Eating disorders, body image dissatisfaction and their association with gluten-free diet adherence among patients with celiac disease

BACKGROUND

Considering the higher prevalence of psychological problems in patients with Celiac disease (CD), the current study aims to assess the prevalence of eating disorders (EDs) and body image disturbance in patients with CD and examine the possible correlation between EDs, body image dissatisfaction and distortion, and gluten-free diet (GFD) adherence in these patients.

METHODS

In this cross-sectional study, 217 patients with CD (18-55 years old) were recruited randomly from the CD registry database. EDs and body image issues were assessed using the 26-item Eating Attitude Test (EAT-26) and Stunkard Figure Rating Scale (FRS), respectively. Adherence to GFD was evaluated by the Celiac Dietary Adherence Test (CDAT) questionnaire.

RESULTS

The prevalence of EDs was 43.5%. Furthermore, the prevalence of body dissatisfaction and distortion was 65.9% and 41.1%, respectively. The logistic regression demonstrated a significant negative association between adherence to the GFD and EDs (OR = 2.09, 95% CI: 1.11-3.91, P = 0.022). However, there was no significant association between following GFD and body image dissatisfaction (OR = 1.70, CI: 0.92-3.17, P = 0.090), and distortion (OR = 0.65, CI: 0.36-1.18, P = 0.163).

CONCLUSION

Considering the high prevalence of EDs in patients with CD and owing to the inverse association between EDs and GFD adherence, nutritionists should consider the psychological barriers in adhering to a GFD when consulting patients with CD.

The translation and psychometrics Persian version of irrational food belief scale

BACKGROUND

This study aimed to translate into the Irrational Food Belief Scale proposed by Osberg into the Persian language and determine the psychometric properties of in Iranian culture.

METHODS

Osberg's 57-item scale was translated into Persian by using the forward-backward method. The scale's validity was examined using face validity, content validity, and construct validity (exploratory and confirmatory factor analysis). Its reliability was assessed with Cronbach's alpha and McDonald's Omega coefficient. Exploratory factor analysis and confirmatory factor analysis was performed by SPSS 28 (500 subjects) and also by AMOS 26 (500 subjects). The participants completed the demographic questionnaire and the Irrational Food Belief Scale (IFBS) over the Internet.

RESULTS

After translation into Persian, the validity of the scale was determined by impact score, quantitative and qualitative face validity (modification of 10 items) and qualitative content validity (modification of 8 items), and quantitative content validity (CVR, CVI and Kappa coefficient), which were greater than 0.46, 0.86, and 0.85, respectively. In exploratory factor analysis, 30 items were removed and the remaining 27 items were loaded on five factors, including behavioral and psychological aspects, nutritional attitudes, healthy eating, controlled eating, and diet, which described 30.95% of the total variance. Confirmatory factor analysis showed that the 5-factor model was the best fitting model to explain the data.

CONCLUSION

Considering the need for a tool about in irrational food beliefs, this tool was unable to explain all these dimensions well. It is recommended to create a new questionnaire for the Iranian culture.

The Relationship Between Health-Promoting Behaviors and Socio-demographic and Clinical Characteristics of Patients with Diabetes

Aim: In this study, it was aimed to investigate the relationship between health-promoting attitudes and socio-demographic and the clinical characteristics of patients with diabetes. Method: The study sample comprised a total of 267 patients with diabetes mellitus aged 18 years and older, who had previously been diagnosed as Type 1 or Type 2 diabetes mellitus for at least 6 months, who had no gestational diabetes mellitus and who had presented to the Internal Diseases Outpatient Clinic in Kocaeli between June-September 2015. Collection of the data were realized by the researchers through face-to-face interviews using the “Patient Information Form” and the “Health-Promoting Lifestyle Profile-II”. The validity-reliability study of the scale for the Turkish population was carried out by Bahar et al. The scale comprises six factors including health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations and stress management. Results: The patients scored highest in the interpersonal relations and scored lowest in the physical activity factors. Patients who were aged between 18-44 years, those who were high school graduates, those who were retired, those who had a well-balanced income and those with no additional chronic disease had higher scores in Health-Promoting Lifestyle Profile-II compared to others. We found that the health-promoting attitudes were not affected by the duration of diabetes mellitus, body mass index or the presence of diabetes in the family. Conclusion: We determined that healthy lifestyle attitudes were demonstrated moderately by the patients with diabetes mellitus, and these attitudes were found to be associated with socio-demographic and clinical variables such as patient’s age, education status, diabetes type and presence of diabetes complications.

The prevalence and predictors of diabetes distress in elderly with type 2 diabetes mellitus

AIMS

Diabetes distress (DD) leads to damaging consequences in patients with type 2 diabetes mellitus (T2DM). Few studies have been carried out on the DD among elderly in Iran. The aim of the current study was to investigate the prevalence of DD and some of its related factors on the elderly living in Qom, Iran.

METHODS

This study was cross-sectional, in design. It lasted for three months (December to February 2018). 519 community dwelling(aged 60 and over) participated in the study. Participants' distress measured by diabetes distress scale (DDS). The cut of 3(≥3) was considered as the presence of distress. In addition, socio-demographic information was assessed. In order to determine predictors factors of DD, the logistic regression analysis was applied.

RESULTS

The mean age (±SD) of the participants was 68.38 (SD:6.78) with the majority being female (53.6%). Among them, 48.6% were identified with DD. A multi-variable logistic regression analysis showed that being female (OR = 1.94, [ 1.30-2.31]), sedentary lifestyle (OR = 3.59, [1.43-9.03]), complications (OR = 3.10, [2.06-4.67]), body mass index (BMI) of 25 or more (OR = 2.46, [1.54-3.94]), duration of disease below 10 years (OR = 2.60, [ 1.56-4.31]), two comorbidity (OR = 2.07, [ 1.19-3.61]) and three or more comorbidity (OR = 3.51, [ 1.20-10.27]) are the predictors of DD.

CONCLUSIONS

DD is notably prevalent among the elderly with T2DM. Attention to psychological aspects of diabetes is a health priority, especially among women and other high-risk groups.