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Evaluation of the Relationship between Emotional Appetite, Adherence to the Mediterranean Diet, and Metabolic Control Parameters in Individiuals with Type 2 Diabetes

Year 2022, Volume: 11 Issue: 2, 177 - 187, 31.12.2022

Sinem Bayram , Hilal Çalışkan , Arife Derya Altuner

https://doi.org/10.46971/ausbid.986920

Abstract

Aim: The Mediterranean diet, which is considered one of the healthiest diet models, and emotional appetite control are thought to facilitate diabetes management. In this study, it was aimed to examine the relationship between adherence to the Mediterranean diet, emotional appetite, and metabolic control parameters in Type 2 diabetes mellitus (T2DM) patients. Subjects and Method: The study was conducted with 101 volunteer T2DM patients aged 19-64 years who were diagnosed at least one year ago. In addition to a questionnaire including demographic characteristics, health status, anthropometric measurements and disease-related biochemical parameters, Mediterranean Diet Compliance Scale, Emotional Appetite Questionnaire (EMAQ), and International Physical Activity Questionnaire were administered to the patients. p value less than 0.05 was considered as statistically significant for statistical tests. Results: The haemoglobin a1c (HbA1c) which is an indicator of metabolic control, fasting blood glucose and body mass index (BMI) levels of the patients with high adherence to the Mediterranean diet were found to be significantly lower than incompatible groups (p<0.05). Waist circumference of patients with high adherence to the Mediterranean diet was found to be lower than those with acceptable compliance (p<0.05). Emotional eating positive status mean and total positive score mean of male patients was higher than female patients (p<0.05). Positive correlations were found between EMAQ positive total score and HbA1c and fasting blood glucose, and again weak and moderate correlations were found between positive total scores and BMI (p<0.05). Conclusion: Emotional appetite, which develops in response to emotions and causes overeating, complicates body weight loss in T2DM patients and increases the risk of obesity. Therefore, emotional appetite status should be considered in individuals with T2DM, taking into account the psychological aspect of nutrition. In addition, positive effects on T2DM biomarkers and anthropometric measurements are observed with adherence to the Mediterranean diet. Therefore, adherence to the Mediterranean diet should be increased in the medical nutrition treatment of individuals with T2DM.

Keywords

Mediterranean diet emotional appetite type 2 diabetes

References

  • Agnoli, C., Sieri, S., Ricceri, F., Giraudo, M. T., Masala, G., Assedi, M., Panico, S., Mattiello, A., Tumino, R., Giurdanella, M. C., & Krogh, V. (2018). Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutrition & Diabetes, 8(1), 1-10. https://doi.org/10.1038/s41387-018-0023-3
  • Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, metabolic syndrome and obesity: targets and therapy, 7, 587-591. https://doi.org/10.2147/DMSO.S67400
  • American Diabetes Association. (2018). Lifestyle management: Standards of medical care in diabetes. Diabetes Care, 41, 38–50. https://doi.org/10.2337/ dc18-S004
  • American Diabetes Association. (2020). 5. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2020. Diabetes Care, 43(Suppl 1), 48. https://doi.org/10.2337/dc20-S005
  • Chatterjee, S., Khunti, K. & Davies, M. J. (2017). Type 2 diabetes. The Lancet, 389(10085), 2239-2251. https://doi.org/10.1016/S0140-6736(17)30058-2
  • Ciccarone, E., Di Castelnuovo, A., Salcuni, M., Siani, A., Giacco, A., Donati, M. B., Gaetano, G., Capani, F., & Iacoviello, L., on behalf of the Gendiabe Investigators (2003). A high‐score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes. Journal of Thrombosis and Haemostasis, 1(8), 1744-1752. https://doi.org/10.1046/j.1538-7836.2003.00323.x
  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J., & Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35(8), 1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  • Demirel, B., Yavuz, F. K., Karadere, M. E., Şafak, Y. & Türkçapar, M. H. (2014). Duygusal İştah Anketi'nin Türkçe geçerlik ve güvenilirliği, beden kitle indeksi ve duygusal şemalarla ilişkisi. Journal of Cognitive Behavioral Psychotherapy and Research, 3, 171-181. http://dx.doi.org/10.5455/JCBPR.44046
  • Erkaya, Z. B., Oğuzöncül, A. F., & Kurt, O. (2020). Bir sağlık meslek yüksekokulundaki öğrencilerde duygusal iştah ile obezite arasındaki ilişkinin değerlendirilmesi. Balıkesir Sağlık Bilimleri Dergisi, 9(1), 37-44. https://dergipark.org.tr/tr/pub/balikesirsbd/issue/54282/670776
  • Esposito, K., Maiorino, M. I., Di Palo, C., & Giugliano, D. (2009). Adherence to a Mediterranean diet and glycaemic control in type 2 diabetes mellitus. Diabetic Medicine, 26(9), 900-907. https://doi.org/10.1111/j.1464-5491.2009.02798.x
  • Esposito, K., Maiorino, M. I., Bellastella, G., Chiodini, P., Panagiotakos, D. & Giugliano, D. (2015). A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ, 5(8), e008222. https://doi.org/10.1136/bmjopen-2015-008222
  • Ferreira-Pêgo, C., Rodrigues, J., Costa, A., & Sousa, B. (2020). Eating behavior: The influence of age, nutrition knowledge, and Mediterranean diet. Nutrition and Health, 26(4):303-309. https://doi.org/10.1177/0260106020945076
  • Frayn, M. & Knäuper, B. (2018). Emotional eating and weight in adults: A review. Current Psychology, 37(4), 924-933. https://doi.org/10.1007/s12144-017-9577-9
  • InterAct Consortium. (2011). Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into cancer and nutrition (EPIC) study: the InterAct project. Diabetes Care, 34(9), 1913-1918. https://doi.org/10.2337/dc11-0891
  • International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas (10th ed.). Brussels.
  • Itsiopoulos, C., Brazionis, L., Kaimakamis, M., Cameron, M., Best, J. D., O’Dea, K. & Rowley, K. (2011). Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutrition, Metabolism and Cardiovascular Diseases, 21(9), 740-747. https://doi.org/10.1016/j.numecd.2010.03.005
  • Jayedi, A., Mirzaei, K., Rashidy-Pour, A., Yekaninejad, M. S., Zargar, M. S., & Eidgahi, M. R. A. (2019). Dietary approaches to stop hypertension, mediterranean dietary pattern, and diabetic nephropathy in women with type 2 diabetes: a case-control study. Clinical Nutrition ESPEN, 33, 164-170. https://doi.org/10.1016/j.clnesp.2019.05.021
  • Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107-111. https://doi.org/ 10.2991/jegh.k.191028.001
  • Martínez-González, M. Á., De la Fuente-Arrillaga, C., Nunez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., Benito, S., Tortosa, A., & Bes-Rastrollo, M. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. British Medical Journal, 336(7657), 1348-1351. https://doi.org/10.1136/bmj.39561.501007.BE
  • Martínez-González, M. A., García-Arellano, A., Toledo, E., Salas-Salvado, J., Buil-Cosiales, P., Corella, D., Covas, M., Schröder, H., Arós, F., Gómez-Gracia, E., Fiol, M., Ruiz-Gutiérrez, V., Lapetra, J., Lamuela-Raventos, M., Serra-Majem, L., Pintó, X., Muñoz, M., Wärnberg, J., Ros, E., Estruch, R., & PREDIMED Study Investigators (2012). A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PloS One, 7(8), e43134. https://doi.org/10.1371/journal.pone.0043134
  • Mirabelli, M., Chiefari, E., Arcidiacono, B., Corigliano, D. M., Brunetti, F. S., Maggisano, V., Russo, D., Foti, D. P., & Brunetti, A. (2020). Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases. Nutrients, 12(4), 1066. https://doi.org/ 10.3390/nu12041066
  • Müftüoğlu, S., & Küçükağdaş, Ş. (2019). Bariatrik cerrahi sonrası bireylerin iştah kontrolü ve yeme bağımlılıklarının değerlendirilmesi. Beslenme ve Diyet Dergisi, 47(2), 30-39. https://doi.org/10.33076/2019.BDD.1156
  • Nolan, L. J., Halperin, L. B. & Geliebter, A. (2010). Emotional Appetite Questionnaire. Construct validity and relationship with BMI. Appetite, 54(2), 314-319. https://doi.org/10.1016/j.appet.2009.12.004
  • Park, M., Quinn, L., Park, C., & Martyn-Nemeth, P. (2018). Pathways of the relationships among eating behavior, stress, and coping in adults with type 2 diabetes: A cross-sectional study. Appetite, 131, 84-93. https://doi.org/10.1016/j.appet.2018.09.008
  • Patino-Alonso, M. C., Recio-Rodríguez, J. I., Belio, J. F. M., Colominas-Garrido, R., Lema-Bartolomé, J., Arranz, A. G., Agudo-Conde, C., Gomez-Marcos, M. A, García-Ortiz, L., & EVIDENT Group (2014). Factors associated with adherence to the Mediterranean diet in the adult population. Journal of the Academy of Nutrition and Dietetics, 114(4), 583-589. https://doi.org/10.1016/j.jand.2013.07.038
  • Pehlivanoğlu, E. F. Ö., Balcıoğlu, H., & Ünlüoğlu, İ. (2020). Akdeniz Diyeti Bağlılık Ölçeği’nin Türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi, 42(2), 160-164. https://doi.org/10.20515/otd.504188
  • Sağlam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., & Tokgozoglu, L. (2010). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and Motor Skills, 111(1), 278-284. https://doi.org/10.2466/06.08.PMS.111.4.278-284
  • Toobert, D. J., Glasgow, R. E., Strycker, L. A., Barrera, M., Radcliffe, J. L., Wander, R. C., & Bagdade, J. D. (2003). Biologic and quality-of-life outcomes from the Mediterranean Lifestyle Program: a randomized clinical trial. Diabetes Care, 26(8), 2288-2293. https://doi.org/10.2337/diacare.26.8.2288
  • Tzima, N., Pitsavos, C., Panagiotakos, D. B., Skoumas, J., Zampelas, A., Chrysohoou, C., & Stefanadis, C. (2007). Mediterranean diet and insulin sensitivity, lipid profile and blood pressure levels, in overweight and obese people; the Attica study. Lipids in Health and Disease, 6(1), 1-7. https://doi.org/10.1186/1476-511X-6-22
  • World Health Organization. (2008). Waist circumference and waist-hip ratio: Report of a WHO expert consultation. https://www.who.int/publications/i/item/9789241501491.
  • World Health Organization. (2021). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
  • Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nature Reviews Endocrinology, 12(10), 616-622. https://doi.org/10.1038/nrendo.2016.105

Tip 2 Diyabetli Bireylerde Duygusal İştah, Akdeniz Diyetine Uyum ve Metabolik Kontrol Parametreleri Arasındaki İlişkinin Değerlendirilmesi

Year 2022, Volume: 11 Issue: 2, 177 - 187, 31.12.2022

Sinem Bayram , Hilal Çalışkan , Arife Derya Altuner

https://doi.org/10.46971/ausbid.986920

Abstract

Amaç: Sağlıklı diyet modellerinden biri olarak kabul edilen Akdeniz diyetinin ve duygusal iştah kontrolünün diyabet yönetimini kolaylaştıracağı düşünülmektedir. Bu çalışmada, tip 2 diabetes mellitus (T2DM) hastalarında Akdeniz diyetine uyum, duygusal iştah ve metabolik kontrol parametreleri arasındaki ilişkinin incelenmesi amaçlanmıştır. Örneklem ve Yöntem: Çalışma en az bir yıl önce tanı alan 19-64 yaş arası gönüllü 101 T2DM hastası ile yürütülmüştür. Hastalara demografik özellikler, sağlık durumları, antropometrik ölçümler ve hastalık ile ilişkili biyokimyasal parametreleri kapsayan bir anket formuna ek olarak Akdeniz Diyeti Uyum Ölçeği, Duygusal İştah Anketi (DİA) ve Uluslararası Fiziksel Aktivite Anketi uygulanmıştır. İstatistiksel anlamlılık düzeyi p<0.05 olarak alınmıştır. Bulgular: Akdeniz diyetine uyumu yüksek olan hastalarda metabolik kontrolün göstergesi olan hemoglobin A1c (HbA1c), açlık kan glukozu ve beden kütle indeksi (BKİ) düzeyleri, uyumsuz olanlara göre anlamlı düzeyde düşük bulunmuştur (p<0.05). Akdeniz diyetine yüksek uyumlu hastaların bel çevresi ise kabul edilebilir düzeyde uyumlu olanlara göre düşük bulunmuştur (p<0.05). Erkek hastaların duygusal yemek yeme pozitif durum ortalamaları ve toplam pozitif puan ortalamaları kadın hastalardan daha yüksektir (p<0.05). DİA pozitif toplam puan ile HbA1c ve açlık kan glukozu arasında pozitif yönlü ve yine pozitif toplam puan ile BKİ ve bel çevresi arasında negatif yönlü zayıf ve orta düzey ilişkiler saptanmıştır (p<0.05). Sonuç: Duygulara karşılık olarak gelişen ve aşırı yemeye neden olan duygusal iştah, T2DM hastalarında vücut ağırlığı kaybını zorlaştırmakta ve obezite riskini arttırmaktadır. Bu nedenle T2DM’li bireylerde, beslenmenin psikolojik yönü de dikkate alınarak, duygusal iştah durumları sorgulanmalıdır. Ayrıca Akdeniz diyetine uyum ile T2DM’nin biyobelirteçleri ve antropometrik ölçümler üzerine olumlu etkiler gözlenmektedir. Bu nedenle T2DM’li bireylerin tıbbi beslenme tedavisinde Akdeniz diyetine uyum arttırmalıdır.

Keywords

Akdeniz diyeti duygusal iştah tip 2 diyabet

References

  • Agnoli, C., Sieri, S., Ricceri, F., Giraudo, M. T., Masala, G., Assedi, M., Panico, S., Mattiello, A., Tumino, R., Giurdanella, M. C., & Krogh, V. (2018). Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutrition & Diabetes, 8(1), 1-10. https://doi.org/10.1038/s41387-018-0023-3
  • Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, metabolic syndrome and obesity: targets and therapy, 7, 587-591. https://doi.org/10.2147/DMSO.S67400
  • American Diabetes Association. (2018). Lifestyle management: Standards of medical care in diabetes. Diabetes Care, 41, 38–50. https://doi.org/10.2337/ dc18-S004
  • American Diabetes Association. (2020). 5. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2020. Diabetes Care, 43(Suppl 1), 48. https://doi.org/10.2337/dc20-S005
  • Chatterjee, S., Khunti, K. & Davies, M. J. (2017). Type 2 diabetes. The Lancet, 389(10085), 2239-2251. https://doi.org/10.1016/S0140-6736(17)30058-2
  • Ciccarone, E., Di Castelnuovo, A., Salcuni, M., Siani, A., Giacco, A., Donati, M. B., Gaetano, G., Capani, F., & Iacoviello, L., on behalf of the Gendiabe Investigators (2003). A high‐score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes. Journal of Thrombosis and Haemostasis, 1(8), 1744-1752. https://doi.org/10.1046/j.1538-7836.2003.00323.x
  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J., & Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35(8), 1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  • Demirel, B., Yavuz, F. K., Karadere, M. E., Şafak, Y. & Türkçapar, M. H. (2014). Duygusal İştah Anketi'nin Türkçe geçerlik ve güvenilirliği, beden kitle indeksi ve duygusal şemalarla ilişkisi. Journal of Cognitive Behavioral Psychotherapy and Research, 3, 171-181. http://dx.doi.org/10.5455/JCBPR.44046
  • Erkaya, Z. B., Oğuzöncül, A. F., & Kurt, O. (2020). Bir sağlık meslek yüksekokulundaki öğrencilerde duygusal iştah ile obezite arasındaki ilişkinin değerlendirilmesi. Balıkesir Sağlık Bilimleri Dergisi, 9(1), 37-44. https://dergipark.org.tr/tr/pub/balikesirsbd/issue/54282/670776
  • Esposito, K., Maiorino, M. I., Di Palo, C., & Giugliano, D. (2009). Adherence to a Mediterranean diet and glycaemic control in type 2 diabetes mellitus. Diabetic Medicine, 26(9), 900-907. https://doi.org/10.1111/j.1464-5491.2009.02798.x
  • Esposito, K., Maiorino, M. I., Bellastella, G., Chiodini, P., Panagiotakos, D. & Giugliano, D. (2015). A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ, 5(8), e008222. https://doi.org/10.1136/bmjopen-2015-008222
  • Ferreira-Pêgo, C., Rodrigues, J., Costa, A., & Sousa, B. (2020). Eating behavior: The influence of age, nutrition knowledge, and Mediterranean diet. Nutrition and Health, 26(4):303-309. https://doi.org/10.1177/0260106020945076
  • Frayn, M. & Knäuper, B. (2018). Emotional eating and weight in adults: A review. Current Psychology, 37(4), 924-933. https://doi.org/10.1007/s12144-017-9577-9
  • InterAct Consortium. (2011). Mediterranean diet and type 2 diabetes risk in the European Prospective Investigation into cancer and nutrition (EPIC) study: the InterAct project. Diabetes Care, 34(9), 1913-1918. https://doi.org/10.2337/dc11-0891
  • International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas (10th ed.). Brussels.
  • Itsiopoulos, C., Brazionis, L., Kaimakamis, M., Cameron, M., Best, J. D., O’Dea, K. & Rowley, K. (2011). Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutrition, Metabolism and Cardiovascular Diseases, 21(9), 740-747. https://doi.org/10.1016/j.numecd.2010.03.005
  • Jayedi, A., Mirzaei, K., Rashidy-Pour, A., Yekaninejad, M. S., Zargar, M. S., & Eidgahi, M. R. A. (2019). Dietary approaches to stop hypertension, mediterranean dietary pattern, and diabetic nephropathy in women with type 2 diabetes: a case-control study. Clinical Nutrition ESPEN, 33, 164-170. https://doi.org/10.1016/j.clnesp.2019.05.021
  • Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107-111. https://doi.org/ 10.2991/jegh.k.191028.001
  • Martínez-González, M. Á., De la Fuente-Arrillaga, C., Nunez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., Benito, S., Tortosa, A., & Bes-Rastrollo, M. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. British Medical Journal, 336(7657), 1348-1351. https://doi.org/10.1136/bmj.39561.501007.BE
  • Martínez-González, M. A., García-Arellano, A., Toledo, E., Salas-Salvado, J., Buil-Cosiales, P., Corella, D., Covas, M., Schröder, H., Arós, F., Gómez-Gracia, E., Fiol, M., Ruiz-Gutiérrez, V., Lapetra, J., Lamuela-Raventos, M., Serra-Majem, L., Pintó, X., Muñoz, M., Wärnberg, J., Ros, E., Estruch, R., & PREDIMED Study Investigators (2012). A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PloS One, 7(8), e43134. https://doi.org/10.1371/journal.pone.0043134
  • Mirabelli, M., Chiefari, E., Arcidiacono, B., Corigliano, D. M., Brunetti, F. S., Maggisano, V., Russo, D., Foti, D. P., & Brunetti, A. (2020). Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases. Nutrients, 12(4), 1066. https://doi.org/ 10.3390/nu12041066
  • Müftüoğlu, S., & Küçükağdaş, Ş. (2019). Bariatrik cerrahi sonrası bireylerin iştah kontrolü ve yeme bağımlılıklarının değerlendirilmesi. Beslenme ve Diyet Dergisi, 47(2), 30-39. https://doi.org/10.33076/2019.BDD.1156
  • Nolan, L. J., Halperin, L. B. & Geliebter, A. (2010). Emotional Appetite Questionnaire. Construct validity and relationship with BMI. Appetite, 54(2), 314-319. https://doi.org/10.1016/j.appet.2009.12.004
  • Park, M., Quinn, L., Park, C., & Martyn-Nemeth, P. (2018). Pathways of the relationships among eating behavior, stress, and coping in adults with type 2 diabetes: A cross-sectional study. Appetite, 131, 84-93. https://doi.org/10.1016/j.appet.2018.09.008
  • Patino-Alonso, M. C., Recio-Rodríguez, J. I., Belio, J. F. M., Colominas-Garrido, R., Lema-Bartolomé, J., Arranz, A. G., Agudo-Conde, C., Gomez-Marcos, M. A, García-Ortiz, L., & EVIDENT Group (2014). Factors associated with adherence to the Mediterranean diet in the adult population. Journal of the Academy of Nutrition and Dietetics, 114(4), 583-589. https://doi.org/10.1016/j.jand.2013.07.038
  • Pehlivanoğlu, E. F. Ö., Balcıoğlu, H., & Ünlüoğlu, İ. (2020). Akdeniz Diyeti Bağlılık Ölçeği’nin Türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Dergisi, 42(2), 160-164. https://doi.org/10.20515/otd.504188
  • Sağlam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., & Tokgozoglu, L. (2010). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and Motor Skills, 111(1), 278-284. https://doi.org/10.2466/06.08.PMS.111.4.278-284
  • Toobert, D. J., Glasgow, R. E., Strycker, L. A., Barrera, M., Radcliffe, J. L., Wander, R. C., & Bagdade, J. D. (2003). Biologic and quality-of-life outcomes from the Mediterranean Lifestyle Program: a randomized clinical trial. Diabetes Care, 26(8), 2288-2293. https://doi.org/10.2337/diacare.26.8.2288
  • Tzima, N., Pitsavos, C., Panagiotakos, D. B., Skoumas, J., Zampelas, A., Chrysohoou, C., & Stefanadis, C. (2007). Mediterranean diet and insulin sensitivity, lipid profile and blood pressure levels, in overweight and obese people; the Attica study. Lipids in Health and Disease, 6(1), 1-7. https://doi.org/10.1186/1476-511X-6-22
  • World Health Organization. (2008). Waist circumference and waist-hip ratio: Report of a WHO expert consultation. https://www.who.int/publications/i/item/9789241501491.
  • World Health Organization. (2021). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
  • Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nature Reviews Endocrinology, 12(10), 616-622. https://doi.org/10.1038/nrendo.2016.105
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Sinem Bayram 0000-0003-1569-7747

Hilal Çalışkan 0000-0001-6418-1806

Arife Derya Altuner This is me 0000-0003-4975-4041

Publication Date December 31, 2022
Published in Issue Year 2022 Volume: 11 Issue: 2

Cite

APA Bayram, S., Çalışkan, H., & Altuner, A. D. (2022). Tip 2 Diyabetli Bireylerde Duygusal İştah, Akdeniz Diyetine Uyum ve Metabolik Kontrol Parametreleri Arasındaki İlişkinin Değerlendirilmesi. Ankara Sağlık Bilimleri Dergisi, 11(2), 177-187. https://doi.org/10.46971/ausbid.986920
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