The Brazilian version of the DOS for the detection of orthorexia nervosa: transcultural adaptation and validation among dietitians and Nutrition college students

Psychometric Properties of Various Factorial Models of the ORTO-15 Tested With Brazilian Respondents

The ORTO-15 is a commonly used screening instrument for symptoms of Orthorexia Nervosa (ON), an obsessive overconcern with healthy eating. However, its limitations have been evidenced in several published factorial models. We analyzed the psychometric properties of seven different ORTO-15 factorial models using data from Brazilian adult participants (n = 1455; 71.4% women; M age = 29.5, SD = 8.9 years) from the country's five macro-regions who answered online questions for sample characterization and completed the Portuguese version of the ORTO-15 containing 15 items. We tested the fit of each model separately, analyzing data for men and women with separate confirmatory factor analysis, and using the Weighted Least Squares Mean and Variance Adjusted estimation method and goodness-of-fit indices. We also calculated the average variance extracted and the alpha ordinal and omega coefficients to analyze the convergent validity and reliability of the factors. None of the models tested presented adequate properties of validity and reliability. Although we found some acceptable reliability coefficients, they do not guarantee the validity of the data. Future investigators should be cautious when choosing the ORTO-15 for ON screening.

Orthorexia nervosa in dietitians and dietetics students-prevalence, risk factors, and interventions: a scoping review using a systematic approach

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.

Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students

This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 dietetics students, with a mean age of 22.94 ± 3.5 years, who completed a series of questionnaires that recorded sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); ON indicators as determined by the ORTO-15 questionnaire; body image flexibility, with the Body Image-Acceptance and Action Questionnaire (BI-AAQ-5); the risk for ED as assessed using the EAT-26; anxiety level according to the STAIT 6 instrument; and recollection of their parents' attitudes towards them during the first 16 years of life, with the Parental Bonding Instrument (PBI). ON risk appeared to be significantly associated with BMI (p = 0.002), exercise frequency (p = 0.023), anxiety level (p = 0.002), risk of ED (p < 0.001), body image inflexibility (p < 0.001), and inversely with the affectionate constraint of maternal bonding (p = 0.036). In conclusion, disordered eating behaviors and body shape concerns are prevalent among dietetics students, with parental attachment to the mother influencing their occurrence. Identification of potential ON and development of prevention mechanisms during childhood could help eliminate these concerns and improve the lives of dietetics students.

Nutrition knowledge, diet quality and orthorexic behaviors in Polish students-a pre-post repeated cross-sectional study

Nutrition knowledge acquired in college students may not only help in promoting an adequate diet, but also lead to excessive preoccupation with healthy eating, which is referred to as orthorexic behaviors. This study aimed to assess the relationship between nutrition knowledge, diet quality and orthorexic behaviors among college students of food and nutrition majors. Data were collected from a sample of 131 college students through a pre-post repeated cross-sectional study conducted from 2018 to 2021. The participants were asked to complete the ORTO-6 questionnaire, the nutrition knowledge test "GAROTA", and the Beliefs and Eating Habits Questionnaire (KomPAN). The results indicated that students' preoccupation with healthy eating (orthorexic behaviors score) during the study period did not change, in contrast nutrition knowledge and diet quality increased. There was no correlation between the orthorexic behaviors score and the nutrition knowledge score, both at the beginning and end of the study. At the beginning of the study, the orthorexic behaviors score correlated positively with "Pro-Healthy Diet Index" and "Diet-Quality Index", and inversely with "Non-Healthy Diet Index". However, at the end of the study, no significant correlations were observed between these variables. It can be concluded that nutrition knowledge determined positively the quality of the diet of students in food and nutrition majors, while did not affect the occurrence of orthorexic behaviors.

Orthorexia nervosa and eating disorder behaviors: A systematic review of the literature

BACKGROUND

Orthorexia nervosa (ON) involves obsessive thoughts about healthy eating and distress related to this obsession. There is still dispute over whether ON should be considered on the obsessive-compulsive spectrum, the eating disorder (ED) spectrum, or as its own disorder. Based on current research, orthorexic behaviors seem to be closely related to eating disorder behaviors. However, given the range of instruments used to measure ED and ON, and the lack of consistency in the specific ED domains explored, a review of the current literature is warranted.

OBJECTIVE

The objective of this study was to review the literature relating ON and ED symptoms in an effort to understand the nature of their relationship, and to identify ED symptom domains most closely related to ON.

METHODS

A search was conducted on PubMed, Science Direct, and Web of Science using the term "orthorexia" and at least one of the following: "anorexia nervosa," "bulimia nervosa," "eating disorder," "arfid," "restrictive," "body image," "weight concern," "shape concern." After exclusion criteria were applied, 42 articles were included in the review.

RESULTS

The results indicated that ON is consistently related to both trait and disordered restrictive eating symptoms of anorexia nervosa, and weight control motivations for food choice. However, ON was less consistently related to binge-spectrum eating disorder symptoms, emotional eating, uncontrolled eating, or body dissatisfaction/shape and weight concerns.

CONCLUSION

The finding that ON symptoms are related to restraint and weight loss efforts, but not to body dissatisfaction or dysregulated eating suggests that ON may represent a distinct ED.