Evaluation of Eating Habits and Nutrient Intake in Adolescents with and without Suspected Eating Disorders in Iran

Anahtar Kelimeler:

Eating disorder, Eating habit, Dietary intake, Adolescents

Evaluation of Eating Habits and Nutrient Intake in Adolescents with and without Suspected Eating Disorders in Iran

Objective: Increasing the incidence of eating disorder (ED) attitude during adolescence may lead to inadequate nutrient intake and consequently to growth disorders. This study aimed to compare eating habits and nutrient intakes of adolescents with high risk and low risk of developing eating disorders in high schools in Tehran, Iran. Methods: In the current cross-sectional study, the Eating Attitude Test (EAT-26) was applied to 299 students (185 females and 114 males) aged 15-18 years for the determination of ED attitudes. Food habits and nutrient intake were assessed by a self-administered questionnaire and a validated Food Frequency Questionnaire (FFQ), respectively. Nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated using nutrient’s Dietary Reference Intake (DRI) for age and sex. Results: Of all students, 17.7% were at risk of developing ED. The results showed that girls, unlike boys, consumed more energy than they needed, but this difference between the ED group in both sexes was not significant. The distribution of sweetened drinks, candy, chocolate, and fast food frequency was significantly different between the two groups of girls (P<0.05). In contrast, boys at risk of developing ED tended to eat healthier followed by higher vegetable intake and nutritional components. NAR scores were above 1 for all nutrients excluding potassium and vitamin D. The mean MAR in ED groups of boy and girl participants was 2.1% and 13.2% higher than non-ED subjects, respectively. Conclusion: Eating habits and accordingly nutrient intake can be affected by eating disorder attitudes in girls and boys adolescents.

Keywords:

Eating habit, Dietary intake, Adolescents, Eating disorder (ED),

PDF

___

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington (D.C.): American Psychiatric Association;2013.
Mohammadi MR, Mostafavi SA, Hooshyari Z, Khaleghi A, Ahmadi N, Molavi P, Armani Kian A, Safavi P, Delpisheh A, Talepasand S, Hojjat SK, Pourdehghan P, Ostovar R, Hosseini SH, Mohammadzadeh S, Salmanian M, Alavi SS, Ahmadi A, Zarafshan H. Prevalence, correlates and comorbidities of feeding and eating disorders in a nationally representative sample of Iranian children and adolescents. Int J Eat Disord. 2020;53(3):349-361. DOI: 10.1002/eat.23197.
Brambilla F, Monteleone P. Physical complications and physiological aberrations in eating disorders. Eating Disorders. Maj M,Halmi K, López-Ibor JJ, Sartorius N, editors. Wiley Online Library; 2003.6.p.139-222. DOI: 10.1002/047.086.7183.ch3
Tremblay L, Lariviere M. The influence of puberty onset, body mass index, and pressure to be thin on disordered eating behaviors in children and adolescents. Eat Behav. 2009;10(2):75-83. DOI: 10.1016/j.eatbeh.2008.12.001.
Davis C. Psychobiological traits in the risk profile for overeating and weight gain. Int J Obes. 2009;33(2): S49-S53. DOI: 10.1038/ijo.2009.72.
Da Luz FQ, Hay P, Touyz S, Sainsbury A. Obesity with comorbid eating disorders: associated health risks and treatment approaches. Nutrients. 2018;10(7):829-837. DOI: 10.3390/nu10070829.
Azadbakht L, Akbari F, Esmaillzadeh A. Diet quality among Iranian adolescents needs improvement. Public Health Nutr. 2014;18(4):615-21.
Shayan-Moghadam R, Heidari-Beni M, Riahi R, Motlagh ME, Fesharaki S, Heshmat R, Daniali SSH, Kelishad R. Assessment of Lifestyle and Eating Habits among a Nationally Representative Sample of Iranian Adolescent Girls: the CASPIAN-V Study. Archives of Iranian Medicine (AIM). 2020;23(8).
Jalali-Farahani S, Chin YS, Mohd Nasir MT, Amiri P. Disordered eating and its association with overweight and health-related quality of life among adolescents in selected high schools of Tehran. Child Psychiatry Hum Dev. 2015;46(3):485-92.
World Health Organization. WHO STEPS Surveillance Manual, Part 3: Data Collection, Section 5: Collecting Step 2 Data: Physical Measurements. Updated [26 January 2017]. Accessed [03 March 2019]. https://www.who.int/docs/default-source/ncds/ncd-surveillance/steps/steps-manual.pdf?sfvrsn=c281673d_5
WHO (2007). The WHO Child Growth Standards. Accessed [12 April 2019]. https://www.who.int/tools/child-growthstandards.
Mintz LB, O’Halloran MS. The Eating Attitudes Test: Validation with DSM-IV eating disorder criteria. J Personal Assess. 2000; 74:489–503.
Babaee S, Khodapanah MK, Sedghpour BS. Validity and reliability of Eating Attitude Test. JBS. 2008;1(1):61-68.
Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979;9(2):273-9.
Hatami M, Taib MNM, Jamaluddin R, Saad HA, Djazayery A, Chamari M, Nazari M. Dietary factors as the major determinants of overweight and obesity among Iranian adolescents. A cross-sectional study. Appetite. 2014; 82:194-201.
Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns and markers of systemic inflammation among Iranian women. The Journal of nutrition. 2007;137(4):992-8.
Trumbo P, Schlicker S, Yates AA, Poos M; Food and Nutrition Board of the Institute of Medicine, The National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002; 102(11):1621-1630. DOI: 10.1016/s0002-8223(02)90346-9.
Steyn NP, Nel J, Labadarios D, Maunder EM, Kruger HS. Which dietary diversity indicator is best to assess micronutrient adequacy in children 1 to 9 y? Nutrition. 2014;30(1):55-60. DOI: 10.1016/j.nut.2013.06.002
Rouhani MH, Mirseifinezhad M, Omrani N, Esmaillzadeh A, Azadbakht L. Fast food consumption, quality of diet, and obesity among Isfahanian adolescent girls. Journal of Obesity. 2012; 597924. DOI; 10.1155/2012/597924
Garrusi B and Baneshi M R. Body dissatisfaction among Iranian youth and adults. Cadernos de Saude Publica. 2017;33(9):e00024516. DOI: 10.1590/0102-311X00024516
Simons M, Taft T H, Doerfler B, Ruddy J S, Bollipo S, Nightingale S, Siau K, van Tilburg M A. Narrative review: Risk of eating disorders and nutritional deficiencies with dietary therapies for irritable bowel syndrome. Neurogastroenterology & Motility. 2021;34:e14188. DOI:10.1111/nmo.14188
Marashi T, Ramezankhani A, Dadipoor S, Safari-Moradabadi A. Health problem multiple behaviors in Iranian adolescents: A cross-sectional study. International Journal of Adolescence and Youth. 2019;24(2):224-233. DOI: 10.1080/02673.843.2018.1513851
Ghafari M, Doosti-Irani A, Amiri M, Cheraghi Z. Prevalence of the skipping breakfast among the Iranian students: A review article. Iran J Public Health. 2017;46(7):882-889. PMID: 28845398; PMCID: PMC5563869.
Mullan BA, Singh MA. Systematic review of the quality, content, and context of breakfast consumption. Nutrition & Food Science. 2010; 40(1): 81-114. DOI: 10.1108/003.466.51011015953
Wisting L, Reas DL, Bang L, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology. Appetite. 2017; 114:226-231. DOI:10.1016/j.appet.2017.03.035
Quiles-Marcos Y, Balaguer-Solá I, Pamies-Aubalat L, QuilesSebastián MJ, Marzo-Campos JC, Rodríguez-Marín J. Eating habits, physical activity, consumption of substances and eating disorders in adolescents. Span J Psychol. 2011;14(2):712-723. DOI: 10.5209/rev_sjop.2011.v14.n2.19
Elran-Barak R, Sztainer M, Goldschmidt AB, Crow SJ, Peterson CB, Hill LL, CrosbyRD, PowersP, MitchellJE, GrangeDL. Dietary restriction behaviors and binge eating in anorexia nervosa, bulimia nervosa and binge eating disorder: Trans-diagnostic examination of the restraint model. Eat Behav. 2015; 18:192- 196. DOI: 10.1016/j.eatbeh.2015.05.012.
Mahan LK, Raymond JL. Nutrition in Adolescence. Food & The Nutrition Care Process. 14th ed: Elsevier; 2017. p. 331-351. DOI: 10.1111/pme 12679
Chang Y-J, Lin W, Wong Y. Survey on eating disorder–related thoughts, behaviors, and their relationship with food intake and nutritional status in female high school students in Taiwan. J Am Coll Nutr. 2011;30(1):39-48. DOI: 10.1080/07315.724.2011.10719942
Schmidt R, Hiemisch A, Kiess W, von Klitzing K, SchlensogSchuster F, Hilbert A. Macro – and micronutrient intake in children with avoidant/restrictive food intake disorder. Nutrients. 2021;13(2). DOI: 10.3390/nu13020400
Beals KA. Eating behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players. J Am Diet Assoc. 2002;102(9):1293-1296. DOI: 10.1016/S0002- 8223(02)90285-3