Orthorexia nervosa risk and associated factors among Chilean nutrition students: a pilot study

Abstract

Background Orthorexia nervosa (ON) is characterized by an excessive, obsessive concern with healthy eating generating psychological complications and even malnutrition at a caloric and protein level. Current evidence suggests that people with greater food knowledge are the most likely to be affected, placing nutrition students as a populational risk group. Since there are no nationwide studies dealing with orthorexia nervosa in this risk group, the present pilot study intends to identify risk factors for orthorexia nervosa in a sample of Nutrition and Dietetics students in Chile. Method A descriptive cross-sectional pilot study was done on 90 Nutrition and Dietetics students from a Chilean university, representing 70% of its population. The ORTHO-11-ES instrument was applied to determine ON risk, along with consulting about attitudinal, physical-clinical and social variables. Statistical tests were performed in GraphPad PRISM 8.0®, applying probability ratios and personal correlation, between the sociodemographic variables and the risk of orthorexia nervosa. This study was approved by the university Ethics Committee based on the Helsinki Declaration. Results 23.3% of the studied population was at risk of suffering ON. Associated variables were being in the second year of their major (OR 2.22), coming from a charter school (OR 3.00) and cohabitation being limited to ≤ 1 person (OR 2.47). Particularly, declared physical activity limits are associated to the risk of suffering ON (Sedentary OR 2.42, Heavy OR 3.53), as well as time spent on the social network Instagram (< 1 h OR 2.77, > 3 h OR 1.80). Conclusions There is an ON risk prevalence of 23.3% in the present pilot sample under study, indicating that years of study, cohabitation, secondary educational establishment, physical activity and Instagram use constitute associated factors for the studied condition. Some results vary from international evidence, describing a dual nature in the variables for Instagram time and declared physical activity for ON risk. This study needs replication in more representative samples and longitudinal character with control groups which can confirm the studied elements as ON risk factors. Plain English summary Orthorexia nervosa (ON) is an expression created to indicate a possible new eating disorder characterized by excessive and obsessive preoccupation with healthy eating. Some of its most distinctive traits include marked anxiety over food, exaggerated fear over the appearance of some diseases and shame about physical appearance. This ultimately impacts food choice, planning, acquisition, preparation and consumption, creating psychological complications along with some associated with malnutrition. Considering that Nutrition students are an at-risk group, the present pilot study evaluated its prevalence and associated factors in a specific sample in Chile. Conditions associated with the risk of orthorexia nervosa identified in the present study include: number of hours spent using Instagram, limited cohabitation, extreme physical activity, and number of years in the major. These results should be taken cautiously, with their association confirmed in follow-up studies.

Psychometric Properties and Measurement Invariance of The Fear of Missing Out Scale (FoMOs) In Chilean University Students

“…Otherwise, the non-presence in social networks can generate anxiety. (64) Likewise, the above may be associated with anxiety disorders and depression, (65,66) eating disorders, (67) selfregulation, and social skills problems in life offline. (68) A second factor was the fear of missing something great (FMS).…”

Associations between Orthorexia Nervosa, Body Self-Image, Nutritional Beliefs, and Behavioral Rigidity

“…Behavioral rigidity is a characteristic of individuals who tend to follow rules more than others. Considering that one of the characteristics of orthorexia nervosa is the tendency to present an excessive preoccupation with food and the non-acceptance of a different diet [ 35 , 36 ], which involves being under the control of strict rules regarding one’s own food, it is likely that behavioral rigidity interferes with the food patterns adopted by people and is also a feature of orthorexia nervosa. Thus, based on the finding that women are more likely to present orthorexic self-reports, it seems logical that behavioral rigidity is associated with being female, which points to the need for interventions aimed at producing behavioral flexibility.…”

Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students

“…HO can be the successful result of dissemination campaigns aimed to increase nutrition knowledge from WHO and National recommendations, but the proposed etiology of ON includes high level of education, pseudoscientific nutritional news on social media and psychological factors[ 12 ]. From a study carried out in nutrition and dietetics, university students emerged that Instagram use might be considered as an ON-risk factor[ 47 ]. Besides, K10 median of the scores of students enrolled in health-related study courses was higher than those of non-health-related degree courses[ 48 ].…”

“…Although a generalization to the whole population should not be made, considering the recent suggestions on the need for further investigation of the comorbidity between ON and OCD across different cultural groups[ 50 ], it emerged that ON could be an indicator/symptom of other problems related to body image perception, as well as high PA, psychological distress, appearance, fitness, health, or IO, in some university students. Accordingly, recent studies have found relationships between ON, vigorous-intensity PA and dieting[ 47 , 57 ]. In our study, the ORTO-7 was found to be independent from these confounders, after the exclusion of UW, OW, OB, and EAT-26 and K10 positive students, suggesting the possibility of defining subjects with ON.…”

“…Moreover, a high percentage of students (25.5% males and 40.1% females) with NW obesity (NWO) have been reported, and stress management behavior decreased the risk of NWO in females[ 58 ]. In this context, Villa et al [ 47 ] observed that ON was associated not only with heavy exercise but also with sedentary behavior. In students with NWO, low PA could be associated with dieting, inducing ON.…”