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Disordered eating behaviors and energy and nutrient intake in a regional sample of Brazilian adolescents from public schools

  • Lorena Gasparini Caran
  • Danilo Dias Santana
  • Luana Silva Monteiro
  • Gloria Valeria da Veiga
Original Article

Abstract

Purpose

To estimate the prevalence of disordered eating behaviors and the association with energy and nutrient intake and nutritional status in adolescents.

Methods

A school-based cross-sectional study was performed involving a probabilistic sample of 487 teenagers (aged 15–19 years) from public schools in the Metropolitan area of Rio de Janeiro, Brazil. The Eating Attitude Test and the Bulimic Investigatory Test Edinburgh questionnaires were applied to identify abnormal eating patterns and unusual dietary patterns, respectively. Nutritional status was defined by sex- and age-specific body mass index cutoffs. Energy and nutrient intake were assessed by a 3-day food record. The association between variables was assessed by the prevalence ratio and 95% confidence intervals, Pearson’s Chi-square test, and linear regression.

Results

The prevalence of abnormal eating patterns was 7.4% and that of unusual dietary patterns was 18.9%. Vitamin C intake was higher among girls with abnormal dietary patterns, with a consequent lower frequency of vitamin C deficiency when compared to those with normal dietary patterns. Calcium intake was lower in boys with unusual dietary pattern than in those without this behavior. Excess weight was associated with the presence of unusual dietary pattern in girls (PR: 2.4, 95% CI 1.6–3.5).

Conclusions

The prevalence of disordered eating behaviors was high, mainly in those who were overweight. It was associated with lower calcium intake in boys and with higher Vitamin C intake in girls.

Level of evidence

Level V, descriptive studies.

Keywords

Disordered eating behaviors Energy intake Nutrients Anthropometry Adolescents 

Notes

Funding

This study was funded by Foundation for Research Support of the State of Rio de Janeiro (grant number E-26/171.404/2002) and by the National Counsel of Technological and Scientific Development (grant number 305464/2008-6).

Compliance with ethical standards

Conflict of interest

Lorena Caran declares that she has no conflict of interest. Danilo Santana declares that he has no conflict of interest. Luana Monteiro declares that she has no conflict of interest. Gloria Veiga declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Combs JL, Pearson CM, Zapolski TC, Smith GT (2013) Preadolescent disordered eating predicts subsequent eating dysfunction. J Pediatr Psychol 38:41–49.  https://doi.org/10.1093/jpepsy/jss094 CrossRefPubMedGoogle Scholar
  2. 2.
    American Psychiatric Association (APA) (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric, ArlingtonCrossRefGoogle Scholar
  3. 3.
    Chesney E, Goodwin GM, Fazel S (2014) Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 13:153–160.  https://doi.org/10.1002/wps.20128 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Santana DD, Barros EG, Salles-Costa R, Veiga GV (2017) Temporal changes in the prevalence of disordered eating behaviors among adolescents living in the metropolitan area of Rio de Janeiro, Brazil. Psychiatry Res 253:64–70.  https://doi.org/10.1016/j.psychres.2017.03.042 CrossRefPubMedGoogle Scholar
  5. 5.
    Bartholdy S, Allen K, Hodsoll J et al (2017) Identifying disordered eating behaviours in adolescents: how do parent and adolescent reports differ by sex and age? Eur Child Adolesc Psychiatry 26:691–701.  https://doi.org/10.1007/s00787-016-0935-1 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Estecha Querol S, Fernández Alvira JM, Mesana Graffe MI et al (2016) Nutrient intake in Spanish adolescents SCOFF high-scorers: the AVENA study. Eat Weight Disord 21:589–596.  https://doi.org/10.1007/s40519-016-0282-8 CrossRefPubMedGoogle Scholar
  7. 7.
    Aparicio-Llopis E, Canals J, Pérez S, Arija V (2015) Dietary intake and nutritional risk in Mediterranean adolescents in relation to the severity of the eating disorder. Public Health Nutr 18:1461–1473.  https://doi.org/10.1017/S1368980014002043 CrossRefGoogle Scholar
  8. 8.
    Ruschel LF, Henn RL, Backes V et al (2016) Insegurança alimentar e consumo alimentar inadequado em escolares da rede municipal de São Leopoldo, RS, Brasil. Cien Saude Colet 21:2275–2286.  https://doi.org/10.1590/1413-81232015217.00742015 CrossRefPubMedGoogle Scholar
  9. 9.
    Fortes LS, Cipriani FM, Ferreira ME (2013) Risk behaviors for eating disorder: factors associated in adolescent students. Trends Psychiatry Psychother 35:279–286.  https://doi.org/10.1590/2237-6089-2012-0055 CrossRefGoogle Scholar
  10. 10.
    Costa LCF, Vasconcelos FAG, Peres KG (2010) Influence of biological, social and psychological factors on abnormal eating attitudes among female university students in Brazil. J Health Popul Nutr 28:173–181PubMedGoogle Scholar
  11. 11.
    Ferreira JES, Veiga GV (2008) Eating disorder risk behavior in Brazilian adolescents from low socioeconomic level. Appetite 51:249–255.  https://doi.org/10.1016/j.appet.2008.02.015 CrossRefGoogle Scholar
  12. 12.
    Bagni UV, Luiz RR, Veiga GV (2013) Overweight is associated with low hemoglobin levels in adolescent girls. Obes Res Clin Pract 7:218–229.  https://doi.org/10.1016/j.orcp.2011.12.004 CrossRefGoogle Scholar
  13. 13.
    Moreira NF, Sichieri R, Reichenheim ME et al (2015) The associations of BMI trajectory and excessive weight gain with demographic and socio-economic factors: the Adolescent Nutritional Assessment Longitudinal Study cohort. Br J Nutr 114:2032–2038.  https://doi.org/10.1017/S0007114515003712 CrossRefPubMedGoogle Scholar
  14. 14.
    Sune FR, Dias-da-Costa JS, Olinto MT et al (2007) Prevalence of overweight and obesity and associated factors among school children in a southern Brazilian city. Cad Saude Publica 23:1361–1371.  https://doi.org/10.1590/S0102-311X2007000600011 CrossRefPubMedGoogle Scholar
  15. 15.
    Nunes MA (2003) Avaliação do impacto de comportamentos alimentares anormais em uma coorte de mulheres jovens no sul do Brasil. Tese (Doutorado em Psiquiatria e Psicologia Médica), Universidade Federal de São Paulo, São PauloGoogle Scholar
  16. 16.
    Lwanga SK, Lemeshow S (1991) Sample Size determination in health studies: a practical manual. World Health Organization, GenevaGoogle Scholar
  17. 17.
    Gordon CC, Chumlea WC, Roche AF (1988) Stature, recumbent length and weight. In: Lohman TG, Roche AF, Martorell R (eds). Human Kinetics Books, Champaign, pp 3–8Google Scholar
  18. 18.
    Callaway CW, Chumlea WC, Bouchard C et al (1988) Circumferences. In: Lohman TG, Roche AF, Martorell R (eds) Human Kinetics Books, Champaign, pp 39–54Google Scholar
  19. 19.
    Onis M, Onyango AW, Borghi E et al (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85:660–667CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Wu YT, Nielsen DH, Cassady SL et al (1993) Cross-validation of bioelectrical impedance analysis of body composition in children and adolescents. Phys Ther 73:320–327CrossRefPubMedGoogle Scholar
  21. 21.
    Universidade Federal de São Paulo (UNIFESP) (2005) Programa de Apoio a Nutrição (NUTWIN)—programa de computador, versão 1.5.2.51. Escola Paulista de Medicina, São PauloGoogle Scholar
  22. 22.
    Philippi ST (2001) Tabela de composição química de alimentos: suporte para decisão nutricional. Anvisa, BrasíliaGoogle Scholar
  23. 23.
    Universidade Estadual de Campinas (UNICAMP) (2006) Tabela Brasileira de Composição de Alimentos (TACO)—Versão 2. Campinas, São PauloGoogle Scholar
  24. 24.
    Instituto Brasileiro de Geografia e Estatística (IBGE) (2011) Pesquisa de orçamentos familiares (POF) 2008–2009: Tabelas de composição nutricional dos alimentos consumidos no Brasil. IBGE, Rio de JaneiroGoogle Scholar
  25. 25.
    Nusser SM, Fuller WA, Guenther PM (1997) Estimating usual dietary intake distributions: adjusting for measurement error and nonnormality in 24-hour food intake data. In: Lyberg L et al (eds) Wiley, Oxford, pp 689–709Google Scholar
  26. 26.
    Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65:1220–1228CrossRefGoogle Scholar
  27. 27.
    Institute of Medicine (IOM) (2000) Dietary reference intakes: applications in dietary assessment. National Academy, WashingtonGoogle Scholar
  28. 28.
    Institute of Medicine (IOM) (2001) Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academy, WashingtonGoogle Scholar
  29. 29.
    Institute of Medicine (IOM) (2011) Dietary reference intakes for calcium and vitamin D. National Academy, WashingtonGoogle Scholar
  30. 30.
    Slater B, Marchioni DL, Fisberg RM (2004) Estimando a prevalência da ingestão inadequada de nutrientes. Rev Saúde Públ 38:599–605.  https://doi.org/10.1590/S0034-89102004000400019 CrossRefGoogle Scholar
  31. 31.
    Garner DM, Olmsted MP, Boher Y, Garfinkel PE (1982) The Eating Attitudes Test: psychometric features and clinical correlates. Psychol Med 12:871–878CrossRefPubMedGoogle Scholar
  32. 32.
    Nunes MA, Bagatini LF, Abuchaim AL et al (1994) Distúrbios da conduta alimentar: considerações sobre o Teste de Atitudes Alimentares (EAT). Rev ABPAPAL 16:7–10Google Scholar
  33. 33.
    Henderson M, Freeman CPL (1987) A self-rating scale for bulimia: the BITE. Br J Psychiatry 150:18–24CrossRefPubMedGoogle Scholar
  34. 34.
    Cordás TA, Hochgraf PB (1993) O Bite. Instrumento para avaliação da Bulimia nervosa: Versão para o português. J Bras Psiquiatr 42:141–144Google Scholar
  35. 35.
    Ximenes R, Colares V, Bertulino T et al (2011) Versão brasileira do “BITE” para uso em adolescentes. Arq Bras Psicol 63:1–110Google Scholar
  36. 36.
    Miotto P, De Coppi M, Frezza M, Preti A (2003) The spectrum of eating disorders: prevalence in an area of Northeast Italy. Psychiatry Res 119:145–154CrossRefPubMedGoogle Scholar
  37. 37.
    Ferreira JES, Souza PR, Costa RS et al (2013) Disordered eating behaviors in adolescents and adults living in the same household in metropolitan area of Rio de Janeiro, Brazil. Psychiatry Res 210:612–617.  https://doi.org/10.1016/j.psychres.2013.06.021 CrossRefPubMedGoogle Scholar
  38. 38.
    Dunker KLL, Philippi ST (2003) Hábitos e comportamentos alimentares de adolescentes com sintomas de anorexia nervosa. Rev Nutr 16:51–60.  https://doi.org/10.1590/S1415-52732003000100006 CrossRefGoogle Scholar
  39. 39.
    Tsai MR, Chang YJ, Lien PJ, Wong Y (2011) Survey on eating disorders related thoughts, behaviors and dietary intake in female junior high school students in Taiwan. Asia Pac J Clin Nutr 20:196–205PubMedGoogle Scholar
  40. 40.
    Veiga GV, Costa RS, Araújo MC et al (2013) Inadequate nutriente intake in Brazilian adolescents. Rev Saude Publica 47:212–221.  https://doi.org/10.1590/S0034-89102013000700007 CrossRefGoogle Scholar
  41. 41.
    Louie JCY, Flood VM, Hector DJ et al (2011) Dairy consumption and overweight and obesity: a systematic review of prospective cohort studies. Obes Rev 12:582–592.  https://doi.org/10.1111/j.1467-789X.2011.00881.x CrossRefGoogle Scholar
  42. 42.
    Milos G, Kuenzli C, Soelch CM et al (2013) How much should I eat? Estimation of meal portions in anorexia nervosa. Appetite 63:42–47.  https://doi.org/10.1016/j.appet.2012.12.016 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lorena Gasparini Caran
    • 1
  • Danilo Dias Santana
    • 1
  • Luana Silva Monteiro
    • 2
  • Gloria Valeria da Veiga
    • 1
  1. 1.Department of NutritionFederal University of Rio de JaneiroRio de JaneiroBrazil
  2. 2.Nutrition CourseFederal University of Rio de Janeiro (Campus UFRJ-Macaé)MacaéBrazil

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