Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Group
2.2. Eating Habits and Physical Activity
2.3. Questionnaire ORTO-15
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Study Participants
3.2. Reliability Assessment of the ORTO-15 Questionnaire
3.3. Prevalence of Orthorexia in Celiac Participants
3.4. The Relationship between the Age of Study Participants and the ORTO-15 Questionnaire Total Score
3.5. Eating Habits and Behaviors and the Incidence of Orthorexia Risk
3.6. Differences between the Risk Group of Orthorexia and Non-Risk Participants in ORTO-15 Questionnaire
3.7. Self-Assessed Impact of Celiac Disease on Diet
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Value |
---|---|
Age (year) | |
(Median/Q1–Q3) | 34 (28–39) |
(Average/age range/min-max) | 34 ± 8.7/18–64 |
BMI (kg/m2) | |
(Average/range) | 21.51 (14.1–29.75) |
(Median/Q1–Q3) | 21.25 (19.1–23.6) |
Education (%) | |
Tertiary | 80.5 |
Secondary | 15.4 |
Middle | 3.2 |
Primary | 0.8 |
Occupation (%) | |
Pension/retirement | 1.6% |
Odd job | 1.6% |
Unemployed | 5.7% |
Parental leave | 8.1% |
Students | 8.1% |
Permanent employment | 74.8% |
Weight Status (%) | |
Underweight (moderate thinness) (16.0–16.99) | 6% |
Underweight (mild thinness) (17.0–18.49) | 11% |
Normal body weight (18.5–24.99) | 73% |
Overweight (25.0–29.99) | 10% |
Duration of celiac disease (n/%) | |
Newly diagnosed (1–3 years) | 29 (24%) |
Patients with the celiac disease for at least 3 years | 94 (76%) |
Comorbidities (%) | |
Lactose intolerance | 23% |
Hashimoto’s disease | 22% |
Hypothyroidism | 17% |
Food allergy | 14% |
Duhring’s disease | 6.5% |
The most common symptoms reported before treatment of celiac patients | |
Bloating | 53% |
Chronic diarrhea | 49% |
Anemia | 41% |
Low body weight | 24% |
Adherence to gluten-free diet (%) | |
Full | 100% |
Health self-assessment on a gluten-free diet (%) | |
Better | 87% |
No change | 10% |
Worse | 3% |
Questions from ORTO-15 Test | Score * (Mean ± SD) | Spearman’s Rho | Cronbach’s Alpha Coefficient ** | Mean ± SD of Total Points *** |
---|---|---|---|---|
1. When eating, do you pay attention to the calories of the food? | 2.91 ± 0.90 | 0.33 | 0.66 | 34.82 ± 5.07 |
2. When you go in a food shop do you feel confused? | 3.34 ± 0.89 | 0.31 | 0.66 | 34.39 ± 5.08 |
3. In the last 3 months, did the thought of food worry you? | 2.57 ± 1.00 | 0.53 | 0.63 | 35.16 ± 4.83 |
4. Are your eating choices conditioned by your worry about your health status? | 1.66 ± 0.61 | 0.15 | 0.68 | 36.07 ± 5.30 |
5. Is taste of food more important than the quality when you evaluate food? | 2.53 ± 0.77 | 0.12 | 0.68 | 35.20 ± 5.29 |
6. Are you willing to spend more money to have healthier food? | 2.01 ± 0.66 | 0.11 | 0.68 | 35.72 ± 5.32 |
7. Does the thought about food worry you for more than three hours a day? | 3.34 ± 0.87 | 0.55 | 0.63 | 34.38 ± 4.90 |
8. Do you allow yourself any eating transgressions? | 3.00 ± 0.82 | −0.03 | 0.70 | 34.73 ± 5.39 |
9. Do you think your mood affects your eating behavior? | 2.33 ± 0.79 | 0.58 | 0.63 | 35.43 ± 4.93 |
10. Do you think that the conviction to eat only healthy food increases self-esteem? | 2.96 ± 0.93 | 0.51 | 0.63 | 34.77 ± 4.90 |
11. Do you think that eating healthy food changes your life-style (frequency of eating out, friends…)? | 2.38 ± 0.92 | 0.34 | 0.66 | 35.35 ± 5.05 |
12. Do you think that consuming healthy food may improve your appearance? | 2.07 ± 0.82 | 0.38 | 0.65 | 35.67 ± 5.06 |
13. Do you feel guilty when transgressing? | 2.52 ± 1.11 | 0.26 | 0.67 | 35.21 ± 5.03 |
14. Do you think that on the market there is also unhealthy food? | 1.43 ± 0.68 | 0.02 | 0.69 | 36.30 ± 5.35 |
15. At present, are you alone when having meals? | 2.72 ± 0.83 | 0.09 | 0.69 | 35.02 ± 5.29 |
Reliability Analysis | Mean ± SD * | Min-Max * | Cronbach’s Raw α Coefficient | Standardized Cronbach’s α Coefficient | Average Spearman’s Rho between Questions |
---|---|---|---|---|---|
ORTO-15 questionnaire (15 scale items) | 37.73 ± 5.45 | 23–53 | 0.67 | 0.66 | 0.11 |
ORTO-15 questionnaire (excluding question 8) | 34.73 ± 5.41 | 20–50 | 0.70 | 0.68 | 0.13 |
Risk of Orthorexia | ORTHO-15 * | |
---|---|---|
n * | % | |
The entire study group | 123 | 100 |
Participants at risk of orthorexia ** | 87 | 71 |
Participants at risk of orthorexia *** | 39 | 32 |
Eating Habits and Behaviors * | Risk of Orthorexia | χ² Test p | ||
---|---|---|---|---|
Yes (n = 87) | No (n = 36) | |||
Frequency of meals per day | 3 times a day | 36%(n = 31) | 19% (n = 7) | p = 0.014 |
4 times a day | 38% (n = 33) | 67% (n = 24) | ||
5 times a day | 26% (n = 23) | 14% (n = 5) | ||
Independent preparation of gluten-free meals | 94% (n = 82) | 78% (n = 28) | p = 0.006 | |
Difficulty eating out | 78% (n = 68) | 92%% (n = 33) | p = 0.075 | |
Paying attention to the caloric content of gluten-free meals | 54% (n = 47) | 53% (n = 19) | p = 0.899 | |
Paying attention to the composition of gluten-free products | 87% (n = 76) | 92% (n = 33) | p = 0.493 | |
Physical activity * | ||||
Total number of active people | 70% (n = 61) | 81% (n = 29) | p = 0.234 | |
Aerobic (fitness) | 13% (n = 13) | 31% (n = 11) | p = 0.046 | |
Swimming | 9% (n = 8) | 6% (n = 2) | p = 0.050 | |
Strength training gym | 9% (n = 8) | 22% (n = 8) | p = 0.050 | |
Running | 5% (n = 4) | 17% (n = 6) | p = 0.025 | |
Walking | 46% (n = 40) | 53% (n = 19) | p = 0.492 | |
Yoga | 5% (n = 4) | 0% | p = 0.190 | |
Cycling | 30% (n = 26) | 42% (n = 15) | p = 0.207 | |
Frequency of physical activity | 71% (n = 87) | 29% (n = 36) | p = 0.599 | |
1 time per week | 16% (n = 14) | 11% (n = 4) | ||
2–3 times a week | 37% (n = 32) | 44% (n = 16) | ||
4 and more per week | 14% (n = 12) | 17% (n = 6) | ||
Daily | 9% (n = 8) | 14% (n = 5) | ||
No physical activity | 24% (n = 21) | 14% (n = 5) |
Risk of Orthorexia | χ² Test | ||
---|---|---|---|
ORTO-15 Questions | Yes (n = 87) | No (n = 36) | p |
1. When eating, do you pay attention to the calories of the food? | p = 0.001 | ||
Always/Often % | 46%** | 69% | |
2. When you go in a food shop do you feel confused? | p = 0.003 | ||
Always/Often % | 73% | 94% | |
3. In the last 3 months, did the thought of food worry you? | p = 0.001 | ||
Always/Often % | 64% | 8% | |
4. Are your eating choices conditioned by your worry about your health status? | p = 0.086 | ||
Always/Often % | 92% | 95% | |
5. Is taste of food more important than the quality when you evaluate food? | p = 0.043 | ||
Always/Often % | 49% | 72% | |
6. Are you willing to spend more money to have healthier food? | p = 0.071 | ||
Always/Often % | 85% | 67% | |
7. Does the thought about food worry you for more than three hours a day? | p = 0.001 | ||
Always/Often % | 22% | 0% | |
8. Do you allow yourself any eating transgressions? | p = 0.437 | ||
Always/Often % | 73% | 87% | |
9. Do you think your mood affects your eating behavior? | p = 0.001 | ||
Always/Often % | 20% | 80% | |
10. Do you think that the conviction to eat only healthy food increases self-esteem? | p = 0.001 | ||
Always/Often % | 43% | 6% | |
11. Do you think that eating healthy food changes your life-style (frequency of eating out, friends…)? | p = 0.001 | ||
Always/Often % | 68% | 31% | |
12. Do you think that consuming healthy food may improve your appearance? | p = 0.001 | ||
Always/Often % | 83% | 59% | |
13. Do you feel guilty when transgressing? | p = 0.001 | ||
Always/Often % | 42% | 39% | |
14. Do you think that on the market there is also unhealthy food? | |||
Always/Often % | 95% | 94% | p = 0.012 |
15. At present, are you alone when having meals? | |||
Always/Often % | 41% | 42% | p = 0.819 |
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Kujawowicz, K.; Mirończuk-Chodakowska, I.; Witkowska, A.M. Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease. Nutrients 2022, 14, 904. https://doi.org/10.3390/nu14040904
Kujawowicz K, Mirończuk-Chodakowska I, Witkowska AM. Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease. Nutrients. 2022; 14(4):904. https://doi.org/10.3390/nu14040904
Chicago/Turabian StyleKujawowicz, Karolina, Iwona Mirończuk-Chodakowska, and Anna Maria Witkowska. 2022. "Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease" Nutrients 14, no. 4: 904. https://doi.org/10.3390/nu14040904
APA StyleKujawowicz, K., Mirończuk-Chodakowska, I., & Witkowska, A. M. (2022). Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease. Nutrients, 14(4), 904. https://doi.org/10.3390/nu14040904