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Gulich M, Fedorova D, Petrenko O, Vepsäläinen H, Erkkola M. War exposure and changes in eating behaviours in Ukrainian school-aged children: A cross-sectional online survey. MATERNAL & CHILD NUTRITION 2024:e13729. [PMID: 39238282 DOI: 10.1111/mcn.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024]
Abstract
The war in Ukraine has exposed children to extremely high levels of acute and chronic stressors, which can impact their eating behaviour (EB). We aimed to determine the prevalence of war-induced, stress-related disruptions in EB of Ukrainian children. We conducted a cross-sectional online survey among parents of 5- to 17-year-old children, who had experienced the war in Ukraine in February-May 2023. Guardians reported their child's various war exposure changes in EBs using a modified version of the Child Eating Behaviour Questionnaire. We assessed associations between total and medium-term EB changes and age, sex, and war exposure using bivariate correlations and χ2 tests. Logistic regression models were fitted to explore the associations between socio-demographic factors, war exposure and frequency of EB changes. Of the 4854 children, 63% had changes in EBs during the war. The most common EB changes included food cravings (38%), food fussiness (37%), and aversion to certain foods (29%). Of the reported EB changes, 40% were medium-term, lasting over a month, and related to altered attitudes towards food. Food insecurity (adjusted OR 2.35, 95% CI: 1.76-3.14), and displacement (internally 2.01, 1.19-3.42) emerged as the most influential determinants of medium-term EB changes. The findings underscore a significant and robust association between war-related exposures and an increased risk of frequent EB changes. As healthy EBs are learned during childhood and have been shown to track into adulthood, the identified disruptions in EB may have medium-term consequences for the physical and mental health of Ukrainian children.
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Affiliation(s)
- Maria Gulich
- State Institution "O.M. Marzіeiev Institute for Public Health" of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Dina Fedorova
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Department of Restaurant and Craft (Food) Technologies, State University of Trade and Economics, Kyiv, Ukraine
| | - Olena Petrenko
- State Institution "O.M. Marzіeiev Institute for Public Health" of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Shamir-Stein N, Feldblum I, Rotman E, Cohen S, Brand E, Kivity S, Saban M. Exploring the Self-Reported Physical and Psychological Effects in a Population Exposed to a Regional Conflict. J Community Health 2024; 49:674-681. [PMID: 38393653 PMCID: PMC11306501 DOI: 10.1007/s10900-024-01337-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Conflict profoundly impacts community health and well-being. While post-conflict research exists, little is known about initial effects during active hostilities. OBJECTIVE To assess self-reported changes in health behaviors, distress, and care access within one month of regional warfare onset in a conflict-affected community. METHODS An online survey was conducted in November 2023 among 501 residents (mean age 40.5 years) of a community where war began October 7th. Measures evaluated physical health, mental health, diet, substance use, sleep, weight changes, and healthcare access before and after the declaration of war. RESULTS Relative to pre-war, respondents reported significantly increased rates of tobacco (56%) and alcohol (15%) consumption, worsening sleep quality (63%), elevated distress (18% sought help; 14% needed but didn't receive it), and postponed medical care (36%). Over a third reported weight changes. Distress was higher among females and those endorsing maladaptive coping. CONCLUSION Within one month, substantial impacts on community psychosocial and behavioral health emerged. Unmet mental health needs and risk-taking behaviors were early indicators of conflict's health consequences. Continuous monitoring of conflict-affected communities is needed to inform tailored interventions promoting resilience and prevent entrenchment of harms over time.
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Affiliation(s)
| | - Ilana Feldblum
- Maccabi healthcare services, Tel Aviv-Jaffa, 6812509, Israel
| | - Eran Rotman
- Maccabi healthcare services, Tel Aviv-Jaffa, 6812509, Israel
| | - Shir Cohen
- Maccabi healthcare services, Tel Aviv-Jaffa, 6812509, Israel
| | - Einat Brand
- Maccabi healthcare services, Tel Aviv-Jaffa, 6812509, Israel
| | - Sara Kivity
- Maccabi healthcare services, Tel Aviv-Jaffa, 6812509, Israel
| | - Mor Saban
- Nursing Department, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Ramat Aviv, 69978, Israel.
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Coop A, Clark A, Morgan J, Reid F, Lacey JH. The use and misuse of the SCOFF screening measure over two decades: a systematic literature review. Eat Weight Disord 2024; 29:29. [PMID: 38652332 PMCID: PMC11039549 DOI: 10.1007/s40519-024-01656-6] [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: 09/03/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested. METHODS The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors. RESULTS 180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use. CONCLUSION This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Amy Coop
- Schoen Clinic Newbridge, Birmingham, UK
| | | | - John Morgan
- St George's, University of London, London, UK
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Bachir Y, El-Hachem C, Richa S, Bou Khalil R. The risk of eating disorders following the August 4th, 2020 explosion in Beirut and its relationship with trauma exposure and PTSD symptoms. Asian J Psychiatr 2023; 89:103749. [PMID: 37639769 DOI: 10.1016/j.ajp.2023.103749] [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: 06/11/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION To date, no study has demonstrated the link between the diagnosis of provisional PTSD and ED in people exposed to the explosion of August 4th, 2020. METHODS Online participants were classified into 4 categories according to the degree of exposure to the explosion (unexposed, slightly exposed, moderately exposed, and severely exposed). The screening for ED was done using the standardized SCOFF questionnaire and the screening for provisional PTSD using the standardized IES-R questionnaire. RESULTS Our sample included 703 participants. In the bivariate analysis, there was a trend for an association between degree of exposure to the explosion and the risk of development of an ED (p = 0.055). The independent variables included in the multivariate analysis that were statistically associated with a risk of developing eating disorders are secondary school as the highest level of education (p = 0.029; OR = 2.15) and the risk of PTSD (p = 0.041; OR = 2.05) according to IES-R, specifically hyperarousal (p = 0.028; OR = 1.07) as a symptom cluster. Provisional PTSD played a mediating role, creating a partial and indirect relationship between the degree of exposure to the explosion and the risk of developing ED with a β coefficient of 0.075 (p < 0.001) CONCLUSION: The risk of PTSD according to IES-R was found to be a determinant of a higher risk of developing ED among participants exposed to the explosion in addition to mediating between the effect of exposure severity and the risk of ED. It is essential to fully assess and manage PTSD symptoms and ED patients exposed to such a psychological trauma.
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Affiliation(s)
- Yara Bachir
- Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Charline El-Hachem
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Sami Richa
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Rami Bou Khalil
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon.
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Azzi R, Samaha S, Malaeb D, Akel M, Azzi V, Hallit S, Obeid S. The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation. BMC Psychiatry 2023; 23:335. [PMID: 37173734 PMCID: PMC10175933 DOI: 10.1186/s12888-023-04847-0] [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: 11/16/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN. METHODS This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175). RESULTS Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia. CONCLUSION Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.
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Affiliation(s)
- Reine Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Serena Samaha
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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Peleg O, Boniel-Nissim M, Tzischinsky O. Adolescents at risk of eating disorders: The mediating role of emotional distress in the relationship between differentiation of self and eating disorders. Front Psychol 2023; 13:1015405. [PMID: 36710825 PMCID: PMC9874111 DOI: 10.3389/fpsyg.2022.1015405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Adolescents may feel dissatisfied with their bodies, which may lead to a risk of eating disorders (EDs) due to several factors, with emotional distress being one of the most important. Evidence suggests that family might be one of the most significant factors that may increase or decrease emotional distress. An important family pattern found to contribute to mental and physical health is the differentiation of self (DoS). The primary purpose of the current study was to map the complex relationships between DoS, emotional distress, and EDs among adolescents. We hypothesized that emotional distress would mediate the relationship between DoS and the risk of EDs among adolescents. Moreover, based on findings indicating a higher risk of EDs among females, we expected sex differences in the research indices and the mediation model. Methods The sample included 194 non-clinical adolescents (mean age 15.15; mean BMI 21.66). Preliminary analyses examined differences between males and females using t-tests. In addition, Pearson correlations were run to assess the association between background variables and the study metrics among males and females. To examine the mediation effect, we ran SEM. Results Due to a sex moderation effect, two mediation models were run (SEM), one for females and one for males. Results indicated that emotional distress partially mediated the relationships between DoS and the risk of EDs. In addition, sex differences were found in the mediated indices, showing that among female adolescents, perfectionism is the only dimension of EDs that was associated with DoS through the mediation of emotional distress. While the relationship between emotional distress and the risk of EDs is well documented. Conclusions It is concluded that high DoS may reduce emotional distress, which may, in turn, decrease the risk of EDs. In addition, the results enable an in-depth understanding of specific risk factors of EDs that characterize each sex.
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Bahi A, Dreyer JL. Effects of chronic psychosocial stress on 'binge-like' sucrose intake in mice. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110625. [PMID: 36055562 DOI: 10.1016/j.pnpbp.2022.110625] [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: 01/24/2022] [Revised: 08/25/2022] [Accepted: 08/25/2022] [Indexed: 11/26/2022]
Abstract
Binge eating episodes are persistent and are essential features of numerous eating disorders (EDs). Susceptibility to EDs is largely presumed to be associated with early life stress. In fact, converging evidence from preclinical animal studies have implicated stress as a driver of binge eating. Still, literature examination indicates that vulnerability to EDs may depend on factors such as severity, time, and the type of stressor. Therefore, we aimed at exploring the link between chronic psychosocial stress and 'binge-like' sucrose intake in adolescent mice. To this aim, intruders' experimental mice were exposed to the chronic subordinate colony (CSC) housing, in the presence of a resident aggressive mouse for 2 weeks. At the end of the stress period, mice were tested for anxiety-like behavior then assessed for 'binge-like' intake of sucrose using a long-term drinking in the dark (DID) method that successfully replicates binge eating in humans. As expected, and compared to single housed colony controls (SHC), CSC exposure elicited an anxiogenic-like response in the open field (OF) and elevated-plus maze (EPM) tests and reduced weight gain. Most importantly, we report here for the first time, that mice exposed to chronic psychosocial stress displayed a 'binge-like' consumption of sucrose. However, neither quinine (bitter) nor saccharin (sweet) intakes were affected by CSC exposure. Finally, using Pearson's correlation, results showed a strong correlation between anxiety-like behavior parameters and sucrose intake. Overall these findings support the validity of our chronic psychosocial stress to model binge EDs and establish the long-term consequences of stress on 'binge-like' eating in male mice. These data suggest that chronic psychosocial stress is a risk factor for developing anxiety-associated EDs.
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Affiliation(s)
- Amine Bahi
- College of Medicine, Ajman University, Ajman, United Arab Emirates; Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; Department of Anatomy, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Jean-Luc Dreyer
- Division of Biochemistry, Department of Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
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Nikitina IM, Sуnkina AA, Yakymchuk YB, Sukhostavets NP, Kopytsia TV, Нerasymenko SF, Babar TV. MENSTRUAL DISORDER IN ADOLESCENTS DURING WAR. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:984-991. [PMID: 37326080 DOI: 10.36740/wlek202305115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: To investigate the peculiarities of menstrual cycle disorders in teenagers against the background of excessive stress in order to develop a scientifically based set of measures for their correction. PATIENTS AND METHODS Materials and methods: 120 girls aged 9-18 who were in the war zone or became forced migrants were examined. Examination methods included anamnesis collection, assessment of psycho-emotional state, anthropometry, laboratory and instrumental studies. RESULTS Results: It was found that the frequency of menstrual cycle disorders in the subjects was 65.8% (n = 79). Among menstrual cycle disorders: dysmenorrhea - 45.6% (n = 36), excessive menstruation - 27.8% (n = 22), secondary amenorrhea - 26.6% (n = 21). 71.7% (n = 86) of the examinees noted a change in eating behavior over the past few months. Almost half of these children had dyshormonal disorders or met the criteria of metabolic syndrome - 45.3% (n = 39). CONCLUSION Conclusion: Timely detection and adequate correction of psycho-emotional and metabolic disorders in adolescent girls in stressful conditions contributes to the prevention of disorders of menstrual and reproductive function.
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Affiliation(s)
| | | | - Yulia B Yakymchuk
- TERNOPIL STATE MEDICAL UNIVERSITY NAMED AFTER I. YA. HORBACHEVSKI, TERNOPIL, UKRAINE
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Alfalahi M, Mahadevan S, Balushi RA, Chan MF, Saadon MA, Al-Adawi S, Qoronfleh MW. Prevalence of eating disorders and disordered eating in Western Asia: a systematic review and meta-Analysis. Eat Disord 2022; 30:556-585. [PMID: 34486495 DOI: 10.1080/10640266.2021.1969495] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to systematically synthesize and appraise existing literature on the prevalence of eating disorders and disordered eating in Western Asia. A systematic literature search of major English and Arabic databases, i.e., PubMed/Medline, EMBASE, PsychInfo, Web of Science and Scopus (English), Al-Manhal (Arabic) and grey literature was done to obtain the prevalence of disordered eating and eating disorders in Western Asia. The literature search was conducted on June 12th, 2020, and included papers from 1990-2020. Out of the 249 unduplicated original studies reviewed, 27 were included in the final meta-analysis. Data were then categorized according to the tools used to identify the presence of disordered eating or eating disorders. The pooled prevalence of disordered eating as solicited by both the Eating Attitudes Scale 26 and the Eating Attitudes Scale 40 (N = 11841) was 22.07%, the Sick, Control, One stone, Fat, Food Questionnaire (n = 3160) was 22.28% and the Eating Disorder Examination-Questionnaire (n = 425) was 7.95%. The pooled prevalence obtained from those studies using semi-structured interviews for anorexia nervosa (n = 118190) was 1.59%, bulimia nervosa (n = 118513) was 2.41% and the estimated prevalence of Eating Disorder Not Otherwise Specified (EDNOS) (n = 118087) was 3.51%. Although the prevalence rate of eating disorders solicited using semi-structured interviews appeared to parallel the international range, the overall prevalence rate of disordered eating appeared to be slightly higher than the global rates of prevalence. A significant number of the suspected/detected cases of disordered eating appear to fulfill the criteria for EDNOS. This study is classified as evidence obtained from systematic reviews and meta-analyses (i.e. Level 1).
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Affiliation(s)
- Maryam Alfalahi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Rola Al Balushi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, SultanQaboos University, Muscat, Oman
| | - Muna Al Saadon
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - M Walid Qoronfleh
- Research & Policy Department, Q3CG Research Institute (QRI) Research & Policy Division, Ypsilanti, Michigan, USA
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Validation of a shortened version of the Eating Attitude Test (EAT-7) in the Arabic language. J Eat Disord 2022; 10:127. [PMID: 36028891 PMCID: PMC9412802 DOI: 10.1186/s40337-022-00651-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders are quite common around the world, disabling, and potentially lethal; but they remain so far under-captured and subject to substantial delays in treatment. We propose through this study to develop and validate a shortened version of the Eating Attitude Test (EAT) in the Arabic language among non-clinical Arabic-speaking Lebanese participants from the general population. METHODS 1175 participants enrolled in this cross-sectional study, based on an online survey. The Eating Attitude Test-26 items, Drunkorexia Motives and Behaviors Scales and Lebanese Anxiety Scale were used to answer our objectives. RESULTS Our results confirmed validity and reliability of the questionnaire. Exploratory Factor Analyses showed that all items converged over a one-factor solution, with an excellent Cronbach's alpha (> 0.9). Confirmatory Factor Analyses found that the 7-item-version yielded excellent model fit. The instrument also revealed strong evidence of divergent validity, being highly correlated with measures of anxiety and drunkorexia motives and behaviors. DISCUSSION Findings provided evidence supporting that the Arabic seven-item one-factor structure of the scale (EAT-7) is valid, reliable, and can be used in clinical practice, preventive interventions and future eating disorders research in Arab settings.
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Hoteit M, Mohsen H, Bookari K, Moussa G, Jurdi N, Yazbeck N. Prevalence, correlates, and gender disparities related to eating disordered behaviors among health science students and healthcare practitioners in Lebanon: Findings of a national cross sectional study. Front Nutr 2022; 9:956310. [PMID: 35928833 PMCID: PMC9345498 DOI: 10.3389/fnut.2022.956310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe raised prevalence of eating disorders (ED) amongst health science students and health professionals is of mounting concern. This study aims to determine the prevalence and correlates of eating disorders risk amongst a sample of Lebanese health science students and healthcare practitioners of both genders.MethodsThis cross-sectional study enrolled a convenient sample of 1,000 participants (mean age: 23 ± 5.4; females: 74.9%) from faculties of health sciences, clinics, pharmacies, and hospitals. The validated Eating Attitudes Test (EAT-26) was used to screen for eating disorders. Anthropometric data were self-reported by respondents to assess their nutritional status.ResultsThe risk of eating disorders was prevalent in 22.5% of participants. Females were at higher risk of ED compared to males p = 0.03. Eating disorders risk did not differ between students and practitioners (p = 0.3). The highest proportion of high-risk participants were students studying nutrition and practitioners (40.9%), outracing their counterparts in nursing (18.7%), medicine (17.8%), pharmacy (17.7%), and midwifery (4.9%) sciences (p = 0.02). Most high-risk participants had normal body weight (60.4%), and 28.9% were overweight (p = 0.001). Female gender, nutrition profession, and dieting were associated with increasing the odd of ED. Particularly, dieting increased the risk around five times. Further, each 3 participants over 10 were facing binge eating behavior.ConclusionThis study uncovers an undervalued profession-related-health-disorder in Lebanese health science students and healthcare practitioners. Specific attention should be given to EDs in professional educational programmes across healthcare disciplines.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
- *Correspondence: Maha Hoteit
| | - Hala Mohsen
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
| | - Khlood Bookari
- National Nutrition Committee, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
- Executive Department of Monitoring and Risk Assessment, Food Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Madina, Saudi Arabia
| | - Ghadir Moussa
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Najwa Jurdi
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Nour Yazbeck
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
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Bizri M, Geagea L, Kobeissy F, Talih F. Prevalence of Eating Disorders Among Medical Students in a Lebanese Medical School: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:1879-1887. [PMID: 32801721 PMCID: PMC7414930 DOI: 10.2147/ndt.s266241] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Eating disorders are among the most severe psychiatric disorders. Medical students are subjected to high levels of stress and have a high risk of developing burnout and mental health problems, including eating disorders. Due to societal stigma and lack of awareness, it is plausible that disordered eating behaviors among students may go unrecognized and under-reported. The current study aimed to evaluate the prevalence and possible factors associated with eating disorders among medical students at the American University of Beirut in Lebanon (AUB). METHODS This cross-sectional descriptive study was conducted in 2017 at AUB. Electronic anonymous surveys were sent to all 412 medical students, with a mean age of 23, enrolled in our four-year medical school. In addition to demographic data, students were asked to complete two validated questionnaires, the SCOFF and EAT-26, to assess eating disorders risk. RESULTS Total responses were 156, out of which 124 completed the whole survey. A total of 131 participants completed the Eat-26 questionnaire and 124 participants completed the SCOFF questionnaire. Out of those, 17% on EAT-26 and 19% on SCOFF were found to be at high risk of developing eating disorders. CONCLUSION There seems to be a high level of underrecognized and under-treated disordered eating behaviors among female medical students at AUB. Raising awareness among medical students is important, as well as developing better prevention and treatment strategies.
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Affiliation(s)
- Maya Bizri
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Luna Geagea
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Firas Kobeissy
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Farid Talih
- American University of Beirut Medical Center, Beirut, Lebanon
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Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr 2019; 109:1402-1413. [PMID: 31051507 DOI: 10.1093/ajcn/nqy342] [Citation(s) in RCA: 620] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/30/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern. OBJECTIVES The aim of this study was to give an exhaustive view of the studies reporting the prevalence of the different EDs or total EDs and to study their evolution. METHODS A literature search following PRISMA Guidelines and limited to studies in English or French published between 2000 and 2018 was performed and relevant studies were included in this systematic review on the prevalence of EDs. The literature search revealed 94 studies with accurate ED diagnosis and 27 with broad ED diagnosis. RESULTS In 94 studies with accurate ED diagnosis, the weighted means (ranges) of lifetime ED were 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The weighted means (ranges) of 12-month ED prevalence were 2.2% (0.8-13.1%) for women and 0.7% (0.3-0.9%) for men. The weighted means (ranges) of point prevalence were 5.7% (0.9-13.5%) for women and 2.2% (0.2-7.3%) for men. According to continents, the weighted means (ranges) of point prevalence were 4.6% (2.0-13.5%) in America, 2.2% (0.2-13.1%) in Europe, and 3.5% (0.6-7.8%) in Asia.In addition to the former, 27 other studies reported the prevalence of EDs as broad categories resulting in weighted means (ranges) of total point prevalence of any EDs of 19.4% (6.5-36.0%) for women and 13.8% (3.6-27.1%) for men. CONCLUSIONS Despite the complexity of integrating all ED prevalence data, the most recent studies confirm that EDs are highly prevalent worldwide, especially in women. Moreover, the weighted means of point ED prevalence increased over the study period from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. This highlights a real challenge for public health and healthcare providers.
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Affiliation(s)
- Marie Galmiche
- TargEDys SA, Rouen, France.,Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Pierre Déchelotte
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | | | - Marie Pierre Tavolacci
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,ClC-CRB 1404, Rouen University Hospital, Rouen, France
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14
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Aoun A, Joundi J, El Gerges N. Prevalence and correlates of a positive screen for eating disorders among Syrian refugees. EUROPEAN EATING DISORDERS REVIEW 2018; 27:263-273. [DOI: 10.1002/erv.2660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 10/27/2018] [Accepted: 11/21/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Antoine Aoun
- Faculty of Nursing and Health SciencesNotre Dame University‐Louaize Zouk Mosbeh Lebanon
| | - Janine Joundi
- Faculty of Nursing and Health SciencesNotre Dame University‐Louaize Zouk Mosbeh Lebanon
| | - Najwa El Gerges
- Faculty of Nursing and Health SciencesNotre Dame University‐Louaize Zouk Mosbeh Lebanon
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15
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Saleh RN, Salameh RA, Yhya HH, Sweileh WM. Disordered eating attitudes in female students of An-Najah National University: a cross-sectional study. J Eat Disord 2018; 6:16. [PMID: 30083319 PMCID: PMC6069992 DOI: 10.1186/s40337-018-0204-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders (ED) are serious psychiatric disorders characterized by unhealthy eating habits. There is a limited number of studies on eating disorders among female university students in Arab countries. Therefore, the objective of this study was to examine the prevalence of disordered eating attitudes (EA) among female students at An-Najah National University, Palestine. METHODS A survey study on 2001 female students at An-Najah National University was carried out. The Sick, Control, One Stone, Fat, Food (SCOFF) screening questionnaire and the Eating Attitudes Test (EAT-26) were used. RESULTS Of the 2001 participants, 28.6% scored ≥ 20 on the EAT-26 while 38.2% scored ≥ 2 on the SCOFF scale. A significant positive correlation was found between body mass index (BMI) and EAT-26 and SCOFF scores. There was a significant difference in EAT-26 (p < .01) and SCOFF scores (p = .037) between different academic specializations. Female students in non-scientific fields (arts and humanities) obtained higher scores than female students in scientific/medical fields. Age was significantly and negatively correlated with EAT-26 scores but not with SCOFF scores. Approximately 85% of students with scores in the "high risk" category of the EAT-26 scale endorsed the item "I am terrified about being overweight". CONCLUSION Awareness regarding appropriate nutrition in relation to body weight is needed among female university students. A general university elective course in this regard might be helpful.
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Affiliation(s)
- Raghad N Saleh
- 1Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Razan A Salameh
- 1Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Heba H Yhya
- 1Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M Sweileh
- 2Department of Physiology, Pharmacology, and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Su X, Liang H, Yuan W, Olsen J, Cnattingius S, Li J. Prenatal and early life stress and risk of eating disorders in adolescent girls and young women. Eur Child Adolesc Psychiatry 2016; 25:1245-1253. [PMID: 27083434 PMCID: PMC5083758 DOI: 10.1007/s00787-016-0848-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 04/06/2016] [Indexed: 12/24/2022]
Abstract
Females are more likely than males to develop eating disorders (EDs) in the adolescence and youth, and the etiology remains unclear. We aimed to estimate the effect of severe early life stress following bereavement, the death of a close relative, on the risk of EDs among females aged 10-26 years. This population-based cohort study included girls born in Denmark (from 1973 to 2000) or Sweden (from 1970 to 1997). Girls were categorized as exposed if they were born to mothers who lost a close relative 1 year prior to or during pregnancy or if the girl herself lost a parent or a sibling within the first 10 years of life. All other girls were included in unexposed group. An ED case was defined by a diagnosis of EDs at ages of 10-26 years, including broadly defined bulimia nervosa, broadly defined anorexia nervosa and mixed EDs. Poisson regression models were used to estimate the incidence rate ratio (IRR) between exposed group and unexposed group.A total of 64453 (3.05 %) girls were included in the exposed group. We identified 9477 girls with a diagnosis of EDs, of whom 307 (3.24 %) were from the exposed group. Both prenatal and postnatal exposure following bereavement by unexpected death was associated with an increased overall risk of EDs (IRRprenatal: 1.49, 95 % CI: 1.01-2.19 and IRRpostnatal: 1.34, 95 % CI: 1.05-1.71). We observed similar results for subtypes of broadly defined bulimia nervosa (IRR: 2.47, 95 % CI: 1.67-3.65) and mixed EDs (IRR: 1.45, 95 % CI: 1.02-2.07).Our findings suggest that prenatal and early postnatal life stress due to unexpected death of a close relative is associated with an increased overall risk of eating disorders in adolescent girls and young women. The increased risk might be driven mainly by differences in broadly defined bulimia nervosa and mixed eating disorders, but not broadly defined anorexia nervosa.
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Affiliation(s)
- Xiujuan Su
- Department of Women's and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200120, People's Republic of China.
| | - Hong Liang
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, 200032 People’s Republic of China
| | - Wei Yuan
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 8200 N Denmark
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 8200 N Denmark
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Tavolacci MP, Grigioni S, Richard L, Meyrignac G, Déchelotte P, Ladner J. Eating Disorders and Associated Health Risks Among University Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:412-20.e1. [PMID: 26363936 DOI: 10.1016/j.jneb.2015.06.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 06/23/2015] [Accepted: 06/25/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine the prevalence of eating disorders among university students and its relationship to behavioral characteristics and substance use. DESIGN Cross-sectional study collected socioeconomic characteristics and behavioral risk. SETTING University of Upper Normandy, France. PARTICIPANTS University student volunteers. PHENOMENON OF INTEREST The Sick, Control, One stone, Fat, Food (SCOFF) screening test was used to identify subjects with eating disorders by a confidential questionnaire self-administered either online or on paper. ANALYSIS Multivariate logistic regression models with P < .05 considered significant. RESULTS A total of 3,457 students were included with a male-to-female ratio of 0.57. The prevalence of positive SCOFF screening was 20.5% among students. A positive relation between the positive SCOFF was observed with female gender (adjusted odds ratio [AOR], 2.98; 95% confidence interval [CI], 2.28-3.89; P < .001), stress (AOR, 1.10; 95% CI, 1.09-1.12; P < .001), depression (AOR, 8.62; 95% CI, 3.37-22.10; P < .001) alcohol abuse problems (AOR, 1.52; 95% CI, 1.20-1.95; P = .006), and risk of cyber-addiction (AOR, 5.09; 95% CI, 2.69-9.62; P < .001). CONCLUSIONS AND IMPLICATIONS Eating disorders are highly prevalent among university students in France and associated with other behavior risks, stress, and depression. It might prove necessary in the future to screen students with the SCOFF questionnaire upon entry to the university to inform student about the risk of eating disorders and advise them to consult with their general practitioner.
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Affiliation(s)
- Marie Pierre Tavolacci
- Clinical Investigation Center 1404, Rouen University Hospital, Rouen, France; INSERM UMR 1073, University of Rouen, Rouen, France.
| | - Sébastien Grigioni
- INSERM UMR 1073, University of Rouen, Rouen, France; Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Laure Richard
- Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Gilles Meyrignac
- Department of Preventive Medicine of University, Rouen University, Rouen, France
| | - Pierre Déchelotte
- INSERM UMR 1073, University of Rouen, Rouen, France; Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Joël Ladner
- INSERM UMR 1073, University of Rouen, Rouen, France; Department of Epidemiology and Public Health, Rouen University Hospital, Rouen, France
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