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Magni O, Detopoulou P, Fappa E, Perrea A, Levidi D, Dedes V, Tzoutzou M, Gioxari A, Panoutsopoulos G. Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study. Diseases 2024; 12:108. [PMID: 38785763 PMCID: PMC11120143 DOI: 10.3390/diseases12050108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.
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Affiliation(s)
- Olga Magni
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Paraskevi Detopoulou
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece
| | - Evangelia Fappa
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Anastasia Perrea
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Despoina Levidi
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Vasilios Dedes
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Milia Tzoutzou
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Aristea Gioxari
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Georgios Panoutsopoulos
- Department of Nutritional Sciences and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults. Nutrients 2024; 16:638. [PMID: 38474767 DOI: 10.3390/nu16050638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Measuring orthorexia nervosa is challenging due to the use of various existing tools and problems with sample representativeness. Another challenge for the Polish population is the adaptation of existing research tools and the evaluation of their relevance and research reliability. Our research aimed to adapt the TOS to the Polish language and measure pathological and nonpathological orthorexic behavior among the Polish population. The adaptation of the PL-TOS has high psychometric value and allows us to assess healthy and nervous orthorexia levels. This scale can be used not only for further research but also for diagnostic purposes in the daily work of clinicians and psychologists. Our results obtained in the present study indicate a correlation between TOS and both the use of supplements and diet. Higher TOS, ORTO_R and KZZJ_Diet Restrictions scores were obtained for individuals using dietary supplements than for those not using dietary supplements. In the future, it is worth conducting research aimed at various risk groups of individuals with orthorexia to confirm the psychometric properties of this adaptation of the TOS.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-093 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
| | - Emilia Samardakiewicz-Kirol
- Simulation Laboratory for Patient Safety, Department of Medical Education, Medical University of Lublin, 20-093 Lublin, Poland
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Ephrem C, Rizk R, Saadeh D, Hallit S, Obeid S, Martijn C. Orthorexia nervosa in dietitians and dietetics students-prevalence, risk factors, and interventions: a scoping review using a systematic approach. Nutr Rev 2024:nuae009. [PMID: 38381921 DOI: 10.1093/nutrit/nuae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
CONTEXT Orthorexia nervosa (ON) is characterized by compulsive behaviors and increased concerns about healthful eating. Dietitians appear to be especially vulnerable to ON, and it is still debatable whether the disordered eating behaviors motivate individuals to enroll in nutrition programs, or whether these behaviors result from an exaggerated preoccupation with healthy eating triggered during their nutrition studies. OBJECTIVE The aim was to provide an overview of the present state of knowledge about the prevalence, risk factors, and interventions addressing ON among dietitians and dietetics students. More specifically, it was examined whether dietitians and dietetics students differ from students attending different education programs or other health professionals with regard to the severity and risk factors of ON, and whether the extent of ON changes during the progression in the nutrition education years of study. DATA SOURCES MEDLINE (Ovid), PubMed, EMBASE (Ovid), PsycInfo (EBSCO), CINAHL (EBSCO), Cochrane, ProQuest Central, CABI, ProQuest Dissertations, Google Scholar, ScienceDirect, and SpringerLink were searched on May 8, 2021, and updated on November 12, 2022. DATA EXTRACTION Records were screened for eligibility; study characteristics, methodology, and findings of included articles were extracted; and the methodological quality assessed using the AXIS tool. Each step was preceded by a calibration exercise and conducted independently and in duplicate by pairs of 2 reviewers. Any disagreements were resolved through discussions. DATA ANALYSIS A narrative synthesis was performed, whereby the characteristics, methodologies, and results of included studies were compared. CONCLUSIONS Results were inconclusive; yet, a general status of the relatively "high" prevalence of ON among dietitians and dietetics students was established, stressing the need for systematic research to understand and mitigate orthorexic tendencies in this group. It is still too early to answer questions pertaining to prevalence, risk factors, interventions, and differences between dietetics students and other majors when it comes to severity and progress of ON throughout the continuing years of study, or between dietitians and other professional groups. SYSTEMATIC REVIEW REGISTRATION Open Science Framework Identifier: DOI 10.17605/OSF.IO/BY5KF.
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Affiliation(s)
- Chloe Ephrem
- Clinical Psychological Science-Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rana Rizk
- Nutrition Program, Department of Natural Sciences, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique, d'Epidemiologie Clinique, et de Toxicology (INSPECT-LB), Beirut, Lebanon
| | - Danielle Saadeh
- Institut National de Santé Publique, d'Epidemiologie Clinique, et de Toxicology (INSPECT-LB), Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Carolien Martijn
- Clinical Psychological Science-Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Novara C, Piasentin S, Mattioli S, Pardini S, Maggio E. Perfectionism or Perfectionisms in Orthorexia Nervosa. Nutrients 2023; 15:3289. [PMID: 37571233 PMCID: PMC10421058 DOI: 10.3390/nu15153289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa.
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
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Budhiwianto S, Bennett CJ, Bristow CA, Dart J. Global Prevalence of Eating Disorders in Nutrition and Dietetic University Students: A Systematic Scoping Review. Nutrients 2023; 15:nu15102317. [PMID: 37242199 DOI: 10.3390/nu15102317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Nutrition and dietetics (ND) training encourages behaviors that can be considered risk factors for eating disorders or disordered eating. This paper aims to explore the prevalence of eating disorders (EDs) and predictors of eating disorders (/P-EDs) in ND students. METHODS A systematic scoping review of the literature was performed on PubMed, ERIC, PsychINFO, OVID Medline, and Scopus in October 2022. RESULTS A total of 2097 papers were retrieved from the search, of which 19 studies met the inclusion criteria. The resultant literature reported that 4-32% of ND students were at high risk of EDs (n = 6 studies), and 23-89% could be classified as having orthorexia nervosa (n = 7 studies). Further, 37-86% reported body image/fat dissatisfaction (n = 10 studies), and 100% of students reported weight dissatisfaction (n = 1 study). CONCLUSIONS This paper highlights the prevalence of EDs and P-EDs across ND students. Further research is warranted to explore the cause, context, and impact on ND students' wellbeing and professional identity and supporting diversity within the profession. Future studies should also consider curriculum approaches to address this occupational hazard.
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Affiliation(s)
- Sarah Budhiwianto
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3800, Australia
| | - Christie J Bennett
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3800, Australia
| | - Claire A Bristow
- Medical Education and Research Quality Unit (MERQ), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia
| | - Janeane Dart
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3800, Australia
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Hafstad SM, Bauer J, Harris A, Pallesen S. The prevalence of orthorexia in exercising populations: a systematic review and meta-analysis. J Eat Disord 2023; 11:15. [PMID: 36747235 PMCID: PMC9903632 DOI: 10.1186/s40337-023-00739-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
AIM Orthorexia Nervosa (ON) describes a pathological obsession with proper and high-quality nutrition that is necessary to research further in order to elucidate its prevalence and correlates which may bear implications for prevention and treatment. The aim of this study was to review studies that report the prevalence of ON in people who exercise, calculate an overall prevalence through a random-effects meta-analysis approach and investigate the association of ON prevalence using a random-effects meta-regression. In addition, a sub-group-analysis based on ON-instruments and a sensitivity analysis excluding students samples, were conducted. METHOD Systematic searches were conducted in the following online databases: PubMed, Embase, Web of Science, PsychInfo, CINAHL, Google Scholar and OpenNet. The following search terms were used: Orthore* AND (prevalenc* OR incidenc* OR frequen* OR cut-off OR epidem*). A total of 613 unique hits were reviewed by two blinded authors, and 24 studies were coded and assessed for risk of bias (Holy et.al). The meta-regression included three independent variables (sex, type of sport, and sample size). RESULTS The overall prevalence of ON in the exercising population was 55.3% (95% CI 43.2-66.8). Cochran's Q was 11,436.38 (df = 23, p < 0.0000), and the I2 was 98.4%, indicating high heterogeneity across studies. The sensitivity showed an overall prevalence of 51.3% (95% CI 51.3-70.0). There was a significant difference in prevalence estimates based on the instruments used (Qbet = 33.6, df = 2, p < 0.01). DISCUSSION The overall prevalence of ON in exercising populations was very high. The between-study disparity was large and was partly explained by the ON-instrument administered. One fourth of the studies had a moderate risk of bias. The majority of the studies did not specify relevant demographic information about the sample, and information about the type of sport was frequently missing.
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Affiliation(s)
- Stine Marie Hafstad
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway.
| | - Jonas Bauer
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway.,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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Özaydın T, Ouyaba AT, Kesim SI. Predictors of Orthorexia Nervosa behavior in women within the framework of the theory of planned behavior. Perspect Psychiatr Care 2022; 58:1599-1606. [PMID: 34758112 DOI: 10.1111/ppc.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to examine the predictors of Orthorexia Nervosa behavior in women. DESIGN AND METHODS This cross-sectional study was conducted with 418 women of reproductive age in Turkey. FINDINGS More positive attitudes towards healthy eating and higher levels of control were significantly associated with more positive intentions. High Orthorexia Nervosa and low control were significantly associated with high body mass index. PRACTICE IMPLICATIONS Within the framework of the Theory of Planned Behavior, predictors of Orthorexia Nervosa behavior in women were determined as an attitude towards healthy eating, perceived behavioral control, intention, and body mass index.
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Affiliation(s)
- Tuba Özaydın
- Department of Public Health Nursing, Selçuk University, Faculty of Nursing, Konya, Turkey
| | - Ayşe Taştekin Ouyaba
- Obstetrics and Gynecology Nursing, Afyonkarahisar Health Sciences University, Faculty of Health Sciences, Afyonkarahisar, Turkey
| | - Selma Infal Kesim
- Department of Nursing, Selçuk University, Akşehir Kadir Yallagöz School of Health, Konya, Turkey
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Hanras E, Dorard G, Boujut E. Une ou plusieurs orthorexies ? Conceptualisation, évaluation et enjeux sociétaux : une revue critique de la littérature. PSYCHOLOGIE FRANCAISE 2022. [DOI: 10.1016/j.psfr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Novara C, Pardini S, Visioli F, Meda N. Orthorexia nervosa and dieting in a non-clinical sample: a prospective study. Eat Weight Disord 2022; 27:2081-2093. [PMID: 34993925 PMCID: PMC8739027 DOI: 10.1007/s40519-021-01353-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Orthorexia Nervosa (ON) is characterised by excessive attention to a dietary regimen perceived as healthy. A critical factor in the distinction between ON and other eating disorders (EDs) is the dichotomy of quality-versus-quantity of food intake. We investigated whether specific types of diet or dieting frequency are associated with orthorexic features, explored the overlap between ON and EDs symptoms, and examined which constructs are predictive of ON after 6 months. METHODS A total of 1075 students (75.1% female, mean age 20.9) completed a set of questionnaires assessing Orthorexia, Eating Disorders, Obsessions and Compulsions, Anxiety and Depression; 358 individuals (79.9 female, mean age 20.9) agreed to participate in the study and completed the same questionnaires after 6 months. Different regression models were defined to investigate our hypothesis. RESULTS Findings suggest that ON is associated with the number and type of diets followed over a lifetime. Moreover, participants with EDs, body dissatisfaction, or a dysfunctional idea of thinness are more likely to report a greater degree of ON features. After 6 months, the best predictors of ON characteristics are the same ON characteristics assessed at the first administration, with a significant role in the ideal of thinness. CONCLUSIONS ON is more frequent in individuals with a previous diagnosis of EDs and in individuals who followed a restrictive diet or a vegan/vegetarian one; the number of lifetime diets, beliefs, and behaviors related to the ideals of thinness or body dissatisfaction is common features of ON. Moreover, considering that having ON features in the past is the best ON predictor in the present, we can presume that ON is a construct stable over time. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.
| | - Susanna Pardini
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy
| | - Francesco Visioli
- Department of Molecular Medicine, University of Padova, Viale G. Colombo 3, Padova, Italy.,IMDEA-Food, CEI UAM + CSIC, Carr. de Canto Blanco 8, E, Madrid, Spain
| | - Nicola Meda
- Department of Medicine, University of Padova, Via Giustiniani 2, Padova, Italy
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Tuck CJ, Sultan N, Tonkovic M, Biesiekierski JR. Orthorexia nervosa is a concern in gastroenterology: A scoping review. Neurogastroenterol Motil 2022; 34:e14427. [PMID: 35811419 PMCID: PMC9541631 DOI: 10.1111/nmo.14427] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/07/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022]
Abstract
There is concern that use of restrictive therapeutic diets, such as those used in disorders of the gut-brain interaction (DGBI), may increase disordered eating. In this issue of Neurogastroenterology and Motility, Burton Murray et al. and Peters et al. both demonstrate a high prevalence of disordered eating in patients with gastrointestinal conditions, particularly those with DGBI. Given these findings, it is likely that orthorexia is common in this patient group, although this was not directly examined in these studies. Orthorexia nervosa is described as an obsessive and unsafe focus on eating foods perceived as healthy. This mini-review therefore focuses on orthorexia by conducting a scoping review, as per the PRISMA extension for scoping reviews, aimed to assess the prevalence of orthorexia, and associations between orthorexia and restrictive eating practices. While a wide range of orthorexia prevalence has been reported (0%-97%) across the 57 studies included, no studies assessed prevalence specifically in gastrointestinal conditions. Four of eight studies describing diseases associated with specific dietary patterns suggested that participants who followed a diet for "digestive issues" or "food intolerances" were at higher orthorexia risk. These results suggest that dietary modifications may be a factor contributing to orthorexia. Additionally, we provide a commentary on the clinical implications of the findings for gastrointestinal conditions including a clinical flow chart. Clinicians should consider if a restrictive diet is appropriate for individuals with DGBI and include screening for disordered eating prior to implementation of dietary modifications. Future prospective studies should evaluate orthorexia within this patient group.
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Affiliation(s)
- Caroline J. Tuck
- Department of Sport, Exercise and Nutrition SciencesLa Trobe UniversityBundooraVictoriaAustralia
| | - Nessmah Sultan
- Department of Sport, Exercise and Nutrition SciencesLa Trobe UniversityBundooraVictoriaAustralia
| | - Matilda Tonkovic
- Department of Sport, Exercise and Nutrition SciencesLa Trobe UniversityBundooraVictoriaAustralia
| | - Jessica R. Biesiekierski
- Department of Sport, Exercise and Nutrition SciencesLa Trobe UniversityBundooraVictoriaAustralia,Department of Nutrition, Dietetics and FoodMonash UniversityNotting HillVictoriaAustralia
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Grajek M, Krupa-Kotara K, Sas-Nowosielski K, Misterska E, Kobza J. Prevalence of Orthorexia in Groups of Students with Varied Diets and Physical Activity (Silesia, Poland). Nutrients 2022; 14:nu14142816. [PMID: 35889771 PMCID: PMC9318289 DOI: 10.3390/nu14142816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 12/27/2022] Open
Abstract
(1) Background: The literature emphasizes the role of many factors influencing the onset of eating disorders (EDs) and their mutual influence on each other. Therefore, this study aimed to evaluate and compare the prevalence of orthorexic behaviors in groups of health-related and non-health-related students in terms of their differential health behaviors—diet and physical activity levels. (2) The study included 300 individuals representing two equal groups of fields of study, which for the study were called the health-related field (HRF) and the non-health-related field (NRF). (3) Results: Based on the results of the dietary assessment, it was found that the best dietary model was characterized by the HRF group; in this group, 97.2% of students were characterized by a very good and good dietary mode. The NRF group, on the other hand, was dominated by a sufficient dietary mode for 64.4% of all cases in this group (94 people), while the dietary model marked as “good” was less popular, at 24.6% of this group (36 people). (4) Conclusions: Based on the cited self-research and information from the literature, it can be concluded that the problem of orthorexia is still a new issue at the level of social sciences, medical sciences, and health sciences. The psychometric tools used in this study allowed us to demonstrate the prevalence of the aforementioned eating disorders in the sample groups of students.
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Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Katowice, Poland; (M.G.); (J.K.)
- Department of Humanistic Foundations of Physical Culture, Faculty of Physical Education, Jerzy Kukuczka Academy of Physical Education in Katowice, 40065 Katowice, Poland;
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Bytom, Poland
- Correspondence:
| | - Krzysztof Sas-Nowosielski
- Department of Humanistic Foundations of Physical Culture, Faculty of Physical Education, Jerzy Kukuczka Academy of Physical Education in Katowice, 40065 Katowice, Poland;
| | - Ewa Misterska
- Department of Pedagogy and Psychology, Faculty of Social Studies in Poznań, Poznań School of Security, 60778 Poznań, Poland;
| | - Joanna Kobza
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41902 Katowice, Poland; (M.G.); (J.K.)
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Lakritz C, Tournayre L, Ouellet M, Iceta S, Duriez P, Masetti V, Lafraire J. Sinful Foods: Measuring Implicit Associations Between Food Categories and Moral Attributes in Anorexic, Orthorexic, and Healthy Subjects. Front Nutr 2022; 9:884003. [PMID: 35769379 PMCID: PMC9234570 DOI: 10.3389/fnut.2022.884003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/16/2022] [Indexed: 11/27/2022] Open
Abstract
Recently, neurocognitive studies have shown that food categorization is sensitive to both the properties of the food stimuli (e.g., calorie content) and the individual characteristics of subjects (e.g., BMI, eating disorders) asked to categorize these stimuli. Furthermore, groups of patients with eating disorders (ED) were described as relying more on moral criteria to form food categories than were control subjects. The present studies built on these seminal articles and aimed to determine whether certain food properties might trigger moral categories preferentially in subjects suffering from ED and in the general population. Using a Go/No-Go Association Task, Study 1 focused on the extent to which food categories are laden with moral attributes in ED patients compared to control subjects. Study 2 was a follow-up with a different design (an Implicit Association Test), another food variable (calorie content), and two non-clinical subgroups (orthorexic and healthy control subjects). Results revealed for the first time implicit associations between food variables cueing for energy density and moral attributes in the general population, the population suffering from anorexia nervosa, and subjects suffering from disordered eating such as orthorexia nervosa. These findings suggest that moralization of food is a pervasive phenomenon that can be measured with methods reputed to be less vulnerable to self-presentation or social desirability biases.
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Affiliation(s)
- Clara Lakritz
- Centre de Recherche de l’Institut Paul Bocuse, Lyon, France
- Laboratoire Parcours Santé Systémique, Université Claude Bernard Lyon 1, Lyon, France
| | - Lola Tournayre
- Centre de Recherche de l’Institut Paul Bocuse, Lyon, France
- GR2TCA-Loricorps, Groupe de Recherche Transdisciplinaire des Troubles du Comportement Alimentaire, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM—CIUSSS Est de Montréal), Montreal, QC, Canada
| | - Marilou Ouellet
- Centre de Recherche de l’Institut Paul Bocuse, Lyon, France
- GR2TCA-Loricorps, Groupe de Recherche Transdisciplinaire des Troubles du Comportement Alimentaire, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sylvain Iceta
- Centre Référent pour les TCA, Centre Intégré de l’Obésité, Hospices Civils de Lyon, Lyon, France
- Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, QC, Canada
| | - Philibert Duriez
- GHU Paris Psychiatry and Neurosciences, Clinic of Mental Illnesses and Brain Disorders, Paris, France
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), University of Paris, Paris, France
| | | | - Jérémie Lafraire
- Centre de Recherche de l’Institut Paul Bocuse, Lyon, France
- *Correspondence: Jérémie Lafraire,
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Skella P, Chelmi ME, Panagouli E, Garoufi A, Psaltopoulou T, Mastorakos G, Sergentanis TN, Tsitsika A. Orthorexia and Eating Disorders in Adolescents and Young Adults: A Systematic Review. CHILDREN 2022; 9:children9040514. [PMID: 35455559 PMCID: PMC9030415 DOI: 10.3390/children9040514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/17/2022] [Accepted: 03/22/2022] [Indexed: 12/17/2022]
Abstract
Background: In recent years a new term in the field of eating behaviors has emerged, namely “orthorexia”. This behavior is associated with significant dietary restrictions and omission of food groups. The aim of the present study is to estimate the possible correlations between orthorexia and eating disorders in young adults and adolescents. Methods: A systematic review of related articles in PubMed, Google Scholar, and PsycInfo was conducted up to 30 June 2021. Results: A total of 37 studies (16,402 subjects) were considered eligible for this systematic review. Significant correlations were observed in most of the studies between orthorexia and eating disorders. However, the majority of studies adopted a cross-sectional design. Conclusions: An association between and eating disorders emerged. Prospective studies seem necessary to investigate associations and succession of orthorexia and eating disorders over time.
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Affiliation(s)
- Panagiota Skella
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Maria Eleni Chelmi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Clinical Psychopathology, University of Macedonia, 546 36 Thessaloniki, Greece
| | - Eleni Panagouli
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Anastasia Garoufi
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
| | - Theodora Psaltopoulou
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodoros N. Sergentanis
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
- Department of Public Health Policy, University of West Attica, 122 43 Athens, Greece
| | - Artemis Tsitsika
- Strategies of Developmental and Adolescent Health, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (P.S.); (M.E.C.); (E.P.); (A.G.); (T.P.); (T.N.S.)
- Correspondence: ; Tel.: +30-216-0033788
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Use of online and paper-and-pencil questionnaires to assess the distribution of orthorexia nervosa, muscle dysmorphia and eating disorders among university students: can different approaches lead to different results? Eat Weight Disord 2022; 27:989-999. [PMID: 34110598 PMCID: PMC8190766 DOI: 10.1007/s40519-021-01231-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/28/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey-WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey-PBS), gives different results. METHODS During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS. RESULTS The WBS response rate was 6.7% (N = 137), and the PBS response rate was 86.5% (N = 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%). CONCLUSION The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results. LEVEL OF EVIDENCE Level V, descriptive cross-sectional survey.
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Zagaria A, Vacca M, Cerolini S, Ballesio A, Lombardo C. Associations between orthorexia, disordered eating, and obsessive-compulsive symptoms: A systematic review and meta-analysis. Int J Eat Disord 2022; 55:295-312. [PMID: 34921564 DOI: 10.1002/eat.23654] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is defined as an unhealthy obsession with healthy eating, focusing on concerns regarding food quality and composition. Currently, there is still a lack of consensus about a clear definition of the construct. Specifically, it has yet to be clarified whether ON pertains to eating disorders (EDs) or obsessive-compulsive disorder (OCD) spectrum. Hence, we conducted a systematic review and meta-analysis addressing the magnitude of the association between these groups of symptoms. METHOD PubMed, Medline, SCOPUS, PsychINFO, CINAHL, and Web of Science were searched from inception up to February 2021. Data from individual studies were pooled using a random-effects model. Pearson's r was used as the effect size metric. Subgroup analyses were conducted exploring the role of ON-related instruments, body mass index, study quality, and cultural context. RESULTS Thirty-six studies met the eligibility criteria and were included in the meta-analysis. Random-effects model yielded a moderate association between ON and EDs symptoms with an overall effect size of r = .36 (p < .001; 95% confidence interval [CI] = 0.30-0.43). On the other hand, the results showed a small association between ON and OCD symptoms with a mean effect size of r = .21 (p < .001; 95% CI = 0.15-0.27). DISCUSSION Meta-analytic findings showed that ON symptoms are more associated to EDs compared to OCD. Despite the similarities, the nonhigh magnitude of the pooled correlations suggests that ON might be different from pre-existing EDs and OCD. Hence, ON might be treated as a stand-alone ED and included as an emerging syndrome in the DSM classification.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Silvia Cerolini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Bennett CJ, Dart J. Disordered eating and eating disorders in nutrition and dietetics students: Is it time to talk? Nutr Diet 2021; 79:419-420. [PMID: 34854187 DOI: 10.1111/1747-0080.12716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Christie Jane Bennett
- Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Janeane Dart
- Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Novara C, Maggio E, Piasentin S, Pardini S, Mattioli S. Orthorexia Nervosa: differences between clinical and non-clinical samples. BMC Psychiatry 2021; 21:341. [PMID: 34238282 PMCID: PMC8265101 DOI: 10.1186/s12888-021-03348-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups. METHODS The sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups. RESULTS Analyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON. CONCLUSION Individuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.
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Affiliation(s)
- C. Novara
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - E. Maggio
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - S. Piasentin
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - S. Pardini
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - S. Mattioli
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
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Roberto da Silva W, Cruz Marmol CH, Nogueira Neves A, Marôco J, Bonini Campos JAD. A Portuguese Adaptation of the Teruel Orthorexia Scale and a Test of Its Utility with Brazilian Young Adults. Percept Mot Skills 2021; 128:2052-2074. [PMID: 34187241 DOI: 10.1177/00315125211029240] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aims for this study were to perform a Portuguese language cross-cultural adaptation of the Teruel Orthorexia Scale (TOS) and to evaluate the scale's psychometric properties, including verifying the frequency of behaviors characteristic of orthorexia nervosa and healthy orthorexia, among a group of Brazilian gym users. First, we adapted the Spanish version of the TOS to the Brazilian Portuguese language following international protocols to guarantee idiomatic, semantic, conceptual, and cultural equivalence. Then participants completed both the new Portuguese version of the TOS and a socioeconomic questionnaire. Among our sample of 226 young Brazilian adults (63.7% men; M age = 28.8, SD = 5.1 years), we assessed the bi-factorial model of the TOS through factorial, convergent, and discriminant validity, reliability, and factorial invariance. We calculated the mean scores of the TOS factors and the frequency of behaviors of both orthorexia nervosa and healthy orthorexia. The new Portuguese version was well understood by participants, and the TOS bi-factorial model presented adequate psychometric properties and showed invariance in independent subsamples and in men and women. The mean scores were different between sexes only for orthorexia nervosa, with women obtaining higher values. The frequency of orthorexia nervosa behaviors was 5.3% and of healthy orthorexia was 41.2%. Based on these findings, the Brazilian Portuguese version of the TOS can be a useful tool for investigating orthorexia-like behaviors in future research.
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Affiliation(s)
- Wanderson Roberto da Silva
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Carlos Hernani Cruz Marmol
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - João Marôco
- William James Center for Research (WJCR), ISPA - University Institute, Lisbon, Portugal
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Niedzielski A, Kaźmierczak-Wojtaś N. Prevalence of Orthorexia Nervosa and Its Diagnostic Tools-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105488. [PMID: 34065506 PMCID: PMC8160773 DOI: 10.3390/ijerph18105488] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 12/12/2022]
Abstract
The aim of this article is to present the up-to-date diagnostic tools of orthorexia and markers of its prevalence on the basis of the available literature. The authors searched PubMedCentral (PMC) and Google Scholar with the search entry of “orthorexia”, “orthorexia nervosa”, and “orthorexicbehaviours”. We describe the tools of evaluation of orthorexicbehaviour (i.e., orthorexia self-test—BOT, the ORTO-15 questionnaire, Eating Habits Questionnaire—EHQ, Düsseldorf Orthorexia Scale—DOS, Teruel Orthorexia Scale—TOS, Barcelona Orthorexia Scale—BOS, and Orthorexia Nervosa Inventory—ONI), and offer a review of the studies on orthorexia nervosa. We conclude that there are no reliable data regarding the prevalence of orthorexia nervosa. The available studies point to significant differences in the prevalence depending on the value of cut-off points and tools used. The prevalence varies across countries and across populations, ranging from 6.9% in the Italian population to 88.7% in the group of Brazilian students of dieting. Thus, it indicates that some groups seem to be susceptible to the risk of ON more than others. It is a challenge to determine the prevalence of orthorexia, and any obtained results should be treated with caution. Consequently, we claim that the use of the ORTO-15 questionnaire to diagnose orthorexia is questionable due to a high percentage of falsely positive results.
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Affiliation(s)
- Antoni Niedzielski
- Independent General Psychology Unit, Medical University in Lublin, 20-093 Lublin, Poland
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
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Caferoglu Z, Toklu H. Orthorexia Nervosa in Turkish dietitians and dietetic students. Encephale 2021; 48:13-19. [PMID: 33814168 DOI: 10.1016/j.encep.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Orthorexia Nervosa (ON) is characterized by a pathological obsession with healthy eating, and dietetic majors may have a potential risk of developing ON due to their occupation that necessitates consideration of optimal food choices. This study aimed to determine the prevalence of ON among a large sample of dietitians and dietetic students in Turkey and to investigate the association of ON with socio-demographic features and eating attitudes within the whole sample. METHODS Participants (n=1429) completed a self-administered online survey that featured socio-demographic characteristics, the Orthorexia Nervosa Questionnaire (ORTO-11), and the Eating Attitudes Test-26 (EAT-26). Scores on the ORTO-11 and EAT-26 determined the prevalence of ON and disordered eating behaviors, respectively. RESULTS The prevalence of ON among Turkish dietetic majors was 59.8% with a higher ratio in dietetic students (63.8%) than dietitians (52.9%) (P<0.001). While graduation was associated with 33.1% lower odds of ON (P=0.006), eating disorders could increase the ON risk approximately five times (P<0.001). Furthermore, the greater total and subscale (dieting, bulimia, and oral control) scores of EAT-26 were associated with higher ON tendency (P<0.001), even after adjustment for potential confounders. CONCLUSIONS Our findings may shed light on the relevance of developing strategies to reduce the prevalence of ON in the dietetic population but need to be supported by further longitudinal and prospective studies.
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Affiliation(s)
- Z Caferoglu
- Erciyes University, Faculty of Health Sciences, Department of Nutrition and Dietetics, 38039 Kayseri, Turkey.
| | - H Toklu
- Erciyes University, Faculty of Health Sciences, Department of Nutrition and Dietetics, 38039 Kayseri, Turkey
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Evaluation of Orthorexia Nervosa and Symptomatology Associated with Eating Disorders among European University Students: A Multicentre Cross-Sectional Study. Nutrients 2020; 12:nu12123716. [PMID: 33271906 PMCID: PMC7760249 DOI: 10.3390/nu12123716] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 12/13/2022] Open
Abstract
The objectives of the present study were to (1) evaluate prevalence of orthorexia nervosa (ON) in university students in Spain and Poland, (2) assess differences in ON and eating disorder (ED) pathology in both samples and (3) examine the relationship between ON and ED symptoms among Spanish and Polish university students. Eight hundred and sixty university students participated in the present study (Mage = 21.17 ± 3.38; MBMI = 22.57 ± 3.76). The Spanish and Polish samples comprised 485 and 375 students, respectively. The Düsseldorf Orthorexia Scale and the Eating Disorder Inventory were used in the present study. ON prevalence rates of 2.3% and 2.9%, respectively, are found in the Spanish and Polish samples. Compared to Polish students, Spanish university students reported increased drive for thinness and lower body dissatisfaction, lower level of ineffectiveness and lower level of interpersonal distrust. ON was positively related to drive for thinness, bulimia, body dissatisfaction, perfectionism interoceptive awareness (in both Spanish and Polish students) and ineffectiveness (in Spanish students). Our findings suggest that ON significantly overlaps with ED symptoms, which is in line with recent studies. Longitudinal studies are needed to assess how ON develops in a sample of young adults and whether it develops in isolation of or in parallel with ED pathology.
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Gorrasi ISR, Bonetta S, Roppolo M, Abbate Daga G, Bo S, Tagliabue A, Ferraris C, Guglielmetti M, Arpesella M, Gaeta M, Gallé F, Di Onofrio V, Liguori F, Liguori G, Gilli G, Carraro E. Traits of orthorexia nervosa and muscle dysmorphia in Italian university students: a multicentre study. Eat Weight Disord 2020; 25:1413-1423. [PMID: 31529388 DOI: 10.1007/s40519-019-00779-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study aimed to evaluate the prevalence of traits of orthorexia nervosa (ON) and muscle dysmorphia (MD) in a group of undergraduates, investigate the associations between the risk of these conditions and the type of university course attended, the individual characteristics (gender, BMI, amount of physical activity, supplements and medicines use, dieting) and the risk of eating disorders (EDs). METHODS A self-reported questionnaire consisting of a socio-demographic section and three tests validated for the evaluation of a risk of ON (ORTO-15), MD (MDDI-ITA) and EDs (EAT-26) was completed by 918 students from three Italian universities. RESULTS 29.0% of participants demonstrated traits of ON and 5.0% of MD, without differences in prevalence in the three areas of study investigated (health-scientific, economic-humanistic, sport sciences); students of sport sciences exhibited a significantly higher score for MDDI-ITA (F = 6.493, p = 0.002). Participants with ON and MD traits were more on a diet (OR = 0.47, p ≤ 0.001 and OR = 0.428, p = 0.020, respectively) and showed a higher prevalence of EDs risk (OR = 3.55, p < 0.001 and OR = 10.23, p ≤ 0.001, respectively). The simultaneous presence of ON, MD, and EDs traits was seen in 5.4% of the students and the three test scores were correlated. CONCLUSIONS The prevalence of ON and MD traits was found similar to that reported in the literature on undergraduates. Some associations observed improvement in the knowledge about these conditions, especially the association of participants with ON and MD traits with dieting and EDs traits and the correlation of the three test scores suggests a connection among these potential conditions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional survey.
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Affiliation(s)
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Mattia Roppolo
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Giovanni Abbate Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - Anna Tagliabue
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Cinzia Ferraris
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Monica Guglielmetti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Marisa Arpesella
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Francesca Gallé
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Valeria Di Onofrio
- Department of Sciences and Technologies, University of Naples "Parthenope", Business District, Block C4, 80143, Naples, Italy
| | - Fabrizio Liguori
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Giorgio Liguori
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Giorgio Gilli
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
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Surała O, Malczewska-Lenczowska J, Sadowska D, Grabowska I, Białecka-Dębek A. Traits of Orthorexia Nervosa and the Determinants of These Behaviors in Elite Athletes. Nutrients 2020; 12:nu12092683. [PMID: 32887460 PMCID: PMC7551559 DOI: 10.3390/nu12092683] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/18/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The purpose of this study was to evaluate the traits of orthorexia nervosa (ON) and its relation to body composition and anthropometric indices among elite athletes. Methods: We studied 273 (125 female, 148 male) competitive athletes. ON was assessed with the self-administered ORTO-15 questionnaire. Total body composition was determined using dual-energy X-ray absorptiometry (DXA). Results: The ORTO-15 score was independent of sex, type of effort or age. The ORTO-15 score was related to: total body mass (TBM) (p = 0.037; R = 0.170), body mass index (BMI) (p = 0.022; R = 0.187), bone mineral content (BMC) (p = 0.035; R = 0.172), lean soft tissue (p = 0.026; R = 0.182) and visceral adipose tissue (VAT) (p = 0.007; R = 0.255) in the male; BMI (p = 0.045; R = 0.412) and BMC (p = 0.012; R = 0.506) in weight-dependent male athletes. There was no relationship between ORTO-15 score and body composition in the total study group and subgroup of female athletes. In female athletes, ON tendencies were related to the weekly training time (p = 0.039), but in sprint and high-intensity intermittent efforts subgroup exclusively. Conclusions: Factors related to ON tendencies concerned exclusively BMI and body composition in male, and the weekly training time in female athletes. The results from this study demonstrate that a significant percentage of athletes, irrespective of sex, age, type of sport or hours of training per week, may manifest traits of orthorexia nervosa.
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Affiliation(s)
- Olga Surała
- Institute of Sport—National Research Institute, 01-982 Warsaw, Poland; (O.S.); (J.M.-L.); (D.S.)
| | | | - Dorota Sadowska
- Institute of Sport—National Research Institute, 01-982 Warsaw, Poland; (O.S.); (J.M.-L.); (D.S.)
| | - Izabela Grabowska
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, 21-500 Biała Podlaska, Poland;
| | - Agata Białecka-Dębek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
- Correspondence:
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Valente M, Syurina EV, Donini LM. Shedding light upon various tools to assess orthorexia nervosa: a critical literature review with a systematic search. Eat Weight Disord 2019; 24:671-682. [PMID: 31228168 PMCID: PMC6647444 DOI: 10.1007/s40519-019-00735-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/07/2019] [Indexed: 12/25/2022] Open
Abstract
AIM The aim of this literature review was to identify the tools developed and used to assess orthorexia nervosa (ON). METHODS A systematic search was executed in PubMed, Biomed Central, and PsycINFO. The final list included 70 articles that were critically analyzed. RESULTS A total of six tools were reported to assess ON: the BOT, the ORTO-15, the EHQ, the DOS, the BOS, and the TOS. The tools were based upon different conceptualizations of ON and of its diagnostic criteria. Although they were different, all the conceptualizations derived from the initial definition of ON provided by Bratman in 1997. None of the methodologies adopted for tool construction considered end users or client perspectives and, when carried out, the validations of the tools were fragmented and often based on specific populations. CONCLUSION This study may be a starting point for the construction of a new diagnostic tool for ON. Starting from the methodological weaknesses identified by this review, it was possible to derive some suggestions for future research: (a) developing a modern re-conceptualization of ON, comprehensive of end-user perspectives; (b) adopting qualitative data collection techniques to gain insights into how to diagnose ON; and (c) actively involving diverse stakeholders for constructing a new tool. LEVEL OF EVIDENCE Level of Evidence: I, systematic review.
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Affiliation(s)
- Martina Valente
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Elena V Syurina
- Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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