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• MakaleAçık Erişim2026Scopus SJRQ1/r/gumushane/16266
  Determinants of healthy orthorexia and orthorexia nervosa: the roles of food security, dietary behaviors, and obesogenic environment

  Koçak, Tevfik; Arpa Zemzemoglu, Tuba Eda; Türkkan, Tugba; Bülbül, Kenan; Yilmaz, Birsen

  Orthorexia has recently gained attention as a two-dimensional construct centered on a shared health orientation. Recent conceptual developments distinguish healthy orthorexia (HeOr), defined as a non-pathological interest in healthy eating, from orthorexia nervosa (OrNe), characterized by rigid and compulsive food control accompanied by psychological and social impairment. This cross-sectional study investigated the associations of HeOr and OrNe with sociodemographic variables, dietary behaviors, and obesogenic environmental factors, and aimed to identify shared and distinct determinants of these tendencies with 1,015 adults aged 18-65 years. Orthorexia tendencies were assessed using the Teruel Orthorexia Scale. Additional measures included the Sustainable and Healthy Eating Behaviors Scale, Short Screening Questionnaire of Highly Processed Food Consumption, Adult Food Security Survey Module, Food Label Reading Attitude Scale, Food Choice Questionnaire, and the Obesogenic Environment Assessment Scale. In the adjusted regression models, HeOr was positively associated with sustainable and healthy eating behaviors (beta = 0.26), AFSS food-insecurity severity score (beta = 0.11), food label reading attitudes (beta = 0.07), health-related food choice motives (beta = 0.09), natural-ingredient preference (beta = 0.14), weight-control motives (beta = 0.15), ethical food choice motives (beta = 0.10), and obesogenic social determinants and effects (beta = 0.09). Conversely, affordability-related motives (beta = -0.08), emotional appeal (beta = -0.15), familiarity (beta = -0.10), and obesogenic cultural determinants/access to experts (beta = -0.12) were negatively associated with HeOr. For OrNe, positive associations were observed with sustainable and healthy eating behaviors (beta = 0.13), AFSS food-insecurity severity score (beta = 0.17), mood-related food choice motives (beta = 0.13), weight-control motives (beta = 0.26), familiarity (beta = 0.09), ethical food choice motives (beta = 0.18), and obesogenic social determinants and effects (beta = 0.30), whereas health-related food choice motives (beta = -0.12), affordability-related motives (beta = -0.08), and emotional appeal (beta = -0.24) showed negative associations. These findings suggest that orthorectic tendencies are associated with individual health motivations as well as broader behavioral and environmental contexts; however, because of the cross-sectional design, these associations should be interpreted as correlational and hypothesis-generating rather than causal.

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• MakaleAçık Erişim2026/r/gumushane/19342
  Evaluation of the Correlation Between Quality of Life and E-Healthy Diet Literacy and Food Choices in Young Adults

  Koçyıgıt, Emıne; Demirel, Yağmur; Koçak, Tevfık

  Aim: This study aimed to assess the correlation between quality of life, dietary literacy, and food choices among young adults. Material and Method: This cross-sectional research involved 522 young individuals aged 19 to 34. Face-to-face interviews and a questionnaire were used for collecting data. A sociodemographic characteristics form, the World Health Organization Quality of Life (QoL) Scale, the Food Choice Questionnaire (FCQ), and the e-Healthy Diet Literacy (e-HDL) Questionnaire were used to obtain data. Results: Of the study population, 50.20% were male and 49.80% were female. Participants had a mean age of 23.66 ± 3.40 years and a BMI of 23.08 ± 3.61 kg/m2. Males had a higher FCQ sensory appeal subdimension score than females, but there were no gender differences in total e-HDL and QoL scores. Overall e-HDL score, assessing, applying, and finding subscores correlated positively with FCQ weight management, ethical concerns, health, and natural content characteristics. The FCQ subdimension scores, overall QoL, and total e-HDL did not correlate significantly. Conclusion: QoL and e-HDL scores were comparable across genders; however, in terms of food choices, females emphasized health and ethical considerations, while males prioritized sensory attributes.

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• Derleme MakaleAçık Erişim2026Scopus SJRQ2/r/gumushane/13803
  Intersection 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.

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  AtıfScopus2·WoS1·OpenAlex2

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• MakaleAçık Erişim2026Scopus SJRQ1/r/gumushane/13582
  Psychological distress and food neophobia: the mediating role of food choice motives among university students

  Kocak, Tevfik; Kocyigit, Emine; Ozbek, Yagmur Demirel

  Background: Food neophobia, defined as the reluctance to try unfamiliar foods, reduces dietary diversity and quality in young adults. University students, often subjected to psychological discomfort including sadness, anxiety, and stress, may be especially susceptible to restrictive eating behaviors. This study examined the link be-tween psychological distress and food neophobia, focusing on the mediating role of food choice motives in Turkish students. Methods: A cross-sectional online survey was conducted among 801 Turkish university students (232 males and 569 females). The data collection included the Food Neophobia Scale (FNS), the Depression, Anxiety, and Stress Scale (DASS-21), and the Food Choice Questionnaire (FCQ). The body mass in-dex was calculated using self-reported anthropometric measurements. Statistical analyses comprised correlations, multivariable linear regression, and mediation mod-eling using Hayes’ PROCESS macro with 5000 bootstrap samples. Results: Food neophobia was positively associated with all DASS-21 subscales (p < 0.001). Regression analyses identified depression (p < 0.001), stress (p = 0.001), convenience (p = 0.001), and ethical concern (p < 0.001) as significant positive predictors, whereas natural con-tent showed a negative association (p = 0.046). Mediation analyses indicated that food choice motives partially explained the associations between psychological distress and food neophobia. Convenience and ethical concern consistently acted as mediators of risk, while natural content demonstrated a more complex role. Conclusions: Food neophobia among university students is influenced by both psychological distress and food choice motives. Depression and stress exert stronger effects than anxiety, with convenience and ethical concern functioning as consistent mediators.

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  AtıfWoS1·OpenAlex1

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• MakaleAçık Erişim2026Scopus SJRQ4/r/gumushane/13509
  Assessment of the effect of conventional and contemporary drying methods on the phenolic profile modulation and antioxidant retention of Trabzon persimmon (Diospyros kaki L.)

  Koçak, Tevfik; Demirel Ozbek, Yagmur; Saral, Ozlem; Kocyigit, Emine

  This study investigated the effects of conventional and modern drying methods on the total phenolic content, antioxidant activity, and phenolic compound composition of Trabzon persimmons (Diospyros kaki L.) fruits harvested from the same tree and at comparable maturity stages were subjected to sun drying, shade drying, oven drying, air-fryer drying, and microwave drying techniques, with raw samples serving as the control group. The total phenolic content was assessed via the Folin–Ciocalteu method, and the antioxidant capacity was evaluated using the ferric reducing antioxidant power (FRAP) and DPPH radical scavenging activity assays. The identification and quantification of phenolic compounds were conducted using the HPLC technique. The results indicated that the drying process produced statistically significant variations in the phenolic content and antioxidant capacity of Trabzon persimmons. The microwave drying technique resulted in highest total phenolic content and antioxidant activity, whereas both sun and shade drying procedures showed higher values than raw samples. The total phenolic content and antioxidant capacity of samples dried in an air fryer were found to be comparable to those of raw samples. The profile of phenolic compounds varied according to the drying process employed; certain compounds exhibited an increase with specific methods, while others were identified solely under particular conditions. Thus, it has been shown that drying techniques can have a significant impact on preserving and improving the functional properties of persimmons. Furthermore, we believe that microwave drying could be an effective alternative, particularly in terms of preserving bioactive compounds.

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  AtıfScopus1·OpenAlex1

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• MakaleAçık Erişim2026Scopus SJRQ4/r/gumushane/12305
  Adherence to the MIND Diet and Its Effect on Glycemic Parameters in Patients with Type 2 Diabetes: A Cross-Sectional Study; [Tip 2 Diyabetlilerde MIND Diyetine Uyumun Glisemik Parametreler Üzerindeki Etkisi: Kesitsel Bir Çalışma]

  Koçyiğit, Emine; Koçak, Tevfik; Özbek, Yağmur Demirel

  Aim: This study aimed to assess the relationship between Mediterranean-Dietary Approach to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet score and indicators of glucose control and lipid metabolism in patients with type 2 diabetes mellitus. Methods: This cross-sectional study involved 459 patients diagnosed with type 2 diabetes mellitus aged 20-64 years. Patients with type 2 diabetes mellitus completed a general information form and anthropometric measures. The MIND diet scores obtained from the MIND diet components form. The biochemical parameters gathered from individuals over the last three months were documented. Results: The mean age and body mass index in the study population were 49.10±10.10 years and 30.62±5.48 kg/m2. Overall, the mean MIND diet score was 8.64±1.75, and 47.10% had high adherence to the MIND diet. A significant difference was found between HbA1c and fasting plasma glucose (FBG) in the MIND groups, as well as a substantial negative association identified among HbA1c, FBG, and MIND scores. Conclusions: This study emphasized the significant incidence of overweight and obesity among Turkish adults with type 2 diabetes mellitus. Higher adherence to the MIND diet is associated with better glycemic control. Higher MIND diet scores associated with reduced HbA1c and FBG levels. However, no significant associations with the parameters of lipid metabolism were found. By emphasizing nutrient-dense foods and supporting both metabolic and psychological health, the MIND diet may represent a valuable adjunct to conventional diabetes management. Keywords.

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• MakaleAçık Erişim2026Scopus SJRQ1/r/gumushane/12175
  Weight self-stigma, weight bias internalization, and eating attitudes in relation to body appreciation

  Koçak, Tevfik; Kocyigit, Emine; Demirel Ozbek, Yagmur; Celik, İsa

  Objective: This study aimed to investigate the relationships between weight self-stigma, weight bias internalization, eating attitudes, and body appreciation in young adults, and to ascertain the distinct impact of these variables on body appreciation. Methods: A cross-sectional study was carried out including young adults aged 19 to 35 years, comprising 69.6% females and 30.4% males. Participants completed a questionnaire evaluating weight self-stigma, internalization of weight bias, eating attitudes, and body appreciation. Hierarchical multiple regression analyses were used to assess the additional impacts of weight-related stigma and eating attitudes on body appreciation, while adjusting for demographic and anthropometric factors. Results: Weight self-stigma, particularly the internalization of weight bias, showed a significant negative association with body appreciation. Weight self-stigma and its subdimensions (self-devaluation and fear of enacted stigma) had substantial negative correlations with body appreciation. These correlations encompassed the subdimensions of body appreciation, specifically general body appreciation and body image investment. While eating attitudes did not show a significant correlation with body appreciation at the bivariate level, they became a significant predictor in the hierarchical regression model, suggesting a conditional (suppression) effect after accounting for weight-related stigma and BMI. Conclusion: The findings emphasize the important function of weight-related stigma in diminishing body appreciation among young adults and stress the necessity of examining eating attitudes in conjunction with stigma-related factors. Interventions designed to enhance positive body image should focus on both internalized weight stigma and maladaptive eating-related attitudes.

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  AtıfScopus1·WoS1·OpenAlex1

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• MakaleAçık Erişim2025Scopus SJRQ2/r/gumushane/10402
  Could GSTP1, PTEN and NKX3.1 gene expression be novel markers in the relationship between prostate cancer and epigenetics?

  Koçak, Tevfik; Acar-Tek, Nilufer; Yesil, Suleyman; Ergün, Mehmet Ali; Icer, Yusuf

  Background: Although numerous treatment modalities exist for Prostate Cancer (PCa) with a complex pathophysiology, a significant worldwide health concern for males, early identification remains the paramount factor influencing disease prognosis. Proposed new biomarkers, including GSTP1, PTEN, and NKX3.1, may provide predictive and prognostic functions, hence enhancing the efficacy of PSA in diagnosing prostate cancer. Epigenetic variables associated with nutrition influence the blood gene expression levels of the new biomarkers GSTP1, PTEN, and NKX3.1. This study aimed to elucidate the correlation between nutrition-related epigenetic variables and the expression of the tumor suppressor genes GSTP1, PTEN, and NKX3.1 in benign prostate and prostate cancer patients. Methods: This study was conducted with 41 newly diagnosed prostate cancer and 42 benign prostate patients, all aged 40 years and older. Participants had specific anthropometric measurements taken, and seven-day food records were kept. Serum levels of novel biochemical markers GSTP1, PTEN, and NKX3.1 were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) method. Expression analyses of tumor-protective GSTP1, PTEN, and NKX3.1 genes were performed on prostate tissues obtained from fresh prostate biopsies taken from the groups and were associated with nutritional status. Results: A significant relationship was found between the serum levels of GSTP1, PTEN, and NKX3.1, which are important in the formation and treatment of prostate cancer, and Gleason grade, tumor stage, and surgical margin status (p < 0.05). However, significant relationships were found between many macro and micronutrients obtained from the dietary pattern and effective in epigenetic pathways and GSTP1, PTEN, and NKX3.1 gene expressions (p < 0.05). Conclusions: The findings of this investigation corroborated the notion that prospective novel markers, including GSTP1, PTEN, and NKX3.1, may serve predictive and prognostic functions in prostate cancer, hence enhancing the efficacy of PSA in its diagnosis. Dietary trends may influence the optimization of many epigenetic processes. Targeted therapeutic nutritional interventions designed to enhance gene expression will facilitate the formulation of prostate cancer prevention methods.

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• MakaleYayıncıda açık erişim2025Scopus SJRQ2/r/gumushane/10483
  Serum neopterin and kynurenine as predictive and prognostic biomarkers in prostate cancer: the role of dietary inflammatory index and biomarker interactions

  Icer, Mehmet Arif; Koçak, Tevfik; Acar-Tek, Nilufer; Yesil, Suleyman; Icer, Yusuf

  Background It has been shown that neopterin levels in various body fluids can help predict the diagnosis of different malignancies. Although many studies have investigated the roles of serum neopterin concentrations, tryptophan metabolism, and the dietary inflammation index (DII) in various cancers, the connection between these factors and prostate cancer (PC) remains uncertain. The aim of this study was to investigate the predictive and prognostic roles of serum neopterin, and kynurenine levels, along with the kynurenine-to-tryptophan ratio (KTR) and DII in prostate cancer. Methods This study was conducted with 57 newly diagnosed prostate cancer patients, 55 benign prostate hyperplasia patients, and 56 healthy male individuals in the control group, all aged 40 years and older. Participants had specific anthropometric measurements taken, and three-day food records were kept. DII was calculated based on data for thirty-four available nutrients by using food records. Serum levels of neopterin, kynurenine, tryptophan, tumor necrosis factor alpha (TNF-alpha), and interferon-gamma (IFN-gamma) were measured using an enzyme-linked immunosorbent assay (ELISA) method. Results Serum neopterin (11.79 +/- 6.09), kynurenine (1655.48 +/- 1122.04), TNF-alpha (221.59 +/- 232.06) and IFN-gamma (137.68 +/- 107.11) levels were higher in the malignant group than in both the control (2.72 +/- 0.76, 352.40 +/- 69.33, 223.94 +/- 226.67, and 23.03 +/- 7.28, respectively) and benign groups (3.17 +/- 0.74, 377.94 +/- 109.05, 179.61 +/- 224.36, and 25.63 +/- 7.50, respectively) (p < 0.05). Another result of our study is that in the malignant group, serum neopterin levels exhibited significant positive correlations with serum kynurenine (r = 0.80, p < 0.0001), IFN-gamma (r = 0.86, p < 0.0001) and TNF-alpha levels (r = -0.27, p = 0.0453) and DII (r = 0.30, p = 0.0229), while they exhibited weak correlations with serum PSA, and other diet parameters. Additionally, kynurenine was the only parameter showing significant differences in mean values concerning surgical margins (p < 0.05). Conclusions The findings of this study support the hypothesis that serum neopterin and specific tryptophan catabolites (e.g., kynurenine), could serve as predictive and prognostic biomarkers for prostate cancer diagnosis. However, our results do not support the hypothesis that DII and certain dietary factors play a direct role in the development or diagnosis of prostate cancer.

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  AtıfScopus3·WoS3·OpenAlex2

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• MakaleAçık Erişim2025Scopus SJRQ2/r/gumushane/10632
  Low Serum and Urine Fetuin-A Levels and High Composite Dietary Antioxidant Index as Risk Factors for Kidney Stone Formation

  Icer, Mehmet Arif; Koçak, Tevfik; Icer, Yusuf; Kocyigit, Emine; Agagündüz, Duygu; Gezmen-Karadag, Makbule; Yesil, Suleyman; Budán, Ferenc

  Background: Fetuin-A prevents the precipitation of hydroxyapatite in supersaturated solutions of calcium and phosphate; however, its relationship with nephrolithiasis has yet to be clarified. The aim of this study was to investigate the protective and predictive roles of serum and urine fetuin-A levels in nephrolithiasis and their relationships with the composite dietary antioxidant index (CDAI). Methods: This study involved 75 adult patients with kidney stone disease and 71 healthy adults without kidney stone disease in the control group. Participants had specific anthropometric measurements taken, and three-day food records were kept. The CDAI was calculated by summing six standard antioxidants, including vitamins A, C, and E, manganese, selenium, and zinc, representing participants' antioxidant profile. In addition to some analyzed serum and urine parameters of the participants, fetuin-A levels were measured using the enzyme-linked immunosorbent assay (ELISA) method. Results: In patients with kidney stones, both serum and urine fetuin-A levels (676.3 +/- 160.14 ng/mL; 166.6 +/- 128.13 ng/mL, respectively) were lower than in the control group (1455.6 +/- 420.52 ng/mL; 2267.5 +/- 1536.78 ng/mL, respectively) (p < 0.00001). In contrast, the CDAI was higher in patients with kidney stones compared to those without kidney stones (p < 0.001). Besides, several dietary parameters had significant positive correlations with serum and/or urinary fetuin-A. Conclusions: The present study suggests that serum and urinary fetuin-A levels may serve as protective factors against kidney stones and could potentially be used as predictive markers for the development of nephrolithiasis. Furthermore, our results suggest that the CDAI above a certain level may increase the risk of stone formation and that some dietary parameters may affect the levels of this biomarker in serum and urine.

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  AtıfScopus6·WoS5·OpenAlex7

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