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Orthorexia nervosa: examining the Eating Habits Questionnaire's reliability and validity, and its links to dietary adequacy among adult women.
Public Health Nutr. 2020 07; 23(10):1684-1692.PH

Abstract

OBJECTIVE

There has been increasing interest in identifying individuals with pathological healthy eating behaviours, or orthorexia nervosa (ON). This study aimed to investigate the validity (construct- and criterion-related) and reliability (internal consistency) of the Eating Habits Questionnaire (EHQ) as a measure of ON. A secondary aim was to examine how the EHQ would predict a distinct feature of ON, adequate dietary intake.

DESIGN

Cross-sectional online questionnaire incorporating existing measures of ON and dietary intake.

SETTING

Participants were recruited online via social media and a university's research webpage.

PARTICIPANTS

Women (n 286) ranging in age from 17 to 73 years.

RESULTS

Exploratory factor analysis established that the EHQ represented four ON dimensions (Healthy Eating Cognitions, Dietary Restriction, Diet Superiority and Social Impairment), inconsistent with the scale's original three dimensions (Problems, Knowledge and Feelings). Cronbach's α coefficients ranged from 0·72 to 0·80 for the four subscales and was 0·89 for the total EHQ scale. Criterion-related validity revealed a significant moderate to strong correlation (r = -0·54, P < 0·001) between the EHQ and ORTO-10 (a ten-item version of ORTO-15). The EHQ, particularly the EHQ-Diet superiority subscale, was found to be predictive of better, as opposed to, poorer dietary adequacy.

CONCLUSIONS

Findings suggest that improvements still need to be made to the EHQ for it to be a valid and reliable measure of ON. Ideally, new assessment tools based on established diagnostic criteria are needed to advance our understanding of ON.

Authors+Show Affiliations

Nutrition and Dietetics, College of Nursing and Health Science, Flinders University, South Australia, Australia.Nutrition and Dietetics, College of Nursing and Health Science, Flinders University, South Australia, Australia.Psychology, College of Education, Psychology & Social Work, Flinders University, South Australia, Australia.Health and Exercise Sciences, College of Nursing and Health Science, Flinders University, South Australia, Australia. SHAPE Research Centre, Caring Futures Institute, Flinders University, South Australia, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

32204747

Citation

Mohamed Halim, Zakiah, et al. "Orthorexia Nervosa: Examining the Eating Habits Questionnaire's Reliability and Validity, and Its Links to Dietary Adequacy Among Adult Women." Public Health Nutrition, vol. 23, no. 10, 2020, pp. 1684-1692.
Mohamed Halim Z, Dickinson KM, Kemps E, et al. Orthorexia nervosa: examining the Eating Habits Questionnaire's reliability and validity, and its links to dietary adequacy among adult women. Public Health Nutr. 2020;23(10):1684-1692.
Mohamed Halim, Z., Dickinson, K. M., Kemps, E., & Prichard, I. (2020). Orthorexia nervosa: examining the Eating Habits Questionnaire's reliability and validity, and its links to dietary adequacy among adult women. Public Health Nutrition, 23(10), 1684-1692. https://doi.org/10.1017/S1368980019004282
Mohamed Halim Z, et al. Orthorexia Nervosa: Examining the Eating Habits Questionnaire's Reliability and Validity, and Its Links to Dietary Adequacy Among Adult Women. Public Health Nutr. 2020;23(10):1684-1692. PubMed PMID: 32204747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orthorexia nervosa: examining the Eating Habits Questionnaire's reliability and validity, and its links to dietary adequacy among adult women. AU - Mohamed Halim,Zakiah, AU - Dickinson,Kacie M, AU - Kemps,Eva, AU - Prichard,Ivanka, Y1 - 2020/03/24/ PY - 2020/3/25/pubmed PY - 2021/6/5/medline PY - 2020/3/25/entrez KW - Diet KW - Eating Habits Questionnaire KW - Eating behaviour KW - ORTO-15 KW - Orthorexia nervosa SP - 1684 EP - 1692 JF - Public health nutrition JO - Public Health Nutr VL - 23 IS - 10 N2 - OBJECTIVE: There has been increasing interest in identifying individuals with pathological healthy eating behaviours, or orthorexia nervosa (ON). This study aimed to investigate the validity (construct- and criterion-related) and reliability (internal consistency) of the Eating Habits Questionnaire (EHQ) as a measure of ON. A secondary aim was to examine how the EHQ would predict a distinct feature of ON, adequate dietary intake. DESIGN: Cross-sectional online questionnaire incorporating existing measures of ON and dietary intake. SETTING: Participants were recruited online via social media and a university's research webpage. PARTICIPANTS: Women (n 286) ranging in age from 17 to 73 years. RESULTS: Exploratory factor analysis established that the EHQ represented four ON dimensions (Healthy Eating Cognitions, Dietary Restriction, Diet Superiority and Social Impairment), inconsistent with the scale's original three dimensions (Problems, Knowledge and Feelings). Cronbach's α coefficients ranged from 0·72 to 0·80 for the four subscales and was 0·89 for the total EHQ scale. Criterion-related validity revealed a significant moderate to strong correlation (r = -0·54, P < 0·001) between the EHQ and ORTO-10 (a ten-item version of ORTO-15). The EHQ, particularly the EHQ-Diet superiority subscale, was found to be predictive of better, as opposed to, poorer dietary adequacy. CONCLUSIONS: Findings suggest that improvements still need to be made to the EHQ for it to be a valid and reliable measure of ON. Ideally, new assessment tools based on established diagnostic criteria are needed to advance our understanding of ON. SN - 1475-2727 UR - https://www.unboundmedicine.com/medline/citation/32204747/Orthorexia_nervosa:_examining_the_Eating_Habits_Questionnaire's_reliability_and_validity_and_its_links_to_dietary_adequacy_among_adult_women_ L2 - https://www.cambridge.org/core/product/identifier/S1368980019004282/type/journal_article DB - PRIME DP - Unbound Medicine ER -