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Eating Disorders, and Nutritional Beliefs, Trends or Practices

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: closed (20 February 2023) | Viewed by 28184

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Special Issue Editor

Prof. Dr. Ata Ghaderi

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Guest Editor

Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Interests: eating disorders; body image; prevention; treatment; risk factors; psychopathology

Special Issue Information

Dear Colleagues,

Given the high prevalence of eating disorders (EDs), early age of onset and severe negative consequences, their chronic course and complex pychopathology, I would like us to take this opportunity to shed more light on some of the risk factors as well as maintenance mechanisms and their interactions in the emergence and maintenance of EDs. For this Special Issue, I suggest we present original research, meta-analyses or systematic reviews, as well as ideas that are worthy of further exploration related to nutritional beliefs and trends and related behaviors to explain how EDs emerge and/or are maintained. As an example, established risk factors such as body dissatisfaction in combination with the adoption of certain nutritional ideas, standards, trends and practices may increase the risk for EDs or contribute to their maintenance. There is no limit in including other established risk factors or maintaining variables in light of nutritional trends and behaviors or their interactions.

EDs also affect men and seem to be more prevalent among those with non-cisgender identity. Original studies, reviews or meta-analyses that contribute to the further understanding of variables and operating mechanisms in the emergence or maintenance of EDs in light of nutritional trends among marginalized populations are also welcome.

Prof. Dr. Ata Ghaderi
Guest Editor

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Keywords

eating disorders
body image
body dissatisfaction
nutritional beliefs
dieting
excessive exercise
risk factors
gender differences
minority stress

Published Papers (13 papers)

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Editorial

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3 pages, 177 KiB

Open AccessEditorial

Eating Disorders and Nutritional Beliefs, Trends or Practices

by Ata Ghaderi

Nutrients 2023, 15(9), 2058; https://doi.org/10.3390/nu15092058 - 25 Apr 2023

Viewed by 1001

Abstract

This Special Issue of Nutrients on “Eating disorders and nutritional beliefs, trends or practices” contains ten empirical papers that cover various aspects of the topic [...] Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

Research

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12 pages, 305 KiB

Open AccessArticle

Differences in Telomere Length between Adolescent Females with Anorexia Nervosa Restricting Type and Anorexia Nervosa Binge-Purge Type

by Orit Uziel, Hadar Dickstein, Einat Beery, Yael Lewis, Ron Loewenthal, Eran Uziel, Zipi Shochat, Abraham Weizman and Daniel Stein

Nutrients 2023, 15(11), 2596; https://doi.org/10.3390/nu15112596 - 1 Jun 2023

Viewed by 1369

Abstract

Physiological and psychological distress may accelerate cellular aging, manifested by shortening of telomere length (TL). The present study focused on TL shortening in anorexia nervosa (AN), an illness combining physiological and psychological distress. For that purpose, we measured TL in 44 female adolescents with AN at admission to inpatient treatment, in a subset of 18 patients also at discharge, and in 22 controls. No differences in TL were found between patients with AN and controls. At admission, patients with AN-binge/purge type (AN-B/P; n = 18) showed shorter TL compared with patients with AN-restricting type (AN-R; n = 26). No change in TL was found from admission to discharge, despite an improvement in body mass index standard deviation score (BMI-SDS) following inpatient treatment. Older age was the only parameter assessed to be correlated with greater TL shortening. Several methodological changes have to be undertaken to better understand the putative association of shorter TL with B/P behaviors, including increasing the sample size and the assessment of the relevant pathological eating disorder (ED) and non-ED psychological correlates in the two AN subtypes. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

14 pages, 292 KiB

Open AccessArticle

Associations between Parents’ Body Weight/Shape Comments and Disordered Eating Amongst Adolescents over Time—A Longitudinal Study

by Lucy M. Dahill, Phillipa Hay, Natalie M. V. Morrison, Stephen Touyz, Deborah Mitchison, Kay Bussey and Haider Mannan

Nutrients 2023, 15(6), 1419; https://doi.org/10.3390/nu15061419 - 15 Mar 2023

Cited by 7 | Viewed by 1835 | Correction

Abstract

Parents are key influencers of adolescents’ attitudes on weight, shape, and eating, and make more positive than negative comments, with negative comments most impactful. This study examined prospective unique associations of parental positive and negative comments in a community sample of adolescents with paediatric psychosocial quality of life (PED-QoL), Eating Disorder Weight/Shape Cognitions (EDEQ-WS), BMI percentile, and Psychological Distress (K10) scales. Data were from 2056 adolescents from the EveryBODY study cohort. Multiple regressions were conducted for the impacts of parental positive and negative comments on four dependent variables at one year after controlling for their stage of adolescence (early, middle, late). Multiple imputation and bootstrapping were used for handling missing data and violations of normality. Results indicated that positive maternal comments on eating were associated with increased EDCs and better quality of life at one year. Paternal positive weight shape comments were associated with a decrease in psychological distress, but positive eating comments saw a decrease in quality of life. Findings highlight the nuances of parental comments and how these are perceived and interpreted, and could alert health care workers and family practitioners who have weight, shape, and eating conversations to be aware of the potential influence of their communication. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

12 pages, 727 KiB

Open AccessArticle

Enhancing Efficacy of a Brief Obesity and Eating Disorder Prevention Program: Long-Term Results from an Experimental Therapeutics Trial

by Eric Stice, Paul Rohde, Meghan L. Butryn, Christopher Desjardins and Heather Shaw

Nutrients 2023, 15(4), 1008; https://doi.org/10.3390/nu15041008 - 17 Feb 2023

Cited by 2 | Viewed by 1662

Abstract

Objective: Test whether the efficacy of Project Health, an obesity/eating disorder prevention program, is improved by delivering it in single-sex groups and adding food response inhibition and attention training. Method: High-risk young adults (N = 261; M age = 19.3, 74% female) were randomized to (1) single-sex or (2) mixed-sex groups that completed food response inhibition and attention training or (3) single-sex or (4) mixed-sex groups that completed sham training with nonfood images in a 2 × 2 factorial design. Results: There was a significant sex-composition by training-type by time interaction; participants who completed single- or mixed-sex Project Health groups plus food response and attention training showed significant reductions in body fat over a 2-year follow-up, though this effect was more rapid and persistent in single-sex groups, whereas those who completed single- or mixed-sex Project Health groups plus sham training did not show body fat change. However, there were no differences in overweight/obesity onset over the follow-up. The manipulated factors did not affect eating disorder symptoms or eating disorder onset, but there was a significant reduction in symptoms across the conditions (within-condition d = −0.58), converging with prior evidence that Project Health produced larger reductions in symptoms (within-condition d = −0.48) than educational control participants. Average eating disorder onset over the 2-year follow-up (6.4%) was similar to that observed in Project Health in a past trial (4.5%). Conclusions: Given that Project Health significantly reduced future onset of overweight/obesity in a prior trial and the present trial found that body fat loss effects were significantly greater when implemented in single-sex groups and paired with food response and attention training, there might be value in broadly implementing this combined intervention. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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14 pages, 324 KiB

Open AccessArticle

The 26-Item Eating Attitudes Test (EAT-26): Psychometric Properties and Factor Structure in Vegetarians and Vegans

by Courtney P. McLean, Jayashri Kulkarni and Gemma Sharp

Nutrients 2023, 15(2), 297; https://doi.org/10.3390/nu15020297 - 6 Jan 2023

Cited by 7 | Viewed by 3835

Abstract

The eating disorder screener, Eating Attitudes Test (EAT), has been used widely; however, its usability in specific dietary groups such as vegetarians and vegans remain unknown. Considering the rising popularity of vegetarianism and veganism, the current study aimed to assess the psychometric properties and theoretical assumptions of the 26-item EAT in separate groups of vegetarians (n = 278), vegans (n = 580), and omnivores (n = 413). Confirmatory factor analysis of four models from previous literature revealed inadequate fit of the data, with the exception of a 16-item four-factor model in vegetarians and vegans. Further assessment of the original three-factor model and 16-item four-factor model demonstrated poor psychometric properties. The primarily inadequate test–retest reliability discovered in this study, independent of whether a shortened version was used, raises concerns around the utility and stability of the EAT-26 in vegetarians and vegans. Future research should potentially investigate novel ways of measuring eating disorder pathology in these groups. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

14 pages, 6345 KiB

Open AccessArticle

Food Restriction in Mice Induces Food-Anticipatory Activity and Circadian-Rhythm-Related Activity Changes

by Theo Gabloffsky, Sadaf Gill, Anna Staffeld, Ralf Salomon, Nicole Power Guerra, Sarah Joost, Alexander Hawlitschka, Markus Kipp and Linda Frintrop

Nutrients 2022, 14(24), 5252; https://doi.org/10.3390/nu14245252 - 9 Dec 2022

Cited by 7 | Viewed by 2139

Abstract

Anorexia nervosa (AN) is characterized by emaciation, hyperactivity, and amenorrhea. To what extent AN-related symptoms are due to food restriction or neuronal dysfunction is currently unknown. Thus, we investigated the relevance of food restriction on AN-related symptoms. Disrupted circadian rhythms are hypothesized to contribute to the pathophysiology of AN. Starvation was induced by restricting food access in early adolescent or adolescent mice to 40% of their baseline food intake until a 20% weight reduction was reached (acute starvation). To mimic chronic starvation, the reduced weight was maintained for a further 2 weeks. Locomotor activity was analyzed using running wheel sensors. The circadian-rhythm-related activity was measured using the tracking system Goblotrop. Amenorrhea was determined by histological examination of vaginal smears. All cohorts showed an increase in locomotor activity up to 4 h before food presentation (food-anticipatory activity, FAA). While amenorrhea was present in all groups except in early adolescent acutely starved mice, hyperactivity was exclusively found in chronically starved groups. Adolescent chronically starved mice showed a decrease in circadian-rhythm-related activity at night. Chronic starvation most closely mimics AN-related behavioral changes. It appears that the FAA is a direct consequence of starvation. The circadian activity changes might underlie the pathophysiology of AN. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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8 pages, 235 KiB

Open AccessCommunication

Appearance and Performance-Enhancing Drugs and Supplements, Eating Disorders Symptoms, Drive for Muscularity, and Sexual Orientation in a Sample of Young Men

by Ata Ghaderi and Elisabeth Welch

Nutrients 2022, 14(22), 4920; https://doi.org/10.3390/nu14224920 - 21 Nov 2022

Cited by 3 | Viewed by 1744

Abstract

In an anonymous online study (N = 824), we investigated the frequency of use of appearance and performance-enhancing drugs and supplements (APEDS) in a sample of young men (15–30 years) in Sweden, along with their self-reported eating disorder (ED) symptoms, drive for muscularity and sexual orientation. A total of 129 participants (16.1%) reported regular use of supplements (at least once a week), including one individual using anabolic steroids (0.1%), while a lifetime use of APEDS was reported by 32.3%. The overlap between those using protein supplements and creatine was large (83.6%). Some symptoms of ED (e.g., dietary restraint, objective binge eating, self-induced vomiting, and excessive exercise) significantly predicted the use of APEDS. In addition, the use of APEDS was significantly predicted by the drive for muscularity. The prediction was stronger for the behavioral component of drive for muscularity (Exponential B = 8.50, B = 2.14, SE = 0.16, p < 0.001, Negelkerke R² = 0.517) than for its attitudinal component (Exponential B = 1.52, B = 0.42, SE = 0.06, p < 0.001, Negelkerke R² = 0.088). A significantly larger proportion of those identifying as heterosexual reported using APEDS (34.4%) compared to those identifying themselves as homosexual (25.0%), bisexual (19.2%) or other (23.7%). Overall, our results suggest that the use of APEDS might be more related to the drive for muscularity and sexual orientation than symptoms of ED. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

14 pages, 1008 KiB

Open AccessArticle

Development and Validation of an Eating-Related Eco-Concern Questionnaire

by Baiyu Qi, Emily K. Presseller, Gabrielle E. Cooper, Avantika Kapadia, Alexis S. Dumain, Shantal M. Jayawickreme, Emily C. Bulik-Sullivan, Eric F. van Furth, Laura M. Thornton, Cynthia M. Bulik and Melissa A. Munn-Chernoff

Nutrients 2022, 14(21), 4517; https://doi.org/10.3390/nu14214517 - 27 Oct 2022

Cited by 3 | Viewed by 2194

Abstract

Eco-concern, the distress experienced relating to climate change, is associated with mental health, yet no study has examined disordered eating related to eco-concern. This study developed and validated a 10-item scale assessing Eating-Related Eco-Concern (EREC). Participants (n = 224) completed the EREC, Climate Change Worry Scale (CCWS), and Eating Disorder Examination-Questionnaire (EDE-Q). Construct validity, convergent validity, and internal consistency were evaluated. Sex differences in EREC were evaluated using t-tests. Associations among the EREC, CCWS, and EDE-Q were evaluated using linear regression models. Sensitivity analyses were conducted in individuals below EDE-Q global score clinical cut-offs. Factor analysis suggested that all items loaded adequately onto one factor. Pearson’s correlation and Bland–Altman analyses suggested strong correlation and acceptable agreement between the EREC and CCWS (r = 0.57), but weak correlation and low agreement with the EDE-Q global score (r = 0.14). The EREC had acceptable internal consistency (α = 0.88). No sex difference was observed in the EREC in the full sample; females had a significantly higher mean score than males in sensitivity analysis. The EREC was significantly positively associated with the CCWS and EDE-Q global and shape concern scores, but not in sensitivity analysis. The EREC is a brief, validated scale that can be useful to screen for eating-related eco-concern. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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13 pages, 586 KiB

Open AccessArticle

Traditional, Vegetarian, or Low FODMAP Diets and Their Relation to Symptoms of Eating Disorders: A Cross-Sectional Study among Young Women in Poland

by Weronika Gwioździk, Karolina Krupa-Kotara, Beata Całyniuk, Paulina Helisz, Mateusz Grajek and Joanna Głogowska-Ligus

Nutrients 2022, 14(19), 4125; https://doi.org/10.3390/nu14194125 - 4 Oct 2022

Cited by 9 | Viewed by 2301

Abstract

Background: Eating disorders (EDs) are an ever-growing problem, seen most commonly among young women. People with EDs are particularly predisposed to restrictive eating patterns. Diet therapy for many diseases involves the elimination of certain food groups, and the use of restrictive diets in people with EDs may indirectly influence the recurrence of the disorder. The aim of this study was to assess the prevalence of the possible presence of EDs and orthorexia symptoms among young women following a traditional, alternative (vegetarian), or therapeutic (low FODMAP) diet. Methods: The analysis was based on 420 responses from female respondents aged 19 to 30 years. The research tool consisted of questionnaires to assess the possible presence of EDs (SCOFF), cognitive-behavioral aspects of eating (TFEQ-13), and the presence of orthorexia symptoms (ORTO-15). Results: Uncontrolled and emotional eating was least common in women on a vegetarian diet (5.6 ± 3.7; 3.5 ± 2.7; p < 0.05). Women on a low FODMAP diet were most prevalent with symptoms of orthorexia (n = 37, 47.4%; p < 0.05). Conclusions: It seems important to perform screening tests for eating disorders before recommending diet therapy in order to individually adjust the dietary regimen and refer patients to appropriate specialists. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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12 pages, 645 KiB

Open AccessArticle

Bacon, Brownie, or Broccoli? Beliefs about Stress-Relieving Foods and Their Relationship to Orthorexia Nervosa

by Annebirth Steinmann, Alea Ruf, Kira F. Ahrens, Andreas Reif and Silke Matura

Nutrients 2022, 14(18), 3673; https://doi.org/10.3390/nu14183673 - 6 Sep 2022

Cited by 2 | Viewed by 1999

Abstract

Background: Nutritional beliefs play an important role when it comes to food choice. However, little attention has been paid to which foods individuals believe to be comforting when experiencing stress. With increasing health awareness in the general public, this study aims to examine whether the nutritional belief exists that only healthy foods relieve stress. If so, we are interested in its relationship to Orthorexia Nervosa (ON) tendencies. Methods: 175 participants (mean age 28.5 ± 7.8 years, 124 females) completed questionnaires to assess beliefs about stress-relieving foods and ON tendencies. Principal component analysis was used to reduce foods to food groups. Subsequently, a latent profile analysis was performed to identify groups with distinct nutritional beliefs. Results: Among eight distinct groups, one group (8% of the sample) reported the belief that exclusively healthy foods relieve stress. Multinominal logistic regressions showed that higher ON tendencies were associated with that group. Conclusions: Our findings suggest that individuals with stronger ON tendencies believe that, in particular, healthy foods relieve stress. This indicates that nutritional beliefs in ON concern not only the somatic consequences of certain foods, but also psychological consequences, which might also drive orthorexic behaviour. This offers a new target for the diagnosis and treatment of ON. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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21 pages, 1711 KiB

Open AccessArticle

Gender Differences in Treatment Outcomes for Eating Disorders: A Case-Matched, Retrospective Pre–Post Comparison

by Georg Halbeisen, Karsten Braks, Thomas J. Huber and Georgios Paslakis

Nutrients 2022, 14(11), 2240; https://doi.org/10.3390/nu14112240 - 27 May 2022

Cited by 9 | Viewed by 2474

Abstract

Eating disorders (EDs) are increasingly emerging as a health risk in men, yet men remain underrepresented in ED research, including interventional trials. This underrepresentation of men may have facilitated the development of women-centered ED treatments that result in suboptimal outcomes for men. The present study retrospectively compared pre- vs. post-treatment outcomes between age-, diagnosis-, and length-of-treatment-matched samples of n = 200 men and n = 200 women with Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), or Eating Disorder Not Otherwise Specified (EDNOS), treated in the same setting during the same period, and using the same measurements. Compared to women, men with AN showed marked improvements in weight gains during treatment as well as in ED-specific cognitions and general psychopathology. Likewise, men with BED showed marked weight loss during treatment compared to women with BED; ED-specific cognitions and general psychopathology outcomes were comparable in this case. For BN and EDNOS, weight, ED-specific cognitions, and general psychopathology outcomes remained largely comparable between men and women. Implications for treatments are discussed. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)

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11 pages, 295 KiB

Open AccessFeature PaperArticle

Orthorexia Nervosa and Disordered Eating Attitudes, Self-Esteem and Physical Activity among Young Adults

by Anna Brytek-Matera, Susanna Pardini, Joanna Szubert and Caterina Novara

Nutrients 2022, 14(6), 1289; https://doi.org/10.3390/nu14061289 - 18 Mar 2022

Cited by 11 | Viewed by 3844

Abstract

A relation between Orthorexia Nervosa (ON) and increased frequency of physical activity has been put in evidence by recent studies. It is well known that intense physical exercises are typically related to eating disorders, but its relationship with ON is still a subject of debate. Other transdiagnostic features could be necessary to conceptualize and understand ON; in this way, low self-esteem is related to eating behavior but is not still extensively investigated in ON, and, to date, data are so heterogeneous that they do not allow us to understand if this is a psychological feature somehow associated with ON. The current study aimed to assess whether disordered eating attitudes, self-esteem, and physical activity are associated with ON in young adults from Poland and Italy. Moreover, we investigated the differences by comparing lower and higher ON levels related to disordered eating attitudes, self-esteem, and physical activity. Our results indicated that a great concern about dieting significantly predicted problems associated with healthy eating, knowledge about healthy eating, and feeling positive about healthy eating. In addition, young adults with a high level of ON demonstrated higher levels of disordered eating attitudes and vigorous-intensity physical activity than young adults with a low level of ON. Future studies are needed to assess the direct effect of physical activity and self-esteem on ON. Full article

(This article belongs to the Special Issue Eating Disorders, and Nutritional Beliefs, Trends or Practices)