Mind the Gap: Tools for the Diagnosis and Assessment of Orthorexia Nervosa Based on the Recent Consensus Definition. Reply to Meule, A. Comment on "Sifakaki et al. Orthorexia Nervosa Practices in Rheumatoid Arthritis: The DORA Study. Nutrients 2023, 15, 713".

In a recent manuscript, our team published the results of an original pilot cross-sectional study assessing orthorexia nervosa (ON) tendencies among patients with rheumatoid arthritis (RA) [...].

Orthorexia Nervosa Practices in Rheumatoid Arthritis: The DORA Study.

Medical nutrition therapy (MNT) is an indisputable component of the multidisciplinary therapeutic approach in rheumatoid arthritis (RA). Previous research has suggested that in chronic disease where nutrition is an important effector of prognosis, healthy dietary choices might take an unhealthy turn, with patients developing disordered eating in the form of orthorexia nervosa (ON). ON is characterized by a pathological preoccupation with "healthy", "pure" eating, associated with restrictive dietary patterns, nutrient deficiencies and worsening disease outcomes. The aim of the present cross-sectional study was to evaluate ON tendencies in a sample of adult patients with RA. A total of 133 patients with RA were recruited, and completed the ORTO-15 questionnaire for the assessment of ON tendencies. Most of the patients were overweight/obese (53.4%). The results revealed ON tendencies in the sample, with the median ORTO-15 score reaching 36 (IQR: 33-39). Greater ON tendencies were associated with the female gender, and lowered ON tendencies with increasing age and body mass index. The present findings highlight the need for health professional awareness regarding the problem of ON in patients with RA and the importance of screening patients.

Caries prevalence and caries experience (ICDAS II criteria) of 5-, 12- and 15-year-old Greek children in relation to socio-demographic risk indicators. Trends at the national level in a period of a decade.

PURPOSE: To study the caries status of 5, 12 and 15-year-old Greek children, assess how disease parameters are related to socio-demographic indicators and identify relevant trends at the national level. METHODS: A stratified cluster sample of 3702 children in total was randomly selected and examined clinically for caries (ICDAS II criteria). Caries experience was outlined by adapting ICDAS0-6 criteria to the d/D component of the WHO dmf/DMF index configuration. Percentages (%) of caries experience-free children, of children with initial caries (ICDAS1-2), and the mean d1-2t/D1-2T, d3-6mft/D3-6MFT and d3-6mfs/D3-6MFS indices were calculated. The probability of presenting with d1-2t/D1-2T ≥ 1 was assessed by binary logistic regression analysis, whereas negative binomial regression models examined the effect of socio-demographic parameters on d3-6mfs/D3-6MFS indices (level of significance: p ≤ 0.05). RESULTS: 60.1%, 48.1%, and 34.7% of the 5, 12, and 15-year-old children, respectively, had no caries experience at the defect level (d3-6mft/D3-6MFT = 0). Initial lesions (ICDAS1-2) were detected in 17.7%, 19.3% and 17.4% of the 5, 12 and 15-year-olds, accordingly. Mean d1-2t/D1-2T was 0.93, 1.70, and 2.51, whereas mean d3-6mft/D3-6MFT was 1.48, 1.61, and 2.46 for the 5, 12, and 15-year-olds, respectively. Children with higher educated parents and 15-year-old urban residents exhibited significantly less caries experience at the defect level. Initial caries lesions presented a significantly higher probability of being detected in urban-residing 5- and 15-year-olds, while no consistent trend could be identified for parental education level. Caries prevalence and experience levels declined for all age groups in ten years. CONCLUSION: Although the dental health of Greek children has improved disparities remain, calling for organised primary and secondary preventive interventions.