Ortorexia nervosa em estudantes e egressos do curso de Nutrição da Universidade Federal de Minas Gerais

Abstract

Orthorexia nervosa (ON) denotes a pathological obsession with healthy eating that has biopsychosocial implications. Several instruments were presented in an attempt to measure it, with emphasis on the “Bratman Orthorexia Test” (BOT), “Orthorexia Nervosa 15 Questionnaire” (ORTO-15), “Eating Habits Questionnaire” (EHQ), and “Düsseldorfer Orthorexie Skala” (DOS). Nutrition college students and dietitians have been identified as susceptible groups for orthorexia nervosa, given the wide involvement with food and the emphasis on biological aspects and nutrient utilization processes provided by Nutrition Science. The prevalence of ON in this population varies from 3.40 to 94.69%, depending on the instrument used. Therefore, this study aimed to evaluate the ON in college students and graduates of the Nutrition Course at the Federal University of Minas Gerais (UFMG); in addition to translating and transculturally adapting DOS, a German tool, to Brazil and examining its validity; verify the ON assessment between the Brazilian versions of ORTO-15 and DOS; compare ON between students and graduates of the UFMG Nutrition Course; and identify the factors associated with ON. For this, a cross-sectional study was conducted, in which the ORTO-15 adapted for Brazil and DOS was used, whose Brazilian version was obtained by the back-translation process after two reviews on a focus group. In the validity exam, factor structure, internal consistency, test-rest reliability, and convergent validity were analyzed with theoretically related instruments: “Eating Attitudes Test-26” (EAT-26) and “Obsessive-Compulsive Inventory-Revised” (OCI- R). Data collection took place online using questionnaires in Google Forms. The sample consisted of 177 students and 309 graduates, and the subsample, selected at random to assess test-retest reliability and convergent validity of DOS, was composed of 68 and 91 students and graduates, respectively. DOS presented good psychometric properties (three-factor solution with good adjustment, good internal consistency, and excellent test-retest reliability). Regarding the prevalence, 90.9% of the sample was classified as ON by ORTO-15 and 10.9% at-risk/presence by DOS, with no differences between students and graduates. There was poor agreement between the measurements of the instruments. Students had higher scores on DOS. ON was associated with concerns about additives and calories, a history of an eating disorder, greater concerns about food after the Nutrition Course according to family and friends, weighing of food at meals, and reports of food allergy/intolerance. Despite the limitations of the instruments, DOS seems to provide a more reliable measure compared to ORTO-15, being more recommended for assessing ON in the country. The findings also denote the importance of paying attention to students and graduates of the Nutrition course, by expanding the learning path to focus beyond nutrients and the biological aspects of eating.