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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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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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Atsizata M, Sögüt SC. The relationship between orthorexia nervosa and cyberchondria levels in nurses: A cross-sectional study. Arch Psychiatr Nurs 2024; 48:30-35. [PMID: 38453279 DOI: 10.1016/j.apnu.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/12/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The study was conducted with the aim of investigating the relationship between orthorexia nervosa and cyberchondria levels among nurses. METHODS This cross-sectional study was conducted with 399 nurses through face-to-face interviews. The data were collected using a participant information form, the Cyberchondria Severity Scale, and the Orthorexia Nervosa-11 scale (ORTO-11). RESULTS The mean score of the nurses' cyberchondria severity scale was 73.95 ± 18.53, while the mean score of the Orthorexia Nervosa-11 scale was 28.23 ± 4.76. In the study, a low negative correlation was found between the cyberchondria and orthorexia nervosa levels (p < 0.05). CONCLUSIONS The increase in the level of cyberchondria among nurses increases the risk of orthorexia nervosa. Therefore, it is recommended that nurses receive proper nutritional education and psychosocial support to reduce their tendency towards orthorexia nervosa and cyberchondria.
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Affiliation(s)
| | - Seda Cangöl Sögüt
- Department of Midwifery, Faculty of Health Sciences, Çanakkale Onsekiz Mart University, Turkey.
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Athanasaki D, Lakoumentas J, Milani GP, Agostoni C, Berghea F, Ionescu MD, Vassilopoulou E. Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students. Nutrients 2023; 15:3577. [PMID: 37630767 PMCID: PMC10460006 DOI: 10.3390/nu15163577] [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: 07/26/2023] [Revised: 08/01/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
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.
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Affiliation(s)
- Dafni Athanasaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
| | - Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Florian Berghea
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Spital Clinic Sf. Maria, Bd. Ion Mihalache 37-39, Et 1 Secretariat, 011172 Bucharest, Romania
| | - Marcela Daniela Ionescu
- Department of Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- “Marie S. Curie” Emergency Children’s Clinical Hospital, 041451 Bucharest, Romania
| | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (D.A.); (J.L.); (E.V.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
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Yassıbaş E, Ayyıldız F. Turkish Version of the New Instrument for Orthorexia Nervosa-Test of Orthorexia Nervosa (TON-17): A Validity and Reliability Study. Nutrients 2023; 15:3178. [PMID: 37513596 PMCID: PMC10384101 DOI: 10.3390/nu15143178] [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: 06/03/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to adapt the Test of Orthorexia Nervosa- (TON-17) into Turkish and verify its validity and reliability. The study included 539 adults with a mean age of 30.2 ± 12.26 years. A reliability analysis was performed, along with a confirmatory factor analysis to test its construct validity. The time-invariance of the scale was examined by test-retest analysis, and its convergent validity was evaluated by a correlation analysis conducted to test the relationships between the scale and Eating Attitudes Test-26 and Obsessive Beliefs Questionnaire-9. Analyses were conducted using SPSS Version 28 and the AMOS-24 software. The Cronbach's α internal consistency coefficient of the total scale was found to be 0.82, suggesting a strong internal consistency. The Cronbach's α values of its factors were 0.68 for the "control of food quality", 0.64 for the "fixation on health and a healthy diet", and 0.73 for the "disorder symptoms". In addition, the test-retest reliability was found to be 0.87 for the total scale, suggesting excellent reliability. Most of the fit indices (CMIN/df, RMSEA, AGFI, NFI, and TLI) of the scale were acceptable, and the GFI indicated a good model fit. This study shows that the Turkish version of TON-17, which is a new tool with a three-factor structure to evaluate orthorexia, is a valid and reliable scale.
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Affiliation(s)
- Emine Yassıbaş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, 06490 Ankara, Turkey
| | - Feride Ayyıldız
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, 06490 Ankara, Turkey
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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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Diet Quality and Level of Nutrition Knowledge among Young People with Orthorexic Tendencies. Nutrients 2022; 14:nu14204333. [PMID: 36297017 PMCID: PMC9609964 DOI: 10.3390/nu14204333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to determine the level of nutrition knowledge and diet quality, understood in terms of healthy and unhealthy eating habits, among young people with orthorexic tendencies. The participants were school students, university students, and those employed in the Lublin region (N = 473). The data were collected by means of a questionnaire. The participants were asked to provide socio-demographic data through filling in the ORTO-15 questionnaire and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). The participants obtained results ranging from 9.3 to 100 (M = 31.15; SD = 11.81) in the non-healthy diet index, from 0.4 to 78.6 in the pro-healthy diet index (M = 21.79; SD = 11.08), and from 0 to 23 in the domain of nutrition knowledge (M = 13; SD = 4.23). A variance analysis showed no significant differences between the pro-healthy diet index and the level of nutrition knowledge. The group with orthorexia obtained statistically higher results in the pro-healthy diet index. Those with a tendency toward orthorexia obtained statistically higher results in the non-healthy diet index. The variance analysis showed that the level of nutrition knowledge of those not focused on healthy foods was significantly lower than in the other groups. The results of the ORTO-15 questionnaire correlated negatively with the pro-healthy diet index and the level of nutrition knowledge, and positively with the non-healthy diet index. We concluded that: 1. the orthorexic group and the group with a tendency toward orthorexia could be characterized with a moderate intensity of a healthy diet and a low intensity of a non-healthy diet; and 2. the level of nutrition knowledge in the orthorexic group did not significantly differ from that of the other groups.
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Guglielmetti M, Ferraro OE, Gorrasi ISR, Carraro E, Bo S, Abbate-Daga G, Tagliabue A, Ferraris C. Lifestyle-Related Risk Factors of Orthorexia Can Differ among the Students of Distinct University Courses. Nutrients 2022; 14:nu14051111. [PMID: 35268086 PMCID: PMC8912801 DOI: 10.3390/nu14051111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/21/2022] [Accepted: 03/04/2022] [Indexed: 12/12/2022] Open
Abstract
Orthorexia nervosa (ON) is defined as the excessive attention on healthy eating, and studies especially focused on food quality ON prevalence in university students can be extremely variable. The objective of this study is to investigate whether there was a difference in ON risk between health-scientific, economic-humanistic, sport sciences and dietetics and nutrition students, and to evaluate if lifestyle-related ON risk factors (dieting, physical activity, drugs and supplements use) could have an impact in different ways in determining ON risk among students attending these four programs. Participants were recruited at the University of Pavia and received a two-section questionnaire including demographic and lifestyle information and the ORTO-15 questionnaire. A total of 671 students (54% F e 46% M) completed the questionnaire (median age 21.00 (IQR 20.00−23.00), median BMI 21.77 kg/m2 (IQR 20.06−23.66 kg/m2)). The 31.2% had ORTO-15 test scores < 35, and were considered at risk of having ON. No differences were found in ON risk among the students attending the four university courses. Dieting was confirmed as the major ON risk factor for health-scientific, economic-humanistic and sport sciences students. The type of sport practiced was an important determinant of ON risk only for the economic-humanistic course, while supplements use was statistically different between sport sciences students with or without ON. Our findings may suggest that lifestyle-related risk factors of orthorexia can differ among the students of distinct university courses, but these results need to be supported by further longitudinal and prospective studies.
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Affiliation(s)
- Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Correspondence: (M.G.); (C.F.)
| | - Ottavia Eleonora Ferraro
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy;
| | | | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy; (I.S.R.G.); (E.C.)
| | - Simona Bo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126 Turin, Italy;
| | - Giovanni Abbate-Daga
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy;
| | - Anna Tagliabue
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Correspondence: (M.G.); (C.F.)
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