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Orthorexic tendencies moderate the relationship between semi-vegetarianism and depressive symptoms.
Eat Weight Disord. 2021 Mar; 26(2):623-628.EW

Abstract

PURPOSE

Vegetarianism and semi-vegetarianism (i.e., overly vegetarian diet with rare consumption of meat) have been repeatedly linked with depression. As the nature of this association is unclear, we explored whether orthorexic (i.e., pathologically healthful eating) tendencies and ecological/ethical motives to follow a vegetarian diet may moderate the relationship between (semi-)vegetarian diets and depressive symptoms.

METHODS

Five-hundred eleven adults (63.4% females; 71.2% omnivores, 19.2% semi-vegetarians, 9.6% vegetarians) completed the Patient Health Questionnaire (PHQ-9) questionnaire-measuring depressive symptoms-and the Düsseldorf Orthorexia Scale (DOS)-measuring orthorexic tendencies. Based on respective questions, participants were categorized as omnivores, semi-vegetarians, and vegetarians (including vegans) and were asked to indicate whether they chose their diet based on ecological/ethical motives. Moderation analyses were carried out with PROCESS.

RESULTS

Adjusted for age, sex, and body mass index, there was a statistically significant interaction effect between diet (omnivore vs. semi-vegetarianism vs. vegetarianism) and DOS scores when predicting PHQ depression scores. At low or medium DOS scores, diets did not differ in PHQ depression scores (all ps > 0.05). At high DOS scores, however, semi-vegetarians had higher PHQ depression scores than both omnivores (p = 0.002) and vegetarians (p < 0.001). The interaction between diet and ecological/ethical eating motives when predicting PHQ depression scores was not statistically significant (p = 0.41).

CONCLUSION

Semi-vegetarians with strong orthorexic tendencies show more depressive symptoms than omnivores and vegetarians. The complex nature of the relationship between vegetarianism and depression requires further investigation.

LEVEL OF EVIDENCE

III, case-control analytic studies.

Links

PMC Free PDF

Authors+Show Affiliations

Hessler-Kaufmann JB
Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany. johannes.hessler@med.uni-muenchen.de. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. johannes.hessler@med.uni-muenchen.de.
Meule A
Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Holzapfel C
Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany.
Brandl B
ZIEL-Institute for Food and Health, Technical University of Munich, Freising, Germany.
Greetfeld M
Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.
Skurk T
ZIEL-Institute for Food and Health, Technical University of Munich, Freising, Germany.
Schlegl S
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Hauner H
Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany. Chair of Nutritional Medicine, Else Kröner-Fresenius Center for Nutritional Medicine, Technical University of Munich, Freising, Germany.
Voderholzer U
Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany.

MeSH

AdultDepressionDiet, VegetarianFemaleFood PreferencesHumansMaleVegansVegetarians

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32319025

Citation

Hessler-Kaufmann, Johannes Baltasar, et al. "Orthorexic Tendencies Moderate the Relationship Between Semi-vegetarianism and Depressive Symptoms." Eating and Weight Disorders : EWD, vol. 26, no. 2, 2021, pp. 623-628.
Hessler-Kaufmann JB, Meule A, Holzapfel C, et al. Orthorexic tendencies moderate the relationship between semi-vegetarianism and depressive symptoms. Eat Weight Disord. 2021;26(2):623-628.
Hessler-Kaufmann, J. B., Meule, A., Holzapfel, C., Brandl, B., Greetfeld, M., Skurk, T., Schlegl, S., Hauner, H., & Voderholzer, U. (2021). Orthorexic tendencies moderate the relationship between semi-vegetarianism and depressive symptoms. Eating and Weight Disorders : EWD, 26(2), 623-628. https://doi.org/10.1007/s40519-020-00901-y
Hessler-Kaufmann JB, et al. Orthorexic Tendencies Moderate the Relationship Between Semi-vegetarianism and Depressive Symptoms. Eat Weight Disord. 2021;26(2):623-628. PubMed PMID: 32319025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orthorexic tendencies moderate the relationship between semi-vegetarianism and depressive symptoms. AU - Hessler-Kaufmann,Johannes Baltasar, AU - Meule,Adrian, AU - Holzapfel,Christina, AU - Brandl,Beate, AU - Greetfeld,Martin, AU - Skurk,Thomas, AU - Schlegl,Sandra, AU - Hauner,Hans, AU - Voderholzer,Ulrich, Y1 - 2020/04/21/ PY - 2019/12/11/received PY - 2020/04/07/accepted PY - 2020/4/23/pubmed PY - 2021/6/24/medline PY - 2020/4/23/entrez KW - Depression KW - Diet KW - Moderation KW - Orthorexia nervosa KW - Vegetarianism SP - 623 EP - 628 JF - Eating and weight disorders : EWD JO - Eat Weight Disord VL - 26 IS - 2 N2 - PURPOSE: Vegetarianism and semi-vegetarianism (i.e., overly vegetarian diet with rare consumption of meat) have been repeatedly linked with depression. As the nature of this association is unclear, we explored whether orthorexic (i.e., pathologically healthful eating) tendencies and ecological/ethical motives to follow a vegetarian diet may moderate the relationship between (semi-)vegetarian diets and depressive symptoms. METHODS: Five-hundred eleven adults (63.4% females; 71.2% omnivores, 19.2% semi-vegetarians, 9.6% vegetarians) completed the Patient Health Questionnaire (PHQ-9) questionnaire-measuring depressive symptoms-and the Düsseldorf Orthorexia Scale (DOS)-measuring orthorexic tendencies. Based on respective questions, participants were categorized as omnivores, semi-vegetarians, and vegetarians (including vegans) and were asked to indicate whether they chose their diet based on ecological/ethical motives. Moderation analyses were carried out with PROCESS. RESULTS: Adjusted for age, sex, and body mass index, there was a statistically significant interaction effect between diet (omnivore vs. semi-vegetarianism vs. vegetarianism) and DOS scores when predicting PHQ depression scores. At low or medium DOS scores, diets did not differ in PHQ depression scores (all ps > 0.05). At high DOS scores, however, semi-vegetarians had higher PHQ depression scores than both omnivores (p = 0.002) and vegetarians (p < 0.001). The interaction between diet and ecological/ethical eating motives when predicting PHQ depression scores was not statistically significant (p = 0.41). CONCLUSION: Semi-vegetarians with strong orthorexic tendencies show more depressive symptoms than omnivores and vegetarians. The complex nature of the relationship between vegetarianism and depression requires further investigation. LEVEL OF EVIDENCE: III, case-control analytic studies. SN - 1590-1262 UR - https://www.unboundmedicine.com/medline/citation/32319025/Orthorexic_tendencies_moderate_the_relationship_between_semi_vegetarianism_and_depressive_symptoms_ DB - PRIME DP - Unbound Medicine ER -