Investigation of the Relationship of Chronotype with Eating Attitudes and Body Image in University Students

Öz

Objective: In this study, it was aimed to evaluate the relationship between the chronotype of university students, who are considered to be a high-risk group for the development of eating disorders and the eating attitude and body perception of the students.
Method: This descriptive study was carried out with the participation of 893 students who were actively studying in the 2020-2021 academic year of a university and consented to participate in the study. Data was obtained by sending the questionnaire to students' e-mail through a structured questionnaire created in Google Forms. Descriptive statistics, chi square and correlation test were used to evaluate the data. Institutional and ethical board permissions were obtained for the study and voluntary participation was based on.
Results: It was determined that the students who participated in the study were mostly female (72.2%), did not have a physician diagnosed disease (82.5%), had normal weight (68.5%), and mean age was 21.23 ± 3.80 years. In determining the chronotype of the students, it was found that there was an intermediate type (67.2%) in weight with an average score of 47.54 ± 9.17 in the Morningness Eveningness Test. During the coronavirus pandemic, it was determined that the chronotype of the female students who kept their weight and did not change their sleeping habits were morning type. In the study, no statistically significant relationship was found between the chronotype of the students and the sub-dimensions of the Eating Attitude Test (dieting, bulimic behavior, oral control behavior) and the Body Liking Scale (p> 0.05). However, as the age and BMI of the students increased and the sleep duration decreased, it was found that the Morningness-Eveningness Test score was higher and the result was statistically significant (respectively r = 0.124, r = -0.148, r = 0.069; p <0.05).
Conclusions and Suggestions: It was determined that variables such as gender, change in body weight and sleeping habits during the coronavirus pandemic showed a statistically significant difference between chronotypes. It is clear that students need health counseling that takes into account individual differences to be carried out by nurses and nutrition and dietetics specialists. In addition, further studies supported by methods such as physical activity and food consumption recording are needed to be conducted with different samples in different age groups to examine the relationship between circadian preference and eating habits, eating disorders.

Anahtar Kelimeler

• Chronotype;
• Eating behavior;
• Body liking;
• University students;
• Morningness-eveningness

ÜNİVERSİTE ÖĞRENCİLERİNDE KRONOTİPİN, YEME TUTUMU VE BEDEN ALGISI İLE İLİŞKİSİNİN İNCELENMESİ

Öz

Amaç: Bu çalışmada, yeme bozukluğu gelişimi açısından yüksek riskli grup olarak görülen üniversite öğrencilerinin kronotipinin öğrencilerin yeme tutumu ve beden algılarıyla ilişkisinin değerlendirilmesi amaçlanmıştır.
Yöntem: Tanımlayıcı tipte olan bu çalışma bir devlet üniversitesinin 2020-2021 akademik yılında aktif olarak öğrenim görmekte olan ve çalışmaya katılmayı kabul eden 893 öğrencinin katılımı ile gerçekleştirildi. Veriler Google Formlar'da oluşturulan yapılandırılmış bir anket aracılığıyla, anket formunun öğrencilerin e-postasına gönderilmesiyle elde edilmiştir Verilerin değerlendirilmesinde tanımlayıcı istatistikler, X2 ve korelasyon testi kullanıldı. Çalışma için kurum ve etik kurul izinleri alnmış ve gönüllü katılım esas alınmıştır.
Bulgular: Çalışmaya katılan öğrencilerin çoğunlukla kadın cinsiyetinde (%72.2), hekim tarafından tanı konulmuş bir hastalığı bulunmayan (%82.5), normal kilolu (%68.5) ve yaş ortalaması olarak 21.23±3.80 yıl olduğu belirlendi. Öğrencilerin kronotipinin belirlenmesinde Sabahcıl Akşamcıl Testinden 47.54±9.17 ortalama puan ile ağırlıkta ara tip (%67.2) olduğu bulundu. Pandemi sürecinde kilosunu koruyan ve uyku alışkanlığında herhangi bir değişiklik olmayan ve kadın cinsiyetindeki öğrencilerin kronotipinin sabahçıl tipte olduğu belirlendi. Çalışmada öğrencilerinin kronotipi ile Yeme Tutum Testi alt boyutları (diyet yapma, bulimik davranış, oral ontrol davranışı) ve Bedeni Beğenme Ölçeği arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır (p> 0.05). Ancak öğrencilerin yaşı ve BKI değeri arttıkça ve uyku süresi azaldıkça Sabahçıl-Akşamcıl Testi puanın daha yüksek olduğu, sonucun istatistiksel olarak anlamlı olduğu bulunmuştur (sırasıyla r = 0.124, r= -0.148, r =0.069; p< 0.05).
Sonuç ve Öneriler: Pandemi sürecindeki vücut ağırlığındaki ve uyku alışkanlığındaki değişim ve cinsiyet gibi değişkenlerin kronotipler arasında istatistiksel olarak anlamlı fark gösterdiği belirlendi. Öğrencilerin hemşireler ve beslenme ve diyetetik uzmanları tarafından yürütülecek bireysel farklılıkların dikkate alındığı, sağlık danışmanlıklarına ihtiyacı açıktır. Ayrıca farklı yaş gruplarında, farklı örneklemlerle yapılacak ve sirkadiyen tercih ile beslenme alışkanlıkları, yeme bozuklukları ilişkisinin incelendiği, fiziksel aktivite ve besin tüketim kaydının alınması gibi yöntemlerle desteklenen ileri çalışmalara ihtiyaç vardır. 

Anahtar Kelimeler

• Kronotip
• Bedeni beğenme
• Yeme davranışı

Kaynakça

1. Anlı, G., Akın, A., Eker, H., & Özçelik, B. (2015). Bedeni beğenme ölçeği: geçerlik ve güvenirlik çalışması. The Journal of Academic Social Sciences Studys, 505-511.
2. Arora, T., & Taheri, S. (2015). Associations among late chronotype, body mass index and dietary behaviors in young adolescents. International Journal of Obesity, 39(1), 39–44. https://doi.org/10.1038/ijo.2014.157
3. Asher, G., & Sassone-Corsi, P. (2015). Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell, 161(1), 84–92.
4. Avalos, L., Tylka, T. L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Development and psychometric evaluation. Body Image, 2(3), 285–297. https://doi.org/10.1016/j.bodyim.2005.06.002
5. Bailey, K. A., Gammage, K. L., & van Ingen, C. (2017). How do you define body image? Exploring conceptual gaps in understandings of body image at an exercise facility. Body Image, 23, 69–79.
6. Basnet, S., Merikanto, I., Lahti, T., Männistö, S., Laatikainen, T., Vartiainen, E., & Partonen, T. (2017). Associations of common noncommunicable medical conditions and chronic diseases with chronotype in a population-based health examination study. Chronobiology International, 34(4), 462–470. https://doi.org/10.1080/07420528.2017.1295050
7. Bedont, J. L., & Blackshaw, S. (2015). Constructing the suprachiasmatic nucleus: a watchmaker's perspective on the central clockworks. Frontiers in Systems Neuroscience, 9, 74.
8. Bricio-Barrios, J. A., Ríos-Silva, M., García-Rodríguez, R., Huerta, M., Del Toro-Equihua, M., Ortiz-Mesina, M., Trujillo, X. (2020). Anthropometric and dietary differences among Mexican older adults with and without adequate body image perception. Journal of Psychosomatic Research, 131, 109967.

9. Çakır, Y., Toktaş, N., & Karabudak, E. (2019). Üniversite öğrencilerinde kronotipe göre besin tüketiminin değerlendirilmesi. Beslenme ve Diyet Dergisi, 46(2), 136–146. https://doi.org/10.33076/2018.BDD.298
10. Dalle Grave, R., Sartirana, M., Sermattei, S., & Calugi, S. (2020). Treatment of Eating Disorders in Adults Versus Adolescents: Similarities and Differences. Clinical Therapeutics.
11. Di Renzo, L., Gualtieri, P., Pivari, F., Soldati, L., Attinà, A., Cinelli, G., Lorenzo, A. de (2020). Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey. Journal of Translational Medicine, 18(1), 229. https://doi.org/10.1186/s12967-020-02399-5
12. Díaz-Morales, J. F., & Sorroche, M. G. (2008). Morningness-eveningness in adolescents. The Spanish Journal of Psychology, 11(1), 201.
13. Ergüney-Okumuş, F. E., & Sertel-Berk, H. Ö. (2019). Yeme Tutum Testi Kısa Formunun (YTT-26) Üniversite Örnekleminde Türkçeye Uyarlanması ve Psikometrik Özelliklerinin Değerlendirilmesi. Psikoloji Çalışmaları, 40(1), 57–78.
14. Evans, J. A., & Davidson, A. J. (2013). Health consequences of circadian disruption in humans and animal models. Progress in Molecular Biology and Translational Science, 119, 283–323.
15. Fairburn, C. G., Cooper, Z., & O'Connor, M. (1993). The eating disorder examination. International Journal of Eating Disorders, 6, 1–8.
16. Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279.
17. Harb, A., Levandovski, R., Oliveira, C., Caumo, W., Allison, K. C., Stunkard, A., & Hidalgo, M. P. (2012). Night eating patterns and chronotypes: A correlation with binge eating behaviors. Psychiatry Research, 200(2-3), 489–493. https://doi.org/10.1016/j.psychres.2012.07.004
18. Horne, J. A., & Östberg, O. (1976). A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. International Journal of Chronobiology.
19. Huang, W., Ramsey, K. M., Marcheva, B., & Bass, J. (2011). Circadian rhythms, sleep, and metabolism. The Journal of Clinical İnvestigation, 121(6), 2133–2141. https://doi.org/10.1172/JCI46043
20. Jakovljevic, M., Bjedov, S., Jaksic, N., & Jakovljevic, I. (2020). Covıd-19 Pandemia and Public and Global Mental Health from the Perspective of Global Health Securit. Psychiatria Danubina, 32(1), 6–14. https://doi.org/10.24869/psyd.2020.6
21. Jones, S. E., Tyrrell, J., Wood, A. R., Beaumont, R. N., Ruth, K. S., Tuke, M. A., . . . Weedon, M. N. (2016). Genome-Wide Association Analyses in 128,266 Individuals Identifies New Morningness and Sleep Duration Loci. PLoS Genetics, 12(8), e1006125. https://doi.org/10.1371/journal.pgen.1006125
22. Juda, M., Vetter, C. [Céline], & Roenneberg, T. (2013). Chronotype modulates sleep duration, sleep quality, and social jet lag in shift-workers. Journal of Biological Rhythms, 28(2), 141–151.
23. Julius, A. A., Yin, J., & Wen, J. T. (2019). Time optimal entrainment control for circadian rhythm. PloS One, 14(12), e0225988. https://doi.org/10.1371/journal.pone.0225988
24. Kandeger, A., Egilmez, U., Sayin, A. A., & Selvi, Y. (2018). The relationship between night eating symptoms and disordered eating attitudes via insomnia and chronotype differences. Psychiatry Research, 268, 354–357. https://doi.org/10.1016/j.psychres.2018.08.003
25. Kanerva, N., Kronholm, E., Partonen, T., Ovaskainen, M.‑L., Kaartinen, N. E., Konttinen, H., Männistö, S. (2012). Tendency toward eveningness is associated with unhealthy dietary habits. Chronobiology İnternational, 29(7), 920–927.
26. Kasof, J. (2001). Eveningness and bulimic behavior. Personality and Individual Differences, 31(3), 361–369. https://doi.org/10.1016/S0191-8869(00)00142-2
27. Kennedy, A. K., Schneiderman, J. U., & Winter, V. R. (2019). Association of body weight perception and unhealthy weight control behaviors in adolescence. Children and Youth Services Review, 96, 250–254.
28. Kivelä, L., Papadopoulos, M. R., & Antypa, N. (2018). Chronotype and Psychiatric Disorders. Current Sleep Medicine Reports, 4(2), 94–103. https://doi.org/10.1007/s40675-018-0113-8
29. Konttinen, H., Kronholm, E., Partonen, T., Kanerva, N., Männistö, S., & Haukkala, A. (2014). Morningness-eveningness, depressive symptoms, and emotional eating: A population-based study. Chronobiology İnternational, 31(4), 554–563. https://doi.org/10.3109/07420528.2013.877922
30. Lavender, J. M., Utzinger, L. M., Crosby, R. D., Goldschmidt, A. B., Ellison, J., Wonderlich, S. A., Le Grange, D. (2016). A naturalistic examination of the temporal patterns of affect and eating disorder behaviors in anorexia nervosa. The International Journal of Eating Disorders, 49(1), 77–83. https://doi.org/10.1002/eat.22447
31. Lee, K., Lee, H.‑K., Jhung, K., & Park, J. Y. (2017). Relationship between chronotype and temperament/character among university students. Psychiatry Research, 251, 63–68. https://doi.org/10.1016/j.psychres.2017.01.071
32. Lemoine, P., Zawieja, P., & Ohayon, M. M. (2013). Associations between morningness/eveningness and psychopathology: An epidemiological survey in three in-patient psychiatric clinics. Journal of Psychiatric Research, 47(8), 1095–1098. https://doi.org/10.1016/j.jpsychires.2013.04.001
33. Malone, S. K., Zemel, B., Compher, C., Souders, M., Chittams, J., Thompson, A. L., . . . Lipman, T. H. (2016). Social jet lag, chronotype and body mass index in 14-17-year-old adolescents. Chronobiology İnternational, 33(9), 1255–1266. https://doi.org/10.1080/07420528.2016.1196697
34. Mason, T. B., Engwall, A., Mead, M. P., & Irish, L. A. (2019). Sleep and eating disorders among adults enrolled in a commercial weight loss program: Associations with self-report and objective sleep measures. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 24(2), 307–312. https://doi.org/10.1007/s40519-019-00664-1
35. Mazri, F. H., Manaf, Z. A., Shahar, S., & Mat Ludin, A. F. (2019). The Association between Chronotype and Dietary Pattern among Adults: A Scoping Review. International Journal of Environmental Research and Public Health, 17(1). https://doi.org/10.3390/ijerph17010068
36. Meule, A., Roeser, K., Randler, C. [C.], & Kübler, A. (2012). Skipping breakfast: Morningness-eveningness preference is differentially related to state and trait food cravings. Eating and Weight Disorders : EWD, 17(4), e304-8. https://doi.org/10.3275/8723
37. Mirghani, H. O., Albalawi, K. S., Alali, O. Y., Albalawi, W. M., Albalawi, K. M., Aljohani, T. R., & Albalawi, W. S. (2019). Breakfast skipping, late dinner intake and chronotype (eveningness-morningness) among medical students in Tabuk City, Saudi Arabia. The Pan African Medical Journal, 34, 178. https://doi.org/10.11604/pamj.2019.34.178.16250
38. Natale, V., Ballardini, D., Schumann, R., Mencarelli, C., & Magelli, V. (2008). Morningness–eveningness preference and eating disorders. Personality and Individual Differences, 45(6), 549–553. https://doi.org/10.1016/j.paid.2008.06.014
39. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39(2), 244–251.
40. Nimitphong, H., Siwasaranond, N., Saetung, S., Thakkinstian, A., Ongphiphadhanakul, B., & Reutrakul, S. (2018). The relationship among breakfast time, morningness-eveningness preference and body mass index in Type 2 diabetes. Diabetic Medicine : A Journal of the British Diabetic Association, 35(7), 964–971. https://doi.org/10.1111/dme.13642
41. Özkara, A. B. (2019). Öğretmen Adaylarının Bedensel Memnuniyet Düzeylerinin İncelenmesi. Spor Eğitim Dergisi, 3(1), 17–24.
42. Punder, K. de, Heim, C., & Entringer, S. (2019). Association between chronotype and body mass index: The role of C-reactive protein and the cortisol response to stress. Psychoneuroendocrinology, 109, 104388. https://doi.org/10.1016/j.psyneuen.2019.104388
43. Pündük, Z., Gür, H., & Ercan, İ. (2005). Sabahçil-Akşamcil Anketi Türkçe uyarlamasinda güvenilirlik çalişmasi. Türk Psikiyatri Dergisi.
44. Randler, C. [Christoph] (2007). Gender differences in morningness–eveningness assessed by self-report questionnaires: A meta-analysis. Personality and Individual Differences, 43(7), 1667–1675. https://doi.org/10.1016/j.paid.2007.05.004
45. Randler, C. [Christoph], & Engelke, J. (2019). Gender differences in chronotype diminish with age: a meta-analysis based on morningness/chronotype questionnaires. Chronobiology İnternational, 36(7), 888–905. https://doi.org/10.1080/07420528.2019.1585867
46. Randler, C. [Christoph], Faßl, C., & Kalb, N. (2017). From Lark to Owl: Developmental changes in morningness-eveningness from new-borns to early adulthood. Scientific Reports, 7, 45874. https://doi.org/10.1038/srep45874
47. Randler, C. [Christoph], Vollmer, C., Kalb, N., & Itzek-Greulich, H. (2019). Breakpoints of time in bed, midpoint of sleep, and social jetlag from infancy to early adulthood. Sleep Medicine, 57, 80–86. https://doi.org/10.1016/j.sleep.2019.01.023
48. Roenneberg, T., Kuehnle, T., Juda, M., Kantermann, T., Allebrandt, K., Gordijn, M., & Merrow, M. (2007a). Epidemiology of the human circadian clock. Sleep Medicine Reviews, 11(6), 429–438.
49. Roenneberg, T., & Merrow, M. (2016). The circadian clock and human health. Current Biology, 26(10), R432-R443.
50. Schubert, E., & Randler, C. [Christoph] (2008). Association between chronotype and the constructs of the Three-Factor-Eating-Questionnaire. Appetite, 51(3), 501–505. https://doi.org/10.1016/j.appet.2008.03.018
51. Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Revue D'epidemiologie Et De Sante Publique, 67(5), 295–301. https://doi.org/10.1016/j.respe.2019.04.056
52. Tazegül, Ü. (2016). Elit Düzeydeki Tenisçilerin Olumlu Düşünme Düzeyleri ile Bedenlerini Beğenmeleri Düzeyi Arasındaki İlişkinin Belirlenmesi. Itobiad: Journal of the Human & Social Science Researches, 5(8).
53. Teixeira, G. P. [G. P.], Balieiro, L. C. T., Gontijo, C. A., Fahmy, W. M., Maia, Y. C. P., & Crispim, C. A. [C. A.] (2020). The association between chronotype, food craving and weight gain in pregnant women. Journal of Human Nutrition and Dietetics : The Official Journal of the British Dietetic Association, 33(3), 342–350. https://doi.org/10.1111/jhn.12723
54. Teixeira, G. P. [Gabriela Pereira], Mota, M. C., & Crispim, C. A. [Cibele Aparecida] (2018). Eveningness is associated with skipping breakfast and poor nutritional intake in Brazilian undergraduate students. Chronobiology İnternational, 35(3), 358–367. https://doi.org/10.1080/07420528.2017.1407778
55. Treasure, J., Duarte, T. A., & Schmidt, U. (2020). Eating disorders. The Lancet, 395(10227), 899–911. https://doi.org/10.1016/S0140-6736(20)30059-3
56. Tylka, T. L., & Wood-Barcalow, N. L. (2015). The Body Appreciation Scale-2: item refinement and psychometric evaluation. Body Image, 12, 53–67.
57. Urbán, R., Magyaródi, T., & Rigó, A. (2011). Morningness-eveningness, chronotypes and health-impairing behaviors in adolescents. Chronobiology International, 28(3), 238–247. https://doi.org/10.3109/07420528.2010.549599
58. Usher, W., & Curran, C. (2019). Predicting Australia's university students' mental health status. Health Promotion İnternational, 34(2), 312–322. https://doi.org/10.1093/heapro/dax091
59. Walker, R. J., Christopher, A. N., Wieth, M. B., & Buchanan, J. (2015). Personality, time-of-day preference, and eating behavior: The mediational role of morning-eveningness. Personality and Individual Differences, 77, 13–17. https://doi.org/10.1016/j.paid.2014.12.026
60. Wang, J. B., Patterson, R. E., Ang, A., Emond, J. A., Shetty, N., & Arab, L. (2014). Timing of energy intake during the day is associated with the risk of obesity in adults. Journal of Human Nutrition and Dietetics : The Official Journal of the British Dietetic Association, 27 Suppl 2, 255–262. https://doi.org/10.1111/jhn.12141
61. Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., . . . Tasali, E. (2015). Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep, 38(6), 843–844. https://doi.org/10.5665/sleep.4716
62. Whittier, A., Sanchez, S., Castañeda, B., Sanchez, E., Gelaye, B., Yanez, D., & Williams, M. A. (2014). Eveningness Chronotype, Daytime Sleepiness, Caffeine Consumption, and Use of Other Stimulants Among Peruvian University Students. Journal of Caffeine Research, 4(1), 21–27. https://doi.org/10.1089/jcr.2013.0029
63. Wright, K. P., Linton, S. K., Withrow, D., Casiraghi, L., Lanza, S. M., La Iglesia, H. d., . . . Depner, C. M. (2020). Sleep in university students prior to and during COVID-19 Stay-at-Home orders. Current Biology, 30(14), R797-8. https://doi.org/10.1016/j.cub.2020.06.022
64. Xiao, Q., Garaulet, M., & Scheer, F. A. J. L. (2019). Meal timing and obesity: İnteractions with macronutrient intake and chronotype. International Journal of Obesity (2005), 43(9), 1701–1711. https://doi.org/10.1038/s41366-018-0284-x
65. Zachary, Z., Brianna, F., Brianna, L., Garrett, P., Jade, W., Alyssa, D., & Mikayla, K. (2020). Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obesity Research & Clinical Practice, 14(3), 210–216. https://doi.org/10.1016/j.orcp.2020.05.00