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Background: Orthorexia nervosa (ON) is a relatively new potential eating disorder characterized by an intense fixation on one's eating habits and the imposition of rigid and inflexible rules on oneself. Psychological factors such as obsessive–compulsive tendencies, perfectionism and self-esteem may interact in complex ways and contribute to the development and maintenance of ON. Methods: This cross-sectional study included 977 participants from Italy, Lebanon, and Poland. Participants completed a questionnaire consisting of socio-demographic information, the Eating Habits Questionnaire, Obsessive–Compulsive Inventory, Obsessive Beliefs Questionnaire-44, Multidimensional Perfectionism Scale, and Rosenberg Self-Esteem Scale. Cluster analysis was used to identify subgroups of individuals with common psychological characteristics associated with ON. Results: Three distinct clusters were identified based on their levels of obsession-compulsive beliefs, perfectionism, and self-esteem. The first group, labeled "High Self-Mastery," consisted of 37.0% of participants and exhibited low levels of obsession-compulsion, obsessive beliefs, and perfectionism, but high self-esteem. The second group, "Moderate Self-Mastery," comprised 39.5% of participants and had moderate levels of these traits. The third group, "Low Self-Mastery," consisted of 23.6% of participants and exhibited the highest levels of obsession-compulsion, obsessive beliefs, and perfectionism, but the lowest self-esteem. Additionally, a multivariable analysis revealed that being Lebanese (Beta = 3.39) and belonging to the last cluster (Beta = 4.53) were significantly associated with higher ON tendencies. Conclusion: Our findings show that individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies. This study emphasizes the need to have a comprehensive understanding of how cultural and psychological factors interact in the development of eating disorders. Plain English summary: Orthorexia nervosa (ON) is a relatively new eating disorder that involves an intense focus on eating habits and strict rules about food. This study aimed to identify factors that may predict the development of ON. A questionnaire was given to 977 participants from Italy, Lebanon, and Poland to assess their psychological characteristics such as obsessive–compulsive tendencies, perfectionism, and self-esteem. Cluster analysis was performed to identify subgroups of individuals with common psychological characteristics associated with ON. The study found that participants from Lebanon, and individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies and were particularly vulnerable to the disorder. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m 2 . Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow's healthcare workers.

Background: The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood., Method: Multicentre, cross-sectional study involving Italian (N = 216), Polish (N = 206) and Spanish (N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI])., Results: Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students., Conclusions: The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia.