Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Determination of the Effect of Diet on the Development and Severity of Acne Vulgaris by Using Insulin Index and Glycemic Index
İnsülin İndeksi ve Glisemik İndeks Kullanılarak Diyetin Akne Vulgaris Oluşumu ve Şiddeti Üzerindeki Etkisinin Belirlenmesi
Ömer KUTLUa, İlknur BALTAa, Hatice Meral EKŞİOĞLUa
aAnkara Training and Research Hospital, Department of Dermatology and Venereology, Ankara, TURKEY
Turkiye Klinikleri J Dermatol. 2020;30(1):6-14
doi: 10.5336/dermato.2019-71783
Article Language: EN
Full Text
ABSTRACT
 Objective: Acne vulgaris is a chronic, inflammatory disease of the pilosebaceous unit. Dietary factor is considered to be one of the factors that can trigger acne vulgaris as it is reported to be associated with Western type nutrition. In this study, it is aimed to evaluate the effect of insulin index and dietary factors in patients with acne vulgaris. Material and Methods: Two hundred two consecutive patients with acne vulgaris and 172 patients as control group were included in this study. The dietary habits in patients with acne vulgaris were statistically compared to the control group. Results: The risk for acne was detected increased in those consuming more than 3 servings per week for cola (Odds ratio (OR) 1.57; 1.00-2.46), instant coffee with powdered milk (OR 1.67; 1.03-2.72), feta cheese (OR 1.63; 1.00-2.65) and 1 serving per week for peanut (OR 1.62; 1.02-2.58) while risk for acne was decreased in those consuming more than 3 servings per week for chicken meat (OR 0.65; 0.43-0.99), pasta (OR 0.59; 0.37-0.95), and 1 serving per week for sujuk (OR 0.60; 0.38-0.94) (p<0.05). Conclusion: In this study, the consumption of foodstuffs with a higher insulin index value than glycemic index such as cola, feta cheese, and peanuts was significantly higher in patients with acne vulgaris. It may be useful to take into consideration the value of insulin index along with the glycemic index value for some foodstuffs to evaluate relationship between acne vulgaris and dietary factors.

Keywords: Acne; diet; glycemic index; insulin index
ÖZET
 Amaç: Akne vulgaris, pilosebase ünitenin kronik inflamatuar bir hastalığıdır. Batı tipi beslenmeyle ilişkili olduğu bildirilen akne vulgaris için diyet tetikleyici bir faktördür. Bu çalışmada insulin indeks ve diyet faktörlerinin akne vulgaris üzerindeki etkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: İki yüz iki akne vulgarisli hasta ile 172 kontrol grubu bu çalışmaya dahil edildi. Akne vulgarisli hastalarda diyet alışkanlıkları kontrol grubuyla istatistiksel olarak karşılaştırıldı. Bulgular: Haftada ≥3 porsiyon kola (Odds oranı (OO) 1,57; 1,00-2,46), süt tozlu neskafe (OO 1,67; 1,03-2,72) beyaz peynir (OO 1,63; 1,00- 2,65) ile haftada ≥1 porsiyon fıstık (OO 1,62; 1,02-2,58) tüketenlerde akne vulgaris riski yüksek bulunurken haftada ≥3 porsiyon tavuk eti (OO 0,65; 0,43-0,99), makarna (OO 0,59; 0,37-0,95) ile haftada ≥1 porsiyon sucuk (OO 0,60; 0,38-0,94) tüketenlerde akne vulgaris riski düşük bulundu. Sonuç: Bu çalışmada, insulin indeks değeri glisemik indeks değerinden yüksek olan kola, beyaz peynir ve fıstık tüketimi akne vulgarisli hastalarda anlamlı olarak fazla bulundu. Akne vulgaris ile diyet faktörleri arasındaki ilişkinin değerlendirilmesinde glisemik indeks yanında insulin indeksini de değerlendirmek faydalı olabilir.

Anahtar Kelimeler: Akne; diyet; glisemik indeks; insulin indeks
REFERENCES:
  1. Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet. 2012;379(9813):361-72. [Crossref] 
  2. Kutlu Ö, Balta İ, Karaarslan E, Nalbant EEK, İmren G, Ekşioğlu HM. Facial paralysis probably related to systemic isotretinoin. Int J Sci Rep. 2019;5(5):130-2. [Crossref] 
  3. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: a disease of Western civilization. Arch Dermatol. 2002;138(12):1584-90. [Crossref]  [PubMed] 
  4. Juhl C, Bergholdt H, Miller I, Jemec GBE, Kanters JK, Ellervik C. Dairy intake and acne vulgaris: a systematic review and meta-analysis of 78,529 children, adolescents, and young adults. Nutrients. 2018;10(8):1049. [Crossref]  [PubMed]  [PMC] 
  5. Melnik BC, John SM, Plewig G. Acne: risk indicator for increased body mass index and insulin resistance. Acta Derm Venereol. 2013;93(6):644-9. [Crossref]  [PubMed] 
  6. Cheng Z, White MF. Targeting Forkhead box O1 from the concept to metabolic diseases: lessons from mouse models. Antioxid Redox Signal. 2011;14(4):649-61. [Crossref]  [PubMed]  [PMC] 
  7. Dong XC, Copps KD, Guo S, Li Y, Kollipara R, DePinho PA, et al. Inactivation of hepatic Foxo1 by insulin signaling is required for adaptive nutrient homeostasis and endocrine growth regulation. Cell Metab. 2008;8(1):65-76. [Crossref]  [PubMed]  [PMC] 
  8. Foster KG, Fingar DC. Mammalian target of rapamycin (mTOR): conducting the cellular signaling symphony. J Biol Chem. 2010;285(19):14071-7. [Crossref]  [PubMed]  [PMC] 
  9. Tan JK, Vasey K, Fung KY. Beliefs and perceptions of patients with acne. J Am Acad Dermatol. 2001;44(3):439-45. [Crossref]  [PubMed] 
  10. Kim H, Moon SY, Sohn MY, Lee WJ. Insulin-like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes. Ann Dermatol. 2017;29(1):20-5. [Crossref]  [PubMed]  [PMC] 
  11. Holt S, Miller J, Petocz P. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr. 1997;66(5):1264-76. [Crossref]  [PubMed] 
  12. Melnik BC. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestle Nutr Workshop Ser Pediatr Program. 2011;67:131-45. [Crossref]  [PubMed] 
  13. Ismail NH, Manaf ZA, Azizan NZ. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatol. 2012;12:13. [Crossref]  [PubMed]  [PMC] 
  14. Kwon HH, Yoon JY, Hong JS, Jung JY, Park MS, Suh DS. Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial. Acta Derm Venereol. 2012;92(3):241-6. [Crossref]  [PubMed] 
  15. Karadağ AS, Balta İ, Saricaoğlu H, Kiliç S, Kelekçi KH, Yildirim M, et al. The effect of personal, familial, and environmental characteristics on acne vulgaris: a prospective, multicenter, case controlled study from Turkey. G Ital Dermatol Venereol. 2019;154(2):177-85. [Crossref]  [PubMed] 
  16. Burris J, Shikany JM, Rietkerk W, Woolf K. A low glycemic index and glycemic load diet decreases insulin-like growth factor-1 among adults with moderate and severe acne: a short-duration, 2-week randomized controlled trial. J Acad Nutr Diet. 2018;118(10):1874-85. [Crossref]  [PubMed] 
  17. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36(6):416-8. [Crossref]  [PubMed] 
  18. Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, et al. Management of acne: a report from a global alliance to improve outcomes in acne. J Am Acad Dermatol. 2003;49(1 Suppl):S1-37.
  19. Melnik B. Dietary intervention in acne: attenuation of increased mTORC1 signaling promoted by Western diet. Dermatoendocrinol. 2012;4(1):20-32. [Crossref]  [PubMed]  [PMC] 
  20. Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol. 2018;32(10):1631-7. [Crossref]  [PubMed] 
  21. Khayef G, Young J, Burns-Whitmore B, Spalding T. Effects of fish oil supplementation on inflammatory acne. Lipids Health Dis. 2012;11:165. [Crossref]  [PubMed]  [PMC] 
  22. Dai R, Hua W, Chen W, Xiong L, Li L. The effect of milk consumption on acne: a meta‐analysis of observational studies. J Eur Acad Dermatol Venereol. 2018;32(12):2244-53. [Crossref]  [PubMed] 
  23. Lu PH, Hsu CH. Body mass index is negatively associated with acne lesion counts in Taiwanese women with post‐adolescent acne. J Eur Acad Dermatol Venereol. 2015;29(10):2046-50. [Crossref]  [PubMed] 
  24. Burris J, Rietkerk W, Woolf K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet. 2014;114(3):384-92. [Crossref]  [PubMed] 
  25. Seleit I, Bakry OA, Abdou AG, Hashim A. Body mass index, selected dietary factors, and acne severity: are they related to in situ expression of insulin-like growth factor-1? Anal Quant Cytopathol Histopathol. 2014;36(5):267-78.
  26. Tanacan E, Karaosmanoğlu N, Kutlu Ö, Ekşioğlu HM. [Evaluation of the relationship between androgenetic alopecia severity and body mass index]. Ankara Eğt Arş Hast Derg. 2018;51(3):193-5.
  27. Ghodsi SZ, Orawa H, Zouboulis CC. Prevalence, severity, and severity risk factors of acne in high school pupils: a community-based study. J Invest Dermatol. 2009;129(9):2136-41. [Crossref]  [PubMed] 
  28. Jung JY, Yoon MY, Min SU, Hong JS, Choi YS, Suh DH. The influence of dietary patterns on acne vulgaris in Koreans. Eur J Dermatol. 2010;20(6):768-72.
  29. Law MP, Chuh AA, Molinari N, Lee A. An investigation of the association between diet and occurrence of acne: a rational approach from a traditional Chinese medicine perspective. Clin Exp Dermatol. 2010;35(1):31-5. [Crossref]  [PubMed] 
  30. Youssef EN, Youssef MKE. Diet and acne in Upper Egypt. Am J Dermatol Venereol. 2014;3(1):13-22.
  31. Abo El-Fetoh NM, Alenezi NG, Alshamari NG, Alenezi OG. Epidemiology of acne vulgaris in adolescent male students in Arar, Kingdom of Saudi Arabia. J Egypt Public Health Assoc. 2016;91(3):144-9. [Crossref]  [PubMed] 
  32. El-Akawi Z, Abdel-Latif Nemr N, Abdul-Razzak K, Al-Abbosi M. Factors believed by Jordanian acne patients to affect their acne condition. East Mediterr Health J. 2006;12(6):840-6.
  33. Tom WL, Barrio VR. New insights into adolescent acne. Curr Opin Pediatr. 2008;20(4):436-40. [Crossref]  [PubMed] 
  34. Huang X, Zhang J, Li J, Zhao S, Xiao Y, Huang Y, et al. Daily intake of soft drinks and moderate-to-severe acne vulgaris in Chinese Adolescents. J Pediatr. 2019;204:256-62.e3. [Crossref]  [PubMed] 
  35. Romańska-Gocka K, Woźniak M, Kaczmarek-Skamira E, Zegarska B. The possible role of diet in the pathogenesis of adult female acne. Postepy Dermatol Alergol. 2016;33(6):416-20. [Crossref]  [PubMed]  [PMC] 
  36. Melnik BC. Diet in acne: further evidence for the role of nutrient signaling in acne pathogenesis. Acta Derm Venereol. 2012;92(3):228-31. [Crossref]  [PubMed] 
  37. Inoki K, Ouyang H, Li Y, Guan KL. Signaling by target of rapamycin proteins in cell growth control. Microbiol Mol Biol Rev. 2005;69(1):79-100. [Crossref]  [PubMed]  [PMC] 
  38. Fouladi RF. Aqueous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trial. J Diet Suppl. 2012;9(4):253-61. [Crossref]  [PubMed] 
  39. Docherty JJ, McEwen HA, Sweet TJ, Bailey E, Booth TD. Resveratrol inhibition of Propionibacterium acnes. J Antimicrob Chemother. 2007;59(6):1182-4. [Crossref]  [PubMed] 
  40. Taylor EJ, Yu Y, Champer J, Kim J. Resveratrol demonstrates antimicrobial effects against Propionibacterium acnes in vitro. Dermatol Ther (Heidelb). 2014;4(2):249-57. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com