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Almoraie NM, Alothmani NM, Alomari WD, Al-Amoudi AH. Addressing nutritional issues and eating behaviours among university students: a narrative review. Nutr Res Rev 2024:1-16. [PMID: 38356364 DOI: 10.1017/s0954422424000088] [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: 02/16/2024]
Abstract
University life is a critical period for establishing healthy eating habits and attitudes. However, university students are at risk of developing poor eating habits due to various factors, including economic conditions, academic stress and lack of information about nutritional concepts. Poor diet quality leads to malnutrition or overnutrition, increasing the risk of preventable diseases. Food environments on university campuses also play a significant role in shaping the dietary habits of students, with the availability of and accessibility to healthy food options being important factors influencing food choices and overall diet quality. Disordered eating habits and body dissatisfaction are prevalent among university students and can lead to eating disorders. Income and living arrangements also influence dietary habits, with low household income and living alone being associated with unhealthy eating habits. This study is a narrative review that aimed to address nutritional issues and eating behaviours, specifically among university students. We investigated the eating behaviours of university students, including their dietary patterns, food choices and food environments. The objective of this review was to provide insights into the nutritional issues and eating behaviours of university students, with the aim of identifying target areas for intervention to improve the overall health and wellbeing among college students. University food environments need to be restructured to promote healthy eating, including the availability, accessibility, affordability and labelling of healthy foods, and policies to limit the availability of unhealthy foods and drinks on campus.
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Affiliation(s)
- Noha M Almoraie
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor M Alothmani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wajd D Alomari
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal H Al-Amoudi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
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Schaumberg KE, Robinson L, Hochman A, Micali N. Prospective Associations Between Driven Exercise and Other Eating Disorder Behaviors in Adolescence: A Longitudinal Cohort Study. J Adolesc Health 2022; 70:781-787. [PMID: 35086755 PMCID: PMC9038608 DOI: 10.1016/j.jadohealth.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Dysfunctional exercise is a common, debilitating symptom across eating disorders (ED). We examined the cross-sectional and longitudinal associations between experiences of exercise and ED behaviors and cognitions in an adolescent, population-based sample. METHODS Adolescents (n = 4,054) self-reported whether they exercised to control shape and weight (exercise for weight loss [EWL]), and, if so, whether they exercised even when injured, and whether exercise interfered with life functioning (driven exercise) at age 14 years, allowing delineation of three exercise-based groups: no-EWL, EWL, and driven exercise. Participants also reported ED cognitions at age 14 years along with other ED behaviors (fasting, purging, binge eating) at ages 14 and 16 years. Sex-stratified regression approaches were employed to examine relationships between these exercise categories at age 14 and ED behaviors and cognitions at ages 14 and 16. RESULTS Cross-sectionally, those in the driven exercise group, compared to the no-EWL group, consistently reported higher levels of ED cognitions and behaviors, with those in the EWL group also reporting higher levels of some ED cognitions and behaviors relative to the no-EWL group. Those in the EWL and driven exercise groups at age 14 also demonstrated a higher prospective likelihood of fasting (boys and girls) and purging (girls only) at age 16, relative to those in the no-EWL group at age 14. DISCUSSION Results inform our understanding of EWL and driven exercise and the developmental timing of ED behaviors in adolescence and point toward the potential utility of targeted prevention for young people who report EWL.
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Affiliation(s)
| | - Lauren Robinson
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; GOSH Institute of Child Health, University College London, London, UK
| | - Ayelet Hochman
- Department of Psychology, St. John's University, Queens, New York
| | - Nadia Micali
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; GOSH Institute of Child Health, University College London, London, UK; Great Ormond Street Institute of Child Health, Child and Adolescent Mental Health Palliative care and Pediatrics Section, UCL, London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Pediatrics, gynecology and obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Huryk KM, Drury CR, Loeb KL. Diseases of affluence? A systematic review of the literature on socioeconomic diversity in eating disorders. Eat Behav 2021; 43:101548. [PMID: 34425457 DOI: 10.1016/j.eatbeh.2021.101548] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/01/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
The stereotype that eating disorders (ED) primarily present among individuals of higher socioeconomic status (SES) has long persisted in popular and professional perception. This belief has likely contributed to disparities in ED identification and treatment, particularly among those of lower SES backgrounds. The objective of this article was to systematically review the literature investigating socioeconomic diversity in distinct ED diagnoses. A PRISMA search was conducted to identify studies that empirically assessed the association between ED pathology and indicators of SES via PubMed and PsycINFO. This search generated 13,538 articles, of which 62 articles published between 1973 and August 2020 met criteria for inclusion in the review. Included studies were primarily cross-sectional and covered diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with quality ratings of poor, fair, and good. Results are examined in the context of studies' sampling methods, operationalization of SES, and statistical analyses. There is no consistent pattern of evidence to suggest a relationship between high SES and ED. Instead, all ED present across a wide range of socioeconomic backgrounds. Limitations included the predominance of cross-sectional study designs and poor to fair quality ratings. Future research should include adequately powered, community-based longitudinal studies that examine how sociocultural factors, including SES, intersect to influence ED risk and treatment outcome. The existing data suggest an urgent need to prioritize affordable and accessible ED treatment.
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Affiliation(s)
- Kathryn M Huryk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Catherine R Drury
- School of Psychology, Fairleigh Dickinson University, 1000 River Road, T-WH1-01, Teaneck, NJ 07666, USA.
| | - Katharine L Loeb
- Chicago Center for Evidence-Based Treatment, 25 E Washington St, Suite 1015, Chicago, IL 60602, USA.
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AlShebali M, AlHadi A, Waller G. The impact of ongoing westernization on eating disorders and body image dissatisfaction in a sample of undergraduate Saudi women. Eat Weight Disord 2021; 26:1835-1844. [PMID: 33011958 DOI: 10.1007/s40519-020-01028-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study addressed the prevalence of eating disorders and levels of eating pathology, body image, and psychological comorbidities in undergraduate women in Saudi Arabia. It examined the role of the current internalization of western culture that is under way in that country, focusing on political and economic issues rather than on issues such as media exposure per se. METHOD Participants were 503 Saudi female university students (mean age = 19.78 years). Each completed a diagnostic measure of eating disorders and measures of disordered eating attitudes and behaviours, body image, depression, social anxiety, and self-esteem. They also completed a measure of the internalization of western culture, specific to current political and cultural developments in Saudi Arabia. RESULTS Eating disorder prevalence and pathology rates among undergraduates females were comparable to western levels, though the pattern was more one of bulimic than anorexic pathology. Internalization of western values was associated with eating pathology, body image, and psychological comorbidities. CONCLUSION Eating disorders are not an exclusively western issue, as the levels in Saudi undergraduate women are similar to those in western cultures (though they tend more towards bulimic than anorexic presentations). Internalization of western values appears to be key to this pattern. LEVEL OF EVIDENCE : Level III, case-control analytic study.
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Affiliation(s)
- Munirah AlShebali
- Princess Nourah Bint Abdulrahman University, 3652 Bashir Street, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
- Department of Psychology, University of Sheffield, Sheffield, UK.
| | - Ahmad AlHadi
- SABIC Psychological Health Research and Applications Chair, Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
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Romano KA, Stamates A, Heron KE, Braitman AL, Lau-Barraco C. Sex and Racial Differences in Patterns of Disordered Eating and Alcohol Use. Behav Med 2021; 47:272-284. [PMID: 32275196 DOI: 10.1080/08964289.2020.1748862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The present study aimed to determine how young adults' use of disordered eating behaviors (DEBs) and alcohol uniquely cluster with one another, how these clusters differ by sex and race, and map onto health-related correlates. As a part of a cross-sectional study assessing college student health and experiences, female (n = 1,026), male (n = 336), White (n = 640), and Black (n = 561) young adult college students at three universities (Mage = 20.54, SD = 1.80) completed measures assessing DEBs and alcohol use, and physical and mental health. Multigroup mixture modeling was used to identify subgroups of female, male, White, and Black young adults that are characterized by different levels of DEBs (fasting, food avoidance, loss of control eating, overeating) and alcohol use (binge drinking, drinking quantity). Whether group membership relates to theoretically and clinically relevant health correlates (stress, depressive symptoms, sleep health) was examined via auxiliary analyses. Qualitative and quantitative differences were identified in the best-fitting mixture models for female (four groups), male (four groups), White (five groups), and Black (three groups) participants that suggest sex and racial variations exist in patterns of DEBs and alcohol use severity. Generally, classification in groups characterized by moderate to high probabilities of DEBs only, or the combination of moderate to high DEBs and alcohol use, was associated with worse affective concerns across sexes and races. Targeting young adults' DEBs and alcohol use via diversity-informed treatments focused on coping skill development may help promote health and well-being.
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Affiliation(s)
- Kelly A Romano
- Psychology, The Virginia Consortium Program in Clinical Psychology
| | - Amy Stamates
- Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Abby L Braitman
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Cathy Lau-Barraco
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
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Falvey SE, Hahn SL, Anderson OS, Lipson SK, Sonneville KR. Diagnosis of Eating Disorders Among College Students: A Comparison of Military and Civilian Students. Mil Med 2021; 186:975-983. [PMID: 33686412 DOI: 10.1093/milmed/usab084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/01/2020] [Accepted: 02/20/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Eating disorders are often under-detected, which poses a serious threat to the health of individuals with eating disorder symptoms. There is evidence to suggest that the military represents a subpopulation that may be susceptible to high prevalence of eating disorders and vulnerable to their underdiagnosis. Underreporting of eating disorder symptoms in the military could lead to this underdiagnosis of individuals with eating disorder symptoms. The purpose of this study was to examine the association between military affiliation and eating disorder symptoms among college students and the likelihood of eating disorder diagnosis among those with eating disorder symptoms using a large, diverse college-aged sample of both military-involved and civilian students. MATERIALS AND METHODS Participants for this study were from the 2015-2016, 2016-2017, and 2017-2018 Healthy Minds Study (HMS). Healthy Minds Study is a large, cross-sectional cohort study of both undergraduate and graduate students from universities and colleges across the United States and Canada. The Healthy Minds Study survey questions include assessment of demographic information, military status, self-reported eating disorder symptoms using the SCOFF questionnaire, and self-reported eating disorder diagnosis. Univariate analysis, chi-square analysis, and logistic regression with an unadjusted and covariate adjusted model were used to examine the association between eating disorder symptoms and military affiliation. These analyses were also used to examine the association between eating disorder diagnosis among those with eating disorder symptoms and military affiliation. All analyses were conducted using SPSS. RESULTS The prevalence of eating disorder symptoms was high among both the civilian (20.4%) and military-involved (14.4%) students. Among females, there was a significantly higher (P value = .041) prevalence of eating disorder symptoms among civilian college students (24.7%) compared to military-involved students (21.3%). Among those with eating disorder symptoms, the prevalence of diagnosis was low in both military and civilian students. Specifically, the prevalence of diagnosis was significantly lower (P value = .032) among military-involved college students (10.8%) compared to civilian college students (16.4%). Differences in sociodemographic characteristics (e.g., gender, race/ethnicity, and age) among military-involved and civilian college students appear to explain this association. CONCLUSIONS The underdiagnosis of eating disorders is far too common, and this represents a threat to the health of military and civilian populations alike. Underdiagnosis of eating disorders within military environments may be due to underreporting, particularly among men and racial/ethnic minority groups.
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Affiliation(s)
- Sarah E Falvey
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Samantha L Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.,Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55454, USA
| | - Olivia S Anderson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA 02118, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
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Hazzard VM, Hahn SL, Bauer KW, Sonneville KR. Binge eating-related concerns and depressive symptoms in young adulthood: Seven-year longitudinal associations and differences by race/ethnicity. Eat Behav 2019; 32:90-94. [PMID: 30665179 PMCID: PMC8253512 DOI: 10.1016/j.eatbeh.2019.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To examine longitudinal associations between binge eating-related concerns (i.e., cognitions associated with binge eating, such as embarrassment over amount eaten and fear of losing control over eating) and depressive symptoms among U.S. young adults and assess whether associations differ by race/ethnicity. METHODS This study used longitudinal data from Waves III (baseline; mean age = 21.77 years) and IV (follow-up; mean age = 28.76 years) of the National Longitudinal Study of Adolescent to Adult Health (N = 12,040). Linear regression models were run to examine associations between binge eating-related concerns at baseline and depressive symptoms at follow-up, adjusting for demographic covariates, baseline body mass index, and baseline depressive symptoms. RESULTS At baseline, 5.9% of participants reported embarrassment over amount eaten, 2.1% reported fear of losing control over eating, and 0.9% reported both binge eating-related concerns. In adjusted models, embarrassment over amount eaten (B = 0.81, p < .001), fear of losing control over eating (B = 1.57, p < .001), and endorsement of both binge eating-related concerns (B = 1.75, p < .001) at baseline were associated with higher depressive symptoms seven years later. The association between fear of losing control over eating and depressive symptoms differed by race/ethnicity (p = .001). Fear of losing control over eating was associated with higher depressive symptoms among non-Hispanic whites (B = 2.51, p < .001) and Asians/Pacific Islanders (B = 2.54, p = .009) but not among non-Hispanic blacks (B = -0.55, p = .48) or Hispanics/Latinos (B = -0.11, p = .92). DISCUSSION Binge eating-related concerns may contribute to depression risk among young adults, particularly among non-Hispanic whites and Asians/Pacific Islanders. Early identification of these cognitions and early intervention may help reduce depression risk in young adulthood.
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