Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students

Validation of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in Spanish University Students

OBJECTIVE

The aim of this study was to explore the factorial structure, psychometric properties and association with anthropometric and clinical variables of the Modified Yale Addiction Scale 2.0 (mYFAS 2.0) in a Spanish university population.

METHODS

A cross-sectional study of n = 270 university students in Spain was conducted.

VARIABLES MEASURED

mYFAS 2.0, Emotional Eater Questionnaire (EEQ), Alcohol Use Disorder Identification Test (AUDIT), Pittsburg Sleep Quality index (PSQI) and Perceived Stress Scale (PSS). In mYFAS 2.0 were performed an Exploratory Factor Analysis (EFA), an Unweight Least Square (ULS), a model fit using comparative fit index (CFI) and nomological validity.

RESULTS

EFA revealed that a two-factor structure is the most appropriate in a non-clinical population of Spanish university students. The factors accounted for 18.54% and 16.33% of the variance, and the correlation between them was moderate-0.487 (p < 0.001). This different structure from that reported in the original scale could be derived from the cultural characteristics and intrinsic eating habits of the study population. The correlation matrix reported an inverse association of mYFAS 2.0 with Body Mass Index (BMI). In addition, participants with a BMI below 25 showed a higher mYFAS 2.0 and EEQ score.

CONCLUSIONS

These results suggest some changes in the psychometric assessment structure of the mYFAS 2.0 in a non-clinical population of university students, as well as the usefulness of this questionnaire to identify individuals with an adequate BMI but with compensatory behaviours that predispose to different eating disorders.

Weight-Inclusive Podcasts Improved Intuitive Eating, Body Appreciation, and Anti-Fat Attitudes Among Nutrition Students

OBJECTIVE

Assess the impact of a weight-inclusive podcast (WIP) intervention on body appreciation, intuitive eating (IE), anti-fat attitudes, and weight and health attitudes in university students enrolled in an upper-division nutrition course.

METHODS

Quasi-experimental design: Intervention participants listened to 8 weekly WIP episodes (n = 16); the comparison group listened to 8 weekly general nutrition podcasts (n = 29). Intuitive eating, body appreciation, anti-fat attitudes, and general weight and health attitudes were measured preintervention and postintervention.

RESULTS

Two-way, repeated measures analysis of variance revealed significant interaction effects of time × group, with participants in the WIP group experiencing significantly greater improvements in body appreciation (P = 0.03) and IE (P = 0.02) and greater reductions in anti-fat attitude scores (P = 0.006) than the comparison group.

CONCLUSIONS AND IMPLICATIONS

Podcasts may be a cost-effective tool to improve body appreciation and IE and reduce anti-fat attitudes in future nutrition professionals. Future research would benefit from recruiting prehealth professionals across different majors.

Exploring the Associations between Media and Instagram Interaction Patterns with Weight Bias among Undergraduate Nutrition Students in the Brazilian Nutritionists' Health Study

This study examined the association between media and Instagram interaction patterns with weight bias among undergraduate nutrition students in the Brazilian Nutritionists' Health Study. We also explored the potential mediating role of students' own body image perception in these relationships. A total of 406 students (78% women) participated in this cross-sectional analysis. Sociodemographic data, media influence, Instagram interaction patterns, body image perception, and weight bias were assessed using semi-structured questionnaires. Findings indicated that exposure to fitness content on Instagram (β = 0.17, p < 0.001) and the pursuit of an ideal athletic body (β = 0.12, p = 0.034) were associated with increased weight bias. In contrast, engagement with body diversity content (β = -0.23, p < 0.001) and perceived pressure from media to conform to appearance ideals (β = -0.24, p < 0.001) had a mitigating effect on weight bias. Notably, body image perception did not mediate these relationships (p > 0.05). In conclusion, this study revealed a link between media exposure and weight bias among undergraduate nutrition students, independent of their body image perception. Developing social media literacy programs that encourage students to critically evaluate media content is imperative to reduce weight bias. Additionally, a deeper examination of the media content that contributes to weight bias and the potential need for targeted regulatory measures is warranted.

Associations between disordered eating behaviour and sexual behaviour amongst emerging adults attending a tertiary education institution in Coastal Kenya

BACKGROUND

Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.

METHODS

We applied a cross-sectional design nested in a young adults' cohort study. Eligibility included sexually active emerging adults aged 18-24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed using exploratory factor analysis. Seven SB indicators were assessed: non-condom use, casual sex, multiple sex partners, transactional sex, group sex, age-disparate relationship and anal sex, and grouped into low vs. high SB using latent class analysis. Logistic regression was used to assess the association between DEB and SB.

RESULTS

Of 273 eligible participants (female, n = 110 [40.3%]), the mean of emotional, restrained and external eating was 1.9 [0.6], 2.0 [0.6] and 3.0 [0.5] respectively. Overall, 57 (20.9%) were grouped into the latent high SB class. Emotional (Adjusted odds ratio, AOR [95% confidence interval, CI]: 1.0 [0.9-1.0], p = 0.398), restrained (AOR, 1.0 [CI: 0.9-1.1], p = 0.301) and External (AOR, 1.0 [CI: 0.8-1.2], p = 0.523) eating were not independently associated with latent high SB.

CONCLUSION

There was no significant association between DEB and SB in this study sample. In low- and middle-income countries like Kenya, interventions targeted at DEB among emerging adults towards controlling SB are unnecessary.

Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study

University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.

Emotional Eating among College Students in Israel: A Study during Times of War

Emotional eating, the act of consuming food to cope with negative emotions rather than responding to hunger cues, can lead to overeating in an attempt to regulate and alleviate these emotions. This study aimed to assess emotional eating among college students in Israel, specifically during times of war, which present unique and heightened stressors that accumulate on top. A total of 575 participants from the Ashkelon Academic College completed an online questionnaire examining background information, stress levels, and emotional eating symptoms. Our findings indicate that factors, such as being female, not having children, younger age, lower body satisfaction, higher BMI, and increased stress, are predictors of heightened emotional eating. These results highlight risk factors predisposing college students to engage in emotional eating. Developing targeted interventions, particularly campus-based programs to address emotional eating by promoting healthy coping strategies, a positive body image, and stress management skills is needed. In addition, raising awareness concerning emotional eating risks during challenging life transitions and distressing situations is necessary. The college leadership, led by the departments of Nutrition, Psychology, and Public Health, in collaboration with stakeholders in the Israeli Ministry of Health, must consider the mental effects of war on students and their involvement in emotional eating.

Risk of Eating Disorders and Social Desirability among Higher Education Students: Comparison of Nutrition Students with Other Courses

The transition to college is a period of higher risk of the development of eating disorders, with nutrition/dietetics students representing a group of particular vulnerability. Hence, it is interesting to assess eating disorders, taking into consideration potential sources of bias, including social desirability. Our aims were to compare the risk of eating disorders between students of nutrition/dietetics and those attending other courses and to study potential social desirability biases. A total of 799 higher education students (81.7% females) aged 18 to 27 years old completed a questionnaire assessing the risk of eating disorders (EAT-26) and social desirability (composite version of the Marlowe-Crowne Social Desirability Scale). The proportion of students with a high risk of eating disorders was higher among females (14.5% vs. 8.2%, p = 0.044). Nutrition/dietetics students did not differ from those attending other courses regarding the risk of eating disorders. The social desirability bias when assessing the risk of eating disorders was overall low (EAT-26 total score: r = -0.080, p = 0.024). Social desirability correlated negatively with the Diet (r = -0.129, p < 0.001) and Bulimia and food preoccupation subscales (r = -0.180, p < 0.001) and positively with Oral self-control (r = 0.139, p < 0.001).

The Prevalence of Disordered Eating Behaviours (DEBs) among Adolescent Female School Students in Riyadh, Saudi Arabia: A Cross-Sectional Study

Adolescence is a sensitive stage of life that is particularly vulnerable to nutritional problems, including DEBs. This cross-sectional study aims to explore the prevalence of DEBs among adolescent female school students in four intermediate and secondary schools in the city of Riyadh and to examine predictors associated with DEBs, including age, BMI and school regions. A total of 416 female students aged 12-19 years took part in this study. Weight and height were measured for students before the EAT-26 test was completed. Overweight and obesity were observed among 37.7% (n = 157) of students, 50.7% (n = 211) had a normal BMI and 11.5% (n = 48) were underweight. Results indicated that 123 (29.6%) students reported an EAT-26 score of 20 or more, indicating a high risk of DEB. Age was a significant predictor of DEB risk (OR = 3.087, 95% CI = 1.228-7.760), with the older age group (16-19 years) reporting a higher risk than the younger age group (12-15 years) (p = 0.017). DEB risk partially differed by school region, but BMI was not a statistically significant predictor. The high-risk group reported more binging (p = 0.008), induced vomiting (p < 0.001), laxative consumption (p < 0.001) and exercising (p < 0.001) compared with the low-risk group. Further research is warranted to understand DEB current patterns and predictors.

Factors increasing the risk for food addiction in Ecuadorian students

Background

Food addiction (FA) is a construct that has gained interest in recent years, but its relevance in the Ecuadorian population has not yet been explored. The aims of this study were to explore the differences in the psychological profile (including FA) between university students from Ecuador and to identify the underlying structure of the relationships of the FA severity level through a mediational model.

Methods

The sample consisted of 972 university students, women and men (mean age: 20.1 years old, SD = 2.6), recruited from four Ecuadorian regions. The assessment tools included a unidimensional scale of FA, eating-related measures, emotion regulation state, impulsivity, and psychopathology state. Path analysis modeled the direct and indirect effects explaining the FA severity level.

Results

The results indicated that higher psychopathological levels were associated with FA. Similarly, no differences in FA were observed between the Ecuadorian regions. The path analysis suggested that older age, female sex, and higher difficulties in emotional regulation, impulsivity, negative mood, and anxiety trigger disordered eating; subsequently, more impaired eating behavior impacted the FA level.

Conclusion

FA is a complex clinical entity that includes multiple components related to eating disorders (EDs) and other mental health problems. The results of this study provide empirical knowledge for designing evidence-based prevention and treatment strategies.

Depressive, Anxiety, and Stress Symptoms Among Schoolgirls With Disordered Eating Behaviors

Objectives This study aimed to assess the relationship between depression, anxiety, stress, and disordered eating behaviors among schoolgirls in Riyadh, Saudi Arabia. The current study could provide insights into potential intervention strategies for addressing both aspects simultaneously, contributing to a more holistic approach in the field. Method Via simple sampling technique, the current quantitative, descriptive, and cross-sectional study included 347 female adolescents aged between 13 and 18 years in public schools in Riyadh, Saudi Arabia. A self-administered questionnaire comprised demographic information, items on body image satisfaction and perception, the Eating Attitude Test-26 (EAT-26), and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Results Among the participants, 32.6% scored at or above the cutoff point on the EAT-26, indicating a negative eating attitude. Additionally, multiple factors such as age, obesity, body image dissatisfaction, and peer pressure were correlated with disordered eating behaviors, with excessive exercise being the most reported weight control behaviors. The prevalence of depression, anxiety, and stress were 58.5%, 73.2%, and 40.9%, respectively. Notably, anxiety was significantly associated with disordered eating behaviors. Conclusion In conclusion, disordered eating behaviors were reported by 32.6% of the participants, and symptoms of anxiety were significantly associated with these behaviors. Media consumption appeared to influence more than half of the participants in their weight loss attempts.

Unhealthy Eating Habits and Insomnia Symptoms are Associated with Internet Addiction in Chinese Left-Behind Children: The Gender Difference

Purpose

This study aimed to evaluate the associations between unhealthy eating habits and insomnia symptoms with Internet addiction (IA) among Chinese left-behind children (LBC) based on potential gender difference.

Methods

This cross-sectional study was conducted in junior high schools from an economically disadvantaged area of China in May 2020. Participants were asked to complete the information and scales of socio-demographic characteristics, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), insomnia severity and IA. A total of 3156 LBCs (43.9% males and 56.1% females, aged 14.2 years in average) were used for final analyses. Associations between eating habits and insomnia symptoms with IA were analyzed by generalized linear model with binary logistic regression.

Results

The study found that left-behind children (LBCs) had unhealthy eating habits, particularly among females. Females reported more insomnia symptoms than males. The prevalence of IA was similar across genders. Consuming fewer fruits and vegetables and skipping breakfast were linked to increased IA risk, especially in females. Insomnia was significantly associated with higher IA risk in both genders.

Conclusion

In LBCs, unhealthy eating and sleep were notably linked to IA, especially in females. Addressing these factors might reduce the prevalence of IA among LBCs.

Are healthiness and pleasure dimensions perceived similarly by people with food addiction in Brazil? A case study using holistic sensory methodologies

The relationship between the consumption of hyper-palatable ultra-processed foods and the process of addiction gains notoriety due to its relationship with obesity. Food addiction is a complex phenomenon intrinsically related to the individual's behavioral, emotional, and subjective aspects. Therefore, using classical approaches to sensory science may be insufficient to understand better the individual's sensory experience with hyper-palatable foods. In this context, sensory and consumer science techniques with holistic approaches have been aimed at accessing more subjective consumer perceptions. This study used the Yale Food Addiction Scale (YFAS 2.0) to investigate the prevalence of food addiction and the Structured Projective Mapping (S-MP) and Sorting techniques to verify how individuals with and without food addiction perceive and understand different types of food. The prevalence of food addiction was 21.77% (n = 59 out of 271) and was associated with a higher BMI but not with sociodemographic aspects. Projective Mapping (RV = 0.937) and Sorting (RV = 0.934) indicated that perception in relation to attributes such as health and pleasure was similar for all investigated foods in individuals with or without food addiction. The presence of addictive eating behavior does not seem to be related to the way individuals perceive foods from different categories, for example, minimally or highly processed and hyper-palatable foods.

Association between Body Image Flexibility and Intermittent Fasting in Chinese Medical Students: A Cross-Sectional Study

Unhealthy dietary behaviors and body dissatisfaction are becoming increasingly common among college students. Understanding the association between body image flexibility and intermittent fasting is particularly meaningful, especially for medical college students. This study aimed to investigate the association between body image flexibility and intermittent fasting among medical students. We conducted a cross-sectional study with 5138 medical college students at Jitang College of North China University of Science and Technology. Univariate and multivariate logistic regression were used to evaluate the association between body image flexibility and intermittent fasting. Subgroup analysis and interaction tests were further used to examine the possible interaction between body image flexibility and intermittent fasting. In this study, 1329 (25.87%) students had intermittent fasting behavior. After adjustment for confounding factors, there was a negative association between body image flexibility and intermittent fasting (OR = 0.94, 95%CI = 0.93 to 0.95, p < 0.001). A significant interaction between body image flexibility and intermittent fasting was found in gender, academic year, major, and monthly living expenses (p for interaction < 0.05). E-value analysis suggested there was unlikely to be an unmeasured confounding. This association could contribute to the establishment of personalized health intervention strategies and provide recommendations for promoting the physical and mental health of medical students.

Exploring the perceived influence of social media use on disordered eating in nutrition and dietetics students

BACKGROUND

Social media use (SMU) is increasingly widespread. More recently, SMU has been associated with increases in disordered eating; however, few qualitative studies have explored this issue in nutrition and dietetics students specifically, where susceptibility to disordered eating may be particularly high. The present study therefore aimed to investigate the perceived impact of SMU on disordered eating in nutrition and dietetics students.

METHODS

One-to-one, in-depth, semi-structured interviews were conducted with nutrition and dietetics students from universities across the UK. Interviews explored students' views on the potential influence of SMU on their eating-related thoughts, feelings and behaviours. Data were thematically analysed to identify key themes.

RESULTS

The findings suggested that SMU may provide students with a useful tool for the exploration of new recipes, ingredients and health-related information, thus enabling them to improve their eating behaviour and diet quality. However, students also showed high levels of objective awareness regarding the problems associated with SMU, including the presence of misinformation, body image dissatisfaction, social pressures and disordered eating. Interestingly, despite enabling them to detect sources of misinformation, students also discussed the negative impact that their course had on their eating habits, suggesting course content may be an additional risk factor for the development of disordered eating for this particular group.

CONCLUSIONS

Future research should investigate ways to mitigate the negative impact of SMU and course content on disordered eating in nutrition and dietetics students.

Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students

This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 dietetics students, with a mean age of 22.94 ± 3.5 years, who completed a series of questionnaires that recorded sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); ON indicators as determined by the ORTO-15 questionnaire; body image flexibility, with the Body Image-Acceptance and Action Questionnaire (BI-AAQ-5); the risk for ED as assessed using the EAT-26; anxiety level according to the STAIT 6 instrument; and recollection of their parents' attitudes towards them during the first 16 years of life, with the Parental Bonding Instrument (PBI). ON risk appeared to be significantly associated with BMI (p = 0.002), exercise frequency (p = 0.023), anxiety level (p = 0.002), risk of ED (p < 0.001), body image inflexibility (p < 0.001), and inversely with the affectionate constraint of maternal bonding (p = 0.036). In conclusion, disordered eating behaviors and body shape concerns are prevalent among dietetics students, with parental attachment to the mother influencing their occurrence. Identification of potential ON and development of prevention mechanisms during childhood could help eliminate these concerns and improve the lives of dietetics students.

Study the Effect of an Innovative Educational Program Promoting Healthy Food Habits on Eating Disorders, Mediterranean Diet Adherence and Body Composition in University Students

The university stage is a good time to promote healthy eating strategies. The sociological and cultural changes experienced by students lead them to skip meals, increase their intake of fast food and energy-dense foods, decreasing adherence to the Mediterranean diet (MD). Professionals related to food such as nutritionists and dietitians are also considered a population at risk of developing eating disorders due to the extensive knowledge they possess, which can be used for both good and bad practice. The objective was to analyze the impact of a 4-month educational program promoting the Mediterranean diet on risky eating behaviors, adherence to the Mediterranean diet, and body composition in nutrition and dietetics students, studying the differences according to the group investigated (control group and educated group). The context of the research was 196 students (49 males and 147 females) from two consecutive years. The control group did not receive any type of intervention, while with the control group (educated) an educational program was carried out. Results showed that women with greater control over energy intake, carbohydrates, and sugar had a lower percentage of fat mass, while in men, the relationship was established with weight. Regarding adherence to the Mediterranean diet, at post, it is adequate in both men (8.25 ± 2.87) and women (7.90 ± 2.89), with no significant differences between the intervention groups.

Food addiction, orthorexia nervosa and dietary diversity among Bangladeshi university students: a large online survey during the COVID-19 pandemic

PURPOSE

Maladaptive eating behaviors like food addiction (FA) are common among students, and orthorexia nervosa (ON) is being evaluated as a new condition among eating disorders (EDs). Moreover, dietary diversity (DD) is recognized as an important component of a healthy diet. Thus, the current study sought to examine the prevalence of ON and FA as well as the factors associated with ON, FA, and DD among university students in Bangladesh during the COVID-19 pandemic.

METHODS

Four-thousand-and-seventy-six students were recruited and completed an online survey consisting of the Bratman Orthorexia test, the modified Yale Food Addiction Scale, and a questionnaire based on the Food and Agriculture Organizations' guidelines. Inferential statistics, bivariate and multivariable linear regression were used for analyzing data.

RESULTS

ON and FA were observed in 1.7% and 7.5% of participants, respectively, with 43.8% exhibiting Health Fanatic eating attitude. The mean DD score was 5.96 (SD = 1.56). Students with ON consumed more legumes, nuts, seeds, and vegetables including dark green leafy vegetables whereas students with FA consumed more organ meats and eggs. Students who were older-aged, married, formerly smoked, had fitness goals, and had guilty feelings about violating food rules were more likely to have ON, whereas those who were female, were married, actively smoked, and were overweight and obese were more likely to have FA.

CONCLUSIONS

The findings suggest that students from Bangladesh are at risk of FA, and less so for ON. These entities and low DD deserve more research attention in Bangladesh to increase awareness and ensure appropriate interventions.

The influencing factors in food addiction of nursing students: A qualitative study

PURPOSE

This study aims to determine the factors that influence food addiction (FA) in female nursing students.

DESIGN AND METHODS

Twenty-four out of 51 (mean age = 19.8 ± 1.36) women were identified from a sample of 645, who met the diagnostic criteria of FA using the Yale Food Addiction Scale (YFAS), and participated in this qualitative study.

FINDINGS

Results of the study revealed that the factors affecting FA in students were conceptualized under four themes: "Social circle," "Situational and emotional signs," "Cognitive process," and "Weight gain and quality of life."

PRACTICE IMPLICATIONS

It is recommended to offer specific intervention programs including personal or group counseling for those, recognized as having FA based on an addiction model, and to have a successful therapy.

Everyday discrimination is a stronger predictor of eating competence than food insecurity or perceived stress in college students amidst COVID-19

Stress is a common experience of college students, which has been exacerbated by COVID-19. Perceived stress may help predict students’ eating behaviors. Eating competence is an adaptive model of eating characterized as being flexible, comfortable, and positive with food and eating, and reliable about getting enough nourishing and enjoyable food to eat. Eating competence is associated with numerous health benefits and may be developing and/or disrupted as young adults transition to college. No prior research has explored the associations of everyday discrimination and food insecurity with eating competence, and there is limited research on the eating competence of trans and gender nonconforming (TGNC) college students. This cross-sectional study sought to examine the associations of everyday discrimination, food insecurity, and perceived stress with eating competence in a sample of 1996 undergraduate students. Participants completed an online survey comprised of validated tools assessing socio-demographics, eating competence, everyday discrimination, food insecurity, and perceived stress and stress management. After accounting for covariates (gender, stress management), multivariate regression analyses were conducted, and the coefficients of partial determination revealed that everyday discrimination was the strongest predictor of eating competence. Results demonstrated that lower experience of everyday discrimination, less stress, and being food secure were associated with greater likelihood of being eating competent (EC). Men were more likely to be EC than women or TGNC identities. Since the experience of everyday discrimination was the strongest, inverse predictor of eating competence, addressing discrimination must be considered in future efforts to improve eating competence.

Comparison of the Prevalence of Eating Disorders among Dietetics Students and Students of Other Fields of Study at Selected Universities (Silesia, Poland)

Background: Over the past few years, an increase in the incidence of eating disorders has been noted. An increase in the pace of life, an increase in the availability of a wide variety of food products, and, to a large extent, the involvement of mass media are cited as reasons for this phenomenon. The promotion of a slim figure by the mass media is equated with achieving success in life, but also the advertising of a wide selection of food products (often highly processed) can have a serious impact on the development of eating disorders. This phenomenon is particularly observed in industrialized Western countries. Objective: Therefore, it was decided to test and compare whether dietetics students are indeed more predisposed to developing eating disorders than students not in the nutrition field. Material and methods: the study included 310 individuals representing two equal groups of fields of study—dietetics and other students. The study used standardized questionnaire—EAT-26. Results: It was found that almost half (46%) of the respondents (both dietetics students and students of other majors) met at least one criterion out of three that could indicate the probable existence or susceptibility to an eating disorder. These individuals should see a specialist for further diagnosis. There was no significant effect of the field of study on the overall EAT-26 test score (p > 0.05). When this result was corrected for BMI values for those with the lowest scores on this indicator, the risk of eating disorders was found to be higher among students of majors other than dietetics (X2 = 13.572; V = 0.831 p = 0.001). Conclusions: Almost half of the respondents in both study groups showed a predisposition to eating disorders based on the EAT-26 test. Despite the presence of a correlation in individual responses that dietetics students are more predisposed to eating disorders, no such relationship was found according to the final EAT-26 test scores. However, it was observed that non-dietetics students who had low BMI values showed higher tendencies toward behaviors indicative of eating disorders.

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

Background

The 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.

Methods

This 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.

Results

The 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.

Conclusion

This 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.

Dietary Lifestyle of Clinical Nutrition Students Compared with That of Age-Matched Non-Medical Students

Background:

There is an assumption that clinical nutrition (CLN) students should have better nutritional and health statuses and practice healthier lifestyles than other students. However, the effect of pursuing nutritional studies on student dietary lifestyle is not well known.

Objective:

To investigate differences in nutritional status between CLN-major and Administration/Humanities-major (AHM) students as well as determine their sources of health and nutrition-related information.

Method:

This is a descriptive and cross-sectional study that CLN and AHM (mainly English and Arabic majors) students were recruited. Anthropometric measurements were taken, and a questionnaire was administered to assess their dietary lifestyle.

Results:

In total, 160 female students (CLN, 86; AHM, 74) participated in the study. Most students from both groups (>44%) were within the normal body mass index (BMI) range (18.5–24.9 kg/m2); no CLN students had class II or III obesity. No significant difference in BMI between the two groups was observed. CLN students tended to consume breakfast and snacks more than AHM students. Daily fruit and vegetable consumption was significantly higher among CLN than AHM students. No significant difference was found in fried food or water intake between the two groups. CLN students were more involved in high-intensity exercise than their counterparts.

Conclusion:

Our findings suggest that health status and dietary lifestyle among CLN students are influenced by their study major. Obesity is less prevalent, and consumption of healthy foods, such as fruits and vegetables, is higher among CLN students. Future studies investigating the long-term effect of studying CLN on lifestyle and social relations with family and friends are warranted.

Exploring the impact of BMI on body dissatisfaction and eating behaviors among Caribbean university women

This study aimed to examine the role of BMI in body dissatisfaction and eating pathology among 570, Indo-Caribbean and Afro-Caribbean female university students. Participants, 18-59 years, completed self-reports on body image, weight perceptions and eating behaviors. Data analysis included: analysis of variance, multiple regression, and descriptive discriminant analyses. The majority (67.5%) expressed satisfaction with their bodies. Afro-Caribbean participants reported greater body satisfaction than Indo-Caribbean participants (F(2, 554) = 3.51, p = .031). As BMI increased, so too did body dissatisfaction and disordered eating (F(3, 535) = 19.92, p < .001). Participants with obesity reported more body dissatisfaction and disordered eating (M - F(18, 254 384.046) = 1.580, p = .056). BMI should be considered when examining body dissatisfaction and eating pathology among Caribbean female university students, particularly among those with overweight/obesity. In the Caribbean, previous studies indicate an appreciation for the overweight or 'fluffy' female body ideal but more recently the thick ideal, particularly among Black women. More clarity is needed on the current ideal endorsed by BMI and ethnic categories among Caribbean females.Level of evidenceLevel V: cross-sectional descriptive study.

Assessment of eating disorder psychopathology: The psychometric properties of the Persian version of the Eating Disorder Examination Questionnaire Short Form

BACKGROUND

Eating disorders are complicated health problems that affect both the body and the mind. Eating disorders pose a serious challenge to mental health services because of their often chronic pathway. The current study was done to determine the psychometric properties of the Eating Disorder Examination Questionnaire Short Form (EDE-QS).

MATERIALS AND METHODS

Persian version of the EDE-QS was produced through forward-translation, reconciliation, and back-translation. The design of this research was cross- sectional. A sample of 302 Tehran university's students in 2019-2020 was selected through convenience sampling method and completed a set of questionnaires, including the EDE-QS, Eating Attitude Test (EAT-16), Eating Beliefs Questionnaire-18 (EBQ-18), Self-Esteem Scale (SES), and Self-Compassion Scale (SCS) Short Form. The construct validity of the EDE-QS was assessed using confirmatory factor analysis and divergent and convergent validity. Internal Consistency and test-retest reliability were conducted to evaluate the reliability. Data analysis was conducted using SPSS (version 22) software and LISREL (version 8.8).

RESULTS

EDE-QS was found to be valid and reliable measures, with good internal consistency and good test-retest reliability among students. Cronbach's alpha coefficient for the whole of scale was 0.85. Intraclass correlation coefficient for the whole of scale was 0.90. In terms of convergent validity, EDE-QS showed a significant positive correlation with self-report measures of EAT-16 and EBQ-18 (P < 05). EDE-QS showed a negative correlation with self-compassion and self-esteem, thus demonstrated a good divergent validity (P < 05). The results of this study also provide support for the one-factor model of the EDE-QS (root mean square error of approximation = 0.08, Normed Fit Index [NFI] = 0.90, Incremental Fit Index = 0.92, non-NFI = 0.90, and Comparative Fit Index = 0.92).

CONCLUSION

The EDE-QS showed good validity and reliability and could be useful in assessing eating disorder psychopathology in a nonclinical population of students. The EDE-QS shows notable promise as a measure for use in eating disorder research and clinical settings.

Eating Behavior during First-Year College Students, including Eating Disorders-RUVIC-RUNEAT-TCA Project. Protocol of an Observational Multicentric Study

(1) Introduction: Changes in eating behavior and eating disorders are especially common in young people, especially teenage and college women. The first year of college is a critical period, as students acquire freedoms that can lead to poor eating habits. During this first year, students usually gain weight. The aims of this project are to analyze the risk of developing eating disorders, the composition and dietary intake and the changes in the body composition of two groups of college students (independent from the family nucleus or still living within the family) in the first year of college. (2) Material and Methods: Multicentric prospective observational study protocol in which first-year students at the Universidad Europea del Atlántico and Universitat de Vic-Universitat Central de Catalunya voluntarily took part in the study. The students will be divided into two groups, independent and those residing in the family home, and the evolution of both groups will be compared at the beginning and at the end of the school year by performing anthropometric measurements, tests on lifestyle and eating habits (Test of Adherence to the Mediterranean Diet, MEDAS-14; Emotional Eater Questionnaire, EEQ), validated questionnaires on eating disorders (Eating Attitude Test, EAT26; Teen Figure Drawing Scales; SCOFF, Eating Behavior Test; Bulimia Investigatory Test Edinburgh, BITE) and their intake will be evaluated through 72 h dietary records. (3) Discussion: Determining the risk of suffering eating disorders of alimentary behavior, knowing eating consumption, perception of the corporal image and body composition through the first year of college will be decisive in establishing alimentary education strategies to prevent possible eating disorders in young students.

Relationships among perceived stress, emotional eating, and dietary intake in college students: Eating self-regulation as a mediator

This study aimed to examine the relationships among perceived stress, eating self-regulation, emotional eating, and dietary intake among undergraduate college students. This cross-sectional study was conducted with 523 students recruited from Amazon Mechanical Turk. All participants completed an online survey that assessed perceived stress, eating self-regulation, emotional eating, dietary intake, and demographics. The study sample was 47% female, 30% Hispanic, 8% Black, and 33% Asian. The overweight and obesity rate was 33%. Nearly 83% reported having moderate to high levels of stress, and over 80% had low to medium levels of eating self-regulation skills. On average, students consumed fruits and vegetables 2.42 times per day and sweets and soft drinks about once every other day. Perceived stress was positively correlated with emotional eating (β = 0.12, p = .005), and negatively correlated with eating self-regulation (β = -0.40, p < .001). Eating self-regulation partially mediated the relationship between perceived stress and emotional eating (β = 0.11, p < .001). Emotional eating was positively related to intake of sweets and soft drinks. Eating self-regulation was negatively related to sweet intake (β = -0.19, p < .001). Eating self-regulation and emotional eating fully mediated the relationship between perceived stress and sweet intake (β = 0.09, p < .001). Although warranting further investigation, this study's results emphasize the significant protective role of eating self-regulation for controlling college students' intake of sweets and soft drinks, and the negative effects of perceived stress and emotional eating on their dietary intake. Future interventions could consider strategies focusing on stress management and eating self-regulation to improve dietary intake among this young population.

Binge eating, orthorexia nervosa, restrained eating, and quality of life: a population study in Lebanon

OBJECTIVES

To assess the implication of disordered eating behaviors (DEBs) on the quality of life (QOL) of a sample of the Lebanese population, after adjustment over sociodemographic characteristics of those participants. Secondary objective aimed to assess the role of body dissatisfaction (BD) in the association of DEBs and QOL.

METHODS

This cross-sectional study was done between January and May 2018 and enrolled 811 participants from the community. A proportionate random sample technique was used to select the sample from all Lebanese Mohafazat. The World Health Organization Quality-of-life (WHOQOL)-BREF was used to assess the QOL and it includes four domains: physical health, psychological health, social relations, and environment.

RESULTS

Body dissatisfaction was found to be a major confounding factor contributing to psychological and environmental HQOL impairments in patient with restrained eating. Nevertheless, orthorexia nervosa was associated with QOL impairments in its physical and environmental domains, regardless of body dissatisfaction that was shown to be a major contributor for QOL impairments. Similarly, ON was directly correlated with QOL of life impairment in its physical and environmental domains, independently of all other risk factors.

CONCLUSION

When adding body dissatisfaction as a confounding variable, restrained eating and orthorexia nervosa remained significantly associated with quality-of-life impairments.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Correlations Between Stress, Depression, Body Mass Index, and Food Addiction Among Korean Nursing Students

This study examined the relationships between stress, depression, body mass index, and food addiction in South Korean nursing students. Data from 323 nursing students in Seoul, Gangwon-do, Jeollanam-do, Gyeongsangnam-do, and Jeju-do were collected via self-report questionnaires and analyzed using chi-square tests, Mann-Whitney U tests, logistic regression analyses, and the receiver operating characteristic curve using SPSS 21.0. Overall, 7.1% of students were classified as having a food addiction. Stress and depression affected food addiction, and food addiction influenced obesity. Depression and stress combined were predictors of food addiction. These findings suggest that effective stress management and interventions for depression prevention may be beneficial to prevent food addiction in nursing students.

Disordered eating: The psychometric properties of the Persian version of the Eating Attitudes Test-8

BACKGROUND

Disordered eating attitude may lead to full-blown eating disorders. Recent longitudinal studies show that disordered eating attitudes either remain stable or even increase from childhood to adulthood. The current study was done to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) and introduce the suitable measure for researchers and therapist in the field of clinical psychology and psychiatrist.

MATERIALS AND METHODS

The Persian version of the EAT-8 was produced through forward translation, reconciliation, and back translation. A sample of 302 students were selected through convenience sampling method and completed a set of questionnaires, including the EAT-8, Eating Attitudes Test-16 (EAT-16), Eating Beliefs Questionnaire-18 (EBQ-18), self-esteem scale, and self-compassion scale short-form. The construct validity of the EAT-8 was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (2 weeks' interval) were conducted to evaluate the reliability. Data analysis was conducted using SPSS (version 22) software and LISREL (version 8.8).

RESULTS

EAT-8 was found to be valid and reliable measures, with good internal consistency and good test-retest reliability among students. In terms of convergent validity, EAT-8 showed a significant positive correlation with self-report measures of EAT-16 and EBQ-18. EAT-8 showed a negative correlation with self-compassion and self-esteem, thus demonstrated a good divergent validity. The results of this study also provide support for the one-factor model of the EAT-8.

CONCLUSION

The EAT-8 showed good validity and reliability and could be useful in assessing disordered eating in Iranian population. The EAT-8 shows notable promise as a measure for use in disordered eating research and clinical settings.

Interaction of FTO rs9939609 and the native American-origin ABCA1 p.Arg230Cys with circulating leptin levels in Mexican adolescents diagnosed with eating disorders: Preliminary results

Eating disorders (ED) are characterized by disruption of eating behaviour and alteration of food intake. Leptin, is one of the main hormones that modulate food intake and are altered in individuals diagnosed with ED. Genetic risk variants for obesity, like those reported inFTO and ABCA1, have also been associated to ED disorders. The present study aimed to analysed leptin circulating levels and the interaction between obesity-risk variants in FTO and ABCA1, in adolescents diagnosed with ED. A total of 99 individuals diagnosed with ED were genotype using Taqman probes for FTO (rs9939609) and ABCA1 (p.Arg230Cys, rs9282541). Commercial enzyme-linked immunosorbent assays were utilized to determined circulating leptin. Differences in leptin concentration were analysed by t-Student or ANOVA test. Gene-gene interaction were analysed using general estimation equations. Circulating leptin levels differed between the three diagnostic groups, lead by individuals diagnosed with binge eating-disorder. In individuals with more than 3 of episodes of binge-eating per week having the highest leptin levels. Also, we found that carriers of both risk alleles had the highest leptin levels. Our observations found an interaction between FTO rs9969609 and the native American-origin ABCA1 p.Arg230Cys to modulate circulating leptin levels in Mexican adolescents diagnosed with eating-disorders.

A Pilot Study of a Videoconferencing-Based Binge Eating Disorder Program in Overweight or Obese Females

Background: There has been increasing interest in using videoconferencing in health care, but limited research was conducted in Binge Eating Disorder (BED) patients. This 3-month pilot study aimed to assess the feasibility, acceptability, and preliminary efficacy of a videoconferencing (VC)-based treatment program in overweight and obese females with BED. Methods: Eighteen participants, aged 20-73, were diagnosed and randomized into either a face-to-face (F2F) group or a VC-based group. In the F2F group, participants received 12 one-on-one weekly counseling sessions from a Licensed Mental Health Counselor and Registered Dietitian Nutritionist. In the VC group, participants received the same counseling through an online telemedicine software. Measured outcomes include retention, adherence to treatment, and attitudinal and behavioral changes of participants. Results: In the end of study, of the 9 participants randomized into each group, 8 (88.9%) F2F participants and 4 (44.4%) VC participants completed the study. On average, F2F finishers attended 94.8% of sessions and completed 66.2% of dietary diaries. VC finishers attended 95.8% of sessions and completed 55.4% of diaries. No changes in weight and binge eating episode were observed in either group. F2F finishers had significant improvement on uncontrolled eating (p = 0.01), emotional eating (p = 0.004), food addiction diagnosis (p = 0.04), loss of control (p = 0.04), and clinical significance (p = 0.04). VC finishers observed significant improvements in eating disorder examination shape concern (p = 0.03) and global score (p = 0.03). Conclusion: VC-based treatment program is feasible and could be effective for BED patients. Long-term large-scale randomized clinical trials are warranted to further assess the efficacy.

Depressive symptoms among healthcare undergraduate students

OBJECTIVE

to identify the intensity of depressive symptoms and their associated factors in healthcare undergraduate students.

METHOD

cross-sectional study developed with undergraduate health students from a public higher education institution using the Beck Depression Inventory-version II and a student characterization questionnaire. The study involved 792 participants. For data analysis, we used descriptive statistics, chi-squared test and Poisson regression.

RESULTS

the intensity of depressive symptoms was moderate to severe in 23.6% of the students, associated with the non-performance of physical and leisure activities and with speech therapy and nursing courses.

CONCLUSION

several factors may be associated with depression, thus, further investigation into the related factors that cause its emergence in this period of life is necessary, as well as raising institutional awareness and developing strategies at the personal and group level to promote well-being, improve time management and interpersonal relationships, in order to achieve better academic results and personal development.

Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines

The purpose of the study was to investigate the relationship between mindful eating, disordered eating and mood in university students in health-related disciplines. A total of 221 university students participated in the study; 102 students studied sport and exercise science (SS), 54 students pharmacy sciences (PS), and 65 students health sciences (HS). Participants completed the Binge Eating Scale (BES), the Mindful Eating Questionnaire (MEQ), and the Profile of Mood State questionnaire (POMS). 41% of the students were classified as binge eaters and 57% were above the POMS threshold of depression. Binge eaters were found to have significantly lower MEQ score and significantly higher total mood disturbance scores (TMD) compared to non-binge eaters (p < 0.01). Students with a high depression score exhibited no differences in the MEQ score but a significantly higher BES score compared to non-depressed students (p < 0.01). Gender differences were found in the MEQ with females exhibiting significantly higher scores in the MEQ score and in all MEQ subscales compared to males, with the exception of the emotional subscale that females were noted to have a lower score compared to males (p < 0.01). The MEQ score was inversely related to the BES score (r = −0.30, p < 0.01) and TMD (r = −0.21, p < 0.05). The MEQ score was a significant negative predictor of the variance of the binge eating behavior of the students (B = −3.17, p < 0.001). In conclusion, mindfulness in eating is inversely related to the binge eating behavior and mood state of university students studying health-related subjects and is a significant negative predictor of disordered eating behavior in this high risk population.

Prevalence of Eating Disorders Among Medical Students in a Lebanese Medical School: A Cross-Sectional Study

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.

The association between food addiction, disordered eating behaviors and food intake

ABSTRACT Objective This study was conducted with 370 undergraduate students to investigate the relationship between food intake, food addiction and disordered eating behavior. Methods The Yale Food Addiction Scale, Eating Attitude Test-26 and Food Frequency Questionnaire were used to assess food addiction, disordered eating behavior and food intake. Results A positive weak correlation was found between the Yale Food Addiction Scale and daily energy, carbohydrate and fat intake (r=0.228, p<0.001; r=0.222, p<0.001; r=0.225, p<0.001 respectively) whereas a negative weak correlation was found between Eating Attitude Test-26 and daily energy and carbohydrate intake (r=-0.105, p=0.044; r=-0.116, p=0.025 respectively). Conclusion Food intake is associated with food addiction and disordered eating behaviour. Further research should be conducted with a larger population also examining body composition, exercises and financial situation of the individuals because all of these factors have an influence on the nutritional status and eating behavior as well.

Food addiction and its relationship with disordered eating behaviours and obesity

PURPOSE

Food addiction, eating disorders and obesity are all mutually reinforcing factors, or factors that can trigger each other. The aim of this study was to determine the relationship between food addiction, disordered eating behaviours and obesity.

METHODS

The study was conducted with 370 university students. Food addiction was assessed using the Yale Food Addiction Scale (YFAS) and disordered eating behaviours were assessed with the Eating Attitude Test (EAT)-26. A digital scale was used to measure weight, while for the measurement of height, waist and hip circumferences a non-stretching tape measure was used according to standard techniques.

RESULTS

Among the participants, 35.7% scored high on the EAT-26, while 21.1% scored high on the YFAS. Females constituted a higher ratio of those who had high scores on the YFAS and EAT-26 (p < 0.05). Overall, the ratio of YFAS high scorers was higher in the case of EAT-26 high scorers (32.6%) than that of low scorers (14.7%) (p < 0.001). A positive weak relationship existed between YFAS and EAT-26 scores (r = 0.165, p = 0.001) and the same between YFAS scores, weight, and body mass index (r = 0.263, p < 0.001; r = 0.319, p < 0.001, respectively).

CONCLUSION

In summary, a positive relation was found between food addiction, disordered eating behaviours and body mass index. Females were shown to have a higher risk of food addiction and eating disorders than that of males. Further studies can be carried out to analyze these correlations using a wider range of controlling factors.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Prevention of shape and weight concerns among college students: An examination of education status variables

Objective: The current study examined whether overlooked aspects of the postsecondary student experience predicted individuals' body-related concerns, beyond the influence of demographic factors that have upheld explanatory power in past research. Participants: Undergraduate and graduate students (n = 3,259) took part in the multi-institute Healthy Bodies Study during the 2015 academic year. Method: Participants completed an online survey that assessed their undergraduate/graduate statuses, academic majors, extracurricular involvements, and body-related concerns. Hierarchical multiple regression analyses were run to answer primary study questions. Results: Gender, body mass index (BMI), undergraduate/graduate student status, being a male graduate student, major, and extracurricular activities predicted shape concern (SC), weight concern (WC), and whether these concerns increased since students began at their universities. The addition of the student-specific variables uniquely contributed to the variance in body-related concerns. Conclusions: Further research on the body-related discontent of the identified student groups should be conducted to elucidate potential campus-based treatment targets.

The relationship between risk of eating disorders, age, gender and body mass index in medical students: a meta-regression

PURPOSE

Age, gender and body mass index (BMI) are commonly described risk factors for the development of eating disorders. However, the magnitude of these factors (individually and together) is still not well-defined in some populations.

METHODS

A systematic search was performed for studies that reported the prevalence of eating disorder risk among medical students using the Eating Attitudes Test-26 (EAT-26) and age, gender and BMI as risk factors. We included studies published in English peer-reviewed journals between 1982 and 2017. A total of 14 studies were included in the analyses, and the meta-regression analyses were performed using mean age (years), gender (proportion of female subjects), and mean BMI (kg/m²) as moderators with the risk of eating disorders measured using EAT-26 as an outcome variable. Four interaction terms were created (1) age × gender (2) age × BMI (3) gender × BMI and (4) age × gender × BMI to assess if two or more independent variables simultaneously influence the outcome variable.

RESULTS

Utilizing the EAT-26, the pooled prevalence of at risk for eating disorders among medical students (k = 14, N = 3520) was 10.5% (95% CI 7.3-13.7%). Meta-regression model of age, gender and BMI alone revealed poor predictive capabilities. Meta-regression model of age × gender × BMI interaction revealed statistically significant results with a covariate coefficient of 0.001 and p value of 0.044.

CONCLUSION

Results from this sample of medical students provided evidence for the role of interactions between risk factors (e.g., age × gender × BMI) in predicting individuals at risk for eating disorders, whereas these variables individually failed to predict eating disorders.

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis.

Examining similarities in eating pathology, negative affect, and perfectionism among peers: A social network analysis

Friends tend to be more similar than non-friends (i.e., exhibit homophily) in body image concerns and disordered eating behaviors. These similarities may be accounted for by similarities in eating disorder risk factors and correlates. The current study sought to replicate findings of homophily for eating pathology using social network analysis and to test if similarity in eating pathology is present above and beyond homophily for eating disorder risk factors and correlates. College students (n = 89) majoring in nutrition completed a social network assessment and measures of eating pathology (i.e., body dissatisfaction, binge eating, restricting, excessive exercise), negative affect, and perfectionism. Homophily for eating pathology, negative affect, and perfectionism were tested as predictors of friendship ties using exponential random graph modeling, adjusting for gender, year in school, and body mass index. Results did not support homophily for eating pathology. However, restricting was associated with a lower likelihood of friendship ties. Homophily was present for perfectionism, but not for negative affect. Results suggest that eating pathology may influence the propensity to form friendships and account for previous findings of homophily in the literature. Homophily for perfectionism may have also driven previous findings for homophily. More longitudinal work using social network analysis is needed to understand the role that personality plays in peer influences on eating pathology.

Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis

Objective:

To synthesize the risk of eating disorder (ED) symptoms in Brazilian university students through a systematic review and meta-analysis. Secondary goals were to analyze whether any specific majors were related to higher ED risk and whether any regions of Brazil had higher proportions of college students at risk of ED.

Methods:

The procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and a search was conducted in three electronic databases (MEDLINE, LILACS, and SciELO).

Results:

Thirty-three studies were included in the analysis, of which 14 were included in the meta-analysis. All included studies used self-report questionnaires, the most frequent of which was the Eating Attitudes Test (EAT-26). None of the studies used a structured interview to diagnose ED. A meta-analysis of studies with a cutoff ≥ 20 for the EAT-26 (n=5) found 14.9% (95%CI 12.8-17.2%) positive screenings, while those with a cutoff of t ≥ 21 (n=9) found 13.3% (95%CI 11.3-15.6%) positive screenings. There was a significantly higher proportion of positive screenings among nutrition majors than all other majors combined (26.5 and 20.5%, respectively).

Conclusion:

Nutrition students seem to be at higher risk of ED. Further research should investigate whether positive screenings translate to actual ED diagnoses.

Food addiction, orthorexia, and food-related stress among dietetics students

PURPOSE

Health sciences, and in particular Nutrition and Dietetics students, have been shown to exhibit an increased prevalence of disordered eating. The aim of the present cross-sectional study was to evaluate other specified feeding and eating disorders (OSFEDs), including stress-related eating, food addiction, and orthorexia, in relation to the dietary intake, among nutrition/dietetics students.

METHODS

A total of 176 undergraduate students from a Department of Nutrition and Dietetics, in Greece, participated in the study. Dietary intake was recorded, and the prevalence of Eating and Appraisal Due to Emotion and Stress (EADES), food addiction (with the modified Yale Food Addition scale mYFAS), and orthorexia were assessed. Chi-square and t tests were performed between sexes, orthorexic and non-orthorexic students, as well as between food-addicted and non-addicted participants. Multiple linear regression analysis assessed relationships between energy intake, BMI or waist circumference, and the food-related psychometric scales.

RESULTS

Among participating students, 4.5% had food addiction and 68.2% demonstrated orthorexia. No differences were observed between men and women, concerning the prevalence of food addiction and orthorexia, the sum of mYFAS symptoms, or individual EADES factors. Orthorexic students exhibited increased BMI, reduced energy, and saturated fat intake. In addition, orthorexic men consumed more vegetables. Multiple linear regression analysis revealed that orthorexic behavior was associated with increased BMI, waist circumference and energy intake. Lower BMI was associated with increasing ability to cope with emotion-and-stress-related eating and increasing appraisal of ability and resources to cope with emotions and stress. Emotion-and-stress-related eating was negatively associated with BMI. Appraisal of ability and resources to cope with emotions and stress was associated with the energy intake. Finally, age was positively correlated with the appraisal of outside stressors/influences, indicating increased ability to cope with outside stressors among older students.

CONCLUSIONS

The study shows that despite the suggested interventions, the problem of OSFEDs among nutrition and dietetics students is still valid. Regular screening, counseling, and education is needed to reduce its prevalence.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

How does food addiction influence dietary intake profile?

This study aimed to investigate whether there was any difference in eating pattern, abnormal eating behaviour, obesity and the number of food addiction symptoms according to food addiction presence. A total sample of 851 healthy subjects living in Ankara (n = 360 male, n = 491 female) aged 19-65 years were included in this cross-sectional survey. Data on demographic information, 24-hour dietary recalls, Yale Food Addiction Scale (YFAS), Eating Attitudes Test-26 (EAT-26), and anthropometric measurements were collected through face-to-face interviews. Overall, 11.4% of participants were identified as "food addicted" (F: 13.0%; M: 9.2%). Subjects meeting criteria for 'food addiction' had higher body mass index (35.1% were obese and 3.1% were underweight), compared to subjects without food addiction (13.1% were obese and 10.2% were underweight) (p<0.05). Abnormal eating attitudes estimated with EAT-26 were determined as 45.5% in males, 37.5% in females and 40.2% in total, among subjects with food addiction. Daily energy, protein and fat intakes were significantly higher in food addicted females, compared to non-addicted females (p<0.05). Participants with food addiction reported significantly more problems with foods, which contain high amounts of fat and sugar, compared to the participants without food addiction. Food addiction behaviour should be considered as a part of efforts towards reducing food related problems involving obesity.

Relationship between early menarche, obesity, and disordered eating behaviors: a school-based cross-sectional survey in Northern Saudi Arabia

BACKGROUND

Obesity and disordered eating (DE) behaviors are serious health concerns, regularly observed among female adolescents, which could progress to adverse psychological and nutritional sequels.

AIM

The aim of this study was to determine the prevalence of obesity and the self-reported DE behaviors among high school female students and to evaluate their self-perception of body image, peer pressures, and need for dietary consultation.

METHODS

This is a school-based cross-sectional study conducted in 2018. Self-administered surveys and anthropometric measurements were obtained from adolescent females, randomly selected from eight schools in northern Saudi Arabia. Sample characteristics were age, menarche, and DE behaviors (binge eating, self-induced vomiting, and usage of laxatives). Body mass index was converted to percentiles using the age-to-gender scale. Self-perception of body image, perceived peer pressures, and the Eating Attitude Test-26 (EAT-26) were scored, summated, and then presented in percentage mean scores (PMSs) and mean scores (MSs).

RESULTS

Sample comprised 399 participants. One hundred twenty-eight (32.1%) participants reported early age of menarche (≤12 years). Sixty-five (16.3%) participants reported the prevalence of overweight/obesity, 123 (30.8%) participants reported binge eating, 28 (7.0%) participants reported self-induced vomiting, and 21 (5.3%) participants reported usage of laxatives. The PMS of self-perception of body weight and peer pressure was 68.7±27.1 and 41.9±23.5, respectively. One hundred ninety-two (48.1%) participants needed professional dietary help. Students with early age of menarche were 1.7 times more likely to be overweight/obese (adjusted [adj] P=0.018) compared to others. Overweight/obese participants had significantly poorer self-perception of body image (PMS =47.4±25.0) and higher perceived peer pressure (PMS =49.5±23.1) compared to underweight/normal weight students (PMS =72.8±25.6 [P<0.001] and PMS =40.5±23.3 [P=0.005], respectively). Participants with early age of menarche complained of higher perceived peer pressure compared to others (P=0.045). Participants with DE behaviors had higher peer pressure (PMS =46.8±23.5) and higher scores on E-26 (MS =22.2±11.4) compared to their counter groups (P=0.002 and 0.016, respectively).

CONCLUSION

The high rate of overweight/obesity and DE behaviors among female adolescents is alarming. Special consideration should be made for those with early menarche who were more prone to overweight/obesity.

Assessment of the relationship between food addiction and nutritional status in schizophrenic patients

OBJECTIVE

Obesity is one of today's most important public health problems. It is suggested that overeating and substance addiction show similarities, and addiction to food may be an important factor in the obesity epidemic. This study aimed to determine the prevalence of food addiction among schizophrenic patients and to examine the relationship between food addiction and anthropometric measurements and dietary nutrient intake.

METHODS

Study participants included a total of 104 schizophrenic outpatients, 62 females and 42 males. Food addiction was assessed by using the Yale Food Addiction Scale, and the anthropometric measurements of participants and their three-day food consumption were recorded.

RESULTS

This study found that more than half of the schizophrenic patients (60.6%) had food addiction, and that female schizophrenic patients had a higher prevalence (62.9%) of food addiction than male patients (57.1%). More than one-third of the schizophrenic patients with food addiction (41.3%) were found to be obese and their BMI, body weight, waist circumference, and body-fat ratio were higher than those of schizophrenic patients who did not have food addiction (P > 0.05). Moreover, the schizophrenic patients with food addiction were found to take significantly more energy, carbohydrate, and fat in their diet (P < 0.05).

CONCLUSION

It was observed that the development of food addiction in schizophrenic patients increased the risk of obesity and cardiovascular diseases, which were found to be at higher levels in these patients. Educational programs should be planned for these patients to acquire health dietary habits and to increase their physical activity levels, and an additional psychosocial support should be provided for patients with food addiction.