Turkiye Klinikleri Cardiovascular Sciences

.: REVIEW
Kardiyometabolik Sendrom İçin Yeni Bir Risk Faktörü: Krono-Beslenme
A New Risk Factor for Cardiometabolic Syndrome: Chrononutrition
Ezgi ARSLANa, Tuğçe ÖZLÜa, Emre Batuhan KENGERa, Can ERGÜNa
aBahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, İstanbul, TÜRKİYE
Turkiye Klinikleri J Cardiovasc Sci. 2020;32(3):139-45
doi: 10.5336/cardiosci.2020-75175
Article Language: TR
Full Text
ÖZET
 Sirkadiyen sistem, besin alımı ve enerji harcaması dâhil olmak üzere enerji homeostazını düzenlemektedir. Krono-beslenme, endojen sirkadiyen ritim ve metabolizma arasındaki yakın ilişkiyi temel alan ve gelişmekte olan yeni bir disiplindir. Bu derlemede, besin alımı ve beslenme düzenlerinin, sirkadiyen sistemler yoluyla kardiyometabolik sağlık üzerindeki etkilerinin açığa çıkarılması amaçlanmıştır. Kronobeslenme, yeme davranışının zamanlama, sıklık ve düzenlilik olmak üzere 3 boyutunu kapsamaktadır. Uyku düzeni, açlık/beslenme döngüleri ve aydınlık/karanlık döngüsü arasında gerçekleşen sirkadiyen bozulma, glukoz, lipid metabolizması ve fizyolojik durumları olumsuz etkileyerek, kardiyovasküler hastalıklar için bir risk faktörü olarak tanımlanmaktadır. Krono-beslenme alanında yapılan çalışmaların çoğunluğu, öğün zamanlaması ve sıklığına odaklanmıştır. Buna ilişkin olarak, kahvaltıyı atlamak, akşamları daha yüksek enerjili öğünler tüketmek gibi öğün zamanlama modellerinin, aşırı kiloluluk veya obezite riski ve bireylerde olumsuz metabolik etkiler ile bağlantılı olduğu düşünülmektedir. Yetersiz ve kalitesiz uyku, kardiyometabolik sağlık için risk faktörüdür. Yetersiz uykunun, vücudun ritimlerini bozduğu ve bozulan ritimlerin, artan besin alımı ve düzensiz beslenme profillerine neden olduğu açıklanmıştır. Sonuç olarak; beslenme, uyku ve sirkadiyen ritimler arasında birbirini etkileyen döngüler bulunmakta olup, bu döngüler arasında henüz açığa çıkarılmamış mekanizma ve yolaklar olduğu tahmin edilmektedir. Krono-beslenme ve kardiyometabolik sağlık arasındaki etkileşimi anlamak için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler: Sirkadiyen ritim; uyku; beslenme durumu
ABSTRACT
 Circadian system regulates energy homeostasis, including nutrient intake and energy expenditure. Chrononutrition is a novel developing discipline based on the close relationship between endogenous circadian rhythm and metabolism. In this review, it was aimed to reveal the effects of nutritional intake and diet on cardiometabolic heath through circadian systems. Chrononutrition covers 3 dimensions of eating behaviour: timing, frequency and regularity. Sleep patterns are defined as a risk factor for cardiovascular diseases because of circadian disruption, glucose and lipid metabolism and physiological conditions that occur betwen hunger/feeding cycles and light/dark cycles. The most of studies about chrononutrition focused on meal timing and frequency. Regarding this, meal timing patterns such as skipping breakfast or higher energy intake in the evening might be linked to the risk of overweight/obesity and negative metabolic effects on individuals. Insufficient and poor quality sleep is risk factor for cardiometabolic health. It has been explained that inadequate sleep disrupts the rhythms of body, and deteriorated rhythms cause increased nutritional intake and irregular feeding profiles. It has been explained that inadequate sleep disrupts the rhythms of body, and deteriorated rhythms cause increased nutritional intake and irregular feeding profiles. In conclusion, there are cycles that affect between nutrition, sleep and circadian rhythm. It has been suggested that there are mechanisms and pathways that have not yet been revealed among the cycles. More research is required to understand the interaction between chrononutrition and cardiometabolic health.

Keywords: Circadian rhythm; sleep; nutritional status
REFERENCES:
  1. Poggiogalle E, Jamshed H, Peterson CM. Circadian regulation of glucose, lipid, and energy metabolism in humans. Metabolism. 2018;84:11-27.[Crossref] [PubMed] [PMC] 
  2. Henry CJ, Kaur B, Quek RYC. Chrononutrition in the management of diabetes. Nutr Diabetes. 2020;10(1):6.[Crossref] [PubMed] [PMC] 
  3. Johnston JD, Ordovás JM, Scheer FA, Turek FW. Circadian rhythms, metabolism, and chrononutrition in rodents and humans. Adv Nutr. 2016;7(2):399-406.[Crossref] [PubMed] [PMC] 
  4. Mason IC, Qian J, Adler GK, Scheer FAJL. Impact of circadian disruption on glucose metabolism: implications for type 2 diabetes. Diabetologia. 2020;63(3):462-472.[Crossref] [PubMed] [PMC] 
  5. Almoosawi S, Vingeliene S, Gachon F, Voortman T, Palla L, Johnston JD, et al. Chronotype: implications for epidemiologic studies on chrono-nutrition and cardiometabolic health. Adv Nutr. 2019;10(1):30-42.[Crossref] [PubMed] [PMC] 
  6. Arola-Arnal A, Cruz-Carrión Á, Torres-Fuentes C, Ávila-Román J, Aragonès G, Mulero M, et al. Chrononutrition and polyphenols: roles and diseases. Nutrients. 2019;11(11):2602.[Crossref] [PubMed] [PMC] 
  7. Tahara Y, Shibata S. Chrono-biology, chrono-pharmacology, and chrono-nutrition. J Pharmacol Sci. 2014;124(3):320-35.[Crossref] [PubMed] 
  8. Erren TC, Reiter RJ. Defining chronodisruption. J Pineal Res. 2009;46(3):245-7.[Crossref] [PubMed] 
  9. Laermans J, Depoortere I. Chronobesity: role of the circadian system in the obesity epidemic. Obes Rev. 2016;17(2):108-25.[Crossref] [PubMed] 
  10. Goel N, Stunkard AJ, Rogers NL, Van Dongen HP, Allison KC, O'Reardon JP, et al. Circadian rhythm profiles in women with night eating syndrome. J Biol Rhythms. 2009;24(1):85-94.[Crossref] [PubMed] [PMC] 
  11. Madzima TA, Panton LB, Fretti SK, Kinsey AW, Ormsbee MJ. Night-time consumption of protein or carbohydrate results in increased morning resting energy expenditure in active college-aged men. Br J Nutr. 2014;111(1):71-7.[Crossref] [PubMed] 
  12. Broussard JL, Van Cauter E. Disturbances of sleep and circadian rhythms: novel risk factors for obesity. Curr Opin Endocrinol Diabetes Obes. 2016;23(5):353-9.[Crossref] [PubMed] [PMC] 
  13. Yoshida C, Shikata N, Seki S, Koyama N, Noguchi Y. Early nocturnal meal skipping alters the peripheral clock and increases lipogenesis in mice. Nutr Metab (Lond). 2012;9(1):78.[Crossref] [PubMed] [PMC] 
  14. Cano P, Cardinali DP, Ríos-Lugo MJ, Fernández-Mateos MP, Reyes Toso CF, Esquifino AI. Effect of a high-fat diet on 24-hour pattern of circulating adipocytokines in rats. Obesity (Silver Spring). 2009;17(10):1866-71.[Crossref] [PubMed] 
  15. Barnea M, Madar Z, Froy O. High-fat diet delays and fasting advances the circadian expression of adiponectin signaling components in mouse liver. Endocrinology. 2009;150(1):161-8.[Crossref] [PubMed] 
  16. Gao Y, Gan T, Jiang L, Yu L, Tang D, Wang Y, et al. Association between shift work and risk of type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Chronobiol Int. 2020;37(1):29-46.[Crossref] [PubMed] 
  17. Gan Y, Yang C, Tong X, Sun H, Cong Y, Yin X, et al. Shift work and diabetes mellitus: a meta-analysis of observational studies. Occup Environ Med. 2015;72(1):72-8.[Crossref] [PubMed] 
  18. Toyoura M, Miike T, Tajima S, Matsuzawa S, Konishi Y. Inadequate sleep as a contributor to impaired glucose tolerance: a cross-sectional study in children, adolescents, and young adults with circadian rhythm sleep-wake disorder. Pediatr Diabetes. 2020;21(4):557-64.[Crossref] [PubMed] 
  19. Leproult R, Holmbäck U, Van Cauter E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes. 2014;63(6):1860-9.[Crossref] [PubMed] [PMC] 
  20. Yu JH, Yun CH, Ahn JH, Suh S, Cho HJ, Lee SK, et al. Evening chronotype is associated with metabolic disorders and body composition in middle-aged adults. J Clin Endocrinol Metab. 2015;100(4):1494-502.[Crossref] [PubMed] 
  21. von Schnurbein J, Boettcher C, Brandt S, Karges B, Dunstheimer D, Galler A, et al. Sleep and glycemic control in adolescents with type 1 diabetes. Pediatr Diabetes. 2018;19(1):143-9.[Crossref] [PubMed] 
  22. Kelly RM, Finn J, Healy U, Gallen D, Sreenan S, McDermott JH, et al. Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study. Sleep Med. 2020;66:1-9.[Crossref] [PubMed] 
  23. Roßbach S, Diederichs T, Nöthlings U, Buyken AE, Alexy U. Relevance of chronotype for eating patterns in adolescents. Chronobiol Int. 2018;35(3):336-47.[Crossref] [PubMed] 
  24. Kanerva N, Kronholm E, Partonen T, Ovaskainen ML, Kaartinen NE, Konttinen H, et al. Tendency toward eveningness is associated with unhealthy dietary habits. Chronobiol Int. 2012;29(7):920-7.[Crossref] [PubMed] 
  25. Arora T, Taheri S. Associations among late chronotype, body mass index and dietary behaviors in young adolescents. Int J Obes (Lond). 2015;39(1):39-44.[Crossref] [PubMed] 
  26. St-Onge MP, Ard J, Baskin ML, Chiuve SE, Johnson HM, Kris-Etherton P, et al; American Heart Association Obesity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. Meal Timing and frequency: implications for cardiovascular disease prevention: a scientific statement from the American Heart Association. Circulation. 2017;135(9):e96-121.[Crossref] [PubMed] 
  27. Reutrakul S, Hood MM, Crowley SJ, Morgan MK, Teodori M, Knutson KL, et al. Chronotype is independently associated with glycemic control in type 2 diabetes. Diabetes Care. 2013;36(9):2523-9.[Crossref] [PubMed] [PMC] 
  28. Mu-oz JSG, Ca-avate R, Hernández CM, Cara-Salmerón V, Morante JJH. The association among chronotype, timing of food intake and food preferences depends on body mass status. Eur J Clin Nutr. 2017;71(6):736-42.[Crossref] [PubMed] 
  29. Teixeira GP, Mota MC, Crispim CA. Eveningness is associated with skipping breakfast and poor nutritional intake in Brazilian undergraduate students. Chronobiol Int. 2018;35(3):358-67.[Crossref] [PubMed] 
  30. Reutrakul S, Hood MM, Crowley SJ, Morgan MK, Teodori M, Knutson KL. The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes. Chronobiol Int. 2014;31(1):64-71.[Crossref] [PubMed] 
  31. Adolphus K, Lawton CL, Champ CL, Dye L. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr. 2016;7(3):590S-612S.[Crossref] [PubMed] [PMC] 
  32. Berkey CS, Rockett HR, Gillman MW, Field AE, Colditz GA. Longitudinal study of skipping breakfast and weight change in adolescents. Int J Obes Relat Metab Disord. 2003;27(10):1258-66.[Crossref] [PubMed] 
  33. Kobayashi F, Ogata H, Omi N, Nagasaka S, Yamaguchi S, Hibi M, et al. Effect of breakfast skipping on diurnal variation of energy metabolism and blood glucose. Obes Res Clin Pract. 2014;8(3):e201-98.[Crossref] [PubMed] 
  34. Ogata H, Kayaba M, Tanaka Y, Yajima K, Iwayama K, Ando A, et al. Effect of skipping breakfast for 6 days on energy metabolism and diurnal rhythm of blood glucose in young healthy Japanese males. Am J Clin Nutr. 2019;110(1):41-52.[Crossref] [PubMed] 
  35. Zilberter T, Zilberter EY. Breakfast: to skip or not to skip? Front Public Health. 2014;2:59.[Crossref] [PubMed] [PMC] 
  36. Demir I, Toker A, Zengin S, Laloglu E, Aksoy H. Oxidative stress and insulin resistance in policemen working shifts. Int Arch Occup Environ Health. 2016;89(3):407-12.[Crossref] [PubMed] 
  37. Nagaya T, Yoshida H, Takahashi H, Kawai M. Markers of insulin resistance in day and shift workers aged 30-59 years. Int Arch Occup Environ Health. 2002;75(8):562-8.[Crossref] [PubMed] 
  38. Ye L, Gu W, Chen Y, Li X, Shi J, Lv A, et al. The impact of shift work on glycemic characteristics assessed by CGM and its association with metabolic indices in non-diabetic subjects. Acta Diabetol. 2020;57(1):53-61.[Crossref] [PubMed] 
  39. Merikanto I, Lahti T, Puolijoki H, Vanhala M, Peltonen M, Laatikainen T, et al. Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes. Chronobiol Int. 2013;30(4):470-7.[Crossref] [PubMed] 
  40. Wong PM, Hasler BP, Kamarck TW, Muldoon MF, Manuck SB. Social jetlag, chronotype, and cardiometabolic risk. J Clin Endocrinol Metab. 2015;100(12):4612-20.[Crossref] [PubMed] [PMC] 
  41. Oda H. Chrononutrition. J Nutr Sci Vitaminol (Tokyo). 2015;61 Suppl:S92-4.[Crossref] [PubMed] 
  42. Yamajuku D, Okubo S, Haruma T, Inagaki T, Okuda Y, Kojima T, et al. Regular feeding plays an important role in cholesterol homeostasis through the liver circadian clock. Circ Res. 2009;105(6):545-8.[Crossref] [PubMed] 
  43. Koren D, O'Sullivan KL, Mokhlesi B. Metabolic and glycemic sequelae of sleep disturbances in children and adults. Curr Diab Rep. 2015;15(1):562.[Crossref] [PubMed] [PMC] 
  44. Hanlon EC, Tasali E, Leproult R, Stuhr KL, Doncheck E, de Wit H, et al. Sleep restriction enhances the daily rhythm of circulating levels of endocannabinoid 2-arachidonoylglycerol. Sleep. 2016;39(3):653-64.[Crossref] [PubMed] [PMC] 
  45. Broussard JL, Kilkus JM, Delebecque F, Abraham V, Day A, Whitmore HR, et al. Elevated ghrelin predicts food intake during experimental sleep restriction. Obesity (Silver Spring). 2016;24(1):132-8.[Crossref] [PubMed] [PMC] 
  46. Zarrinpar A, Chaix A, Yooseph S, Panda S. Diet and feeding pattern affect the diurnal dynamics of the gut microbiome. Cell Metab. 2014;20(6):1006-17.[Crossref] [PubMed] [PMC] 
  47. Gombert M, Carrasco-Luna J, Pin-Arboledas G, Codo-er-Franch P. Circadian rhythm variations and nutrition in children. JCS. 2018;8(1):e60-6.[Crossref] 

.: 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