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

doi:10.5498/wjp.v12.i10.1298

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Oct 19, 2022 (publication date) through Dec 26, 2024

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World Journal of Psychiatry

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Observational Study

World J Psychiatry. Oct 19, 2022; 12(10): 1298-1312
Published online Oct 19, 2022. doi: 10.5498/wjp.v12.i10.1298

Table 1 Students’ characteristics

	IT-F, n = 59	IT-M, n = 41	SP-F, n = 33	SP-M, n = 27
Age (yr)	24 (23-28)	25 (23-28)	23 (21-28)	24 (24-26)
Height (m)	1.64 ± 0.06^a	1.78 ± 0.08^a	1.63 ± 0.06^a	1.78 ± 0.07^a
Weight (kg)	55.9 (53.0-61.0)^a	77.0 (70.9-87.5)^a	58.7 (52.4-66.5)^a	76.3 (67.1-82.0)^a
BMI (kg/m²)	20.7 (19.4-22.4)^a	24.5 (22.1-27.1)^a	23.3 (20.2-24.5)	24.1 (21.8-25.5)
Underweight (%)	11.9	0.0	9.1	3.7
Overweight (%)	6.8	31.7	15.1	25.9
Obese (%)	5.1	9.7	3.0	3.7
IPAQ (MET-min/wk)	2232 (1080-4986)	4380 (2305-6277)	2100 (1202-4395)^a	4970 (2575-6780)^a
IPAQ walking	630 (315-1260)	700 (488-1323)	525 (244-1230)	600 (240-1470)
IPAQ moderate	720 (160-1680)	600 (240-1440)	600 (240-1440)	720 (120-1440)
IPAQ intense	480 (0-1920)^a	2160 (400-3840)^a	800 (0-1680)^a	2400 (960-4320)^a
PA low (%)	16.9	7.3	18.2	7.4
PA moderate (%)	40.7	19.5	36.4	14.8
PA high (%)	42.4	73.2	45.5	77.8
Smokers (%)
Habitual	15.3	19.5	9.1	7.7
Occasional	16.9	19.5	15.2	15.4
Ex-smokers	8.5	9.8	9.1	3.8
K10	15.0 (13.0-19.0)	14.0 (12.0-17.0)	19.0 (15.0-27.5)	17.0 (14.0-20.0)
Mild (%)	11.9	0.0^b	15.2	25.9^b
Moderate (%)	6.9	9.8	18.2	3.7
Severe (%)	5.1	4.9	15.2	3.7

^aP < 0.05 between females and males within country.

^bP < 0.05 between Italians and Spaniards within sex.

Categorical variables are expressed as percentages. Continuous variables are expressed as means with standard deviation (Shapiro-Wilk Test passed), or as median (25%-75% range, Shapiro-Wilk Test failed). BMI: Body mass index; IPAQ: International Physical Activity Questionnaire; IT-F: Italian females; IT-M: Italian males; K10: Kessler Psychological Distress Scale; SP-F: Spanish females; SP-M: Spanish males; PA: Physical activity.

Table 2 Body image concerns

	IT-F, n = 59	IT-M, n = 41	SP-F, n = 33	SP-M, n = 27
MBSRQ	227.0 ± 21.7	231.6 ± 27.6^b	227.9 ± 24.3^a	249.3 ± 27.5^a^,^b
MBSRQ-AO	3.3 ± 0.9	3.2 ± 0.5^b	3.5 ± 0.5	3.5 ± 0.5^b
MBSRQ-FO	3.4 (3.0-3.9)	3.5 (3.2-4.2)	3.5 (3.0-4.0)^a	4.2 (3.6-4.4)^a
MBSRQ-HOr	3.4 ± 0.5	3.4 ± 0.6	3.2 ± 0.6^a	3.6 ± 0.6^a
MBSRQ-IO	3.3 ± 0.6	3.3 ± 0.5	3.4 ± 0.5	3.6 ± 0.6
MBSRQ-AS	3.1 ± 0.3	3.1 ± 0.4^b	3.1 ± 0.4^a	3.4 ± 0.4^a^,^b
MBSRQ-BASS	3.2 ± 0.7	3.4 ± 0.6	3.1 ± 0.8^a	3.5 ± 0.7^a
MBSRQ-OP	2.0 (1.8-2.8)	2.5 (1.8-3.0)	2.5 (2.1-3.0)	2.5 (2.0-3.3)
BUT	33.0 (19.0-61.0)	16.0 (6.0-39.0)	60.0 (30.5-82.0)	35.0 (21.0-74.0)
BUT-A	16.0 (9.0-36.0)	10.0 (2.0-20.0)	33.0 (12.5-51.0)	18.0 (13.0-42.0)
BUT-A - WP	0.9 (0.4-1.6)^b	0.5 (0.1-1.0)	1.8 (0.8-2.6)^b	1.1 (0.6-1.8)
BUT-A - BIC	0.7 (0.2-1.3)^a	0.2 (0.0-0.9)^a	0.9 (0.5-1.6)	0.6 (0.2-1.6)
BUT-B	15.0 (7.0-31.0)	11.0 (3.5-21.0)	25.5 (14.0-42.5)	21.0 (8.0-36.0)

^aP < 0.05 between females and males within country.

^bP < 0.05 between Italians and Spaniards within sex.

Categorical variables are expressed as percentages. Continuous variables are expressed as means with standard deviation (Shapiro-Wilk Test passed), or as median (25%-75% range, Shapiro-Wilk Test failed). AO: Appearance orientation; AS: Appearance scales; BASS: Body areas satisfaction scale; BIC: Body image concerns; BUT: Body Uneasiness Test; FO: Fitness orientation; HOr: Health orientation; IO: Illness orientation; IT-F: Italian females; IT-M: Italian males; MBSRQ: Multidimensional Body-Self Relations Questionnaire; OP: Overweight preoccupation; SP-F: Spanish females; SP-M: Spanish males; WP: Weight phobia.

Table 3 Orthorexia, eating attitude and malnutrition

	IT-F, n = 59	IT-M, n = 41	SP-F, n = 33	SP-M, n = 27
ORTO-15	36.8 ± 3.4^a	36.4 ± 34.2^a	34.2 ± 3.6^a	33.8 ± 3.4^a
Cut-off 40 (%)	76.3^a	70.7^a	97.0^a	96.3^a
Cut-off 35 (%)	23.7^a	36.5	48.5^a	55.5
ORTO-12	30.7 ± 3.0^a	30.4 ± 3.4^a	27.5 ± 2.9^a	27.2 ± 2.7^a
ORTO-11	27.8 ± 2.8^a	27.6 ± 3.4^a	25.2 ± 2.9^a	25.4 ± 3.0^a
Cut-off 25 (%)	11.9^a	19.5^a	36.4^a	25.9^a
ORTO-9	30.4 ± 3.4^a	30.0 ± 3.7^a	27.8 ± 3.2^a	27.1 ± 3.2^a
Cut-off 26.7 (%)	13.6^a	19.5^a	30.3^a	40.7^a
ORTO-7	20.0 (18.0-22.0)^a	19.0 (18.0-21.0)	19.0 (15.5-19.5)^a	19.0 (16.0-19.0)
Cut-off 19 (%)	32.2	29.3	48.5	48.1
EAT-26	6.0 (3.0-10.0)^a	5.0 (3.0-8.5)^a	11.0 (5.0-17.5)^a	13.0 (7.0-17.0)^a
Cut-off 20 (%)	8.5	4.9	21.2	11.1
Dieting	2.0 (0.0-5.0)	2.0 (0.04.5)	4.0 (0.5-9.5)	6.0 (3.0-9.0)
Bulimia	3.0 (3.0-3.0)	3.0 (3.0-3.0)	3.0 (3.0-5.5)	3.0 (3.0-5.0)
SSI	14.0 (8.0-22.0)^a	10.0 (4.5-16.0)^a	24.0 (20.0-43.0)^a	18.0 (12.0-30.0)^a

^aP < 0.05 between Italians and Spaniards within sex. Not significant between females and males within country.

Categorical variables are expressed as percentages. Continuous variables are expressed as means with standard deviation (Shapiro-Wilk Test passed), or as median (25%-75% range, Shapiro-Wilk Test failed). EAT-26: Eating Attitudes Test; IT-F: Italian females; IT-M: Italian males; ORTO: Scores for orthorexia nervosa (ON, reverse scores, lower values indicate high ON); SP-F: Spanish females; SP-M: Spanish males; SSI: Starvation Symptom Inventory.

Table 4 Spearman correlations

	ORTO-15	ORTO-12	ORTO-11	ORTO-9	ORTO-7
BMI (n = 160)	NS	NS	NS	-0.184^a	NS
BMI NW-K10^neg-EAT-26^neg(n = 66)	-0.315^a	-0.304^a	-0.284^a	-0.432^c	NS
SSI (n = 160)	-0.169^a	-0.264^c	-0.223^b	-0.244^b	-0.228^b
EAT-26 (n = 160)	-0.363^c	-0.414^c	-0.349^c	-0.432^c	-0.357^c
Dieting (n = 160)	-0.429^c	-0.444^c	-0.387^c	-0.516^c	-0.307^c
Bulimia (n = 160)	-0.188^a	-0.263^c	-0.180^a	-0.304^c	-0.223^b
BUT (n = 160)	NS	NS	NS	NS	-0.160^a
BUT A — WP (n = 160)	NS	-0.187^a	NS	-0.181^a	-0.166^a
BUT B (n = 160)	NS	NS	NS	NS	-0.165^a
MBSRQ (n = 160)	-0.354^c	-0.279^c	-0.341^c	-0.414^c	NS
MBSRQ-AO (n = 160)	-0.333^c	-0.296^c	-0.326^c	-0.359^c	-0.177^a
MBSRQ-AO NW-K10^neg-EAT-26^neg (n = 66)	NS	-0.285^a	NS	-0.289^a	NS
MBSRQ-FO (n = 160)	-0.361^c	-0.310^c	-0.358^c	-0.414^c	-0.180^a
MBSRQ-FO NW-K10^neg-EAT-26^neg (n = 66)	-0.304^a	-0.371^a	-0.373^a	-0.450^c	NS
MBSRQ-HOr (n = 160)	-0.341^c	-0.248^b	-0.333^c	-0.402^c	NS
MBSRQ-HOr NW-K10^neg-EAT-26^neg (n = 66)	-0.358^b	-0.408^c	-0.433^c	-0.491^c	NS
MBSRQ-IO (n = 160)	-0.162^a	NS	-0.181^a	NS	NS
MBSRQ-BASS (n = 160)	NS	NS	NS	NS	-0.169^a
MBSRQ-OP (n = 160)	-0.177^a	-0.216^b	-0.165^a	-0.302^c	NS
MBSRQ-OP NW-K10^neg-EAT-26^neg (n = 66)	NS	-0.366^b	NS	-0.357^b	NS
MBRSQ-AS (n = 160)	-0.195^a	-0.155^a	-0.161^a	-0.265^c	NS
MBSRQ-AS NW-K10^neg-EAT-26^neg (n = 66)	NS	-0.244^a	NS	-0.306^a	NS
IPAQ (n = 160)	NS	NS	NS	-0.183^a	NS
Walking (n = 160)	NS	NS	NS	-0.162^a	NS
Intense activity (n = 160)	NS	NS	NS	-0.178^a	NS
Intense activity NW-K10^neg-EAT-26^neg (n = 66)	-0.404^c	-0.330^b	-0.273^a	-0.461^c	NS

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

AO: Appearance orientation; AS: Appearance scales; BASS: Body areas satisfaction scale; BMI: Body mass index; BUT: Body Uneasiness Test; EAT-26: Eating Attitudes Test; FO: Fitness orientation; HOr: Health orientation; IO: Illness orientation; IPAQ: International Physical Activity Questionnaire; MBSRQ: Multidimensional Body-Self Relations Questionnaire; NS: Not significant; NW- K10^neg-EAT-26^neg: Normal weight students excluded those with K10 or EAT-26 positive test; OP: Overweight preoccupation; ORTO: Scores for orthorexia nervosa; SSI: Starvation Symptom Inventory; WP: Weight phobia.

Citation: Aiello P, Toti E, Villaño D, Raguzzini A, Peluso I. Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students. World J Psychiatry 2022; 12(10): 1298-1312
URL: https://www.wjgnet.com/2220-3206/full/v12/i10/1298.htm
DOI: https://dx.doi.org/10.5498/wjp.v12.i10.1298