araştırma sosyal medyadaki beslenmeyle ilgili paylaşımların yetişkin bireylerin yeme tutum ve davranışlarınaolan etkisini belirlemek amacıyla planlanmıştır.Bireyler ve Yöntem: Bu çalıs?ma, Aralık 2017-Kasım 2018 tarihleri arasında I?stanbul ilinde ikamet eden, 25-65 yas? arası 350yetis?kin birey ile yu?ru?tu?lmu?s?tu?r. Çalışmaya katılmayı kabul eden bireylere genel sag?lık bilgileri, sosyal medya kullanımlarınınderlenmesi ve yeme tutum ve davranışlarının belirlenmesinde kullanılan ölçek (YTT-40) uygulanmış takiben katılımcılarınvücut ağırlığı ve boy uzunluğu olmak üzere antropometrik o?lc?u?mleri alınmıs?tır. Kesim noktası 30 puan olarak bildirilen yemetutum ölçeğinin deg?erlendirmesi sonucunda ölc?ekten 30 ve u?zeri puan alan katılımcılar olumsuz yeme tutum davranıs?ınasahip olarak belirlenmiştir.Bulgular: Çalışmadaki kadın katılımcıların %85.4’u? (n=233), erkek katılımcıların %82.9’u (n=117) sosyal medyakullanmaktadır. En sık kullanılan sosyal medya platformunun Instagram olduğu belirlenmiştir. Sosyal medyada paylas?ılanbeslenme konulu paylas?ımlara kadınlar, erkeklere go?re daha ilgilidir (p<0.05). Olumsuz yeme tutum davranıs?ına sahipbireyler, sosyal medyada beslenme konularını daha c?ok takip etmektedir (p=0.003). Bireyler sosyal medyadan etkilenereksu tüketimini arttırmak (%46.3), etiket bilgisine dikkat etmek (%16.6), hazır besin tüketimini azaltmak (%16.6) gibi olumludavranış değişiklikleri (%46.3) geliştirdiklerini bildirmişlerdir. Çalışmadaki bireylerin yalnızca %8.1’i sosyal medyadakibeslenme konulu paylaşımların yeterli bilgiyle hazırlandığını düşünürken, beslenme konulu paylaşımların bilgi düzeyleriniarttırdığına inananların oranı %73.6’dır. Katılımcılar beslenme konulu paylaşımlarda diyetisyenleri (%58.6) en güvenilirbilgi kaynağı olarak ifade etmişlerdir.Sonuç: Bilgi edinmede hızlı, önemli ve etkili bir araç olan sosyal medyada beslenme ile ilgili yer alan paylaşımların, bireylerindavranış değişikliği geliştirmesinde etkili olduğu tespit edilmiştir. Bu nedenle beslenme ile ilgili paylaşımlar konununuzmanları tarafından yapılmalı ve ilgili kurumlar tarafından denetlenmelidir.Öğe The Effect of Work Stress Levels of Municipal Employees on Nutritional Status, Diet Quality, and Body Mass Index(Gumushane University, 2024) Buz, Emine Hatun; Avuk, Hande Seven; Demirel, BirsenThis study, conducted from January to May 2022, investigated the impact of work-related stress among 384 adult municipal employees (average age: 29.60±7.90 years) in various departments of Zeytinburnu Municipality on their nutritional status, diet quality, and body mass index (BMI). Data collection included participants' sociodemographic details, 24-hour dietary records, anthropometric measurements, and surveys conducted via face-to-face interviews. The surveys utilized the Mediterranean Diet Quality Index (KIDMED) to assess diet quality and the Job Stress Scale (JSS) to evaluate work stress. Results indicated that 58.9% of participants experienced moderate work stress, while 39% reported high levels of stress. The average KIDMED score was 7.76±3.36 points. Notably, female participants scored 7.59±3.00 on the KIDMED, while males scored 8.20±4.17 (p=0.006). On average, female participants had a BMI of 21.57±3.28 kg/m2, while males had a BMI of 26.40±3.04 kg/m2. Among municipal employees, 10.4% were underweight, 56.8% were normal weight, 26.6% were slightly overweight, and 6.3% were obese. Daily energy intake averaged 1624.30±485.03 kcal for women and 1638.14±493.36 kcal for men. The study identified a weak positive association between the job stress scale and KIDMED scores; however, no significant relationship was found between the job stress scale and BMI (r: 0.163, p=0.001; r:0.032, p=0.529). In summary, the research revealed that municipal employees experienced medium to high levels of work-related stress. Additionally, while there was a positive, albeit weak, correlation between Mediterranean diet quality and high work stress levels.
