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Di Tata D, Bianchi D, Rossi F, Fatta LM, Sette S, Laghi F. Past body shaming experiences and food and alcohol disturbance in young adults: indirect effects via psychological distress. Eat Weight Disord 2024; 29:60. [PMID: 39287843 PMCID: PMC11408558 DOI: 10.1007/s40519-024-01687-z] [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: 06/04/2024] [Accepted: 08/21/2024] [Indexed: 09/19/2024] Open
Abstract
PURPOSE This study investigated the associations between retrospective reports of body image victimization (i.e. body shaming) perpetrated by peers and by parents during childhood or adolescence, and food and alcohol disturbance (FAD) in young adulthood, considering the possible mediating role of psychological distress (i.e. subthreshold symptoms of anxiety and depression). METHODS The study involved 1624 young adults aged between 18 and 30 (69% women), who completed an online survey. RESULTS Our findings revealed that participants who reported more frequent body image victimization episodes during childhood and adolescence exhibited higher levels of psychological distress and, in turn, higher scores of FAD in young adulthood. CONCLUSIONS This result represents a novel contribution to understanding the psychological correlates of FAD in youths. Limitations and implications are discussed. Level of evidence Level V, descriptive study.
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Affiliation(s)
- Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, via dei Marsi, 78, 00185, Rome, Italy.
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, via dei Marsi, 78, 00185, Rome, Italy
| | - Franca Rossi
- Department of Developmental and Social Psychology, Sapienza University of Rome, via dei Marsi, 78, 00185, Rome, Italy
| | | | - Stefania Sette
- Department of Developmental and Social Psychology, Sapienza University of Rome, via dei Marsi, 78, 00185, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, via dei Marsi, 78, 00185, Rome, Italy
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Speed S, Ward RM. Drunkorexia and trait mindfulness among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:571-577. [PMID: 35298361 DOI: 10.1080/07448481.2022.2048837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/07/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.
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Affiliation(s)
- Shannon Speed
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
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Shepherd CB, Berry KA, Ye X, Li K. Food and alcohol disturbance among US college students: a mixed methods scoping review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1715-1731. [PMID: 34292851 DOI: 10.1080/07448481.2021.1947300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/05/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Conduct a scoping review of food and alcohol disturbance (FAD) in US college students to overview the literature within this population and identify research opportunities. METHODS Studies (n = 39) were selected using systematic searches of databases and references. Search terms included: drunkorexia, "food and alcohol disturbance," and "compensatory behavior" AND alcohol AND eating. RESULTS Issues with methodological quality were noted. Most studies used quantitative methods and cross-sectional designs with small, biased samples. Terminologies, conceptualizations, and measures varied; however, 30% of studies neglected enhanced intoxication effects. Prevalence ranged from approximately 10-55%, with greater risk for women. Alcohol use and disordered eating were primary predictors. Personality, affective, and social factors are potential correlates. Alcohol-related consequences were higher for those with FAD. CONCLUSIONS While the literature is inconsistent and unclear, FAD appears to be common among college students and associated with negative consequences. Suggestions and considerations for future research are provided.
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Affiliation(s)
- Caitlin B Shepherd
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Katherine A Berry
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Xian Ye
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Kathie Li
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
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Vogt KS, Harper M, Griffin BL. "… because I'm so drunk at the time, the last thing I'm going to think about is calories": Strengthening the argument for Drunkorexia as a food and alcohol disturbance, evidence from a qualitative study. Br J Health Psychol 2022; 27:1188-1208. [PMID: 35384176 PMCID: PMC9540538 DOI: 10.1111/bjhp.12594] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 01/02/2023]
Abstract
Objectives Drunkorexia are inappropriate compensatory behaviours in response to alcohol consumption (restricting food intake, excessive exercise, and purging). Past (predominantly quantitative) research shows that Drunkorexia is prevalent in 18–26‐year‐olds, and has significant negative health‐related consequences. There is a debate whether Drunkorexia constitutes an eating or substance disorder, or a Food and Alcohol Disturbance (FAD). To further explore this, and understand underlying motivators, this study utilized qualitative methods. Design Qualitative interviews with ten participants (aged 18–26). Methods Interviews were analysed with Thematic Analysis. Results Three themes were developed: (1) Appearance concerns as motivators, (2) Drunkorexia behaviours to get value for money, and (3) “It’s just a pattern… something I’ve always done”: Drunkorexia as a routine. Results show that Drunkorexia is driven by appearance‐related concerns, such as, wanting to look better/slimmer, engaged in, in relation to an event, such as going out drinking, and carried out despite negative health‐related consequences. However, disregard for compensatory behaviours once drunk was also described, culminating in the consumption of high‐calorie food. This suggests that Drunkorexia is not a persistent pattern of maladaptive behaviour as found in eating or substance use disorders. Wanting value for money (i.e., feeling the maximum intoxication) was described as another reason for Drunkorexia engagement; thus showing that participants consider compensatory behaviours part of their routine of going out drinking. Conclusions These result support the view of Drunkorexia as a FAD, rather than an eating or substance use disorder, and show that 18–26‐year‐olds are an at‐risk group for Drunkorexia and its negative health‐related consequences.
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Affiliation(s)
- Katharina Sophie Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, UK.,School of Psychology, University of Leeds, UK
| | - Michela Harper
- Department of Psychology, The University of Huddersfield, Queensgate, UK
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Exploring the association between psychological distress and drunkorexia behaviors in non-clinical adolescents: the moderating role of emotional dysregulation. Eat Weight Disord 2021; 26:797-806. [PMID: 32356142 DOI: 10.1007/s40519-020-00912-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Although drunkorexia seems to represent a new form of eating disorder, it shares several features with traditional eating disorders. However, very little is known about the association between drunkorexia and a widely studied correlate of eating disorders, such as psychological distress and about mechanisms underlying this association. The present study aimed to investigate the relation between symptoms of anxiety and depression and drunkorexia, and to explore the role of emotional dysregulation as moderator of this relationship. METHODS The sample was composed of 402 adolescents (222 females, 180 males; range 15-21) who completed self-reported measures: Drunkorexia Motives and Behaviors Scale, which assesses different behaviors and motivations associated with drunkorexia, Emotional dysregulation scale from the Eating Disorder Inventory-3, reflecting difficulties regulating emotions, and Anxiety and Depression scales from the Symptom CheckList-90 Revised, assessing general signs of anxious and depressive symptoms. RESULTS Anxious symptomatology resulted a significant statistical predictor of drunkorexia behaviors (β = .28, p = .001). Furthermore, emotional dysregulation moderated the relation between anxiety and drunkorexia; specifically, a positive relation was found both at medium levels (β = .22, p = .007) and at higher levels of emotional dysregulation (β = .38, p = .000), whereas at lower levels of emotional dysregulation, this association became nonsignificant. CONCLUSIONS Findings suggest that adolescents who experience both elevated anxiety and emotional dysregulation may be more likely to turn to drunkorexia to reduce their unregulated negative affect in the absence of more adaptive emotion regulation strategies. Implications for intervention and prevention programs are discussed. LEVEL OF EVIDENCE Level V, descriptive study.
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Azzi V, Hallit S, Malaeb D, Obeid S, Brytek-Matera A. Drunkorexia and Emotion Regulation and Emotion Regulation Difficulties: The Mediating Effect of Disordered Eating Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052690. [PMID: 33800011 PMCID: PMC7967414 DOI: 10.3390/ijerph18052690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
Drunorexia refers to food calorie intake restriction to prevent weight gain and the desire to enhance the more extensive intoxicating effects of alcohol. The present study aimed to investigate the association of drunkorexia with emotion regulation as well as emotion regulation difficulties across the Lebanese population, and assess disordered eating attitudes as a potential mediator of these relationships. The cross-sectional study enrolled participants (n = 258) from all Lebanese districts. The study was performed through an online survey based on a self-designed and structured questionnaire. The Drunkorexia Motives and Behaviors Scales (DMBS), the College Life Alcohol Salience Scale (CLASS), the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire (ERQ) and the Eating Attitudes Test (EAT-26) were used in the present study. The results showed that higher EAT-26 total scores (more disordered eating attitudes) (B = 0.16) and higher DERS-16 total score (B = 0.30) were significantly associated with more drunkorexia motives. Also, higher EAT-26 total scores (B = 0.09) and higher DERS-16 total score (B = 0.17) were significantly associated with more drunkorexia behaviors. In addition, higher EAT-26 total scores (B = 0.10) and higher DERS-26 total score (B = 0.36) were significantly associated with more drunkorexia fails. Furthermore, higher EAT-26 total scores (B = 0.07), and higher DERS-16 total score (B = 0.37) were significantly associated with more drunkorexia during an alcohol consumption event. Higher EAT-26 total scores (B = 0.09), and higher DERS-16 total score (B = 0.22) were significantly associated with more post-drinking compensation. Higher EAT-26 total scores (B = 0.21), higher DERS-16 total scores (B = 0.65) and higher emotion regulation (B = 0.33) were significantly associated with higher CLASS scores. The results showed that EAT-26 total scores partially mediated the association between DERS-16 total score and drunkorexia motives (25.20%), between DERS-16 total score and drunkorexia behaviors (25.16%), between DERS-16 total score and drunkorexia fails (106.87%), between DERS-16 total score and drunkorexia during an alcohol consumption event (11.84%), between DERS-16 total score and post-drinking compensation (22.55%), between ERQ total score and college life alcohol salience (8.35%) and between DERS-16 total score and college life alcohol salience (20.14%). This study highlighted that only emotional regulation difficulties were associated with drunkorexia, whereas emotional regulation was not significantly associated with such behavior.
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Affiliation(s)
- Vanessa Azzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Correspondence: (S.H.); (A.B.-M.)
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut 1083, Lebanon;
| | - Sahar Obeid
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon
| | - Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527 Wroclaw, Poland
- Correspondence: (S.H.); (A.B.-M.)
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Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Drunkorexia: An Examination of the Role of Theory of Mind and Emotional Awareness among Adolescents. Dev Neuropsychol 2020; 46:70-81. [PMID: 33372552 DOI: 10.1080/87565641.2020.1869743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate Theory of Mind (ToM) and emotional awareness in drunkorexia, an emerging behavior characterized by calorie restriction when drinking alcohol is planned. A sample of 246 adolescents (148 females, 98 males; range 17-20) completed self-reported measures assessing drunkorexia, ToM and lack of emotional awareness. Drunkorexia was negatively correlated with ToM abilities, with reading neutral emotions, and positively with lack of emotional awareness. ToM and lack of emotional awareness were also found to predict drunkorexia. Findings highlighted that adolescents who engage in drunkorexia may have difficulties in reading others' mental states and being aware of their emotions.
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Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome , Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
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Reexamination of the psychometric properties of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) and exploration of alternative scoring. Eat Behav 2020; 38:101410. [PMID: 32736310 DOI: 10.1016/j.eatbeh.2020.101410] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The primary aims of this paper were to reexamine the factor structure of the 21-item Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), a measure of Food and Alcohol Disturbance (FAD), and investigate an alternative scoring structure. FAD is the use of disordered eating behaviors within an alcohol use episode to compensate for alcohol-related calories and/or increase effects of alcohol. The new scoring approach captures FAD behaviors based on whether they occurred before, during, or after alcohol use. METHOD Participants were 586 young adults (18-30 years; 77.6% female; 55.8% non-Hispanic White) who completed online questionnaires on alcohol use, disordered eating behaviors, and FAD. RESULTS Confirmatory factor analyses did not provide unequivocal evidence for any previously proposed factor structures of the CEBRACS. Exploratory factor analysis suggested items capturing FAD "Before" drinking had a two-factor structure (i.e., Alcohol Effects and Compensatory Behaviors), items capturing FAD "During" drinking had a three-factor structure (i.e., Alcohol Effects, Diet & Exercise, and Extreme Weight Control Behaviors [EWCB]), and items capturing FAD "After" drinking had a two-factor structure (i.e., Diet & Exercise & EWCB). DISCUSSION The CEBRACS factor structure is not consistent across samples; however, despite suboptimal fit, the original structure remains the best approach to capture FAD behaviors. The alternative scoring reflects FAD behaviors based on when they occur relative to alcohol use. The two scoring approaches provide researchers and clinicians flexibility to describe FAD behaviors in multiple ways using the CEBRACS.
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Psychological characteristics and eating attitudes in adolescents with drunkorexia behavior: an exploratory study. Eat Weight Disord 2020; 25:709-718. [PMID: 30888609 DOI: 10.1007/s40519-019-00675-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Drunkorexia represents an emerging phenomenon that is still understudied especially among adolescents. The present study aimed to investigate the relation between drunkorexia and psychological characteristics relevant and commonly associated with existing forms of eating disorders. METHODS The sample was composed of 849 adolescents (513 boys, 334 girls, 2 unknown; range 14-22) who completed a survey composed of Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale and Psychological scales of the Eating Disorders Inventory-3. RESULTS Our findings highlighted that drunkorexia was associated with low self-esteem, personal alienation, interoceptive deficits, emotional dysregulation, and asceticism. Hierarchical multiple regression analysis indicated that difficulties with emotion regulation and ascetic tendencies were significant predictors of drunkorexia among adolescents. CONCLUSIONS Our findings suggest the importance for programs preventing drunkorexia to be focused on training adolescents in using more adaptive strategies to manage emotions and accepting both emotional and physical signals without feeling guilty or threatened. LEVEL OF EVIDENCE Level V, descriptive study.
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Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Dysfunctional metacognition processes as risk factors for drunkorexia during adolescence. J Addict Dis 2020; 38:291-300. [DOI: 10.1080/10550887.2020.1756709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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Graupensperger S, Wilson O, Bopp M, Evans MB. Longitudinal association between alcohol use and physical activity in US college students: Evidence for directionality. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:155-162. [PMID: 30570438 PMCID: PMC6586522 DOI: 10.1080/07448481.2018.1536058] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
Objective: To investigate directionality of the association between alcohol use and physical activity in a college student sample, longitudinally across three time points. Participants: A total of 396 undergraduate students from a large university in the United States (62% females) participated in this study. Methods: Self-report data of alcohol use and physical activity were collected at three timepoints with 3-month lags between waves. Random-intercept cross-lagged panel modeling was used to disentangle within- and between-person effects. Results: Despite no significant between-person effects, there were significant cross-lagged paths from alcohol use to vigorous physical activity at the within-person level. Specifically, when individuals consumed more alcohol than normal at earlier timepoints, they reported more subsequent vigorous physical activity at 3-month follow-ups. Conclusion: We provide evidence that alcohol use may positively predict later physical activity in college students over the course of a school year. These findings advance theoretical understanding of how these two health behaviors are linked using sophisticated methods.
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Affiliation(s)
| | - Oliver Wilson
- Pennsylvania State University, Department of Kinesiology,
| | - Melissa Bopp
- Pennsylvania State University, Department of Kinesiology,
| | - M. Blair Evans
- Pennsylvania State University, Department of Kinesiology, , (Senior Author)
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Skelton KR, Evans RR. A Qualitative Investigation of College Student Perceptions of Their Nutrition Environment: Recommendations for Improvement. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1687367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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