Diet Quality and Level of Nutrition Knowledge among Young People with Orthorexic Tendencies.

The aim of the study was to determine the level of nutrition knowledge and diet quality, understood in terms of healthy and unhealthy eating habits, among young people with orthorexic tendencies. The participants were school students, university students, and those employed in the Lublin region (N = 473). The data were collected by means of a questionnaire. The participants were asked to provide socio-demographic data through filling in the ORTO-15 questionnaire and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN). The participants obtained results ranging from 9.3 to 100 (M = 31.15; SD = 11.81) in the non-healthy diet index, from 0.4 to 78.6 in the pro-healthy diet index (M = 21.79; SD = 11.08), and from 0 to 23 in the domain of nutrition knowledge (M = 13; SD = 4.23). A variance analysis showed no significant differences between the pro-healthy diet index and the level of nutrition knowledge. The group with orthorexia obtained statistically higher results in the pro-healthy diet index. Those with a tendency toward orthorexia obtained statistically higher results in the non-healthy diet index. The variance analysis showed that the level of nutrition knowledge of those not focused on healthy foods was significantly lower than in the other groups. The results of the ORTO-15 questionnaire correlated negatively with the pro-healthy diet index and the level of nutrition knowledge, and positively with the non-healthy diet index. We concluded that: 1. the orthorexic group and the group with a tendency toward orthorexia could be characterized with a moderate intensity of a healthy diet and a low intensity of a non-healthy diet; and 2. the level of nutrition knowledge in the orthorexic group did not significantly differ from that of the other groups.

Orthorexic tendencies and the structure of achievement motivation in young people in Poland.

OBJECTIVES: Studies on the psychological aspects of orthorexia nervosa are scarce. What has been studied to date is the correlation between orthorexia nervosa and self-esteem, perfectionism, and personality. The aim of this study is to verify whether patients suffering from orthorexia or those who have a tendency for orthorexia differ in terms of achievement motivation from a healthy control group. METHODS: The study was conducted in the group of 252 medical students. The study relied on the ORTO-15 questionnaire, Eating Attitudes Test-26, and Inventory of Achievement Motivation (Leistungsmotivationsinventar). RESULTS: Patients with a tendency for orthorexia showed higher results in terms of preference of challenging tasks, belief in success, motivation to learn, goal orientation, compensatory effort, care for prestige, achievement satisfaction, and general achievement motivation, as well as self-confidence and ambition. CONCLUSIONS: Patients who suffer from orthorexia differ from those in the control group in terms of achievement motivation. In some respect, their results are parallel to those obtained from girls with anorexia readiness syndrome, which can lead to the conclusion that both orthorexia and anorexia belong to the spectrum of eating disorders.

Prevalence of Orthorexia Nervosa and Its Diagnostic Tools-A Literature Review.

The aim of this article is to present the up-to-date diagnostic tools of orthorexia and markers of its prevalence on the basis of the available literature. The authors searched PubMedCentral (PMC) and Google Scholar with the search entry of "orthorexia", "orthorexia nervosa", and "orthorexicbehaviours". We describe the tools of evaluation of orthorexicbehaviour (i.e., orthorexia self-test-BOT, the ORTO-15 questionnaire, Eating Habits Questionnaire-EHQ, Düsseldorf Orthorexia Scale-DOS, Teruel Orthorexia Scale-TOS, Barcelona Orthorexia Scale-BOS, and Orthorexia Nervosa Inventory-ONI), and offer a review of the studies on orthorexia nervosa. We conclude that there are no reliable data regarding the prevalence of orthorexia nervosa. The available studies point to significant differences in the prevalence depending on the value of cut-off points and tools used. The prevalence varies across countries and across populations, ranging from 6.9% in the Italian population to 88.7% in the group of Brazilian students of dieting. Thus, it indicates that some groups seem to be susceptible to the risk of ON more than others. It is a challenge to determine the prevalence of orthorexia, and any obtained results should be treated with caution. Consequently, we claim that the use of the ORTO-15 questionnaire to diagnose orthorexia is questionable due to a high percentage of falsely positive results.

Prevalence and Characteristics of Orthorectic Disorders in Adolescence and Young People: Polish Preliminary Studies.

The aim of this work was to assess orthorectic behaviors among young people and to evaluate their attitudes towards caring for their health. The study was conducted in 2019 on a group of 538 respondents aged 16-35. After analysis, 65 questionnaires were eliminated from further research, and the assessment of orthorectic disorders was performed using a method based on the modified ORTO-15 questionnaire on a group of 473 respondents. A large percentage of them exhibited an increased risk of orthorectic behaviors (32.8), which was higher among women than men (34.7% and 28.2%, respectively). People with higher risks of orthorectic disorders significantly more often reduced their consumption of foods high in fats and sugars. Attitudes of people with orthorectic disorders towards health care proved neutral, with a tendency to be positive. Nutritional behaviors observed in the studied group show some irregularities, which indicates the need for preventive and educational measures aimed at increasing awareness of the role of proper nutrition among young people. The obtained results may be the basis for further research on ON symptoms. One of the major areas of future research would be to create a reliable diagnostic tool which would allow for distinguishing between orthorexia and overdiagnosis.

Reproducibility of a Short-Form, Multicomponent Dietary Questionnaire to Assess Food Frequency Consumption, Nutrition Knowledge, and Lifestyle (SF-FFQ4PolishChildren) in Polish Children and Adolescents.

The aim of the study was to assess the reproducibility of a short-form, multicomponent dietary questionnaire (SF-FFQ4PolishChildren) in Polish children and adolescents. The study involved 437 children (6-10 years old) and 630 adolescents (11-15 years old) from rural and urban areas of Poland. The self-administered questionnaire was related to nutrition knowledge, dietary habits, active/sedentary lifestyle, self-reported weight and height, and socioeconomic data. The questionnaire was completed with a two-week interval-twice by parents for their children (test and retest for children), twice by adolescents themselves (adolescent's test and retest) and once by adolescents' parents (parent's test). The strength of agreement measured using the kappa statistic was interpreted as follows: 0-0.20 slight, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 good, and 0.81-1.00 excellent. Regarding the frequency of consumption of food items and meals, kappa statistics were 0.46-0.81 (the lowest: fruit/mixed fruit and vegetable juices; the highest: Energy drinks) in test-retest for children, 0.30-0.54 (fruit/mixed fruit and vegetable juices; breakfast, respectively) in adolescent's test-retest, 0.27-0.56 (the lowest: Sweets, fruit, dairy products; the highest: Breakfast) in adolescent's test and parent's test. Lower kappa statistics were found for more frequently consumed foods (juices, fruit, vegetables), higher kappa statistics were found for rarely consumed foods (energy drinks, fast food). Across study groups, kappa statistics for diet quality scores were 0.31-0.55 (pro-healthy diet index, pHDI) and 0.26-0.45 (non-healthy diet index, nHDI), for active/sedentary lifestyle items they were 0.31-0.72, for components of the Family Affluence Scale (FAS) they were 0.55-0.93, for BMI categories (based on self-reported weight and height) they were 0.64-0.67, for the nutrition knowledge (NK) of adolescents the kappa was 0.36, for the nutrition knowledge of children's parents it was 0.62. The Spearman's correlations for diet quality scores were 0.52-0.76 (pHDI) and 0.53-0.83 (nHDI), for screen time score they were 0.45-0.78, for physical activity score they were 0.51-0.77, for the FAS score they were 0.90-0.93, and for the NK score they were 0.68-0.80. The questionnaire can be recommended to evaluate dietary and lifestyle behaviors among children and adolescents.

Evaluation of Qualitative Dietary Protocol (Diet4Hashi) Application in Dietary Counseling in Hashimoto Thyroiditis: Study Protocol of a Randomized Controlled Trial.

The current state of knowledge related to diet in Hashimoto thyroiditis (HT) is far from satisfactory, as many HT subjects experience several disorders and report reduced quality of life. There are three aims of the study: (1) to develop a qualitative dietary protocol (QDP; 'Diet4Hashi') as a simple, graphic-text tool dedicated to TH subjects, (2) to evaluate the use of the QDP in dietetic counseling compared to conventional dietetic counseling (CDC) in HT women, and (3) to assess the impact of both the QDP and the CDC on the diet quality, quality of life, adiposity, and metabolic parameters of HT women. The QDP is based on subject self-monitoring supported with a graphic-text tool to help them in food selection and adequate food frequency consumption, while the CDC on oral explanation and printed sample menus were provided by a dietician. The QDP contains two lists: (A) foods recommended for consumption and (B) foods with limited consumption, along with indicated consumption frequency per day/week/month. Both approaches include the same dietary recommendations for HT extracted from the literature but differ in subject-dietician cooperation. To summarize the evidence regarding dietary recommendations in HT, the PubMed, Embase, and Cochrane Library databases (to March 2019) and the bibliographies of key articles were searched. The study is designed as a dietary intervention lasting six months in two parallel groups: experimental and control. In the experimental group, the QDP will be applied, while in the control group, the CDC will be applied. In total, the study will include a baseline of 100 women with diagnosed HT. The subjects will be randomly allocated into the experimental/control groups (50/50). Data related to diet quality and other lifestyle factors, nutrition knowledge, quality of life, thyroid function, body composition, blood pressure, serum fasting glucose, and lipid profile at baseline and after a six-month follow-up will be collected. This study was conducted to develop a dietary protocol (Diet4Hashi) that is easy to follow for HT subjects, and it will contribute to providing valuable data that are useful to dieticians and physicians. It is anticipated that this graphic-text qualitative dietary protocol, by improving food selection and diet quality, may reduce adiposity and improve metabolic parameters and the quality of life of HT women.