EAT-Lancet Diet, Chronotype, and Well-Being in Obesity

Primary outcomes

1. Questionnaire Form

   Time frame: 3 months

   Sociodemographic characteristics of the individuals (age, gender, smoking and alcohol use, constipation status, swallowing-chewing problem) were questioned.

2. Body Weight (BW)

   Time frame: 3 months

   BW was measured using a calibrated digital scale placed on a flat, tiled surface. The scale was sensitive to 100 grams.

3. Height

   Time frame: 3 months

   Height was measured using a stadiometer with the participant's head positioned in the Frankfort plane and feet placed together.

4. Waist Circumference (WC)

   Time frame: 3 months

   WC was measured at the midpoint between the lowest rib and the iliac crest (cristal point) using a flexible measuring tape.

5. Hip Circumference (HC)

   Time frame: 3 months

   HC was measured at the widest point of the hips using a flexible measuring tape.

6. Body Mass Index (BMI)

   Time frame: 3 months

   BMI was calculated by dividing body weight (in kilograms) by the square of height (in meters): BMI = weight (kg) / height² (m²).

7. Fasting Blood Glucose

   Time frame: 3 months

   Fasting blood glucose was measured using standard laboratory techniques during routine outpatient visits.

8. Triglycerides

   Time frame: 3 months

   Triglyceride levels were measured via fasting blood samples analyzed in the outpatient clinic laboratory.

9. LDL-Cholesterol

   Time frame: 3 months

   LDL-cholesterol was measured from fasting serum samples using standard enzymatic colorimetric methods.

10. Total Cholesterol

    Time frame: 3 months

    Total cholesterol was measured using routine biochemical analysis in a certified laboratory.

11. Albumin

    Time frame: 3 months

    Serum albumin levels were measured using routine laboratory procedures in outpatient visits.

12. Vitamin D

    Time frame: 3 months

    Serum vitamin D (25(OH)D) levels were assessed using chemiluminescence immunoassay methods in the outpatient clinic laboratory.

13. Folic Acid

    Time frame: 3 months

    Serum folic acid levels were measured using standard automated immunoassay techniques.immunoassay methods in the outpatient clinic laboratory.

14. Vitamin B12

    Time frame: 3 months

    Serum vitamin B12 concentrations were measured using automated chemiluminescent immunoassay.immunoassay methods in the outpatient clinic laboratory.

15. Food Frequency Questionnaire

    Time frame: 3 months

    The foods consumed by individuals in the last month were evaluated across seven different groups, including five basic food groups (meat and meat products, milk and dairy products, bread and grains, vegetables and fruits, sugar and fats), beverages, and fast food. Participants were asked how often they consumed foods and beverages in these groups; responses were collected using the following options: "every meal," "every day," "5-6 days a week," "3-4 days a week," "1-2 days a week," "once every 15 days," "once a month," and "never." To determine the average daily consumption amounts based on consumption frequency, the following coefficients were used: 3 for "every meal," 1 for "every day," 0.7855 for "5-6 times a week," 0.498 for "3-4 times a week," 0.2145 for "1-2 times a week," 0.067 for "every 15 days," and 0.033 for "once a month.

16. Evaluation of Food Consumption Records

    Time frame: 3 months

    Responses regarding food consumption frequency were calculated using food consumption frequency calculations. The amounts of food and beverages consumed were multiplied by "3" for "every meal," '1' for "every day," "0.7855" for "5-6 times a week," "0.498" for "3-4 times a week," "0.2145" for "1-2 times a week," "0.067" for "every 15 days," and "0.033" for "once a month" to obtain the average daily amounts. Energy, macronutrients, and micronutrients were calculated using the daily intake amount.

17. Planetary Health Diet (EAT-Lancet)

    Time frame: 3 months

    In this study, the EAT-Lancet diet score was used. Adherence to the EAT-Lancet diet was scored based on the estimated average daily intake of 14 dietary components. Each component was rated as 0 (non-compliance) or 1 point (compliance), resulting in a total score ranging from 0 to 14 points.

18. Chronotype Eating Pattern

    Time frame: 3 months

    Individuals' chronotype eating patterns were determined using the Morning-Evening Questionnaire. The Morning-Evening Questionnaire consists of a total of 19 questions. The questionnaire contains questions about individuals' physical and psychological performance during a 24-hour period, which time of day they perform better, and their preferences regarding sleep and wakefulness times. As a result of the evaluation, those who scored between 70 and 86 were classified as "Definitely Morning Type"; those scoring between 59 and 69 are classified as "Close to Morning Type"; those scoring between 42 and 58 are classified as "Intermediate Type"; those scoring between 31 and 41 are classified as "Close to Evening Type"; and those scoring between 16 and 30 are classified as "Definitely Evening Type."

19. Psychological Assessment

    Time frame: 3 months

    Individuals were psychologically assessed using the Psychological Well-Being Scale. The scale defines many important elements, ranging from feeling satisfied with positive relationships to having a purposeful and meaningful life. There are 8 items on the scale. Each item is answered on a scale of 1 to 7, ranging from 1 (strongly disagree) to 7 (strongly agree). When all items are answered with "strongly disagree," the total test score is 8; when answered with "strongly agree," the total test score is 56. A high score on the test indicates that the individual has abundant psychological resources and strengths.