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Öğe Assessing the association between Mediterranean diet adherence and quality of life among Syrian refugee women in Mardin, Türkiye(Bmc, 2026) Cifci, Sema; Arslan, Nurgul; Alatas, HacerBackground T & uuml;rkiye hosts over 3.5 million Syrian refugees, with women facing heightened socioeconomic and health-related vulnerabilities. Structural constraints, including food insecurity, may influence dietary behaviors and overall well-being. Objective This study aimed to assess quality of life (QoL), Mediterranean diet adherence, and food security levels among Syrian refugee women living in Mardin, T & uuml;rkiye; to examine the association between Mediterranean Diet Score (MDS) and QoL domains; to identify independent predictors of total QoL; and to explore the mediating role of food insecurity in this relationship. Methods A cross-sectional study was conducted with 310 Syrian refugee women aged 18-49 years. Data were collected using structured questionnaires, including the 14-item Mediterranean Diet Adherence Screener and the WHOQOL-BREF instrument. Descriptive statistics, ANOVA, Pearson correlation analysis (continuous variables only), multiple linear regression, and exploratory mediation analysis were performed. Results The mean total QoL score was 59.3 (SD = 14.5). The mean Mediterranean Diet Score (MDS) was 7.1 (SD = 2.6), with 22.6% of participants demonstrating high adherence. Food insecurity was prevalent, affecting 79.4% of households. Higher MDS was positively associated with all QoL domains (physical: r = 0.28, p < 0.001; psychological: r = 0.24, p = 0.002; social: r = 0.21, p = 0.004; environmental: r = 0.19, p = 0.007). Although statistically significant, these correlations were weak in magnitude (r < 0.30). In multiple regression analysis, MDS, education, and income were positive predictors of QoL, whereas food insecurity and larger household size were negatively associated. Exploratory mediation analysis identified a statistically significant indirect effect consistent with a potential partial mediation pattern; however, given the cross-sectional design, these findings should not be interpreted as evidence of a causal pathway. Conclusion Mediterranean diet adherence was positively associated with quality of life among Syrian refugee women. Socioeconomic disadvantage and food insecurity were linked to lower well-being. Given the cross-sectional design, causal inferences cannot be made, and longitudinal studies are needed to clarify these relationships.Öğe Central adiposity outperforms disordered eating behavior in predicting type 2 diabetes risk in young adults: an explainable machine learning approach(Frontiers Media Sa, 2026) Alatas, Hacer; Arslan, Nurgul; Kurt, Harun; Bentli, SerkanBackground: Disordered eating behaviors are often associated with adverse metabolic outcomes, yet their relationship with type 2 diabetes mellitus(T2DM) risk in young adults is less clear. This study aimed to evaluate the impact of disordered eating behaviors on diabetes risk among university students, using both traditional statistical methods and machine learning approaches. Methods: A total of 1,302 university students participated in this cross-sectional study. Disordered eating behavior was assessed using the Eating Attitudes Test-40 (EAT-40), a validated screening tool for abnormal eating attitudes, while type 2 diabetes risk was estimated using the Finnish Diabetes Risk Score (FINDRISK), a widely used non-invasive instrument designed to estimate the 10-year risk of developing T2DM. Anthropometric measures were recorded according to standardized protocols. Bivariate associations were examined using correlation analysis, while multivariable regression and machine learning models (XGBoost) were applied to determine predictors of diabetes risk. Results: Of the 1,302 participants, 90.8% were classified as low/mild risk, 6.2% as moderate risk, and 3.0% as high/very high risk according to FINDRISK. No significant correlation was found between EAT-40 scores and FINDRISK (r = 0.01, p = 0.755). In multivariable regression, waist-to-height ratio (beta = 1.42 per 0.05 increase, p < 0.001) and body mass index (beta = 0.31, p < 0.001) were the strongest predictors of diabetes risk. Machine learning models, particularly XGBoost (AUROC = 0.87), highlighted waist-to-height ratio as the most influential predictor. Conclusion: In young adults, central adiposity specifically waist-to-height ratio was the most significant predictor of T2DM risk, while disordered eating behavior had minimal independent impact. These findings suggest that simple anthropometric measures could be prioritized for early diabetes risk assessment over eating attitude screening.Öğe Challenges in the food supply chain following the great earthquake disaster in Turkey: A study of the regions of Malatya, Adıyaman and Kahramanmaraş(Wolters Kluwer Medknow Publications, 2024) Alatas, Hacer; Arslan, NurgulBACKGROUND:The consequences of natural disasters, such as damage to food systems, destruction of transport infrastructure, and organizational issues, can threaten the food security of people. Hence, food security measures are among the most important responses in the management of natural disasters. This study was conducted to identify the challenges in food security response following a great earthquake in Turkey.MATERIALS AND METHODS:This study used a qualitative approach. Within the scope of this study, 37 food cooking and preparation points were examined in the Malatya, Ad & imath;yaman, and Kahramanmara & scedil;-Pazarc & imath;k regions. Forty-five authorized individuals working at KIZILAY, who were responsible for all aspects of nutrition, were interviewed. Data were collected through semi-structured interviews, with 27 inquiries selected using purposive sampling. Qualitative content analysis was performed to analyze the data. The data analysis process utilized inductive qualitative content analysis to produce themes and categories.RESULTS:Most participants (%80.00) stated that there was no food variety. Menus generally consists of foods with a low nutritional value such as refined grains, legumes, sweets, spices, seasonings, oils, and sugary drinks (particularly soft drinks). The majority of the participants stated that they could not give milk group (%91.11), vegetables (%93.33), fruits (%97.78), and eggs (%100.00). The participants stated that organizational problems (%77.77), transportation problems (%64.44), cold weather conditions (%84.44), and a lack of stock (%64.44) prevent food safety.CONCLUSION:According to the findings of this study, underlying challenges such as geographical and weather conditions, organizational problems, and vulnerability of part of the population threatened food security. The lack of nutritional diversity can cause health problems such as obesity, malnutrition, and anemia, especially in vulnerable people.Öğe Dietary Antioxidant Capacity, Inflammation, and Insulin Resistance in Women with Polycystic Ovary Syndrome: An Integrated Metabolic and Nutritional Assessment(Dove Medical Press Ltd, 2026) Alatas, Hacer; Arslan, Nurgul; Keskin, Lezan; Agrali, CansuBackground: Polycystic ovary syndrome (PCOS) is characterized by metabolic dysfunction, low-grade inflammation, and oxidative stress. However, the role of dietary antioxidant capacity in shaping inflammatory and metabolic outcomes remains insufficiently explored. Objective: To evaluate dietary antioxidant capacity and its associations with inflammation and insulin resistance among women with PCOS compared with healthy controls. Methods: A cross-sectional study was conducted with 129 women with PCOS and 135 age-matched controls. Dietary antioxidant capacity was assessed through a composite antioxidant score. Anthropometric indices, inflammatory markers (WBC, neutrophils, NLR), and metabolic parameters (fasting glucose, insulin, HOMA-IR) were compared. Structural equation modeling (SEM) and hierarchical regression were used to test direct and indirect pathways linking diet, inflammation, and insulin resistance. Results: Women with PCOS had significantly lower total dietary antioxidant scores than controls (11.8 vs. 14.3). Inflammatory status was higher, with NLR values elevated in the PCOS group (2.09 vs. 1.63). Insulin resistance showed the largest difference: HOMA-IR levels were nearly twice as high in women with PCOS (3.52 vs. 1.98). Structural equation modeling indicated that higher antioxidant intake reduced insulin resistance both directly ((3 = -0.21) and indirectly by lowering inflammation ((3 = -0.13). Regression analyses confirmed that PCOS status, higher inflammation, and lower antioxidant intake independently predicted increased HOMA-IR. Conclusion: Reduced antioxidant intake is strongly linked with heightened inflammation and impaired insulin sensitivity in women with PCOS. Enhancing antioxidant-rich dietary patterns may offer a promising nutritional strategy to mitigate metabolic and inflammatory disturbances in PCOS.Öğe Food preferences and associated factors of children aged 7-12 living in temporary shelters after the 2023 earthquake in Turkey: A cross-sectional study(Lippincott Williams & Wilkins, 2025) Berk, Erhan; Alatas, Hacer; Arslan, NurgulFollowing an earthquake, there is a probability of disruption in food security that may deteriorate the nutritional status of individuals, particularly children and adolescents residing in the impacted region. This study aimed to assess the nutritional status and associated factors of children aged 7 to 12 residing in temporary shelters in Malatya province, an area significantly impacted by a major earthquake. This study included 317 children aged 7 to 12 years residing in temporary shelters affected by the earthquake. A quantitative method was employed to evaluate nutritional status and its related malnutrition factors, whereas a qualitative approach was used to explore, triangulate, and gather comprehensive information concerning food safety, water hygiene, sanitation, and health in the post-earthquake context. The mean age of the children was 9.42 +/- 1.98 years. They were living in temporary shelters for 8.97 +/- 1.24 months. Individuals had mild food insecurity due to the earthquakes. Following the earthquake, there was a notable reduction in the consumption of fruits, vegetables, meat, fish, and dairy products (P < .05). In the study area, 35.64% were underweight, 21.76% were stunted, and 17.35% exhibited very low weight for height. Gender, family size, father's employment status, average monthly income, parental education levels, and duration of residence in temporary shelters significantly influenced the body weight of underweight children (P < .05). It shows that in order to ensure food security after a major disaster, socioeconomic conditions should be improved, assistance for adequate and balanced nutrition for children should be increased, and occupancy rates of emergency shelters should be limited.Öğe Nutritional Status and Risk of Sarcopenia among Hospitalized Older Adults Residing in a Rural Region in Turkey(Korean Geriatric Soc, 2023) Alatas, Hacer; Serin, Yeliz; Arslan, NurguelBackground: This study aimed to determine the prevalence of sarcopenia and its associated factors in community-dwelling older adults at risk of malnutrition based on the Mini Nutritional Assessment (MNA), Prognostic Nutritional Index (PNI), and Geriatric Nutritional Risk Index (GNRI).Methods: The study participants were 345 adults aged >65 years who visited Geriatric Internal Medicine outpatient clinics. The study included people without acute illness for whom the risk of malnutrition could be assessed and appropriate measurements taken. At the baseline visit, participants' data and measurements were gathered. The primary data included sociodemographic details, anthropometric measurements, malnutrition screening tests, and functional assessments.Results: The participants' mean age was 76.21 +/- 5.59 years, and 57.1% were men (n=97). The prevalence rate of sarcopenia was 45.5%. Compared to individuals without sarcopenia, those with it were older; had lower MNA, PNI, and GNRI scores; and had lower muscle mass, muscle strength, and lower leg circumferences (p<0.001). After adjusting for potential confounding factors, we found that sarcopenia, advanced age, male sex, high risk of malnutrition, calf circumference, and a low PNI score were all significantly associated with a low GNRI score (p<0.001).Conclusion: Sarcopenia was significantly associated with advanced age, male sex, and high risk of malnutrition. Patients' nutritional and functional status should always be assessed for therapeutic interventions and lifestyle changes.Öğe Sleep, malnutrition, and quality of life in elderly hemodialysis patients: A cross-sectional study(Elsevier, 2023) Alatas, Hacer; Arslan, NurgulObjective. - The goal of this study was to establish a connection between sleep quality (SQ), quality of life, nutritional status, and independent variables of SQ in hemodialysis (HD) patients over the age of 65. Material and method. - The study included 91 HD patients. Every patient was given Post-Sleep Inventory (PSI). The Short-Form Quality of Life-36 scale was used to measure quality of life. MIS score was used together with Geriatric Nutritional Risk Index for nutrition and malnutrition inflammation index. Results. - Patients had been receiving dialysis for a mean of 54.21 +/- 11.33 months and were an age of 72.33 +/- 6.45 years. A negative relationship was found to exist between the sleep quality score and the quality of life scale SF-36 (r = -0.301, p = 0.003). It was found that GNRI and MIS scores have a direct effect on how well you sleep. Conclusion. - HD morbidity and mortality are affected by malnutrition, quality of life, and sleep disorders; these elements are interconnected. (c) 2023 Elsevier Masson SAS. All rights reserved.Öğe The relationship between body mass index, anthropometric measurements and GRACE risk score in acute coronary syndrome(Emerald Group Publishing Ltd, 2023) Arslan, Nurgul; Akbulut, Gamze; Suleymanoglu, Muhammed; Alatas, Hacer; Yaprak, BulentPurposeThis study aims to determine the relationship between body mass index (BMI) and Global Registry of Acute Coronary Events (GRACE) risk score in patients diagnosed with acute coronary syndrome (ACS) and to evaluate the results in this context. Design/methodology/approachThis was a prospective cohort study of ACS patients admitted to a cardiac care unit in high specialization hospital's cardiology service. The study included 140 men aged >35 years who were diagnosed with ACS. FindingsThe mean age of the individuals participating in the study was 61.4 +/- 10.9 years old. The mean BMI of the individuals was 25.3 +/- 6.6 kg/m(2), and the mean value of the waist/hip ratio was 0.85 +/- 0.01. Individuals were divided into four quarters according to the GRACE score. It was determined that individuals with the highest GRACE score were very underweight or morbidly obese according to their BMI values (p = 0.04). Originality/valueIt has been observed that there is a U-shaped relationship between the GRACE score and the BMI in individuals diagnosed with ACS. The risk of death of ACS patients with very high or very low BMI values was found to be close to each other. Although there is a relationship between BMI and GRACE score, it is concluded that it is insufficient to determine the risk in coronary disease alone, and body fat distribution should be examined together with BMI.
