Rahime Evra Karakaya

Purpose: Food insecurity is a significant public health issue with growing implications for health systems worldwide. This study aims to examine the impact of food insecurity on health systems and to review current approaches from a public health perspective. Methods: A narrative literature review was conducted using databases including PubMed and Scopus. Peer-reviewed studies published between 2009 and 2026 were reviewed using keywords related to food insecurity, healthcare utilization, health outcomes, healthcare expenditures, and diet quality. Results: The findings indicate that food insecurity is associated with increased healthcare utilization, including more frequent emergency department visits and hospitalizations, higher healthcare expenditures, delayed access to preventive services, and poorer health outcomes. Emerging evidence suggests that food-based interventions and routine screening practices implemented within healthcare settings may improve dietary and clinical outcomes. In Türkiye, current approaches primarily rely on social assistance and community-based interventions, while integration into healthcare services remains limited. Conclusion: Food insecurity imposes a substantial burden on healthcare systems and requires coordinated action across healthcare, social support, and policy sectors. Integrating routine screening and referral mechanisms into primary healthcare services, together with targeted food-based interventions and stronger intersectoral collaboration, may contribute to more effective management of food insecurity. Further longitudinal and healthcare-oriented research is needed to evaluate system-level impacts and the cost-effectiveness of integrated interventions.

Type 2 Diabetes Mellitus (T2DM), characterized by chronic hyperglycemia, is a major global health problem associated with increased morbidity, mortality, and healthcare costs. This narrative review aimed to evaluate the clinical effects of personalized nutrition (PN) approaches supported by Digital Twin (DT) technology in the management of T2DM. A comprehensive literature review was conducted using indexed databases, including PubMed, Scopus, Web of Science, and Google Scholar, without time restrictions and limited to articles published in English. Relevant studies focusing on artificial intelligence (AI), DT technology, PN, continuous glucose monitoring (CGM), and diabetes management were analyzed. The findings indicate that DT-supported PN approaches, which integrate AI, Internet of Things (IoT)-based systems, CGM data, lifestyle factors, and physiological parameters, may contribute to improved glycemic control and individualized diabetes management. Studies reported reductions in HbA1c levels, insulin resistance, medication requirements, and improvements in certain metabolic and cardiovascular risk markers. In addition, DT technology enables the creation of virtual metabolic models that allow simulation of treatment outcomes and support early intervention strategies. However, important limitations remain, including challenges related to data integration, model bias, high implementation costs, and concerns regarding data privacy and security. In conclusion, DT-supported PN approaches represent a promising next-generation strategy for T2DM management by enhancing personalized care and supporting glycemic control. Further large-scale and long-term studies are needed to confirm their clinical effectiveness, cost-efficiency, and applicability in routine healthcare practice.

Amaç: Bu araştırma üniversite öğrencilerinin kronotipi ile uyku kalitesi ve gece yeme sendromu arasındaki ilişkinin incelenmesi amacıyla planlanmıştır. Gereç ve Yöntem: Araştırmaya 19–30 yaş aralığında 300 öğrenci katılmıştır. Araştırmaya katılan bireylerin sosyodemografik özellikleri, beslenme alışkanlıkları, Sabahçıl-Akşamcıl Anketi, Pittsburg Uyku Kalitesi İndeksi, Gece Yeme Anketi verileri anket formu kullanılarak yüz yüze görüşme tekniğiyle toplanmıştır. Verilerin analizi SPSS 26 istatistik paket programı ile yapılmıştır. Bulgular: Bireylerin kronotiplerine göre %18,3'ü sabahçıl tip, %64,0'ü ara tip, %17,7'si akşamcıl tiptir. Uyku kalitesine göre %97,0'si kötü, %3,0’ü iyi uyku kalitesine sahiptir. Gece Yeme Anketine göre bireylerin %98,3'ünde gece yeme sendromu bulunmamıştır. Akşamcıl tip öğrencilerin Pittsburg Uyku Kalitesi İndeksi ve Gece Yeme Anketi ortanca değerleri, sabahçıl ve ara tipe sahip öğrencilerden daha yüksektir (p<0,001). Bireylerin SabahçılAkşamcıl Anketi ve Pittsburg Uyku Kalitesi İndeksi değerleri arasında negatif yönde zayıf derecede anlamlı ilişki (r=-0,367, p<0,001), SabahçılAkşamcıl Anketi ve Gece Yeme Anketi arasında negatif yönde orta derecede anlamlı ilişki (r=-0,450, p<0,001) saptanmıştır. Sonuç: Kronotipin, bireylerin uyku düzeni ve yeme davranışlarını etkileyen önemli bir faktör olduğu gözlemlenmiştir. Bu nedenle, üniversite öğrencilerinin uyku düzenlerini iyileştirmek ve sağlıklı beslenme alışkanlıklarını teşvik etmek amacıyla uygun önlemlerin alınması önem taşımaktadır. Anahtar Kelimeler: Beden kütle indeksi, gece yeme sendromu, sirkadiyen ritim, uyku.

Healthy eating is a crucial concept encompassing biochemical, physical, and psychosocial domains, and various nutritional indices and scales have been developed to assess the healthfulness of individuals' diets. This study aimed to evaluate the validity of the My Nutrition Index and examine its relationship with the Healthy Eating Index-2015 in the Turkish population. This cross-sectional study included 498 participants aged 19-64 years. Demographic and anthropometric data were collected, and three-day food consumption records were obtained to calculate both the My Nutrition Index and the Healthy Eating Index-2015. Validity of the MNI was assessed by examining its correlation with the HEI-2015 using Pearson's correlation test. Additionally, subgroup analyses were conducted to explore associations between MNI scores and demographic variables. Data analysis was performed using the IBM SPSS Statistics 26 software package. Of the 498 participants, 65.4% were female and 34.6% were male. The mean age of the participants was 32.59 ± 14.34 years, and the mean body mass index was 24.58 ± 5.03 kg/m². The mean score for the My Nutrition Index was 47.91 ± 15.88, while the mean score for the Healthy Eating Index was 56.87 ± 10.49. A significant positive correlation was observed between the total score of the My Nutrition Index, the electrolyte, vitamin, and mineral subscales, and the Healthy Eating Index-2015 (p < 0.05). The mineral index scores of women were lower than those of men, and the My Nutrition Index score of individuals classified as underweight was lower than those of individuals with normal weight and obesity. Smokers had lower scores on both the My Nutrition Index and the Healthy Eating Index-2015 compared to non-smokers (p < 0.05). The My Nutrition Index demonstrated a significant correlation with the Healthy Eating Index-2015 in Türkiye. By providing a more culturally and contextually appropriate assessment tool, the My Nutrition Index may facilitate more targeted and effective interventions aimed at improving dietary habits. Future research should focus on validating the MNI in diverse populations and exploring its relationship with long-term health outcomes through longitudinal studies to further establish its clinical and public health relevance.

Background/Objectives: Hashimoto’s thyroiditis (HT) is an autoimmune disease influenced by genetic factors and environmental triggers that affect immune system function. Data suggest that vitamin D may also play a role in the etiopathogenesis of HT. Methods: This retrospective study included patients admitted to the Endocrinology and Metabolic Diseases Outpatient Clinic. Data from individuals aged 18 years and older were analyzed, including serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and vitamin D. HT was diagnosed based on the presence of anti-TPO and/or anti-TG antibodies, while individuals with negative results for both were classified as non-HT. Thyroid function was categorized as euthyroid if TSH levels were between 0.55 mU/L and 4.78 mU/L and fT4 levels were between 0.89 ng/dL and 1.76 ng/dL; hypothyroid status was defined as TSH > 4.78 mU/L. Vitamin D levels were classified as deficient (p < 0.001). Vitamin D deficiency was present in 65.5% of the non-HT group and 62.1% of the HT group (p < 0.001). Subgroup analyses based on thyroid function showed that vitamin D levels were highest in the euthyroid HT group and similar in the euthyroid non-HT, hypothyroid non-HT, and hypothyroid HT groups (p < 0.001). Conclusions: In conclusion, while vitamin D levels were higher in the HT group compared to the non-HT group, no clinically significant association between vitamin D levels and HT or autoantibody positivity was observed. Vitamin D deficiency was more prevalent in the hypothyroid group compared to the euthyroid group. This study suggests that although vitamin D deficiency may not be directly involved in the pathogenesis of HT, it may still play a role in modulating immune activity or influencing the disease phenotype..

Aim: The use of herbal supplements is increasing today, and these products have a significant impact on individuals' health. The aim of this study is to examine the use and reasons for using herbal supplements, as well as to determine individuals' attitudes towards these products. Materials and Methods: The study was conducted with individuals aged 19-65 who use medications. A questionnaire containing questions about the participants' demographic characteristics, herbal supplement usage, and attitudes was administered by the researcher through face-to-face interviews. Results: Of the 274 participants in the study, 10.6% use herbal supplements, with the most preferred products being ginseng, St. John's wort, and garlic (20.7%, 27.6%, and 37.9%, respectively). It was found that individuals who consume alcohol use herbal supplements 3.188 times more, and those who exercise use them 3.470 times more than those who do not (p=0.043, p=0.015, respectively). Most herbal supplement users agreed with the statement, "Herbal supplements can be used immediately when experiencing symptoms related to illness," while most non-users disagreed (p

Background/Objectives: Postprandial hypotension (PPH) is an important clinical condition in patients presenting with postprandial symptoms. The aims of this study were to determine the prevalence of PPH in patients with postprandial symptoms and to investigate the relationship between PPH and insulin, particularly in healthy adults. Methods: This study was conducted with 111 adult patients who were admitted to the clinic due to postprandial symptoms. Patients underwent the mixed meal test (MMT). Blood glucose, insulin, and C-peptide levels were measured at 0, 30, 60, 90, 120, 180, 240, and 300 min along with systolic blood pressure (sBP), diastolic blood pressure (dBP), and heart rate measurements during the MMT. Results: Serum adrenocorticotropic hormone (ACTH) levels were similar (p > 0.05), and cortisol levels were found to be higher in individuals without PPH compared to those with PPH before the MMT (p = 0.014). During the MMT, 23 patients (23.2%) had PPH. At the beginning of the test, serum glucose, insulin, C-peptide, and heart rate values were similar in patients with and without PPH; however sBP and dBP were significantly higher in the PPH group (p = 0.002 and p = 0.010, respectively). No correlation was found between sBP and insulin, glucose, and C-peptide at any time during the MMT except for a moderately significant positive correlation between glucose and sBP at 90 min in patients with PPH (r = 0.490, p = 0.018). A moderately negative correlation was found between the magnitude of sBP fall between 30 and 60 min and insulin and C-peptide levels in people with PPH (r = −0.420, p = 0.046; r = −0.564, p = 0.005; respectively). However, no significant relationships were observed between the magnitude of sBP fall at other time points and blood parameters (p > 0.05). Conclusions: A significant portion of adults with postprandial symptoms might have PPH, contributing to these symptoms. The lack of a relationship between insulin and glucose suggests that other physiological mechanisms beyond insulin and glucose may play a role in the pathogenesis of PPH in healthy individuals. Therefore, further research is needed to better understand the underlying causes of PPH.

Obesity and certain associated environmental factors increase the risk of type 2 diabetes mellitus (T2DM). This research aims to evaluate the relationship between sociodemographic characteristics, lifestyle, and diet quality with diabetes risk in overweight and obese Turkish adults. A questionnaire form including sociodemographic characteristics, lifestyle, body weight and height was applied. Finnish Diabetes Risk Score (FINDRISC) tool was used to identify the risk of T2DM. Dietary assessments were made by 24 h dietary recall and diet quality was evaluated by Healthy Eating Index-2015 (HEI-2015). According to FINDRISC score, 38.1% of adults were at mild risk, 21.9% were at moderate risk, and 20.9% were at high risk. In regression model, factors such as low educational level, being married, being employed, smoking, and the presence of comorbidities were found to increase the risk of developing diabetes. Each unit decline in HEI-2015, the risk of diabetes increased by a factor of 0.983. Sociodemographic factors, lifestyle, and diet quality significantly contribute to the increased risk of diabetes in overweight and obese Turkish adults. This trial was registered at clinicaltrials.gov with number NCT06614075 and registration date of 26 September 2024, retrospectively registered.

Objective: This study was conducted to examine the relationship between eating disorder risk, social media, and psychological factors among high school students. Material and Methods: In this cross-sectional study, eating disorder risk was assessed using the Eating Attitudes Test-40 (EAT-40), fear of being disliked on social media was evaluated using the Social Media Fear of Dislike Scale (SMFDS), psychological factors were measured with the Depression, Anxiety and Stress Scale-42 (DASS-42) high school form. Results: According to the EAT-40 scale, 15.4% of students were at risk for eating disorders. Based on the DASS-42 scale, extremely severe levels of depression, anxiety, and stress were revealed in 18.3%, 21.5%, and 10.5% of students, respectively. Female students had higher levels of fear of being disliked on social media, depression, anxiety, and stress compared to male students; however, no significant difference was observed regarding eating disorder risk. A positive and significant correlation was found between eating disorder risk and fear of being disliked on social media, depression, anxiety, and stress values (r=0.215, p<0.001; r=0.217, p<0.001; r=0.302, p<0.001; r=0.245, p<0.001, respectively). Conclusion: The risk of eating disorders in high school students is associated with social media use and psychological factors. These findings emphasize the need for a more detailed examination of the effects of social media use and related psychological factors on eating behaviors.