Journals / Etkili Hemşirelik Dergisi / 2026 / Cilt: 18 Sayı: 2

The Relationship between Diabetes Risk, Activity Levels and Mediterranean Type Nutritional Behaviors

Diyabet Riski, Aktivite Düzeyleri ile Akdeniz Tipi Beslenme Davranışları İlişkisi

İbrahim Topuz(Kütahya Sağlık Bilimleri Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Halk Sağlığı Hemşireliği Anabilim Dalı, Kütahya, Türkiye)0000-0003-0540-2095
Sercan Gümüş(Kütahya Merkez Sağlıklı Hayat Merkezi)0000-0001-5925-7220
Sebahat Gözüm(AKDENİZ ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0001-8672-8016
Pages
193–208
Publication Date
2025-04-15
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Since the physical activity and adherence to the Mediterranean diet are very low in the population in which the study was conducted, it is thought that the risk of diabetes will increase further in the future.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background: According to the American Diabetes Association data, individuals aged 45 and over are at risk for diabetes.
📊
Key Findings & Data:Objectives: It is the determination of diabetes risk, physical activity levels and Mediterranean type nutritional behaviors in individuals aged 45 and over.
💡
Conclusion & Impact:Since the physical activity and adherence to the Mediterranean diet are very low in the population in which the study was conducted, it is thought that the risk of diabetes will increase further in the future.
🔬Design:Survey & Empirical Study
📍Scope:2022 Verileri
⚙️Variables:Akdeniz Tipi Beslenme · Diyabet Riski · Fiziksel Aktivite

Abstract

Background: According to the American Diabetes Association data, individuals aged 45 and over are at risk for diabetes. Objectives: It is the determination of diabetes risk, physical activity levels and Mediterranean type nutritional behaviors in individuals aged 45 and over. Methods: Individuals aged 45 and over 250 who applied to XXX Provincial Healthy Life Center between October 2022 and January 2023 were included in this descriptive, relationship-seeking study. Descriptive Characteristics Form and Finnish Type 2 Diabetes Risk Questionnaire, International Physical Activity Questionnaire and Mediterranean Diet Adherence Scale were applied to the individuals participating in the study. Results: 50.8% of individuals are slightly overweight in terms of body mass index. Waist circumference of 49.2% of individuals is in the risky range (80-88 cm). 32% of individuals had a high risk of diabetes, 43.2% were inactive and 92.4% had low adherence to the Mediterranean diet. Diabetes risk increases as physical activity level decreases (r=-.17, p<.05). As the level of adherence to the Mediterranean diet increases, the level of physical activity also increases significantly (r=.23, p<.001). Conclusion: Increased physical activity and high adherence to the Mediterranean diet are of great importance in reducing the risk of diabetes in individuals aged 45 and over. Since the physical activity and adherence to the Mediterranean diet are very low in the population in which the study was conducted, it is thought that the risk of diabetes will increase further in the future.

Özet

Giriş: Amerikan Diyabet Birliği verilerine yönelik 45 yaş ve üzeri bireyler diyabete yönelik risklidir. Amaç: 45 yaş ve üzeri bireylerde diyabet riski, fiziksel aktivite düzeyleri ile akdeniz tipi beslenme davranışlarının belirlenmesidir. Yöntem: Tanımlayıcı, ilişki arayıcı türde olan bu çalışmaya Ekim 2022-Ocak 2023 tarihleri arasında XXX İli Sağlıklı Hayat Merkezi’ne başvuran, 45 yaş ve üzeri 250 birey dahil edilmiştir. Araştırmaya katılan bireylere Tanımlayıcı Özellikler Formu ve Finlandiya Tip 2 Diyabet Risk Anketi, Uluslararası Fiziksel Aktivite Anketi ve Akdeniz Diyeti Bağlılık Ölçeği uygulanmıştır. Bulgular: Bireylerin %50.8’i beden kitle indeksine göre hafif kiloludur. Bireylerin %49.2’sinin bel çevresi riskli aralıkta (80-88 cm) yer almaktadır. Bireylerin %32’si yüksek diyabet riskine sahip olup, %43.2’si inaktif ve %92.4’ünün akdeniz diyeti uyumu düşük düzeyde bulunmuştur. Fiziksel aktivite düzeyi düştükçe diyabet riski artmaktadır (r=-.17, p<.050). Akdeniz diyeti bağlılık düzeyi arttıkça fiziksel aktivite düzeyi de anlamlı bir şekilde artmaktadır (r=.23, p<.001). Sonuç: 45 yaş ve üzeri bireylerin diyabet risklerinin azaltılmasında artmış fiziksel aktivitenin, Akdeniz diyetine yüksek bağlılığın önemi büyüktür. Çalışmanın yapıldığı popülasyonda fiziksel aktivite ve akdeniz diyetine bağlılık çok düşük olduğu için diyabet riskini ilerleyen dönemlerde daha da artacağı düşünülmektedir.

🔖

Cite This Article

Topuz, İ., Gümüş, S., Gözüm, S. (2025). The Relationship between Diabetes Risk, Activity Levels and Mediterranean Type Nutritional Behaviors. Etkili Hemşirelik Dergisi, Cilt: 18 Sayı: 2, 193–208. https://doi.org/10.46483/jnef.1367601

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (59)

  1. ADA. (2017). Classification and diagnosis of diabetes. Diabetes Care, 40(Suppl. 1), 11–24. https://doi.org/10.2337/dc17-s005.
  2. ADA. (2022). Standarts of medical care in diabetes. Diabetes Care, 45(Suppl. 1), 17–38. https://doi.org/10.2337/dc22-S002
  3. Agrawal, N., Agrawal, M.K., Kumari, T., ve Kumar, S. (2017). Correlation between body mass in-dex and blood glucose levels in Jharkhand population. International Journal of Contemporary Medical Research, 4(8): 1633-1636.
  4. Alvarez-Alvarez, I., Zazpe, I., de Rojas, J.P., Bes-Rastrollo, M., Ruiz-Canela, M., Fernandez-Montero, A.,. Martínez-González, M.A. (2018). Mediterranean diet, physical activity and their com-bined effect on all-cause mortality: The Seguimiento Universidad de Navarra (SUN) cohort. Preventive Medicine, 106, 45-52. https://doi.org/10.1016/j.ypmed.2017.09.021.
  5. Aune, D., Norat, T., Leitzmann, M., Tonstad, S., ve Vatten, L.J. (2015). Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. European Journal of Epi-demiology, 30(7), 529–542. https://doi.org/10.1007/s10654-015-0056-z
  6. BACPR. (2023). The BACPR Standards and Core Components for Cardiovascular Disease Preven-tion and Rehabilitation. 30 Nisan 2024 tarihinde https://www.bacpr.org/__data/ as-sets/pdf_file/0021/64236/BACPR-Standards-and-Core-Components-2023.pdf. adresinden erişildi.
  7. Bai, A., Tao, J., Tao, L., ve Liu, J. (2021). Prevalence and risk factors of diabetes among adults aged 45 years or older in China: A national cross-sectional study. Endocrinology, Diabetes & Metabo-lism, 4(3), e00265. https://doi.org/10.1002/edm2.265
  8. Cea‐Soriano, L., Pulido, J., Franch‐Nadal, J., Santos, J.M., Mata‐Cases, M., Díez‐Espino, J.,. the PREDAPS Study Group. (2022). Mediterranean diet and diabetes risk in a cohort study of individuals with prediabetes: Propensity score analyses. Diabetic Medicine, 39(6), e14768. https://doi.org/10.1111/dme.14768
  9. Chai, Y., Liu, Y., Yang, R., Kuang, M., Qiu, J., ve Zou, Y. (2022). Association of body mass index with risk of prediabetes in Chinese adults: A population-based cohort study. Journal of Diabetes Inves-tigation, 13(7), 1235-1244. https://doi.org/10.1111/jdi.13783.
  10. Cheng, C.H., Ho, C.C., Yang, C.F., Huang, Y.C., Lai, C.H., ve Liaw, Y.P. (2010). Waist-to-hip ra-tio is a better anthropometric index than body mass index for predicting the risk of type 2 diabetes in Taiwanese population. Nutrition Research (New York, N.Y.), 30(9), 585–593. https://doi.org/10.1016/j.nutres.2010.08.007
  11. Chopra, I., ve Chopra, A. (2017). Risk perception for diabetes in Appalachian women. Women & Health, 57(5), 534–550. https://doi.org/10.1080/03630242.2016.1176100
  12. Craig, C.L., Marshall, A.L., Sjöström, M., Bauman, A.E., Booth, M.L., Ainsworth, B.E.,. Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  13. Deery, C.B., Hales, D.P., Viera, L., Lin, F., Liu, Z., Olsson, E.,. Viera, A.J. (2019). Physical ac-tivity calorie expenditure (PACE) labels in worksite cafeterias: effects on physical activity. BMC Public Health, 19, 1596. https://doi.org/10.1186/s12889-019-7960-1
  14. Elagizi, A., Kachur, S., Carbone, S., Lavie, C.J., ve Blair, S.N. (2020). A review of obesity, physi-cal activity, and cardiovascular disease. Current Obesity Reports, 9(4), 571–581. https://doi.org/10.1007/s13679-020-00403-z
  15. Erdoğan, G., ve Coşansu, G. (2021). Diyabet risk farkındalığı: Bir metropol örneği. Sürekli Tıp Eğitimi Dergisi, 30(5), 307-316. https://doi.org/10.17942/sted.876596
  16. Etbaş Demirağ, H. (2016). Tip-2 diabetes mellituslu hastaların birinci derece yakınlarında di-yabet risk değerlendirmesi. (Yüksek lisans tezi). Erişilen veri tabanı adı: Ulusal tez merkezi (Tez no: 419878).
  17. Filippatos, T.D., Panagiotakos, D.B., Georgousopoulou, E.N., Pitaraki, E., Kouli, G.M., Chryso-hoou, C.,. ATTICA Study Group. (2016). Mediterranean diet and 10-year (2002-2012) incidence of diabetes and cardiovascular disease in participants with prediabetes: The ATTICA study. The Review of Diabetic Studies: RDS, 13(4), 226–235. https://doi.org/10.1900/RDS.2016.13.226
  18. Gezer, C., ve Ulusan, D. (2020). Tip 2 diyabetes mellituslu bireylerde hastalık bilgi durumu, sağlıklı yaşam biçimi ve yaşam kalitesi ilişkili mi?. Türk Hijyen ve Deneysel Biyoloji Dergisi, 77(2), 155-166.
  19. Graham, G.N., Leath, B., Payne, K., Guendelman, M., Reynolds, G., Kim, S.,. Buggs, G. (2006). Perceived versus actual risk for hypertension and diabetes in the African American community. Health Promotion Practice, 7(1), 34–46. https://doi.org/10.1177/1524839905283891
  20. Guo, J., Tang, Y., Zhang, H., Lommel, L., ve Chen, J.L. (2019). The risk, perceived and actual, of developing type 2 diabetes mellitus for mothers of preschool children in urban China. PloS One, 14(9), e0222839. https://doi.org/10.1371/journal.pone.0222839
  21. Hsia, J., Wu, L., Allen, C., Oberman, A., Lawson, W.E., Torréns, J.,. Women’s Health Initiative Research Group. (2005). Physical activity and diabetes risk in postmenopausal women. American Jour-nal of Preventive Medicine, 28(1), 19–25. https://doi.org/10.1016/j.amepre.2004.09.012
  22. İdiz, C. (2019). Diyabetli bireylere hangi beslenme modeli önerilmeli?. Beslenme ve Diyet Dergi-si, 47, 44-51. https://doi.org/10.33076/2019.BDD.1314
  23. International Diabetes Federation (IDF). (2017). Diabetes Atlas, 8th edition. 13 Ağustos 2023 tari-hinde https://diabetesatlas.org/atlas/eighth-edition/ adresinden erişildi.
  24. International Diabetes Federation (IDF). (2021). Diabetes Atlas, 10th edition. 30 Nisan 2024 tari-hinde https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf adre-sinden erişildi.
  25. Jannasch, F., Kröger, J., ve Schulze, M. B. (2017). Dietary patterns and type 2 diabetes: A syste-matic literature review and meta-analysis of prospective studies. The Journal of Nutrition, 147(6), 1174–1182. https://doi.org/10.3945/jn.116.242552
  26. Jeon, C.Y., Lokken, R.P., Hu, F.B., ve van Dam, R.M. (2007). Physical activity of moderate inten-sity and risk of type 2 diabetes: A systematic review. Diabetes Care, 30(3), 744–752. https://doi.org/10.2337/dc06-1842
  27. Kamińska, W., Wiśniewska, K., Okręglicka, K., Pazura, I., ve Nitsch-Osuch, A. (2023). Lifestyle intervention towards Mediterranean Diet, physical activity adherence and anthropometric parameters in normal weight women with Polycystic Ovary Syndrome or Hashimoto’s Thyroiditis –preliminary study. Annals of Agricultural and Environmental Medicine, 30(1), 111-117. https://doi.org/10.26444/aaem/159156
  28. Koloverou, E., Esposito, K., Giugliano, D., ve Panagiotakos, D. (2014). The effect of Mediterrane-an diet on the development of type 2 diabetes mellitus: A meta-analysis of 10 prospective studies and 136,846 participants. Metabolism: Clinical and Experimental, 63(7), 903–911. https://doi.org/10.1016/j.metabol.2014.04.010
  29. Koloverou, E., Panagiotakos, D.B., Pitsavos, C., Chrysohoou, C., Georgousopoulou, E.N., Grekas, A.,. The ATTICA Study Group. (2016). Adherence to Mediterranean diet and 10-year incidence (2002-2012) of diabetes: Correlations with inflammatory and oxidative stress biomarkers in the ATTICA co-hort study. Diabetes/Metabolism Research and Reviews, 32(1), 73–81. https://doi.org/10.1002/dmrr.2672
  30. Lee, G., Choi, H.Y., ve Yang, S.J. (2015). Effects of dietary and physical activity ınterventions on metabolic syndrome: A meta-analysis. Journal of Korean Academy of Nursing, 45(4), 483-494. https://doi.org/10.4040/jkan.2015.45.4.483
  31. Li, S., Xiao, J., Ji, L., Weng, J., Jia, W., Lu, J., … China National Diabetes and Metabolic Disor-ders Study Investigators. (2014). BMI and waist circumference are associated with impaired glucose metabolism and type 2 diabetes in normal weight Chinese adults. Journal of Diabetes and its Complica-tions, 28(4), 470–476. https://doi.org/10.1016/j.jdiacomp.2014.03.015
  32. Lindström, J., ve Tuomilehto, J. (2003). The diabetes risk score: A practical tool to predict type 2 diabetes risk. Diabetes Care, 26(3), 725-731. https://doi.org/10.2337/diacare.26.3.725
  33. Martínez-González, M.A., García-Arellano, A., Toledo, E., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., … 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.
  34. Morrison, M.K., Lowe, J.M., ve Collins, C.E. (2010). Perceived risk of Type 2 diabetes in Austra-lian women with a recent history of gestational diabetes mellitus. Diabetic Medicine: a Journal of the British Diabetic Association, 27(8), 882–886. https://doi.org/10.1111/j.1464-5491.2010.03032.x
  35. Öcal, E.E., ve Önsüz, M.F. (2018). Diyabet hastalığının ekonomik yükü. Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi, 3(1), 24-31.
  36. Özkan Pehlivanoğlu, E.F., Balcıoğlu, H., ve Ünlüoğlu, İ. (2019). 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
  37. Saglam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., ve Tokgozoglu, L. (2010). International physical activity questionnaire: Reliability and validity of the Turkish ver-sion. Perceptual and Motor Skills, 111(1), 278–284. https://doi.org/10.2466/06.08.PMS.111.4.278-284
  38. Salas-Salvadó, J., Guasch-Ferré, M., Lee, C. H., Estruch, R., Clish, C. B., ve Ros, E. (2015). Pro-tective effects of the mediterranean diet on type 2 diabetes and metabolic syndrome. The Journal of Nu-trition, 146(4), 920S–927S. https://doi.org/10.3945/jn.115.218487
  39. Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinccag, N.,. TURDEP-II Study Group. (2013). Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology, 28(2), 169–180. https://doi.org/10.1007/s10654-013-9771-5
  40. Satman, I., Yilmaz, T., Sengül, A., Salman, S., Salman, F., Uygur, S.,. King, H. (2002). Popula-tion-based study of diabetes and risk characteristics in Turkey: Results of the Turkish diabetes epidemi-ology study (TURDEP). Diabetes Care, 25(9), 1551–1556. https://doi.org/10.2337/diacare.25.9.1551
  41. Schwingshackl, L., Missbach, B., König, J., ve Hoffmann, G. (2015). Adherence to a Mediterrane-an diet and risk of diabetes: A systematic review and meta-analysis. Public Health Nutrition, 18(7), 1292–1299. https://doi.org/10.1017/S1368980014001542
  42. Sleiman, D., Al-Badri, M.R., ve Azar, S.T. (2015). Effect of mediterranean diet in diabetes control and cardiovascular risk modification: A systematic review. Frontiers in Public Health, 3, 69. https://doi.org/10.3389/fpubh.2015.00069
  43. Tokay, A., Yılmaz, C., Bölük, S., Boyraz, Ö., ve Bülbül, N. (2022). Sürdürülebilir beslenme mo-dellerinden Akdeniz diyetinin sürdürülebilirlikteki yeri. TOGÜ Sağlık Bilimleri Dergisi, 2(2), 187-201.
  44. Topuz, İ. (2019). Amasya İl Merkezi’nde yaşayan 40-65 yaş arası erkeklerin gerçek ve algıladıkla-rı kardiyovasküler hastalık risklerinin karşılaştırılması. (Yüksek lisans tezi). Erişilen veri tabanı adı: Ulusal tez merkezi (Tez no: 554432).
  45. Topuz, İ., ve Gözüm, S. (2022). Determining diabetes risk and health literacy levels in individuals aged 45 and above: A descriptive correlational study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 13(4), 624-629. https://doi.org/10.31067/acusaglik.1066190
  46. Türk Endokrinoloji ve Metabolizma Derneği (TEMD). (2020). Diabetes mellitus ve komplikasyon-larının tanı, tedavi ve izlem kılavuzu. Ankara: Bayt Yayınları.
  47. Vandali, M.V. (2019). Role of nurse in diabetes: A review. MAT Journals, 1(1), 24-26. https://doi.org/10.5281/zenodo.2574294
  48. Yan, Y., Wu, T., Zhang, M., Li, C., Liu, Q., ve Li, F. (2022). Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health, 22(1), 1382. https://doi.org/10.1186/s12889-022-13759-9
  49. Yu, H. J., Ho, M., Liu, X., Yang, J., Chau, P. H., ve Fong, D. Y. T. (2023). Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies. Journal of Global Health, 13, 04088. https://doi.org/10.7189/jogh.13.04088
  50. Alvarez-Alvarez, I., Zazpe, I., de Rojas, J.P., Bes-Rastrollo, M., Ruiz-Canela, M., Fernandez-Montero, A.,. Martínez-González, M.A. (2018). Mediterranean diet, physical activity and their com-bined effect on all-cause mortality: The Seguimiento Universidad de Navarra (SUN) cohort. Preventive Medicine, 106, 45-52. https://doi.org/10.1016/j.ypmed.2017.09.021.
  51. Cea‐Soriano, L., Pulido, J., Franch‐Nadal, J., Santos, J.M., Mata‐Cases, M., Díez‐Espino, J.,. the PREDAPS Study Group. (2022). Mediterranean diet and diabetes risk in a cohort study of individuals with prediabetes: Propensity score analyses. Diabetic Medicine, 39(6), e14768. https://doi.org/10.1111/dme.14768
  52. Craig, C.L., Marshall, A.L., Sjöström, M., Bauman, A.E., Booth, M.L., Ainsworth, B.E.,. Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  53. Deery, C.B., Hales, D.P., Viera, L., Lin, F., Liu, Z., Olsson, E.,. Viera, A.J. (2019). Physical ac-tivity calorie expenditure (PACE) labels in worksite cafeterias: effects on physical activity. BMC Public Health, 19, 1596. https://doi.org/10.1186/s12889-019-7960-1
  54. Filippatos, T.D., Panagiotakos, D.B., Georgousopoulou, E.N., Pitaraki, E., Kouli, G.M., Chryso-hoou, C.,. ATTICA Study Group. (2016). Mediterranean diet and 10-year (2002-2012) incidence of diabetes and cardiovascular disease in participants with prediabetes: The ATTICA study. The Review of Diabetic Studies: RDS, 13(4), 226–235. https://doi.org/10.1900/RDS.2016.13.226
  55. Graham, G.N., Leath, B., Payne, K., Guendelman, M., Reynolds, G., Kim, S.,. Buggs, G. (2006). Perceived versus actual risk for hypertension and diabetes in the African American community. Health Promotion Practice, 7(1), 34–46. https://doi.org/10.1177/1524839905283891
  56. Hsia, J., Wu, L., Allen, C., Oberman, A., Lawson, W.E., Torréns, J.,. Women’s Health Initiative Research Group. (2005). Physical activity and diabetes risk in postmenopausal women. American Jour-nal of Preventive Medicine, 28(1), 19–25. https://doi.org/10.1016/j.amepre.2004.09.012
  57. Koloverou, E., Panagiotakos, D.B., Pitsavos, C., Chrysohoou, C., Georgousopoulou, E.N., Grekas, A.,. The ATTICA Study Group. (2016). Adherence to Mediterranean diet and 10-year incidence (2002-2012) of diabetes: Correlations with inflammatory and oxidative stress biomarkers in the ATTICA co-hort study. Diabetes/Metabolism Research and Reviews, 32(1), 73–81. https://doi.org/10.1002/dmrr.2672
  58. Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinccag, N.,. TURDEP-II Study Group. (2013). Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology, 28(2), 169–180. https://doi.org/10.1007/s10654-013-9771-5
  59. Satman, I., Yilmaz, T., Sengül, A., Salman, S., Salman, F., Uygur, S.,. King, H. (2002). Popula-tion-based study of diabetes and risk characteristics in Turkey: Results of the Turkish diabetes epidemi-ology study (TURDEP). Diabetes Care, 25(9), 1551–1556. https://doi.org/10.2337/diacare.25.9.1551