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Ng QX, Lee DYX, Yau CE, Han MX, Liew JJL, Teoh SE, Ong C, Yaow CYL, Chee KT. On Orthorexia Nervosa: A Systematic Review of Reviews. Psychopathology 2024:1-14. [PMID: 38432209 DOI: 10.1159/000536379] [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: 08/12/2023] [Accepted: 01/15/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Orthorexia nervosa (ON), characterized by a pathological preoccupation with "extreme dietary purity," is increasingly observed as a mental health condition among young adults and the general population. However, its diagnosis is not formally recognized and has remained contentious. OBJECTIVE In this systematic review, we attempt to overview previous reviews on ON, focusing on the methodological and conceptual issues with ON. This would serve both as a summary and a way to highlight gaps in earlier research. METHODS This systematic review took reference from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, and using combinations of the search terms ("orthorexia" OR "orthorexia nervosa" OR "ON") AND ("review" OR "systematic review" OR "meta-analysis"), a literature search was performed on EMBASE, Medline and PsycINFO databases from inception up to October 31, 2023. Articles were included if (1) they were written or translated into English and (2) contained information pertaining to the diagnostic stability or validity of ON, or instruments used to measure ON symptoms and behaviors. Only review articles with a systematic literature search approach were included. RESULTS A total of 22 reviews were qualitatively reviewed. Several studies have reported variable prevalence of ON and highlighted the lack of thoroughly evaluated measures of ON with clear psychometric properties, with no reliable estimates. ORTO-15 and its variations such as ORTO-11, ORTO-12 are popularly used, although their use is discouraged. Existing instruments lack specificity for pathology and several disagreements on the conceptualization and hence diagnostic criteria of ON exist. DISCUSSION Previous reviews have consistently highlighted the highly variable (and contradictory) prevalence rates with different instruments to measure ON, lack of stable factor structure and psychometrics across ON measures, paucity of data on ON in clinical samples, and a need for a modern re-conceptualization of ON. The diagnosis of ON is challenging as it likely spans a spectrum from "normal" to "abnormal," and "functional" to "dysfunctional." "Non-pathological" orthorexia is not related to psychopathological constructs in the same way that ON is.
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Affiliation(s)
- Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dawn Yi Xin Lee
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Chun En Yau
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ming Xuan Han
- Department of Paramedicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline Jin Li Liew
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seth En Teoh
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Clarence Ong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Clyve Yu Leon Yaow
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kuan Tsee Chee
- Department of General and Community Psychiatry, Institute of Mental Health, Singapore, Singapore
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Bez NS, Haddad J, Tedde GS, Rose K, Ivanov AV, Milazzo M, Wickart J, Casale G, D'Ascanio M, Van der Horst K, Herter-Aeberli I, Bogl LH. Development of a diet quality score and adherence to the Swiss dietary recommendations for vegans. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:17. [PMID: 38291526 PMCID: PMC10829326 DOI: 10.1186/s41043-024-00498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Vegan diets have recently gained popularity in Switzerland as well as globally. The aim of the present study was to develop a diet quality score for vegans (DQS-V) based on the Swiss dietary recommendations for vegans. METHODS The dataset included 52 healthy vegan adults. Dietary intake data were assessed by three-day weighed food records. Body weight and height were measured, and a venous blood sample for the analysis of vitamin and mineral status was collected. Spearman rank correlation coefficients were used due to not-normally distributed data. Dietary patterns were identified using principal component analysis (PCA). RESULTS The DQS-V score (mean ± SD) was 48.9 ± 14.7. Most vegans adhered to the recommended portions of vegetables, vitamin C-rich vegetables, fruits, omega-3-rich nuts, fats and oils, and iodized salt. However, the intake of green leafy vegetables, vitamin C-rich fruits, wholegrains, legumes, nuts and seeds, selenium-rich nuts, zero caloric liquid, and calcium-fortified foods was suboptimal. The sample overconsumed sweet-, salty-, fried foods, and alcohol. The DQS-V had a significantly positive correlation with intakes of fibre, polyunsaturated fatty acids, potassium, zinc, and phosphorus intakes (p's < 0.05) but was negatively correlated with vitamin B12 and niacin intakes (p's < 0.05). Two dietary patterns were derived from PCA: 1) refined grains and sweets and 2) wholegrains and nuts. The correlation between the DQS-V and the first dietary pattern was negative (- 0.41, p = 0.004) and positive for the second dietary pattern (0.37, p = 0.01). The refined grains and sweets dietary pattern was inversely correlated with beta-carotene status (- 0.41, p = 0.004) and vitamin C status (r = - 0.51, p = 0.0002). CONCLUSION The newly developed DQS-V provides a single score for estimating diet quality among vegan adults. Further validation studies examining the DQS-V in relation to an independent dietary assessment method and to biomarkers of nutritional intake and status are still needed before the general application of the DQS-V.
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Affiliation(s)
- Natalie S Bez
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Joyce Haddad
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Giulia S Tedde
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Karolin Rose
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Aljoscha V Ivanov
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Marina Milazzo
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Joëlle Wickart
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Giulia Casale
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Michele D'Ascanio
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Klazine Van der Horst
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | | | - Leonie H Bogl
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
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McLean CP, Chen Z, Song R, Le J, Fielding J, Sharp G. Development and preliminary validation of a novel eating disorder screening tool for vegetarians and vegans: the V-EDS. J Eat Disord 2024; 12:4. [PMID: 38195575 PMCID: PMC10775595 DOI: 10.1186/s40337-024-00964-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Eating disorders have one of the highest mortality of all mental illnesses but are associated with low rates of screening and early intervention. In addition, there remains considerable uncertainty regarding the use of current standardised screening tools in measuring eating pathology in vegetarians and vegans. With these groups presenting as potential at-risk groups for disordered eating development, the present study aimed to develop and preliminary validate a novel eating disorder screening tool, the Vegetarian Vegan Eating Disorder Screener (V-EDS). METHODS We utilised a mixed-methods approach, comprising four phases. RESULTS A conceptual framework was developed from 25 community, clinician, and lived experience interviews and used to derive a preliminary set of 163 items (Phase 1). Phase 2 piloted the items to establish face and content validity through cognitive debriefing interviews of 18 additional community, clinician, and lived experience participants, resulting in a reduced, revised questionnaire of 53 items. Phase 3 involved scale purification using Item Response Theory in analysis of 230 vegetarians and 230 vegans resulting in a further reduced 18-item questionnaire. Phase 4 validated the screening tool in a large community sample of 245 vegetarians and 405 vegans using traditional psychometric analysis, finding the V-EDS supports a unidimensional factor structure with excellent internal consistency (α = 0.95-0.96) and convergent validity (0.87-0.88), and moderate discriminate validity (0.45-0.55). CONCLUSIONS This study provided strong initial support for the psychometric validity and theoretical assumptions of the novel V-EDS screening tool. The V-EDS has the potential to increase early intervention rates for vegetarians and vegans experiencing eating disorder symptoms, further supporting advocacy and treatment approaches for these expanding dietary groups.
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Affiliation(s)
- Courtney P McLean
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia.
| | - Zhibin Chen
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Richard Song
- University of Melbourne, Grattan Street, Parkville, VIC, Australia
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Jessica Le
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Gemma Sharp
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
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Salehi G, Díaz E, Redondo R. Forty-five years of research on vegetarianism and veganism: A systematic and comprehensive literature review of quantitative studies. Heliyon 2023; 9:e16091. [PMID: 37223710 PMCID: PMC10200863 DOI: 10.1016/j.heliyon.2023.e16091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/25/2023] Open
Abstract
Meat production and consumption are sources of animal cruelty, responsible for several environmental problems and human health diseases, and contribute to social inequality. Vegetarianism and veganism (VEG) are two alternatives that align with calls for a transition to more ethical, sustainable, and healthier lifestyles. Following the PRISMA guidelines, we conducted a systematic literature review of 307 quantitative studies on VEG (from 1978 to 2023), collected from the Web of Science in the categories of psychology, behavioral science, social science, and consumer behavior. For a holistic view of the literature and to capture its multiple angles, we articulated our objectives by responding to the variables of "WHEN," "WHERE," "WHO," "WHAT," "WHY," "WHICH," and "HOW" (6W1H) regarding the VEG research. Our review highlighted that quantitative research on VEG has experienced exponential growth with an unbalanced geographical focus, accompanied by an increasing richness but also great complexity in the understating of the VEG phenomenon. The systematic literature review found different approaches from which the authors studied VEG while identifying methodological limitations. Additionally, our research provided a systematic view of factors studied on VEG and the variables associated with VEG-related behavior change. Accordingly, this study contributes to the literature in the field of VEG by mapping the most recent trends and gaps in research, clarifying existing findings, and suggesting directions for future research.
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Affiliation(s)
- Gelareh Salehi
- Faculty of Economics and Business Administration, Universidad Pontificia Comillas. ICADE, Spain
- Business Management Department, Spain
| | - Estela Díaz
- Faculty of Economics and Business Administration, Universidad Pontificia Comillas. ICADE, Spain
- Business Management Department, Spain
| | - Raquel Redondo
- Faculty of Economics and Business Administration, Universidad Pontificia Comillas. ICADE, Spain
- Quantitative and Statistical Analysis Department, Spain
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Wirnitzer K, Tanous D, Motevalli M, Raschner C, Wagner KH, Wirnitzer G, Leitzmann C, Rosemann T, Knechtle B. Training Behaviors and Periodization Outline of Omnivorous, Vegetarian, and Vegan Recreational Runners (Part A)-Results from the NURMI Study (Step 2). Nutrients 2023; 15:nu15071796. [PMID: 37049635 PMCID: PMC10096545 DOI: 10.3390/nu15071796] [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: 03/16/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Runners train for long-distance competitions based on underlying motivations, which may be similar to individual dietary motivations (e.g., well-being and performance). Fundamental training differences may arise in recreational runners following different diet types (omnivore, vegetarian, vegan) considering possible motive variations. Following a cross-sectional design, distance runners completed a survey (online), including a thorough assessment of training behaviors with generic training details and periodization specifics in three phases: 1. an intermediary and rebound stage, 2. a main preparatory stage, and 3. a main event stage (tapering or interim event level/s). Kruskal-Wallis and chi-squared tests were used in the statistical analysis. A total of 245 fit recreational runners following omnivore (n = 109), vegetarian (n = 45), and vegan diets (n = 91) were included. Significant differences in the initial running motivation were found across dietary subgroups (p = 0.033) as well as for current motivations (p = 0.038), with vegetarians being the least health motivated (27% and 9%, respectively). No differences in each of the specific periods were found between diet types across the outline (p > 0.05). The present evidence shows that there is a lack of fundamental training differences based on recreational runners following different generic types of diets. The results of the present investigation may be especially relevant for future studies on safety, sustainability, and performance-enhancing dietary practices among athletes.
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Affiliation(s)
- Katharina Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, 6020 Innsbruck, Austria
| | - Derrick Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Christian Raschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, 1090 Vienna, Austria
| | | | - Claus Leitzmann
- Institute of Nutrition, University of Gießen, 35390 Gießen, Germany
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
- Medbase St. Gallen, Am Vadianplatz, 9001 St. Gallen, Switzerland
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Traditional, Vegetarian, or Low FODMAP Diets and Their Relation to Symptoms of Eating Disorders: A Cross-Sectional Study among Young Women in Poland. Nutrients 2022; 14:nu14194125. [PMID: 36235777 PMCID: PMC9570588 DOI: 10.3390/nu14194125] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Eating disorders (EDs) are an ever-growing problem, seen most commonly among young women. People with EDs are particularly predisposed to restrictive eating patterns. Diet therapy for many diseases involves the elimination of certain food groups, and the use of restrictive diets in people with EDs may indirectly influence the recurrence of the disorder. The aim of this study was to assess the prevalence of the possible presence of EDs and orthorexia symptoms among young women following a traditional, alternative (vegetarian), or therapeutic (low FODMAP) diet. Methods: The analysis was based on 420 responses from female respondents aged 19 to 30 years. The research tool consisted of questionnaires to assess the possible presence of EDs (SCOFF), cognitive-behavioral aspects of eating (TFEQ-13), and the presence of orthorexia symptoms (ORTO-15). Results: Uncontrolled and emotional eating was least common in women on a vegetarian diet (5.6 ± 3.7; 3.5 ± 2.7; p < 0.05). Women on a low FODMAP diet were most prevalent with symptoms of orthorexia (n = 37, 47.4%; p < 0.05). Conclusions: It seems important to perform screening tests for eating disorders before recommending diet therapy in order to individually adjust the dietary regimen and refer patients to appropriate specialists.
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McLean CP, Kulkarni J, Sharp G. Disordered eating and the meat-avoidance spectrum: a systematic review and clinical implications. Eat Weight Disord 2022; 27:2347-2375. [PMID: 35729472 PMCID: PMC9556390 DOI: 10.1007/s40519-022-01428-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/31/2022] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Meat avoidance has long been thought to be related to eating psychopathology; however, research does not necessarily support this notion. Furthermore, commonly used eating disorder scales may be picking up on normal meat-avoiding behaviours in vegetarians and vegans. As such, we systematically reviewed the association between vegetarianism, veganism, and disordered eating, and reviewed the psychometric properties of eating disorder scales for use in these populations. METHODS We searched electronic databases MEDLINE, PsychINFO, and CINAHL for literature published until June 2021. RESULTS Forty-eight studies met eligibility criteria, with no consensus as to whether meat avoidance was associated with higher rates of disordered eating. Most studies reported a significant positive association with both vegetarianism and veganism, and orthorexia nervosa. Six studies provided evidence for the use of eating disorder measures in vegetarians and vegans, reporting poor psychometric fit among all scales. CONCLUSION This systematic review highlights the extent to which vegetarians and vegans have been highly understudied, with limited research suggesting higher levels of orthorexia nervosa behaviours in vegetarians and vegans. Furthermore, our results provide tentative evidence that the factorial validity of commonly used eating disorder scales, such as the EDE-Q, may be poor in vegans. LEVEL OF EVIDENCE Level I, systematic review.
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Affiliation(s)
- Courtney P McLean
- Monash Alfred Psychiatry research centre, Monash University, 4/607 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry research centre, Monash University, 4/607 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Gemma Sharp
- Monash Alfred Psychiatry research centre, Monash University, 4/607 St Kilda Road, Melbourne, VIC, 3004, Australia
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Ernährungstherapie bei veganer Ernährung und Anorexia nervosa aus diaetologischer Sicht. Prax Kinderpsychol Kinderpsychiatr 2022; 71:449-466. [DOI: 10.13109/prkk.2022.71.5.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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McLean CP, Moeck EK, Sharp G, Thomas NA. Characteristics and clinical implications of the relationship between veganism and pathological eating behaviours. Eat Weight Disord 2022; 27:1881-1886. [PMID: 34786670 DOI: 10.1007/s40519-021-01330-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/29/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Veganism may serve as a socially acceptable means to restrict food intake and disguise pathological eating behaviours. Studies that include vegan participants typically group them with other meat avoiders (e.g., vegetarians), potentially masking risk factors unique to veganism. METHOD We addressed this issue by recruiting two Amazon Mechanical Turk samples of 110 vegan and 118 omnivore participants, with comparable gender composition. We aimed to examine whether vegans showed higher disordered eating than omnivores, and if motives for pursuing a vegan diet impacted disordered eating. We assessed disordered eating using the Eating Attitudes Test, the Eating Disorder Examination-Questionnaire, and the Eating Pathology Symptom Inventory. RESULTS Vegans displayed more pathological eating behaviours than omnivores, which was significantly predicted by cognitive restraint. However, body dissatisfaction levels were higher in omnivores than vegans. Diet motives did not influence vegans' disordered eating. CONCLUSION We propose vegans have high levels of cognitive restraint, possibly due to their intention to avoid animal products. In turn, cognitive restraint subscales in eating disorder measures might be over-pathologising rates of eating disorders in vegans. Future research should monitor the progression of people's eating-related attitudes and behaviours before and after they transition to veganism to establish whether veganism increases the risk of disordered eating, or vice versa. LEVEL OF EVIDENCE IV, cross-sectional study.
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Affiliation(s)
- Courtney P McLean
- Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, VIC, 3004, Australia.
| | - Ella K Moeck
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
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Fuller SJ, Brown A, Rowley J, Elliott-Archer J. Veganism and eating disorders: assessment and management considerations. BJPsych Bull 2022; 46:116-120. [PMID: 33928893 PMCID: PMC9074139 DOI: 10.1192/bjb.2021.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The number of people following a vegan diet in the UK is increasing. Eating disorder clinicians are anecdotally reporting that more of their patients with anorexia nervosa are wanting to follow a vegan diet. The relationship between veganism and eating disorders is unclear. A fictitious scenario is used to explore these issues. An approach is described that clinicians may follow to help patients to understand the potential relationship between their eating disorder and veganism. The human rights issues this involves are also explored. It is hoped that this article will make readers more aware of this complex issue and the impact it can have on engagement with services and on treatment options.
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Exploring Consumer Perceptions of the Value Proposition Embedded in Vegan Food Products Using Text Analytics. SUSTAINABILITY 2022. [DOI: 10.3390/su14042075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Given the increasing interest in sustainable food consumption and production, this study aims to understand how consumers perceive the value proposition of vegan food. Over 120,000 tweets relating to veganism were extracted from Twitter, which were then analysed using the text analytics tool Leximancer to ascertain the predominant themes of conversation taking place around vegan food. Our results show that, in light of the three main drivers for vegan food choice—ethical, personal health, and environmental—surprisingly, we see a limited number of environmental or sustainability motivated tweets. This is a significant finding, as, while vegan food consumption is reported to be sustainable, this is not a preferred topic of conversation for consumers. Value propositions communicated with respect to personal health attributes (e.g., dairy free, gluten free, and nutrition), and consumption benefits (e.g., tasty, delicious) are more likely to resonate with consumers and motivate increased consumption while concurrently delivering environmental benefits as a positive side-effect. Furthermore, the polarity of the attitudes and conversations taking place between vegans and non-vegans on Twitter underscores that a single value proposition is unlikely to reach both groups simultaneously and that different value propositions are likely to be required to reach these respective groups.
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Abstract
From health and sustainability perspectives, reduction in the consumption of animal-based foods, especially red meat, is a key strategy. The present study examined the prevalence, sociodemographic and lifestyle factors, food consumption and food choice motives of vegetarians and consumers of low and high amounts of red and processed meat (RPM) among Finnish adults. We applied the data from three national health studies: FINRISK 2007 (n 4874), FINRISK 2012 (n 4812) and FinHealth 2017 (n 4442). Participants addressed their food consumption with a FFQ and answered other questionnaires about sociodemographic and lifestyle factors, as well as food choice motives. The prevalence of vegetarianism increased from 0·7 % in 2012 to 1·8 % in 2017, and median daily RPM consumption decreased from 128 g in 2007 to 119 g in 2012 and to 96 g in 2017. Vegetarians and members of the low-RPM group were more often women, younger and more highly educated than the high-RPM group, both in 2007 and 2017. Still, the importance of sex for the probability of a vegetarian diet decreased, while its importance for high-RPM consumption increased. Vegetarians consumed more fruit, vegetables, legumes, nuts and seeds than either the low- or high-RPM groups. The high-RPM group had the lowest scores in several aspects of healthy and sustainable diet, healthy food choice motives and healthy lifestyle. Vegetarians and groups differing in their RPM consumption levels might benefit from differing interventions and nutrition information taking into account their other dietary habits, food choice motives and lifestyle factors.
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Gallagher CT, Hanley P, Lane KE. Pattern analysis of vegan eating reveals healthy and unhealthy patterns within the vegan diet. Public Health Nutr 2021; 25:1-11. [PMID: 33971998 PMCID: PMC9991567 DOI: 10.1017/s136898002100197x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/01/2021] [Accepted: 05/05/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to identify the types of foods that constitute a vegan diet and establish patterns within the diet. Dietary pattern analysis, a key instrument for exploring the correlation between health and disease, was used to identify patterns within the vegan diet. DESIGN A modified version of the EPIC-Norfolk FFQ was created and validated to include vegan foods and launched on social media. SETTING UK participants, recruited online. PARTICIPANTS A convenience sample of 129 vegans voluntarily completed the FFQ. Collected data were converted to reflect weekly consumption to enable factor and cluster analyses. RESULTS Factor analysis identified four distinct dietary patterns including: (1) convenience (22 %); (2) health conscious (12 %); (3) unhealthy (9 %) and (4) traditional vegan (7 %). Whilst two healthy patterns were defined, the convenience pattern was the most identifiable pattern with a prominence of vegan convenience meals and snacks, vegan sweets and desserts, sauces, condiments and fats. Cluster analysis identified three clusters, cluster 1 'convenience' (26·8 %), cluster 2 'traditional' (22 %) and cluster 3 'health conscious' (51·2 %). Clusters 1 and 2 consisted of an array of ultraprocessed vegan food items. Together, both clusters represent almost half of the participants and yielding similar results to the predominant dietary pattern, strengthens the factor analysis. CONCLUSIONS These novel results highlight the need for further dietary pattern studies with full nutrition and blood metabolite analysis in larger samples of vegans to enhance and ratify these results.
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Affiliation(s)
- Catherine T Gallagher
- Research Institute for Sport and Exercise Sciences, I. M. Marsh Campus, Liverpool John Moores University, Barkhill Road, Aigburth, LiverpoolL17 6BD, UK
| | - Paul Hanley
- Research Institute for Sport and Exercise Sciences, I. M. Marsh Campus, Liverpool John Moores University, Barkhill Road, Aigburth, LiverpoolL17 6BD, UK
| | - Katie E Lane
- Research Institute for Sport and Exercise Sciences, I. M. Marsh Campus, Liverpool John Moores University, Barkhill Road, Aigburth, LiverpoolL17 6BD, UK
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Heiss S, Walker DC, Anderson DA, Morison JN, Hormes JM. Vegetarians and omnivores with diagnosed eating disorders exhibit no difference in symptomology: a retrospective clinical chart review. Eat Weight Disord 2021; 26:1007-1012. [PMID: 32383038 DOI: 10.1007/s40519-020-00903-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/09/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Past work suggests that vegetarianism is common in patients diagnosed with eating disorders (EDs), but the exact nature of this association is unclear, with reports conflicting as to whether vegetarianism is a risk factor for EDs, complicates ED treatment, or is wholly innocuous. Since vegetarianism has been on the rise, the need for current data on possible links with EDs is substantial. METHODS We collected data on demographics, vegetarian status, ED diagnosis, current body mass index (BMI), highest and lowest BMI, Eating Attitudes Test, and Multifactorial Assessment of Eating Disorders Symptoms scores at intake in 124 patients (84.7% women, 90.3% white, Mage = 23.92 ± 9.16 years) admitted to an intensive outpatient ED program. RESULTS We first compared omnivores (n = 72, 58.1%), meat-reducers (n = 27, 21.8%), vegetarians (n = 20, 16.1%), and vegans (n = 5, 4.0%) and found no significant differences in any demographic or outcome variable, with the exception that vegetarians reported significantly lower highest-ever BMI compared to meat-reducers (p = 0.03). To mirror past chart reviews, we then compared the combined groups of meat avoiders (n = 52, 41.9%) to the omnivores (n = 72, 58.1%) and found no significant differences in demographics or ED symptoms (all ps > 0.05). CONCLUSION Overall, data support that meat restriction does not imply greater ED severity. LEVEL OF EVIDENCE Level V, descriptive study, retrospective chart review.
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Affiliation(s)
- Sydney Heiss
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | | | - Drew A Anderson
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | | | - Julia M Hormes
- Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
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Vegetarian diet and orthorexia nervosa: a review of the literature. Eat Weight Disord 2021; 26:1-11. [PMID: 31784944 DOI: 10.1007/s40519-019-00816-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The number of individuals following a vegetarian diet has increased in the last 50 years. Although the causal connection between orthorexic behaviors and vegetarianism remains widely assumed, evidence in support of this assumption has been largely inconsistent. OBJECTIVE The purpose of the study was to conduct a review of the relationship between vegetarian diet and orthorexic eating behavior and to give future directions in this area. METHODS A search of the literature within PubMed/Medline was conducted. The search terms were "orthorexia", "orthorexic", "orthorexia and vegetarian", "orthorexia and vegan" and "orthorexia and vegetarianism". Out of 117 journal articles, 14 met the predefined inclusion criteria and were analyzed. RESULTS The results demonstrated that following a vegetarian diet was found to be related to orthorexic eating behaviors (in 11 out of 14 studies). CONCLUSION Further longitudinal research is needed to investigate whether following a vegetarian diet serves as a risk factor in the development of orthorexia nervosa. LEVEL OF EVIDENCE Level V, narrative review.
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Sergentanis TN, Chelmi ME, Liampas A, Yfanti CM, Panagouli E, Vlachopapadopoulou E, Michalacos S, Bacopoulou F, Psaltopoulou T, Tsitsika A. Vegetarian Diets and Eating Disorders in Adolescents and Young Adults: A Systematic Review. CHILDREN-BASEL 2020; 8:children8010012. [PMID: 33379220 PMCID: PMC7823335 DOI: 10.3390/children8010012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is to evaluate the association between eating disorders and vegetarian diets in adolescents and young adults. METHODS Systematic review of related articles published in PubMed, PsycInfo and Google Scholar up to 30 May 2019. RESULTS A total of 20 studies (14,391 subjects) were deemed eligible for this systematic review. The majority of the studies reported significant correlations between vegetarianism and eating disorders. However, due to the cross-sectional design, a causal link between eating disorders and vegetarian status cannot be established. CONCLUSIONS Vegetarianism seems to be associated with eating disorders. Longitudinal studies are needed to establish temporal patterns between vegetarianism and the emergence of disordered eating.
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Affiliation(s)
- Theodoros N. Sergentanis
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Maria-Eleni Chelmi
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Clinical Psychopathology, University of Macedonia, 546 36 Thessaloniki, Greece
| | - Andreas Liampas
- Medical School, Department of Neurology, University of Cyprus, 1678 Nicosia, Cyprus;
| | - Chrysanthi-Maria Yfanti
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
| | - Eleni Panagouli
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
| | - Elpis Vlachopapadopoulou
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Stefanos Michalacos
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, “Agia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Theodora Psaltopoulou
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Artemis Tsitsika
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Correspondence: ; Tel./Fax: +30-2107710824
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Collins M, Quinton S. The inter-relationship between diet, selflessness, and disordered eating in Australian women. Brain Behav 2020; 10:e01774. [PMID: 32767655 PMCID: PMC7507084 DOI: 10.1002/brb3.1774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/04/2020] [Indexed: 12/23/2022] Open
Abstract
Personality traits and diet can be used to predict if a person is predisposed to disordered eating. Results of this study demonstrate a strong significant relationship between the personality trait of selflessness, diet group, and disordered eating. Vegans were most likely to display selflessness tendencies associated with disordered eating; however when selflessness was controlled for, vegans displayed substantially less disordered eating pathology than non-vegetarians. OBJECTIVE To explore the relationship between diet group (non-vegetarian, semi-vegetarian, true-vegetarian, and vegan) and disordered eating while investigating to what extent personality trait of selflessness mediates the relationship between diet group and disordered eating. METHOD Cross-sectional data from 634 Australian nonclinical women who completed a series of online questionnaires including measures of diet group, disordered eating, and selflessness were used to examine associations between diet, personality (selflessness), and disordered eating. RESULTS Selflessness was found to be a significant positive predictor of disordered eating. Results confirm that selflessness played a suppressing role in the relationship between the vegan diet group and disordered eating, when compared to non-vegetarians. Surprisingly, vegans displayed significantly less disordered eating than non-vegetarians and semi-vegetarians. DISCUSSION Results of the current study imply that the role of selflessness on disordered eating, when broken down across diet group, may be more complex than first thought. If replicated, these results suggest that targeted treatment of selflessness in different diet groups may improve treatment outcomes for disordered eating. Further research should explore why diet groups differ in terms of selflessness and how this impacts disordered eating.
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Brytek-Matera A. Restrained Eating and Vegan, Vegetarian and Omnivore Dietary Intakes. Nutrients 2020; 12:nu12072133. [PMID: 32709060 PMCID: PMC7400884 DOI: 10.3390/nu12072133] [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: 06/05/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 12/17/2022] Open
Abstract
There are a significant number of studies on cognitive restraint among individuals with varying dietary patterns. Although most research has found that vegetarians report higher levels of cognitive restraint compared to non-vegetarians, many studies have contributed inconsistent results. The aim of the current study, therefore, was to assess any differences between groups with varying dietary patterns on cognitive restraint and other disordered eating pattern. The second objective was to examine determinants of cognitive restraint in individuals adhering to a vegan diet, a vegetarian diet and an omnivore diet. Two-hundred and fifty-four participants with varying dietary patterns completed the Three-Factor Eating Questionnaire, the Perseverative Thinking Questionnaire and the Eating Habits Questionnaire. Our results indicated that both vegetarian and vegan groups showed a significantly lower cognitive restraint, lower emotional eating and lower uncontrolled eating than those who followed an omnivorous diet. In addition, these both groups following a plant-based diet have shown more cognitions, behaviours and feelings related to an extreme focus on healthy eating (orthorexia nervosa) than group following an omnivorous diet. There were no significant differences between the groups in perseverative thinking. Core characteristics of repetitive negative thinking was a significant predictor of cognitive restraint in vegans. Feeling positively about healthy eating predicted cognitive restraint among vegetarians. Problems associated with healthy eating and feeling positively about healthy eating predicted cognitive restraint among individuals following an omnivorous diet. Knowledge of predictors of cognitive restraint may serve as a psychological intervention goal or psychoeducation goal among individuals with varying dietary patterns.
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Affiliation(s)
- Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527 Wroclaw, Poland
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19
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Protudjer JLP, Mikkelsen A. Veganism and paediatric food allergy: two increasingly prevalent dietary issues that are challenging when co-occurring. BMC Pediatr 2020; 20:341. [PMID: 32650748 PMCID: PMC7350184 DOI: 10.1186/s12887-020-02236-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 07/02/2020] [Indexed: 12/16/2022] Open
Abstract
Vegan diets – defined as the exclusion of all foods of animal origin from the diet- are becoming popular. In recent years, the prevalence of food allergy has also increased, and disproportionately affects children. When vegan diets and food allergy co-occur, this combination can be challenging and pose risks of nutritional deficiencies, particularly during childhood. In this paper, we aim to summarise the major concerns regarding vegan diets and food allergy, review the literature on this topic, and provide some suggestions for healthcare providers, particularly dietitians and nutritionists, who work with food allergic, vegan patients and their family. When working with this patient population, a regular and complete medical nutrition history, including screening for any possible nutritional deficiencies, is warranted. Likewise, the routine tracking of serum markers (especially iodine, iron, zinc, calcium, Vitamins B12, D, B2, and A, selected n-3 fatty acids and protein, which are more abundant in animal vs. plant foods) and symptoms of co-morbid diseases, including asthma, is important, as comorbid diseases may increase energy and nutrient requirements. For infants and children, anthropometry ought to be tracked longitudinally at regular intervals to identify any deviations from the child’s previous growth pattern, and to accommodate any increased requirements for growth and development. Correct diagnoses, education and allergy management must be disseminated to the family in a clear and appropriate manner. Children with allergy may have increased nutritional needs due to comorbidity. This is complicated by coincident food allergy and vegan diet as both impose diet restrictions (limiting sources of important nutrients, need for dietary variety and/or increased consumption due to reduced bioavaliability).
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Affiliation(s)
- Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada. .,George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada. .,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada. .,Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada. .,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
| | - Andrea Mikkelsen
- Paediatric Primary Health Care Clinics of Västra Götaland, Västra Götaland, Sweden.,Research and Development Primary Health Care, Gothenburg and Södra Bohuslän, Region Västra Götaland, Sweden.,Institute of Medicine, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Paslakis G, Richardson C, Nöhre M, Brähler E, Holzapfel C, Hilbert A, de Zwaan M. Prevalence and psychopathology of vegetarians and vegans - Results from a representative survey in Germany. Sci Rep 2020; 10:6840. [PMID: 32321977 PMCID: PMC7176641 DOI: 10.1038/s41598-020-63910-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/08/2020] [Indexed: 01/17/2023] Open
Abstract
The aim of the study was to investigate the prevalence of, and attitudes toward, vegetarianism and veganism. We also assessed the association between vegetarianism/veganism and eating disorder, depressive, and somatic symptoms. A cross-sectional questionnaire survey in adults in Germany that was representative in terms of age, gender, and educational level was carried out. Data from 2449 adults (53.5% females) were included. Mean age was 49.6 (SD 17.1) years. A total of 5.4% of participants reported following a vegetarian or vegan diet. While the majority of participants agreed that vegetarian diets are healthy and harmless (56.1%), only 34.8% believed this to be true of vegan diets. The majority of participants also believed that a vegetarian (58.7%) or vegan (74.7%) diet can lead to nutritional deficiency. Female gender, younger age, higher education, lower body mass index (BMI), and higher depressive and eating disorder symptoms were found to be associated with vegetarianism/veganism. We did not find increased physical complaints in the group of vegetarians/vegans. Our results point toward a moderate prevalence of vegetarianism/veganism among the general population. Our findings suggest that health care professionals should keep eating disorder pathology, affective status in mind when dealing with individuals who choose a vegetarian/vegan dietary pattern.
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Affiliation(s)
- Georgios Paslakis
- Toronto General Hospital, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Else Kroener-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.
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Miki AJ, Livingston KA, Karlsen MC, Folta SC, McKeown NM. Using Evidence Mapping to Examine Motivations for Following Plant-Based Diets. Curr Dev Nutr 2020; 4:nzaa013. [PMID: 32110769 PMCID: PMC7042611 DOI: 10.1093/cdn/nzaa013] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/06/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
Motivations to adopt plant-based diets are of great public health interest. We used evidence mapping to identify methods that capture motivations to follow plant-based diets and summarize demographic trends in dietary motivations. We identified 56 publications that described 90 samples of plant-based diet followers and their dietary motivations. We categorized the samples by type of plant-based diet: vegan (19%), vegetarian (33%), semivegetarian (24%), and other, unspecified plant-based diet followers (23%). Of 90 studies examined, 31% administered multiple-choice questions to capture motivations, followed by rate items (23%), Food Choice Questionnaire (17%), free response (9%), and rank choices (10%). Commonly reported motivations were health, sensory/taste/disgust, animal welfare, environmental concern, and weight loss. The methodological variation highlights the importance of using a structured questionnaire to investigate dietary motivations in epidemiological studies. Motivations among plant-based diet followers appear distinct, but evidence on the association between age and motivations appears limited.
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Affiliation(s)
- Akari J Miki
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Kara A Livingston
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | | | - Sara C Folta
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA
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Sakkas H, Bozidis P, Touzios C, Kolios D, Athanasiou G, Athanasopoulou E, Gerou I, Gartzonika C. Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E88. [PMID: 32098430 PMCID: PMC7073751 DOI: 10.3390/medicina56020088] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/15/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
The human gut microbiota is considered a well-known complex ecosystem composed of distinct microbial populations, playing a significant role in most aspects of human health and wellness. Several factors such as infant transitions, dietary habits, age, consumption of probiotics and prebiotics, use of antibiotics, intestinal comorbidities, and even metabolic diseases may continously alter microbiota diversity and function. The study of vegan diet-microbiota interactions is a rapidly evolving field, since plenty of research has been focused on the potential effects of plant-based dietary patterns on the human gut microbiota. It has been reported that well-planned vegan diets and their associated components affect both the bacterial composition and metabolic pathways of gut microbiota. Certain benefits associated with medical disorders but also limitations (including nutritional deficiencies) have been documented. Although the vegan diet may be inadequate in calorific value, it is rich in dietary fiber, polyphenols, and antioxidant vitamins. The aim of the present study was to provide an update of the existing knowledge on nutritional status of vegan diets and the influence of their food components on the human gut microbiota and health.
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Affiliation(s)
- Hercules Sakkas
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
| | - Petros Bozidis
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
| | - Christos Touzios
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Damianos Kolios
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Georgia Athanasiou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Eirini Athanasopoulou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Ioanna Gerou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Constantina Gartzonika
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
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Vegetarianism and other eating practices among youth and young adults in major Canadian cities. Public Health Nutr 2019; 23:609-619. [DOI: 10.1017/s136898001900288x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AbstractObjective:To estimate the prevalence and sociodemographic characteristics of youth and young adults in major Canadian cities with self-reported vegetarian dietary practices and examine efforts to alter their diets.Design:Data were collected in autumn 2016 via web-based surveys. Respondents reported vegetarian dietary practices (vegan, vegetarian or pescatarian) and efforts in the preceding year to consume more or less of several nutrients, food groups and/or foods with particular attributes. Logistic regression models examined sociodemographic correlates of each vegetarian dietary practice and differences in other eating practices by diet type.Setting:Participants were recruited from five major Canadian cities.Participants:Youth and young adults, aged 16–30 years (n 2566).Results:Overall, 13·6 % of respondents reported vegetarian dietary practices: 6·6 % vegetarian, 4·5 % pescatarian and 2·5 % vegan. Sex, race/ethnicity, self-reported frequency of using the Nutrition Facts table and health literacy were significantly correlated with self-reported vegetarian dietary practice (P < 0·01 for all). Efforts to consume more fruits and vegetables (66·8 %) and protein (54·8 %), and less sugar (61·3 %) and processed foods (54·7 %), were prevalent overall. Respondents with vegetarian dietary practices were more likely to report efforts to consume fewer carbohydrates and animal products, and more organic, locally produced, ethically sourced/sustainably sourced/fair trade and non-GM foods (P < 0·01 for all), compared with those without these reported dietary practices.Conclusions:Nearly 14 % of the sampled youth and young adults in major Canadian cities reported vegetarian dietary practices and may be especially likely to value and engage in behaviours related to health-conscious diets and sustainable food production.
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L’orthorexie : une nouvelle forme de trouble des conduites alimentaires ? Presse Med 2019; 48:1065-1071. [DOI: 10.1016/j.lpm.2019.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/17/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023] Open
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Graça J, Godinho CA, Truninger M. Reducing meat consumption and following plant-based diets: Current evidence and future directions to inform integrated transitions. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.07.046] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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What does the ORTO-15 measure? Assessing the construct validity of a common orthorexia nervosa questionnaire in a meat avoiding sample. Appetite 2019; 135:93-99. [DOI: 10.1016/j.appet.2018.12.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/19/2018] [Accepted: 12/27/2018] [Indexed: 10/27/2022]
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Healthy Vegan Lifestyle Habits among Argentinian Vegetarians and Non-Vegetarians. Nutrients 2019; 11:nu11010154. [PMID: 30642046 PMCID: PMC6356967 DOI: 10.3390/nu11010154] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/23/2018] [Accepted: 01/08/2019] [Indexed: 12/16/2022] Open
Abstract
Although current research has contributed to the promotion of whole-food plant-based diets, few studies have examined healthy vegan dietary and lifestyle factors, especially in South America. Therefore, we aimed at investigating the adherence to healthy vegan lifestyle habits among Argentinian vegetarians and omnivorous, using a recently developed vegetarian lifestyle index adapted to the vegan dietary pattern. Also, accessibility of vegetarian foods, and the proportion of household income spent on food were assessed in a cross-sectional approach with 1454 participants. The population was comprised of females (84.9%), singles (55.0%), young-adults (mean age 32.1, standard deviation (SD) = 13.6), employed (50.8%), with high educational levels (50.4%), and low prevalence of both tobacco smoking (7.0%) and frequent alcohol consumption (7.6%). The mean score of adherence to healthy vegan lifestyle habits was 6.64 (SD = 1.72), with higher scores indicating better adherence. Non-vegetarians (5.75; 95% confidence interval (CI), 5.61–5.89) had a significantly lower adjusted mean score compared to semi-(6.32; 95% CI, 6.17–6.47), pesco-(6.99; 95% CI, 6.59–7.39), lacto-ovo-vegetarians (7.10; 95% CI, 6.96–7.24), as well as vegans (8.59; 95% CI, 8.35–8.83). The mean proportion of household income spent on food was significantly lower among vegans compared with other dietary patterns. The whole population that was studied showed a low consumption of whole grains, legumes, vegetables, nuts, and seeds. Although vegans showed a better diet and lifestyle pattern there is a need to improve eating and lifestyle habits to address risk factors for non-communicable diseases in Argentina.
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The psychology of vegetarianism: Recent advances and future directions. Appetite 2018; 131:125-138. [DOI: 10.1016/j.appet.2018.09.011] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/21/2022]
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Heiss S, Boswell JF, Hormes JM. Confirmatory factor analysis of the Eating Disorder Examination-Questionnaire: A comparison of five factor solutions across vegan and omnivore participants. Int J Eat Disord 2018. [PMID: 29533473 DOI: 10.1002/eat.22848] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Eating Disorder Examination-Questionnaire (EDE-Q) is a valid and reliable measure of eating-related pathology, but its factor structure has proven difficult to replicate. Given differences in dietary patterns in vegans compared to omnivores, proper measurement of eating disorder symptoms is especially important in studies of animal product avoiders. METHOD This study compared goodness-of-fit of five alternative models of the EDE-Q in vegans (i.e., individuals refraining from all animal products, n = 318) and omnivores (i.e., individuals not restricting intake of animal products, n = 200). Confirmatory factor analyses were used to compare fit indices of the original four-factor model of the EDE-Q, along with alternative three-, two-, full one-, and brief one-factor models. RESULTS No model provided adequate fit of the data in either sample of respondents. The fit of the brief one-factor model was the closest to acceptable in omnivores, but did not perform as well in vegans. Indicators of fit were comparable in vegans and omnivores across all other models. DISCUSSION Our data confirm difficulties in replicating the proposed factor structure of the EDE-Q, including in vegans. More research is needed to determine the suitability of the EDE-Q for quantifying eating behaviors, including in those abstaining from animal products.
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Affiliation(s)
- Sydney Heiss
- Department of Psychology, University at Albany, State University of New York, Albany, New York
| | - James F Boswell
- Department of Psychology, University at Albany, State University of New York, Albany, New York
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, Albany, New York
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