Orthorexia FINAL FINAL...Tremelling K., Sandon L., Vega G., McAdams C., Journal of the Academy of Nutrition and Dietetics, 2017 o Key Findings: oFor the entire sample, scores on the

OrthorexiaLynz D. Jo rdan , CLS D ietet i c In ternFa l l 2018Un ivers i t y o f Wiscons in -Green Bay

Objectives•Overviewoforthorexia

•Whatdoestheresearchsay?

•Takehomemessage

LicensedunderCreativeCommonsZeroonPixabay.com

Definition&HistoryoAnobsessionwithproper,healthful,orpurefoods.

oDefinedin1996byDoctorSteveBateman

Bateman,S.(2014,January23).WhatisOrthorexia?Retrievedfromhttp://www.orthorexia.com/what-is-orthorexia/

SteveBateman

oNotformallyrecognizedoNoformaldiagnosticcriteria

Diagnoses

Signs&SymptomsoCompulsivelycheckingnutritionlabelsandingredientlistsoCuttingouttotalfoodgroups

NoSalt

LowFat

NoSugar

Organic

NoArtificial Colors

Non-GMO

WhyIchosethistopic….


Whatdoestheresearchsay?


Article#1:OrthorexiaNervosaandEatingDisorderSymptomsinRegisteredDietitianNutritionistsintheUnitedStatesoAuthors:KayleeTremelling,MCN,RDN;LonaSandon,PhD,RDN;GloriaL.Vega,PhD;CarrieJ.McAdams,MD,PhDoLocation:UnitedStatesoDatePublished: June152017oResearchPurpose:ToexaminetheprevalenceofOrthorexiaNervosaandEatingDisordersinRDNsintheUnitedstates

TremellingK.,SandonL.,VegaG.,McAdamsC.,JournaloftheAcademyofNutritionandDietetics,2017

oMethods:oRecruitment:CommissionofDieteticRegistrationprovidedrandomsampleof2500e-mailaddressesofRDNsoSurvey:GoogleFormsurveysweresentviaMailChimpoInclusion:RegisteredDietitianNutritionistslivingintheU.S.oExclusion:Pregnancy,breastfeeding&unabletoreadEnglish

OrthorexiaNervosaandEatingDisorderSymptomsinRegisteredDietitianNutritionistsintheUnitedStates


oSurveysoGeneralquestionsoOrthorexiaNervosaQuestionnaire(ORTO-15)oEatingDisorderExaminationQuestionnaire(EDE-Q)

oDefinitions:oEatingDisorder:EDoOrthorexiaNervosa:ON



ORTO-15oAhighriskofONisseenasascorebelow40oHigherscores(max.60points)indicativeofnormaleatingbehavior

Donini, L., Marsili, D., Graziani, M., Imbriale, M., & Cannella, C. (2005). Orthorexia nervosa: Validation of a Diagnosis Questionnaire. Eating Weight Disord,10, 28-32.

Always Often Sometimes Never

1. Wheneating, doyoupayattentiontothecaloriesinthefood?

2.Whenyougoinafoodshopdoyoufeelconfused?

3.Inthelast3months, didthethoughtoffoodworryyou?4.Are youreatingchoicesconditionedbyyourworryaboutyourhealthstatus?5. Isthetasteofthefoodmoreimportantthanthequalitywhenyouevaluatefood?

ORTO-15



6.Areyouwillingtospendmoremoneytohavehealthierfood?

7.Doesthethoughtaboutfoodworryyouformorethanthreehoursaday?

8.Doyouallowyourselfanyeatingtransgressions?

9.Doyouthinkyourmoodaffectsyoureatingbehavior?

10.Do youthinkthattheconvictiontoeatonlyhealthyfoodincreasesself-esteem?

11.Doyouthinkthateating healthyfoodchangesyourlife-style?(frequencyofeatingout;friends….)?

ORTO-15



12.Doyouthinkthatconsuminghealthyfoodmayimproveyourappearance?

13.Doyoufeelguiltywhentransgressing?

14.Doyouthinkthat onthemarketthereisalsounhealthyfood?15.Atpresent,areyoualonewhen havingmeals?

Items Always Often Sometimes Never

2-5-8-9 4 3 2 13-4-6-7-10-11-12-14-15 1 2 3 41-13 2 4 3 1

2,500 • RegisteredDietitiansthatwereinitiallysentsurvey

684 • Numberofresponsesreceived

48• ParticipantsthatwereexcludedduetopregnancybreastfeedingorunabletoreadEnglish

636 • TotalofRDNsthatcompletedquestionnaires



Sex HealthyComparison RDNs

RDNs thatareatRiskfor

Orthorexia

RDNsReportingLifetimeTreatmentforEating

Disorders

Female 291 272 52

Males 9 12 0



YearsasanRDN

HealthyComparisonRDNs


Orthorexia

RDNsReportingLifetimeTreatmentfor

EatingDisorders

0-5 54 73 14

6-10 34 27 4

11-20 69 64 15

21-30 67 69 12

>30 76 51 7



Number ofDietary

Restrictions

HealthyComparison RDNs


Orthorexia

RDNsReportingLifetimeTreatmentfor

EatingDisorders

None 233 157 23

1 43 80 16

2 21 32 8

3 3 9 5

4 0 6 0



oKeyFindings:oFortheentiresample,scoresontheORTO-15suggested49.5%wereatriskforONoScoresontheEDE-Qsuggested12.9%wereatriskforanED

oConclusionoFindingssuggestthatRDNsmaybeathigherriskofEDorONoNostatisticalsignificance



OrthorexiaNervosaandEatingDisorderSymptomsinRegisteredDietitianNutritionistsintheUnitedStatesoStrengthso Questionsaskedo Nutritionprofessionals

oLimitationso SampleSizes(includingmalevs.female)o Nocomparisontogeneralpublic

oQualityRaitingo+Positive

oInterestingPointso YearsasanRDNo DietaryRestrictions


Article#2:HealthStatus,PhysicalActivity,andOrthorexiaNervosa:AComparisonBetweenExerciseScienceStudentsandBusinessStudentsoAuthors:JuliaMalmborg,AnnBremander,M.CharlotteOlsson,StefanBergmanoLocation:SouthwestSwedenoDatePublished: November24,2016oResearchPurpose:Tocomparehealthstatus,physicalactivity,andfrequencyoforthorexianervosabetweenuniversitystudentsenrolledinanexercisescienceprogramorabusinessprogram.

oMethods:oRecruitment:StudentsatUniversitywereaskedtoparticipateinsurvey.oSurvey:NoinformationwasgivenastohowitwasdispersedoInclusion:Undergraduatestudentsin1st,2nd,or3rd yearuniversityprogram,eitherexercisescienceorbusiness.oExclusion:Anystudentsolderthan30

HealthStatus,PhysicalActivity,andOrthorexiaNervosa:AComparisonBetweenExerciseScienceStudentsandBusinessStudents

MalmborgJ.,BremanderA.,OlssonM.,BergmanS.,Appetite,2016

oSurveysoHealthstatuswasmeasuredviaShortForm-36(SF-36)questionnaireoPhysicalActivitywasmeasuredviaInternationalPhysicalActivityQuestionnaire(IPAQ)oOrthorexiaNervosawasmeasuredviaORTO-15



327 •Eligiblestudentstoparticipate

216 •Agreedtoparticipate

9 •Participantsthatwereexcludedduetoage>30

207 •Totalparticipants



Sex Studentsenrolled inBusinessProgram

StudentsenrolledinExerciseScience

Program

Female 53 64

Males 36 54





87

74.6

75

66

45.1

25.4

16.7

14.6

45.1

22.4

13.3

8.3

EXERCISESCIENCEMEN EXERCISESCIENCEWOMEN

BUSINESSMEN BUSINESSWOMEN

PERC

ENT

HighIPAQ ON<35 High&ON<35

oKeyFindings:oDifferenceinmenthatscoredhighforONstudyingExercisesciencethantheothertwosubgroups.o DifferenceinwomenthatscoredhighforONstudyingExercisesciencethanthosewomenwhostudiedBusiness

oConclusionoFindingssuggestthatstudents(especiallymen)thatstudyexercisesciencemaybeatgreaterriskfordevelopingON



HealthStatus,PhysicalActivity,andOrthorexiaNervosa:AComparisonBetweenExerciseScienceStudentsandBusinessStudentsoStrengthso ONanalyzedtogetherwithotheraspectsofhealth&levelsofphysicalactivity

oLimitationso SampleSizeso Nomentionofhowsurveysweredistributed

oQualityRatingo+Positive

oInterestingPointsoUseofanalyzingperceptionofhealthandpain


Article#3:APilotStudyComparingthePrevalenceofOrthorexiaNervosainRegularStudentsandThoseinUniversitySportsTeamsoAuthors:TomClifford&CharlotteBlythoLocation:NorthEastofUnitedKingdomoDatePublished: September17,2018oResearchPurpose:ToassesstheprevalenceofONinstudentscompetinginBritishUniversity&CollegeSportsandthosewhowerenot.

Clifford,T.,BlythC.,EatingandWeightDisorders,2018

APilotStudyComparingthePrevalenceofOrthorexiaNervosainRegularStudentsandThoseinUniversitySportsTeamsoMethods:oRecruitment:Studentswererecruitedviadirectclass,sportsclubs&universitysocieties.oSurvey:distributedviae-mailoInclusion:UniversityStudentsoExclusion:N/a

Clifford,T.,BlythC.,EatingandWeightDisorders,2018LicensedunderCreativeCommonsZeroonPixabay.com

APilotStudyComparingthePrevalenceofOrthorexiaNervosainRegularStudentsandThoseinUniversitySportsTeams

oSurveysoBasicinformation:oAgeoGenderoCourseofstudy

oSportsParticipationoORTO-15



215• Studentsthatcompletedsurvey

74• Males(49sportsstudents)

141• Females(67sportsstudents)




HoursofExercise > 10 < 10

NumberofFemales 31 110

NumberofMales 29 45

ORTO-15 score 35.6± 4.3 37.3± 3.6


APilotStudyComparingthePrevalenceofOrthorexiaNervosainRegularStudentsandThoseinUniversitySportsTeamsoKeyFindings:oThosewhomexercisemorethan10hoursaweekmaybeathigherriskforONoNosignificantdatasupportingahigherriskofONwhilecompetinginsports(weightdependentornot)


APilotStudyComparingthePrevalenceofOrthorexiaNervosainRegularStudentsandThoseinUniversitySportsTeamsoStrengthso ResultscorrelatedwithotherstudiesoVarietyofsportsoNotjustweightdependent

oLimitationso SampleSizes

oQualityRatingox Neutral

oInterestingPointsoNostatisticaldifferenceforONinthosethatdoanddonotparticipateinsports.


Otherresearch………..• HigherBMIformencanbeassociatedwithgreatersymptomologyforON(Oberle,2016)

• Narcissism&perfectionismpositivelycorrelatewithONsymptomology(Oberle,2016)

• ONisdifferentthenAvoidantRestrictiveFoodIntakeDisorder(ARFID)(Dunn,2015)

• ThosewithONtendnottohaveissueswithhowtheirperceivetheirweightorbodyshape,noristheirself-evaluationinfluencedbyweightorshapebutmorebyoverallhealth(Dunn,2015)

TakeHomeMessage….• Newinmedicalworld• Roughly70%ofOrthorexiaarticlespublishedonPubMedare< 5yearsold

• Orthorexiacanaffectanyone• Dietitians/Nutritionprofessionalsmaybeathigherrisk

• Lackofcleardiagnostictoolmakesitdifficulttodiagnose

•Moreresearchneedstobedone

Wolfram, T. (2018, May 15). Orthorexia An Obsession with Eating Pure. Retrieved from https://www.eatright.org/health/diseases-and-conditions/eating-disorders/orthorexia-an-obsession-with-eating-pure

ThankYou!LYNZD. JORDANORTHOREXIA

HTTPS://UWGBRESEARCHREVIEWS.WEEBLY.COM

ReferencesBateman, S. (2014, January 23). What is Orthorexia? Retrieved from http://www.orthorexia.com/what-is-orthorexia/

Brytek-Matera, A., Czepczor-Bernat, K., Jurzak, H., Kornacka, M., & Kołodziejczyk, N. (2018). Strict health-oriented eating patterns (orthorexic eating behaviours) and their connection with a vegetarian and vegan diet. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. doi:10.1007/s40519-018-0563-5

Clifford, T., & Blyth, C. (2018). A pilot study comparing the prevalence of orthorexia nervosa in regular students and those in University sports teams. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. doi:10.1007/s40519-018-0584-0

Dennett, C. (2018, February). Understanding Orthorexia - Today's Dietitian Magazine. Retrieved from https://www.todaysdietitian.com/newarchives/0218p24.shtml


Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors,21, 11-17. doi:10.1016/j.eatbeh.2015.12.006

EATING QUESTIONNAIRE[PDF]. (n.d.). Guilford Press, New York.

Karakuş, B. (2017). Orthorexia Nervosa Trends Among Students Of Nutrition And Dietetics Department At A University In Istanbul. Northern Clinics of Istanbul. doi:10.14744/nci.2017.20082

Malmborg, J., Bremander, A., Olsson, M. C., & Bergman, S. (2017). Health status, physical activity, and orthorexia nervosa: A comparison between exercise science students and business students. Appetite,109, 137-143. doi:10.1016/j.appet.2016.11.028

Oberle, C. D., Samaghabadi, R. O., & Hughes, E. M. (2017). Orthorexia nervosa: Assessment and correlates with gender, BMI, and personality. Appetite,108, 303-310. doi:10.1016/j.appet.2016.10.021

Orthorexia. (2018, February 22). Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

Orthorexia Signs & Symptoms | Timberline Knolls Treating Women & Girls. (n.d.). Retrieved from https://www.timberlineknolls.com/eating-disorder/orthorexia/signs-effects/

Tremelling, K., Sandon, L., Vega, G. L., & Mcadams, C. J. (2017). Orthorexia Nervosa and Eating Disorder Symptoms in Registered Dietitian Nutritionists in the United States. Journal of the Academy of Nutrition and Dietetics,117(10), 1612-1617. doi:10.1016/j.jand.2017.05.001

Wolfram, T. (2018, May 15). Orthorexia An Obsession with Eating Pure. Retrieved from https://www.eatright.org/health/diseases-and-conditions/eating-disorders/orthorexia-an-obsession-with-eating-pure

Documents

Orthorexia FINAL FINAL...Tremelling K., Sandon L., Vega G., McAdams C., Journal of the Academy of Nutrition and Dietetics, 2017 o Key Findings: oFor the entire sample, scores on the