Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature

Cena, Hellas; Barthels, Friederike; Cuzzolaro, Massimo; Bratman, Steven; Brytek-Matera, Anna; Dunn, Thomas M.; Varga, Màrta; Missbach, Benjamin; Donini, Lorenzo Maria

doi:10.1007/s40519-018-0606-y

Cited by 264 publications

(321 citation statements)

References 103 publications

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“…As already stated, an assessment based on self-administered questionnaires entails problems in terms of realibility and possible underestimation/overestimation. The ORTO-15 Questionnaire does not allow to make a diagnosis of ON, and has intrinsic limitations already described by the scientific literature [59], with contradictory results regarding its psychometric properties, including construct validity [9,[60][61][62][63].…”

Section: Limitationsmentioning

confidence: 99%

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

et al. 2019

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Background The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood. Method Multicentre, cross-sectional study involving Italian ( N = 216), Polish ( N = 206) and Spanish ( N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI]). Results Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students. Conclusions The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia.

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Section: Limitationsmentioning

confidence: 99%

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

et al. 2019

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“…Nevertheless, in some cases, interest in healthy food consumption and health could lead to orthorexia nervosa-an obsessional focus on a diet considered to be healthy, focusing on concerns regarding the quality of food, with overly care for one's health [4]. This unhealthy eating pattern is associated with excessive time spent preparing food, inflexible dietary rules, recurrent and persistent preoccupations related to "pure" or "clean" food, rigid avoidance of foods considered "unhealthy", compulsive behaviors, distress at violation of food rules, as well as consequent, clinically significant, impairment (e.g., medical or psychological complications, social isolation, and/or impairment in important areas of functioning) [5][6][7]. Recently, the bidimensional nature of orthorexia nervosa was proposed: with one dimension related to healthy interest in diet and healthy behavior with regard to diet (a protective factor against emotional distress) named healthy orthorexia (HeOr) and another dimension related to a pathological preoccupation with Nutrients 2020, 12, 646 2 of 14 eating healthily (a new variant of disordered eating related to negative affect) named orthorexia nervosa (OrNe) [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Interaction between Vegetarian Versus Omnivorous Diet and Unhealthy Eating Patterns (Orthorexia Nervosa, Cognitive Restraint) and Body Mass Index in Adults

Brytek-Matera

2020

Nutrients

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The objective of the present study was two-fold: Firstly, to investigate unhealthy eating patterns and body mass index among individuals following a vegetarian diet and those following an omnivorous diet. Secondly, to examine interaction between vegetarian versus omnivorous diet and unhealthy eating patterns (orthorexia nervosa, cognitive restraint) and body mass index using a structural equation modeling approach (SEM). The study included 370 participants: 188 participants following a vegetarian diet and 182 following an omnivorous diet. Unhealthy eating patterns and body mass index were measured. Our results showed that individuals following a vegetarian diet were more likely to engage in orthorexic eating behavior compared to individuals following an omnivorous diet. In addition, they had a significantly lower levels of cognitive restraint and lower body mass index than individuals following an omnivorous diet. Use of SEM method showed that:(1) following a vegetarian diet and orthorexia nervosa were directly associated, (2) following an omnivorous diet and cognitive restraint were directly related and (3) following an omnivorous diet had a greater tendency to cognitive restraint and an elevated body mass index. More research is necessary to further understand the complexity of the relationship between type of diet and unhealthy eating patterns in adults.

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“…Misunderstanding can lead to overanalysis of food intake and a fixation on righteous eating or orthorexia nervosa, a condition in which a patient will avoid food that they believe to be harmful. 39 Commonly, patients will present with extended self-initiated food and symptom diaries and limit their social activities around food. Concern about reintroducing or testing the impact of food is also common among these people.…”

Section: Introductionmentioning

confidence: 99%

Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

Halmos

Gibson

2019

J of Gastro and Hepatol

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Since its first trial showing evidence of efficacy for managing symptoms of irritable bowel syndrome, the fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has been gaining popularity but not without criticism. Application of the diet has changed from a rigid list of “allowed” and “not allowed” foods to a structured program of initial FODMAP restriction followed by food reintroduction and finally personalization so that patients are empowered to adjust their diet themselves to achieve good predictability of symptoms. Safety concerns of the diet have centered around its initial elimination leading to compromise of nutritional and psychological health, but careful patient assessment and management, preferably through a FODMAP‐trained dietitian, will reduce the risk of such negative health outcomes. Most negative attention for the FODMAP diet has been the notion that it will ruin the microbiota. Controlled studies have indicated that reducing FODMAP intake has no effects on bacterial diversity but will reduce total bacterial abundance, and higher FODMAP intakes will increase health‐promoting bacteria, supporting the concept of the full FODMAP program, including attaining a minimal “maintenance” level of FODMAP restriction. This review addresses all these concerns in detail and how to overcome them, including the use of a “FODMAP‐gentle” diet, describing restriction of a select few foods very concentrated in FODMAPs. This version of the diet is commonly applied in practice by experienced FODMAP‐trained dietitians but is not clearly described in literature. Careful direction and assessment of response or nonresponse will decrease the risks of over‐restriction and under‐restriction of diet.

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Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature

Cited by 264 publications

References 103 publications

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

Interaction between Vegetarian Versus Omnivorous Diet and Unhealthy Eating Patterns (Orthorexia Nervosa, Cognitive Restraint) and Body Mass Index in Adults

Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome

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