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      Strict health-oriented eating patterns (orthorexic eating behaviours) and their connection with a vegetarian and vegan diet

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          Abstract

          Purpose

          Although research on vegetarianism is becoming more prevalent, to date, only a few research has been conducted on relationship between vegetarian diet and orthorexia nervosa (ON). The objective of the present study was to examine the orthorexic dietary patterns and eating behaviours among individuals following a vegetarian, vegan, and meat diet. We examined the moderating role of ethical and health reasons for following a meat-free diet on the relation between vegan versus vegetarian diet and eating behaviours and ON. The study aimed to determine the predictors of ON in individuals with differential food preferences.

          Methods

          Seventy-nine individuals following a meat-free diet and 41 individuals following an omnivore diet completed the EHQ and the TFEQ-R18.

          Results

          Our findings indicated that individuals following a vegan diet showed a higher level of knowledge of healthy eating than those who followed a vegetarian diet and those who followed an omnivore diet. Participants maintaining a vegan diet for health reasons were more likely to have greater knowledge about healthy eating. Cognitive restraint was a predictor of ON among a sample following a meat-free diet.

          Conclusions

          Our results could contribute to identify potential risk factors for strict health-oriented eating patterns and to gain a better insight into ON.

          Level of evidence

          Level V, descriptive study.

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          Most cited references28

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          The clinical basis of orthorexia nervosa: emerging perspectives

          Orthorexia nervosa describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Although prompted by a desire to achieve optimum health, orthorexia may lead to nutritional deficiencies, medical complications, and poor quality of life. Despite its being a distinct behavioral pattern that is frequently observed by clinicians, orthorexia has received very little empirical attention and is not yet formally recognized as a psychiatric disorder. In this review, we synthesize existing research to identify what is known about the symptoms, prevalence, neuropsychological profile, and treatment of orthorexia. An examination of diagnostic boundaries reveals important points of symptom overlap between orthorexia and anorexia nervosa, obsessive–compulsive disorder (OCD), obsessive–compulsive personality disorder (OCPD), somatic symptom disorder, illness anxiety disorder, and psychotic spectrum disorders. Neuropsychological data suggest that orthorexic symptoms are independently associated with key facets of executive dysfunction for which some of these conditions already overlap. Discussion of cognitive weaknesses in set-shifting, external attention, and working memory highlights the value of continued research to identify intermediate, transdiagnostic endophenotypes for insight into the neuropathogenesis of orthorexia. An evaluation of current orthorexia measures indicates a need for further psychometric development to ensure that subsequent research has access to reliable and valid assessment tools. Optimized assessment will not only permit a clearer understanding of prevalence rates, psychosocial risk factors, and comorbid psychopathology but will also be needed to index intervention effectiveness. Though the field lacks data on therapeutic outcomes, current best practices suggest that orthorexia can successfully be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication.
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            When Eating Right, Is Measured Wrong! A Validation and Critical Examination of the ORTO-15 Questionnaire in German

            The characteristic trait of individuals developing a pathological obsession and preoccupation with healthy foods and a restrictive and avoidant eating behavior is described as orthorexia nervosa (ON). For ON, neither universal diagnosis criteria nor valid tools for large-scale epidemiologic assessment are available in the literature. The aim of the current study is to analyze the psychometric properties of a translated German version of the ORTO-15 questionnaire. The German version of the ORTO-15, a eating behavior and dieting habits questionnaire were completed by 1029 German-speaking participants (74.6% female) aged between 19 and 70 years (M = 31.21 ± 10.43 years). Our results showed that after confirmatory factor analysis, the best fitting model of the original version is a single-factor structure (9-item shortened version: ORTO-9-GE). The final model showed only moderate internal consistency (Cronbach’s alpha = .67), even after omitting 40% of the original question. A total of 69.1% participants showed orthorectic tendencies. Orthorectic tendencies are associated with special eating behavior features (dieting frequency, vegetarian and vegan diet). Education level did not influence ON tendency and nutritional students did not show higher ON tendency compared to students from other disciplines. This study is the first attempt to translate and to evaluate the psychometric properties of a German version of the ORTO-15 questionnaire. The ORTO-9-GE questionnaire, however, is only a mediocre tool for assessing orthorectic tendencies in individuals and shows moderate reliability and internal consistency. Our research suggests, that future studies are needed to provide more reliable and valid assessment tools to investigate orthorexia nervosa.
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              Prevalence of orthorexia nervosa is less than 1 %: data from a US sample.

              Orthorexia nervosa, or pathological dieting based on being "healthy," has been of growing interest. Clinical data are limited to less than a half-dozen case studies reporting instances of medical problems due to healthful eating. However, more than a dozen studies using a measure to identify orthorexia, the ORTO-15, report very high prevalence rates in non-clinical samples. Point prevalence rates are reported from 6 % to nearly 90 %. Such variability could be due to cultural issues or psychometric problems with the instrument. This study examines prevalence rate of orthorexia in a US sample.
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                Author and article information

                Contributors
                abrytek-matera@swps.edu.pl
                Journal
                Eat Weight Disord
                Eat Weight Disord
                Eating and Weight Disorders
                Springer International Publishing (Cham )
                1124-4909
                1590-1262
                29 August 2018
                29 August 2018
                2019
                : 24
                : 3
                : 441-452
                Affiliations
                [1 ]ISNI 0000 0001 2184 0541, GRID grid.433893.6, Katowice Faculty of Psychology, , SWPS University of Social Sciences and Humanities, ; Technikow 9, 40-326 Katowice, Poland
                [2 ]ISNI 0000 0001 2184 0541, GRID grid.433893.6, Interdisciplinary Doctoral Studies, Wroclaw Faculty of Psychology, , SWPS University of Social Sciences and Humanities, ; Wroclaw, Poland
                [3 ]ISNI 0000 0001 2184 0541, GRID grid.433893.6, Faculty of Psychology, , SWPS University of Social Sciences and Humanities, ; Warsaw, Poland
                Author information
                http://orcid.org/0000-0001-5178-371X
                Article
                563
                10.1007/s40519-018-0563-5
                6531404
                30155858
                2c33a55e-4d14-403b-b789-ff1b6d50a82c
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 6 July 2018
                : 13 August 2018
                Funding
                Funded by: National Science Centre (NCN), Poland
                Award ID: 2017/01/X/HS6/00007
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © Springer Nature Switzerland AG 2019

                orthorexia nervosa,vegetarian diet,vegan diet,eating behaviours

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