Marle dos Santos Alvarenga

Concurrent and discriminant validity of the Stunkard’s figure rating scale adapted into Portuguese

This study examined the concurrent and discriminant validity of the Figure Rating Scale adapted into Portuguese. The sample was composed of a control group (98 students without eating disorders) and a clinical group (16 women diagnosed with Bulimia Nervosa). Respondents chose schematic figures representing their current and ideal body sizes. The difference between the two choices was calculated to give an ideal discrepancy score. There were high correlations between body mass index and current body size or ideal discrepancy score. The ideal discrepancy scores were greater among the clinical group, indicating that the scale could discriminate between the two groups. The results of this preliminary work indicate that the scale is a valid measure of body image when used in Brazil.

Insatisfação com a imagem corporal em universitárias brasileiras

Body image dissatisfaction is evaluated according to the difference between the real figure and idealized figure, and could influence eating behaviors. OBJECTIVE: To evaluate body dissatisfaction among female university students from the five regions of Brazil and possible associations and correlations with age, nutritional status, individual income and parental education. METHODS: 2,402 students answered the Stunkards Body Image Scale and regions were compared by variance analysis, and correlations among variables with Pearsons and Spearmans coefficients. RESULTS: 64.4% desired a figure smaller than their actual one, and even the normal weight range students chose ideal and healthy smaller figures. In North region the ideal and healthy patterns were smaller and in the Central West bigger. CONCLUSION: Occurrence of body dissatisfaction was common among Brazilian university students and some regional and socio demographic differences must be considered.

Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15.

BACKGROUND: Orthorexia nervosa (ON) is described as an obsessive pathological behavior characterized by a strong preoccupation with healthy eating and the avoidance of foods or ingredients considered unhealthy by the subject. Although it is still not officially recognized as an eating disorder, previous studies have discussed its frequency in some groups and a fifteen-question test (ORTO-15) was developed elsewhere to assess ON behavior. OBJECTIVE: The present study aimed to evaluate ON behavior in a sample of Brazilian dietitians after testing the psychometric properties of the Portuguese version of ORTO-15. METHODS: A total of 392 dietitians answered an online version of the test. The answers were analyzed regarding ON tendency, according with the scoring grid proposed by its authors. Exploratory factor analysis was performed and internal consistency was assessed. RESULTS: It was found that three questions of the test presented loadings lower than 0.5. The 12 remaining question formed 3 factors with internal consistency of -0.51, 0.63 and 0.47. The answers of the participants to these questions revealed a tendency to orthorexic behavior, mainly regarding aspects such as: making food choices conditioned by worry about health status, evaluating food rather from nutritional quality than from its taste, believing that consuming healthy food may improve appearance, discrediting the influence of mood on eating behavior and banning food choices considered by them as eating transgressions. CONCLUSION: There is no evidence of the validity and reliability of the ORTO-15 with the initial psychometric evaluation performed. Further analyses are needed. Nevertheless, it was possible to observe a high frequency of orthorexic behavior among the studied Brazilian dietitians. However, additional studies are needed to completely understand dietitians behavior toward ON.

Comportamento de risco para transtorno alimentar em universitárias brasileiras

CONTEXTO: Comportamentos de risco para transtornos alimentares envolvem atitudes e praticas inadequadas para com o alimento e o peso e podem ser avaliados com base em instrumentos validados. OBJETIVOS: Avaliar comportamento de risco para transtornos alimentares em universitarias brasileiras das cinco regioes do pais. METODOS: 2.483 universitarias responderam ao Teste de Atitudes Alimentares (EAT-26) nas cinco regioes. A pontuacao no teste foi comparada entre as regioes por meio do teste qui-quadrado. Possiveis associacoes ou correlacoes com curso de graduacao, idade, estado nutricional, renda individual e escolaridade do chefe da familia foram avaliadas pelos coeficientes de Pearson e Spearman. Uma analise de covariância comparou o escore do EAT entre as regioes. RESULTADOS: A frequencia de comportamento de risco para transtornos alimentares variou de 23,7% a 30,1% nas cinco regioes e nao houve diferenca na pontuacao media do EAT e na proporcao de escores positivos para comportamento de risco entre as regioes. Nao houve forte correlacao do escore do EAT com nenhuma das variaveis. CONCLUSAO: Universitarias brasileiras apresentam alta frequencia de comportamentos de risco para TA em todas as regioes do pais. Medidas de prevencao devem ser planejadas para a populacao jovem feminina do Brasil.

Tradução, adaptação e avaliação psicométrica da Escala de Conhecimento Nutricional do National Health Interview Survey Cancer Epidemiology

OBJECTIVE: The study aimed to translate and adapt into Portuguese the nutrition knowledge scale applied in the National Health Interview Survey Cancer Epidemiology and to evaluate its validity and precision. METHODS: The scale was translated, back-translated, and then adapted. Typical foods from the American diet were replaced by other foods that are typical of the Brazilian diet. The questionnaire was administered to 39 women with eating disorders and 57 Dietetics students. The students were expected to have higher scores, which would attest the discriminating validity of the scale. The students were tested twice and a correlation coefficient between test and retest was obtained. RESULTS: The students scored 10.5 points with a standard deviation of 1.7 points while the patients scored 7.4 points with a standard deviation of 2.6 points (p=0.0000001). Only 1.75% of the students presented low knowledge versus 34.21% of the patients (p<0.005). High knowledge was found among 57.90% of the students and among 13.16% of the patients (p<0.005). Spearmans correlation coefficient was 0.52 (p=0.00009). CONCLUSION: The test fulfilled all the psychometric criteria for validation but its precision needs to be reassessed. The time interval between the first and second test should be smaller. Since the students are still learning, it would be interesting to apply the scale to dietitians given that their knowledge is more stable.

Development and Validity of the Disordered Eating Attitude Scale (Deas)

The aim of this study was to develop and validate the Disordered Eating Attitude Scale to measure disordered eating attitudes, defined as abnormal beliefs, thoughts, feelings, behaviors, and relationship regarding food. Exploratory factor analysis was performed and internal consistency assessed in a sample of female university students (N = 196). Convergent validity was acceptable based on statistically significant correlations with the Eating Attitude Test–26 and Restraint Scale. Known-groups validity was determined by comparing the student samples mean scores against scores of an eating disorder group (N = 51). The Disordered Eating Attitude Scale comprises 25 questions and five subscales explaining 54.3% of total variance. The total scores differentiated student, bulimia, and anorexia groups. The scale should prove useful for evaluating eating attitudes in various population groups and eating disordered patients.

Psychometric Testing and Applications of the Body Attitudes Questionnaire Translated into Portuguese

Although many body attitudes scales have been developed, none have been translated into Portuguese. This study aimed to translate the Ben-Tovim and Walker Body Attitudes Questionnaire and assess validity and reliability for a Brazilian sample. Women with (n = 39) and without (n = 57) eating disorders completed the scale, to assess discriminant validity. Convergent validity was assessed by the correlations between the scores and a measure of body dissatisfaction. The questionnaire was applied twice to controls after 1 mo. to evaluate reliability. Eating-disordered women had significantly higher mean scores on Feeling Fat, Disparagement, Salience and Lower Body Fatness, and lower scores on Attractiveness. No mean difference on Strength and Fitness was found. Most subscales were significantly correlated with the body-dissatisfaction measure. Test-retest coefficients ranged from .57 to .85. The translated version of the Body Attitudes Questionnaire seems to be a valid and reliable measure of body attitudes.

Tradução da escala de desejo de aceitação social de Marlowe & Crowne para a língua portuguesa

O desejo de aceitacao social (social desirability) pode enviesar os parâmetros medidos por auto-relato. Os objetivos do trabalho foram: a) traduzir para a lingua portuguesa a Marlowe-Crowne Social Desirability Scale, que quantifica o desejo de aceitacao social e; b) analisar sua precisao. A versao da escala foi obtida por meio de traducao e retrotraducao. Foi feito o teste-reteste, no qual o instrumento foi aplicado duas vezes, com intervalo de um mes, em estudantes de Nutricao (n = 57). O teste pareado de Wilcoxon verificou se havia diferenca entre as duas aplicacoes. O coeficiente de correlacao de Spearman entre as duas aplicacoes foi calculado. Foi obtida pontuacao de 13, 6 ± 4,4 (mediana 13) na primeira aplicacao e de 13,4 ± 5,3 (mediana 13) na segunda aplicacao. Nao houve diferenca significativa entre as medias das duas aplicacoes (z = 1,66; p = 0,10) e a correlacao entre elas foi de 0,82 (p = 0,0000001). A pontuacao foi semelhante a de estudantes de paises desenvolvidos, sugerindo que a traducao nao alterou o sentido original da escala. A precisao foi alta e compativel com a obtida na versao original. Estes resultados indicam que a versao final da escala e adequada e precisa.

Psychometric evaluation of the Disordered Eating Attitude Scale (DEAS). English version

UNLABELLED Eating attitudes are defined as beliefs, thoughts, feelings, behaviors and relationship with food. They could influence peoples food choices and their health status. OBJECTIVE This study aimed to adapt from Portuguese to English the Disordered Eating Attitude Scale (DEAS) and evaluate its validity and reliability. The original scale in Portuguese was translated and adapted into English and was applied to female university students of University of Minnesota-USA (n=224). Internal consistency was determined (Cronbachs Alpha). Convergent validity was assessed by correlations between Eating Attitude Test-26 (EAT-26) and Restrain Scale (RS). Reliability was evaluated applying twice the scale to a sub-sample (n=30). The scale was back translated into Portuguese and compared with the original version and discrepancies were not found. The internal consistency was .76. The DEAS total score was significantly associated with EAT-26 (r=0.65) and RS (r=0.69) scores. The correlation between test-retest was r=0.9. The English version of DEAS showed appropriate internal consistency, convergent validity and test-retest reliability and will be useful to assess eating attitudes in different population groups in English spoken countries.

Terapia nutricional na anorexia e bulimia nervosas

Food and diet have an important role in the development and maintenance of eating disorders. Thus, they should be properly addressed in the treatment program for such disorders. Patients with eating disorders present dietary restrictions, unhealthy eating patterns, modified nutritional patterns, and unhealthy eating behaviors due to false myths and beliefs, and to a feeling of incompetence in dealing with food. Dietary restrictions, as well as the unhealthy eating patterns carried out by these patients may lead to changes in the nutritional status that require specific dietetic care in order to be corrected. Nutrition rehabilitation is required to restore the dietetic pattern, teaching the meaning of a normal and balanced diet. Furthermore, this unhealthy eating behavior requires nutritional counseling, aiming at clarifying doubts and demystifying wrong beliefs, discussing and readjusting patients´ relationship with food.