Sürdürülebilir Kalkınma Amaçları
Yayınlar
- Derleme MakaleAçık Erişim2026Intersection of Precision Nutrition and Bladder Cancer: A Narrative State-of-the-Art Review of Potential Applications and Challenges
Koçak, Tevfik; Özbek, Yağmur Demirel; Bodur, Mahmut; Yeşil, Süleyman; Ağagündüz, Duygu
Bladder cancer (BC) is a biologically heterogeneous tumor affected by genetic, metabolic, environmental, and lifestyle factors. Recent research indicates that nutrition can change the way urothelial cancer forms by affecting inflammation, oxidative stress, cellular energy, and the epigenome. It can also change the risk of BC and how well treatment works. Simultaneous progress in precision nutrition (PN) and nutriomic profiling—encompassing nutrigenomics, nutrigenetics, nutriepigenetics, metabolomics, and microbiome science—presents novel options to tailor dietary regimens beyond universal guidelines. In this review, we consolidate existing knowledge regarding the nutritional factors influencing BC, outline pertinent principles of PN for BC prevention and survival, and explore how urine proteomics and molecular subtyping facilitate the integration of PN into precision oncology. Our review examines the methodological, bioinformatic, biomarker, and clinical translation challenges that impede the implementation of PN in BC management; these challenges include the need for validated nutritional biomarkers with mechanistic endpoints, interoperable data platforms, and rigorously designed clinical trials. Finally, we emphasize future prospects for PN-guided medical nutrition therapy and dietary models during and after systemic treatment recovery. We propose research priorities that will facilitate the integration of PN-informed individualized dietary plans with medical and surgical approaches in BC treatment, aiming to decrease the costs associated with expensive or excessively aggressive treatment methods, thereby supporting long-term survival care. This review seeks to establish a conceptual framework for the integration of PN into BC management by delineating the opportunities and challenges, hence promoting hypothesis-driven research in a promising yet underexplored domain.
- MakaleYayıncıda açık erişim2025Validity and reliability of the Turkish version of the chrono-med diet score (CMDS) for adult participants
Koçak, Tevfik; Kocyigit, Emine; Ağagündüz, Duygu
Background: This study aimed to examine the validity and reliability of the Chrono-Med Diet Score (CMDS) to assess adherence to the Mediterranean diet in Turkish adults. Methods: The methodological research conducted in Gümüşhane and Ordu from January to June 2024, including 592 individuals (62.3% women, 37.7% men, and the mean age 43.4 ± 10.6 years). Data were collected through face‒to‒face interview that contained socio-demographic characteristics, the CMDS, the Mediterranean Diet Adherence Screener (MEDAS), and 24-h dietary recall. Internal consistency reliability was assessed using Cronbach’s alpha coefficient, while repeatability was examined using the test–retest method. Construct validity was assessed by the MEDAS, and components of the adapted CMDS obtained from the 24-h dietary recall were analyzed using confirmatory factor analysis. The content validity was assessed by the Paired samples t-test and Wilcoxon test. The Bland–Altman test with 95% limits of agreement was used to evaluate the agreement between sum of CMDS. The results were statistically evaluated at a p < 0.05 significance level. Results: The content validity index of CMDS was 0.87. The overall Turkish version of CMDS had acceptable internal consistency (Cronbach’s α = 0.853), thus indicating that the score was reliable. The Paired samples t test coefficients between each item and the overall questionnaire ranged from 0.234 to 1.000. A higher intake of olive oil and fish obtained from a 24-h dietary recall was associated with a higher CMDS quartile (p < 0.05). The MEDAS score was correlated with a higher CMDS quartile (p < 0.001). A moderate positive correlation was determined between total CMDS and MEDAS (r = 0.467; p < 0.001). Conclusions: Our assessments of the CMDS, consisting of 13 items, in Türkiye demonstrate that it is a viable and reliable instrument to measure adherence to the Mediterranean diet for the adult population. The CMDS is more accurate than other Mediterranean diet scores as it questions about the amount of physical activity and grain products, which helps determine each participant’s eating patterns and general health.
- MakaleAçık Erişim2025The Correlation Between Circulating Fetuin-A Levels and Fetuin-A to Adiponectin Ratio With Obesity in a Turkish Population: A Case-Control Study
Icer, Mehmet Arif; Koçak, Tevfik; Ağagündüz, Duygu; Yıldıran, Hilal
The relationship between serum fetuin-A levels and obesity has not been fully understood. This study aims to elucidate the levels of serum fetuin-A and F/A ratio in obesity and contribute to the literature on whether they could be novel clinical predictors modulated through body composition and nutrition. The study included 73 participants who were obese and 71 participants with normal weight, aged between 18 and 65 years. Certain anthropometric measurements of the individuals were taken, and a body composition analysis was performed. In addition, 3-day food records (consecutive days: 2 weekdays and one weekend day) were taken. Serum levels of fetuin-A (ng/mL) and adiponectin (μg/mL) were measured using an enzyme-linked immunosorbent assay (ELISA) method. The F/A ratio was obtained by dividing fetuin-A (ng/mL) by adiponectin (μg/mL). Serum fetuin-A (ng/mL) level and F/A ratio are higher in obese participants than in normal weight (p < 0.05). Body weight (kg) (r = 0.553, p ≤ 0.001), body mass index (kg/m2) (r = 0.492, p ≤ 0.001), waist circumference (cm) (r = 0.522, p ≤ 0.001), body fat percentage (%) (r = 0.203, p = 0.015), serum fasting blood glucose levels (mg/dL) (r = 0.317, p ≤ 0.001), and dietary protein intake (kg) (r = 0.165, p = 0.048) were observed to be positively correlated with serum fetuin-A levels. Positive correlations were also observed between these parameters and the F/A ratio (p < 0.05). Negative correlations were found between serum adiponectin and these parameters (p < 0.05). In addition, when dietary cholesterol intake was kept constant, a 1-unit increase in dietary energy intake (kcal) resulted in a 0.043-fold increase in serum fetuin-A (p < 0.05). The study results support theories suggesting the involvement of serum fetuin-A levels and the F/A ratio in the pathogenesis of obesity. The higher serum fetuin-A levels and F/A ratio found in obese participants may be considered as new clinical determinants that could be regulated through body composition and nutrition.
- Derleme MakaleAçık Erişim2024Oxylipins Derived from PUFAs in Cardiometabolic Diseases: Mechanism of Actions and Possible Nutritional Interactions
Ağagündüz, Duygu; Yeşildemir, Özge; Koçyiğit, Emine; Koçak, Tevfik; Özen Ünaldı, Buket; Ayakdaş, Gamze; Budán, Ferenc
Oxylipins are oxidized fatty acids, both saturated and unsaturated, formed through pathways that involve singlet oxygen or dioxygen-mediated oxygenation reactions and are primarily produced by enzyme families such as cyclooxygenases, lipoxygenases, and cytochrome P450. These lipid-based complex bioactive molecules are pivotal signal mediators, acting in a hormone-like manner in the pathophysiology of numerous diseases, especially cardiometabolic diseases via modulating plenty of mechanisms. It has been reported that omega-6 and omega-3 oxylipins are important novel biomarkers of cardiometabolic diseases. Moreover, collected literature has noted that diet and dietary components, especially fatty acids, can modulate these oxygenated lipid products since they are mainly derived from dietary omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) or linoleic acid and α-linolenic by elongation and desaturation pathways. This comprehensive review aims to examine their correlations to cardiometabolic diseases and how diets modulate oxylipins. Also, some aspects of developing new biomarkers and therapeutical utilization are detailed in this review.