THE PREVALENCE OF ORTHOREXIA IN TOURISM EDUCATION ASSOCIATE DEGREE STUDENTS

Öz

Healthy eating is not a pathological situation, but when it becomes a long-term and excessive preoccupation and causes negativities in daily life, it can cause personality and behavioural disorders. The study is aimed to determine the prevalence of orthorexia among tourism students with and without a nutrition education background and to develop recommendations accordingly. The research population consists of tourism students in associate degree programs (from junior colleges) at various public and private universities and the sample group consists of 581 volunteers. The measurement scale is composed of five constituents, namely, the demographics, nutrition properties, eating under emotional conditions (emotional eating), eating attitudes test and orthorexia test. In the light of the findings it is concluded that the prevalence of orthorexia is higher among tourism students who have nutrition education than those who have not. Eating attitudes test results have shown that tourism students who get nutrition education are at a moderate level compared to those who do not.

Anahtar Kelimeler

• Tourism
• Tourism students
• Nutrition
• Orthorexia
• Orthorexia Prevalence

TURİZM EĞİTİMİ ALAN ÖNLİSANS ÖĞRENCİLERİNDE ORTOREKSİYA PREVALANSI

Öz

Sağlıklı beslenme patolojik bir durum değildir, ancak uzun süreli ve aşırı bir meşguliyet haline gelip günlük hayatta olumsuzluklara yol açtığında kişilik ve davranış bozukluklarına neden olabilmektedir. Çalışma, beslenme eğitimi almış ve almayan turizm öğrencileri arasında ortoreksiya yaygınlığını belirlemeyi ve buna göre öneriler geliştirmeyi amaçlamaktadır. Araştırmanın evrenini çeşitli kamu ve vakıf üniversitelerinde önlisans programlarında turizm eğitimi alan öğrenciler, örneklemini ise 581 gönüllü oluşturmaktadır. Ölçümler için kullanılan ölçek beş bileşenden oluşmaktadır; yani demografik bilgiler, beslenme özellikleri, duygusal koşullar altında beslenme (duygusal yeme), yeme tutum testi ve ortoreksiya testi. Araştırmada, ortoreksiya test sonuçları beslenme eğitimi alan turizm öğrencilerinin almayanlara göre ortoreksiya yaygınlığının daha yüksek olduğu sonucuna ulaşılmıştır. Yeme tutum testi sonuçları; beslenme eğitimi alan turizm öğrencilerinin almayanlara göre daha ortada düzeyde olduğunu göstermektedir.

Anahtar Kelimeler

• Turizm
• Turizm öğrencileri
• Beslenme
• Ortoreksiya
• Ortoreksiya Prevalaensı

Kaynakça

1. Altınok, M. (2020). Yeme tutumları, duygusal yeme, farkındalıkla yeme ve ortoreksiyanın metakognisyonlar açısından incelenmesi Yayımlanmamış Yüksek Lisans Tezi. Fatih Sultan Mehmet Vakıf Üniversitesi.
2. Arusoğlu, G. (2006). Sağlıklı beslenme takıntısı (ortoreksiya) belirtilerinin incelenmesi, Orto-15 ölçeğinin uyarlanması Yayımlanmamış Yüksek Lisans Tezi. Hacettepe Üniversitesi.
3. Barrada, J. R. and Roncero, M. (2018). Bidimensional structure of the orthorexia: development and initial validation of a new instrument. Anales de Psicologia, 34(2), 283–291.
4. Barthels, F., Meyer, F. and Pietrowsky, R. (2018). Orthorexic and restrained eating behaviour in vegans, vegetarians, and individuals on a diet. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 23(2), 159-166. https://doi.org/10.1007/s40519-018-0479-0
5. Bóna, E., Szél, Z., Kiss, D. and Gyarmathy, V.A. (2019). An unhealthy health behavior: Analysis of orthorexic tendencies among Hungarian gym attendees. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(1), 13–20. https://doi.org/10.1007/s40519-018-0592-0
6. Bosi, A. T. B., Çamur, D. and Güler, Ç. (2007). Prevalence of orthorexia nervosa in resident medical doctors in the Faculty of Medicine (Ankara, Turkey). Appetite, 49(3), 661–666.
7. Bratman, S. and Knight, D. (2000). Health food junkies: Overcoming the obsession with healthful eating. Broadway Books.
8. Bratman, S. (1997). The health food eating disorder. Yoga Journal, 42-50.

9. Brytek-Matera, A. (2019). Vegetarian diet and ortorexia nervosa: a review of the literature. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(1), 1-11. https://doi.org/10.1007/s40519-019-00816-3
10. Brytek-Matera, A., Fonte, M. L., Poggiogalle, E., Donini, L. M. and Cena, H. (2017). Orthorexia nervosa: Relationship with obsessive-compulsive symptoms, disorderd eating patterns and body uneasiness among Italian university students. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(4), 609–617. https://doi.org/10.1007/s40519-017-0427-4
11. Brytek-Matera, A., Donini, L. M., Krupa, M., Poggiogalle, E. and Hay, P. (2015). Orthorexia nervosa and self-attitudinal aspects of body image in female and male university students. Journal of Eating Disorders, 3(1), 1-8. http://dx.doi.org/10.1186/s40337-015-0038-2
12. Brytek-Matera, A., Krupa, M., Poggiogalle, E. and Donini, L. M. (2014). Adaptation of the Ortho-15 test to Polish women and men. Eating and Weight Disorders Studies on Anorexia, Bulimia and Obesity, 19(1), 69-76. http://dx.doi.org/10.1007/s40519-014-0100-0
13. Brytek-Matera, A. (2012). Orthorexia nervosa—an eating disorder, obsessive–compulsive disorder or disturbed eating habit. Archives of Psychiatry and Psychotherapy, 1(1), 55–60.
14. Cena, H., Barthels, F., Cuzzolaro, M., Bratman, S., Brytek-Matera, A., Dunn, T., Varga, M., Missbach, B. and Donini, L. M. (2019). Definition
and diagnostic criteria for orthorexia nervosa: A narrative review of the literature. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(2), 209–246. https://doi.org/10.1007/s40519-018-0606-y
15. Chard, C. A., Hilzendegen, C., Barthels, F. and Stroebele-Benschop, N. (2019). Psychometric evaluation of the English version of the Düsseldorf Orthorexie Scale (DOS) and the prevalence of orthorexia nervosa among a US student sample. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(2), 275–281. https://doi.org/10.1007/s40519-018-0570-6
16. De Souza, Q. J. O. V. and Rodrigues, A. M. (2014). Risk behavior for orthorexia nervosa in nutrition students. Revista Chilena de Nutricion, 63(3), 200-204. http://dx.doi.org/10.1590/0047-2085000000026
17. Dell’Osso, L., Abelli, M., Carpita, B., Massimetti, G., Pini, S., Rivetti, L., Gorrasi, F., Tognetti, R., Ricca, V. and Carmassi, C. (2016). Orthorexia nervosa in a sample of Italian university population. Rivista di Psichiatria, 51(5), 190–196. https://doi:10.1708/2476.25888
18. Dell’Osso, L., Carpita, B., Muti, D., Cremone, I.M., Massimetti, G., Diadema, E., Gesi, C. and Carmassi, C. (2018). Prevalence and characteristics of orthorexia nervosa in a sample of university students in Italy. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 23(1), 55–65. https://doi.org/10.1007/s40519-017-0460-3
19. Depa, J., Barrada, J. R. and Roncero, M. (2019). Are the motives for food choices different in orthorexia nervosa and healthy orthorexia?. Nutrients, 11(3), 1–14. https://doi.org/10.3390/nu11030697
20. Donini, L. M., Marsili, D., Graziani, M.P., Imbriale, M. and Cannella, C. (2005). Orthorexia nervosa: Validation of a diagnosis questionnaire. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 10(2), e28–e32.
21. Donini, L.M., Marsili, D., Graziani, M.P., Imbriale, M. and Cannella, C. (2004). Orthorexia nervosa: A preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eating Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 9(2), 151-7. https://doi.org/10.1007/BF03325060
22. Dunn, T. M. and Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11-7. https://doi.org/10.1016/j.eatbeh.2015.12.006
23. Ergin, G. (2014). Sağlık personeli olan ve olmayan bireylerde ortoreksiya nervoza sıklığı araştırması Yayımlanmamış Yüksek Lisans Tezi. Başkent Üniversitesi.
24. Luck-Sikorski, C., Jung, F., Schlosser, K. and Riedel-Heller, S.G. (2019). Is orthorexic behavior common in the general public? A large representative study in Germany. Eating Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(2), 267-273. https://doi.org/10.1007/s40519-018-0502-5
25. Hayles, O., Wu, M.S., De Nadai, A.S. and Storch, E.A. (2017). Orthorexia nervosa: An examination of the prevalence, correlates, and associated impairment in a university sample. Journal of Cognitive Psychotherapy, 31(2), 124–135. https://doi.org:10.1891/0889-8391.31.2.124
26. Korinth, A., Schiess, S. and Westenhoefer, J. (2010). Eating behaviour and eating disorders in students of nutrition sciences. Public Health Nutrition, 13(1), 32-37. https://doi.org/10.1017/S1368980009005709
27. Koven, N.S. and Abry, A.W. (2015). The clinical basis of orthorexia nervosa: Emerging perspectives. Neuropsychiatric Disease and Treatment, 385-394. https://doi.org/10.2147/NDT.S61665
28. Lucka, I., Domarecki, P., Janikowska-Holowenko, D., Plenikowska-Slusarz, T. and Domarecka, M. (2019). The prevalence and risk factors of orthorexia nervosa among school-age youth of Pomeranian and Warmian-Masurian voivodeships. Psychiatria Polska, 53(2), 383-398. https://doi.org/10.12740/PP/OnlineFirst/90633
29. Mathieu, J. (2005). What is orthorexia?. Journal American Dietetic Association, 105(10), 1510-2. https://doi.org/10.1016/j.jada.2005.08.021
30. Missbach, B. and Barthels, F. (2017). Orthorexia nervosa: moving forward in the field. Eating and Weight Disorders, 22, 1-1. https://doi:10.1007/s40519-017-0365
31. Missbach, B., Dunn, T.M. and König, J.S. (2017). We need new tools to assess orthorexia nervosa. A commentary on prevalence of orthorexia nervosa among college students based on Bratman’s test and associated tendencies. Appetite, v108(1), 521-4. https://doi.org/10.1016/j.appet.2016.07.010
32. Missbach, B., Hinterbuchinger, B., Dreiseitl, V., Zellhofer, S., Kurz, C. and König, J. (2015). When eating right, is measured wrong! A validation and critical examination of the Orto-15 questionnaire in German. PLoS ONE, 10(8), 1-15. https://doi.org/10.1371/journal.pone.0135772
33. Moroze, R. M., Dunn, T. M., Holland, J. C., Yager, J. and Weintraub, P. (2014). Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near-fatal orthorexia nervosa and proposed diagnostic criteria. Psychosomatics, 56(4), 397–403. https://doi:10.1016/j.psym.2014.03.003
34. Niedzielski, A. and Kaźmierczak-Wojtaś, N. (2021). Prevalence of orthorexia nervosa and its diagnostic tools—A literature review. International Journal of Environmental Research and Public Health, 18(10), 5488. https://doi.org/10.3390/ijerph18105488
35. Orsel, S., Canpolat, B.I., Akdemir, A. and Özbay, H. (2004). Comparison of body-image self perception and BMI of dieting adolescents with those of non-dieters. Türk Psikiyatri Dergisi, 15(1), 5-15. PMID: 15095111. Parra-Fernández, M.L., Rodríguez-Cano, T., Onieva-Zafra, M.D., Perez-Haro, M.J, Casero-Alonso, V., Fernández- Martinez, E., et al. (2018). Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry, 18(1), 1-8. https://doi.org/10.1186/s12888-018-1943-0
36. Parra-Fernandez, M.L., Manzaneque-Canadillas, M., Onieva-Zafra, M.D., Fernandez-Martinez, E., Fernandez-Munoz, J.J., Prado-Laguna, M.D.C. and Brytek-Matera, A. (2020). Pathological preoccupation with healthy eating (orthorexia nervosa) in a Spanish sample with vegetarian, vegan, and non-vegetarian dietary patterns. Nutrients, 12(12), 3907. https://doi:10.3390/nu12123907
37. Segura-García, C., Papaianni, M. C., Caglioti, F., Procopio, L., Nistico, C. G., Bombardiere, L. and Capranica, L. (2012). Orthorexia nervosa: A frequent eating disordered behavior in athletes. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 17(4), 226-233. http://dx.doi.org/10.3275/8272
38. Stochel, M., Janas-Kozik, M., Zejda, J., Hyrnik, J., Jelonek, I. and Siwiec, A. (2015). Validation of Orto-15 questionnaire in the group of urban youth aged 15–21. Psychiatria Polska, 49(1), 119–134. https://doi.org/10.12740/PP/25962
39. Strahler, J., Hermann, A., Walter, B. and Stark, R. (2018). Orthorexia nervosa: a behavioral complex or a psychological condition?. Journal of Behavioral Addictions, 7(4), 1143–1156. https://doi.org/10.1556/2006.7.2018.129
40. Strand, E. (2004). An eating disorders?. Psychology Today, 37(5), 1-3.
41. Sünbül, Ş. (2019). Üniversite öğrencilerinin yeme tutumu ve ortoreksiya nervoza eğilimlerinin belirlenmesi Yayımlanmamış Yüksek Lisans Tezi. Selçuk Üniversitesi.
42. Tremelling, K., Sandon, L., Vega, G.L. and McAdams, C.J. (2017). Orthorexia nervosa and eating disorder symptoms in registered dietitian nutritionists in the United States. Journal of the Academy of Nutrition and Dietetics, 117(10), 1612–1617. https://doi.org/10.1016/j.jand.2017.05.001
43. Turner, P.G. and Lefevre, C.E. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(2), 277–284. https://doi:10.1007/s40519-017-0364-2
44. Ural, A. and Kılıç, İ. (2013). Bilimsel araştırma süreci ve SPSS ile veri analizi. Detay Yayıncılık.
45. Ünalan, D., Öztop, D.B., Elmalı, F., Öztürk, A., Konak, D., Pırlak, B. and Güneş, D. (2009). Bir grup sağlık yüksekokulu öğrencisinin yeme tutumları ile sağlıklı yaşam biçimi davranışları arasındaki ilişki. İnönü Üniversitesi Tıp Fakültesi Dergisi, 16(2), 75-81.
46. Vandereycken, W. (2011). Media hype, diagnostic fad or genuine disorder? Professionals’ opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eating Disorders, 19, 145-155.
47. Varga, M., Dukay-Szabó, S., Túry, F. and Van Furth, E.F. (2013). Evidence and gaps in the literature on orthorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 18(2), 103–11. https://doi.org/10.1007/s40519-013-0026-y
48. World Health Organization. (2017). Maternal, Newborn, Child and Adolescent Healthy. http://www.who.int/maternal_child_adolescent/epidemiology/adolescence/en/.
49. Zamora, M. L. C., Bonaechea, B. B., Sanchez, F. G. and Rial, B. R. (2005). Orthorexia nervosa. A new eating behavior disorder?. Actas Esp Psiquiatr, 33(1), 66-68.
50. Zickgraf, H.F., Ellis, J.M. and Essayli, J.H. (2019). Disentangling orthorexia nervosa from healthy eating and other eating disorder symptoms: Relationships with clinical impairment, comorbidity, and self-reported food choices. Appetite,134, 40–49. https://doi.org/10.1016/j.appet.2018.12.006