AppetitePub Date : 2025-07-19DOI: 10.1016/j.appet.2025.108226
Katie A. Loth , Melanie Wall , Zhijun Zhang , Nicole Larson , Vivienne M. Hazzard , Mikayla R. Barry , Dianne Neumark-Sztainer
{"title":"Food insecurity and disordered eating: Associations among adults with and without children","authors":"Katie A. Loth , Melanie Wall , Zhijun Zhang , Nicole Larson , Vivienne M. Hazzard , Mikayla R. Barry , Dianne Neumark-Sztainer","doi":"10.1016/j.appet.2025.108226","DOIUrl":"10.1016/j.appet.2025.108226","url":null,"abstract":"<div><div>Food insecurity affects over 10 % of U.S. households, with higher rates among families with children. Emerging evidence suggests that food insecurity may contribute to disordered eating behaviors. This study explored the prevalence of food insecurity and its associations with restrictive, compensatory and binge-eating behaviors among parents and adults without children (non-parents) using data from two interrelated population-based cohorts (N = 3216) recruited from public schools in the Minneapolis-St. Paul area as part of the Project EAT studies. Adjusting for adult age, food insecurity was more prevalent among parents (23 %) than non-parents (14 %). Food insecurity was associated with more disordered eating, including restrictive behaviors and binge eating in both parents and non-parents, self-induced vomiting and smoking in parents, and laxative misuse in non-parents. Strengths of associations did not differ by parental status except for fasting to control weight, which was more strongly associated with food insecurity among parents. The elevated rates of food insecurity among parents and its association with disordered eating point to a dual risk for health consequences. These behaviors may perpetuate an intergenerational cycle of disordered eating, as children often model caregivers' habits. The findings highlight the need for targeted interventions addressing both food insecurity and disordered eating, especially among parents, to mitigate adverse outcomes and break the cycle of unhealthy eating patterns across generations. Understanding these dynamics is crucial for developing effective strategies that support vulnerable populations, improve health outcomes, and foster healthier eating behaviors within families.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108226"},"PeriodicalIF":3.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-19DOI: 10.1016/j.appet.2025.108241
Letícia Andrade , Katherine N. Balantekin , Jennifer L. Temple
{"title":"Adolescent disordered eating: Associations among food insecurity, stress, and emotional eating patterns","authors":"Letícia Andrade , Katherine N. Balantekin , Jennifer L. Temple","doi":"10.1016/j.appet.2025.108241","DOIUrl":"10.1016/j.appet.2025.108241","url":null,"abstract":"<div><div>Disordered eating is linked to various environmental and psychological factors, including food insecurity, stress, and emotional eating. This study investigates the associations among disordered eating, food insecurity, perceived stress, and emotional eating in adolescents, specifically focusing on parent-reported and adolescent-perceived food insecurity differences. The purpose of this study is to investigate the relationship between food insecurity, perceived stress, and emotional eating, and their impact on disordered eating. The study also examines potential interactions between stress, food insecurity, and emotional eating. 118 adolescents (11–14 years old) from low to moderate-income households participated in the University at Buffalo Eating Among Teens Study (UB-EATS), a 2-year prospective observational cohort study. Food insecurity status was analyzed through adolescent and parent/guardian survey responses. Disordered eating was measured by the Eating Disorder Examination Questionnaire (EDE-Q). Perceived stress was measured using the Perceived Stress Scale (PSS), and emotional eating was assessed using the Emotional Eating Scale (EES-C). General linear models (GLM) and linear regression analyses were conducted to evaluate the relationships among emotional eating, disordered eating, perceived stress, and food insecurity with variables such as BMI percentile, age, and sex, included as covariates. Adolescent-reported food insecurity, but not parent-reported food insecurity, was significantly associated with perceived stress, emotional eating, and disordered eating. Emotional eating was strongly associated with disordered eating, with stress moderating this relationship. These findings underscore the importance of addressing adolescent-perceived food insecurity and stress in interventions targeting disordered eating.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108241"},"PeriodicalIF":4.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-18DOI: 10.1016/j.appet.2025.108235
Urvashi Dixit , Wesley R. Barnhart , Erica M. Ahlich , Rachel R. Henderson , Anna A. Love , Jinbo He , Hana F. Zickgraf
{"title":"Characterizing emotional eating by valence, over-vs under-eating, and contextual factors: A latent profile analysis","authors":"Urvashi Dixit , Wesley R. Barnhart , Erica M. Ahlich , Rachel R. Henderson , Anna A. Love , Jinbo He , Hana F. Zickgraf","doi":"10.1016/j.appet.2025.108235","DOIUrl":"10.1016/j.appet.2025.108235","url":null,"abstract":"<div><div>Few measures of emotional eating (EE) assess nuances within both emotional valence (e.g., positive, negative) and eating behaviors (e.g., undereating, overeating). Additionally, the present study sought to address this gap by using latent profile analyses to better characterize subgroups of positive and negative emotional eaters. An unselected sample of adults (<em>N</em> = 389; <em>M</em><sub>age</sub> = 37.42; <em>SD</em> = 12.84) were recruited online through Prolific Academic. Participants completed self-report measures of emotional eating, distress intolerance, psychological flexibility, disordered eating, loss of control, emotional dysregulation, psychosocial impairment, and emotional eating contextual factors. Latent profile analysis yielded a four-profile solution: 1) <em>Low emotional eating</em> (7 %), <em>Negative overeating and positive undereating</em> (16 %), <em>Negative undereating and positive overeating</em> (41 %), and <em>Moderate emotional eating</em> (36 %). Regression analysis demonstrated that body mass index (BMI) and gender significantly predicted profile membership, while Chi-Square revealed significant differences in levels of disordered eating, psychosocial impairment, and contextual factors (e.g., emotional intensity and physical-environmental cues) across EE profiles. Findings highlight the importance of utilizing emotional eating profiles in eating disorder risk assessment and development of interventions.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108235"},"PeriodicalIF":4.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-16DOI: 10.1016/j.appet.2025.108236
Nithya Serasinghe , Henna Vepsäläinen , Reetta Lehto , Josefine Björkqvist , Maijaliisa Erkkola , Eva Roos , Carola Ray
{"title":"Parental self-efficacy, parental restrictions and young children's food consumption: does socio-economic status play a role?","authors":"Nithya Serasinghe , Henna Vepsäläinen , Reetta Lehto , Josefine Björkqvist , Maijaliisa Erkkola , Eva Roos , Carola Ray","doi":"10.1016/j.appet.2025.108236","DOIUrl":"10.1016/j.appet.2025.108236","url":null,"abstract":"<div><div>Compared with ample evidence on the influence of the home food environment on children's food consumption, associations between certain aspects of the social home food environment (such as parental self-efficacy (PSE) and parental restrictions) and young children's food consumption are less studied. Our aims were 1) to investigate the associations among feeding-related PSE, sugary food and drink (SFD)-related parental restrictions, and children's food consumption, and 2) to determine whether socio-economic factors (parental education level and household relative income) moderate them. We used cross-sectional data from 564 Finnish 3- to 6-year-olds participating in the DAGIS study. Parents completed a questionnaire assessing the home food environment and socio-economic status and a food frequency questionnaire assessing children's food consumption. Principal component analysis was used to identify SFD-related parental restriction patterns. We calculated a children's Healthy Food Intake Index (HFII) using food frequency data. We regressed the associations among feeding-related PSE and SFD-related parental restriction patterns in single and multiple regression models. Moderation by parental education level and household relative income was also tested. We identified three SFD-related parenting practice patterns: restricting SFD consumption, restricting SFD accessibility, and restricting SFD availability. Feeding-related PSE (B = 0.88, <em>p</em> < 0.001) and restricting SFD availability (B = 0.46, <em>p</em> < 0.001) were significantly associated with the children's HFII after adjusting the model for socio-economic factors. Parental education level or household relative income did not moderate any of these associations. Future health promotion interventions should target enhancing feeding-related PSE and restricting SFD availability to improve children's food consumption despite socio-economic status.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"214 ","pages":"Article 108236"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-16DOI: 10.1016/j.appet.2025.108229
Lena Szczepanski , Stella Lorena Leugner, Florian Fiebelkorn
{"title":"The consumption of milk and milk alternatives among young people in Germany: a comparative analysis of consumer groups","authors":"Lena Szczepanski , Stella Lorena Leugner, Florian Fiebelkorn","doi":"10.1016/j.appet.2025.108229","DOIUrl":"10.1016/j.appet.2025.108229","url":null,"abstract":"<div><div>Our food system is a key driver of current environmental issues such as climate change and biodiversity loss, with meat and dairy production creating excessive amounts of greenhouse gases. To counteract these issues, a transition to more plant-based food practices, such as consuming milk alternatives instead of cow's milk, could be helpful. Hence, we examined the consumption of cow's milk and plant-based milk alternatives and the intention to consume ‘animal-free milk’ among young people in Germany (ages 18–26 years; <em>N</em> = 667). Additionally, we compared the socio-demographics, dietary habits, food choice motives, attitudes toward milk and milk alternatives, personal norms, and social norms of young consumers of cow's milk (<em>n</em> = 211), plant-based milk alternatives (<em>n</em> = 73), and both (<em>n</em> = 368). We found that the young people in our study still consume cow's milk more frequently than plant-based milk alternatives. All consumer groups differed significantly in the collected variables, with the largest effect observed for attitudes toward cow's milk and plant-based milk alternatives. Plant-based milk alternative consumers had significantly more negative attitudes toward cow's milk and significantly more positive attitudes toward plant-based milk alternatives compared to cow's milk consumers. All consumer groups were interested in trying animal-free milk but were less interested in buying it regularly. On average, the young people in our study were willing to pay €1.53 for 1 <em>l</em> of animal-free milk, which corresponds to the upper price segment of cow's milk and the regular price segment of plant-based milk alternatives in Germany. Our findings offer preliminary insights for further research and marketing of milk alternatives and for understanding interest in animal-free milk regarding a potential market launch in Germany.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108229"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-16DOI: 10.1016/j.appet.2025.108230
Jatin Thayuman , Richard Whitehead , Casandra Borthwick , Taylah Argent , James Williams
{"title":"Nonattachment to self mediates the relationship between Instagram engagement and orthorexia nervosa amongst Australian university students","authors":"Jatin Thayuman , Richard Whitehead , Casandra Borthwick , Taylah Argent , James Williams","doi":"10.1016/j.appet.2025.108230","DOIUrl":"10.1016/j.appet.2025.108230","url":null,"abstract":"<div><div>Instagram is a popular social media platform with two billion active users every month. Despite its entertainment and social benefits, research has associated Instagram use with adverse mental and physical health outcomes. Recently, Instagram use has been associated with the maladaptive eating practice, orthorexia nervosa. Orthorexia nervosa refers to an unhealthy pre-occupation with the quality of food, rather than quantity, and has been associated with the prolific ‘clean eating’ movement trending on Instagram. The aim of the present study was to examine how Instagram engagement relates to symptoms of orthorexia nervosa, and whether one's contingent sense of self may help explain this relationship. Specifically, the study investigated if ‘nonattachment to self’, which indicates a more flexible and less contingent relationship with self-related thoughts and feelings, may mediate the relationship between Instagram engagement and orthorexia nervosa. Results from a cross-sectional study of 299 Australian undergraduate students (48 male, 247 female, 4 nonbinary) aged 18 to 84 (<em>M</em> = 29.57, <em>SD</em> = 11.91) revealed higher levels of Instagram engagement were associated with higher levels of orthorexia nervosa symptoms and a more rigid and fixed self-concept. Furthermore, nonattachment to self was found to mediate the relationship between Instagram engagement and orthorexia nervosa. The findings suggest a positive relationship between Instagram engagement and orthorexia nervosa symptoms, and that this relationship is partially attributed to the extent to which individuals fixate on their self-concept needing to be a certain way.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108230"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The moral labour of food purchase decision-making – an ethnographic study among families in Denmark","authors":"Katrine Sidenius Duus, Tine Tjørnhøj-Thomsen, Rikke Fredenslund Krølner","doi":"10.1016/j.appet.2025.108234","DOIUrl":"10.1016/j.appet.2025.108234","url":null,"abstract":"<div><div>Understanding families' food purchase decision-making is essential to developing successful interventions to promote healthier behaviours. Several factors can influence the foods people purchase. However, knowledge about how parents handle dilemmas in food purchase decisions and how these decisions affect families' food purchases is scarce. This study explores families' food purchase decisions in supermarkets and illustrates how parents navigate the tension between their values and contextual and situational circumstances (e.g. family situation). We conducted 37 semi-structured, shop-along, and photo-elicited interviews with parents from fifteen families with children ranging from 0 to 19 years of age (September 2022–January 2023). We used an abductive analytical approach to investigate the role of conscience and morality in our empirical findings. We applied the theoretical concept of moral labour to examine how individuals navigate the discomfort associated with guilt or a guilty conscience, which arises from conflicts or dissonance of their values when making food purchases in supermarkets. Food purchase decisions were influenced by moral considerations related to animal welfare, climate, parental responsibility, and good and healthy food. However, product availability and presentation, price, and the parent-child interaction, as well as contextual and situational circumstances, could challenge parents’ values, triggering moral labour. The study illustrates how parents performed moral labour, e.g., minimising the health impact, to reconcile with negative feelings of conflicting values. Future intervention studies should consider focusing on supportive food environments over individual behaviour changes to minimise the potential moral labour among parents from such initiatives.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"214 ","pages":"Article 108234"},"PeriodicalIF":4.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-14DOI: 10.1016/j.appet.2025.108231
Fiona Lavelle , Catherine V. George , Claire McKernan , Carla A. Martins , Vanessa A. Shrewsbury , Julia A. Wolfson , Rachael M. Taylor , Kerith Duncanson , Christopher Elliott , Clare E. Collins
{"title":"‘What have I just eaten?’ A qualitative exploration of awareness and use of ultra-processed food products during pregnancy and the post-partum period in line with the COM-B behaviour model","authors":"Fiona Lavelle , Catherine V. George , Claire McKernan , Carla A. Martins , Vanessa A. Shrewsbury , Julia A. Wolfson , Rachael M. Taylor , Kerith Duncanson , Christopher Elliott , Clare E. Collins","doi":"10.1016/j.appet.2025.108231","DOIUrl":"10.1016/j.appet.2025.108231","url":null,"abstract":"<div><div>Consumption of convenience/ultra-processed foods (UPFs) has been associated with a lower diet quality. However, it is unclear whether consumers are aware of what is classified as UPFs. Additionally, higher maternal diet quality is associated lower risk of adverse pregnancy and infant outcomes. Therefore, the aim was to explore awareness, perception, and usage of UPFs during pregnancy. Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. A thematic analysis was conducted, and themes were aligned to the COM-B behaviour model. Seven focus groups with ROI participants (<em>n</em> = 24) and six with UK participants (<em>n</em> = 28) were completed. Six themes were generated related to <strong>Capability</strong> - 1) ‘What have I just eaten?’ Awareness and understanding of UPF; 2) Education and learning; <strong>Opportunity</strong> - 3) Cheaper, more expensive, the price debate; 4) Time and balance; <strong>Motivation</strong> - 5) Healthiness – ‘but in the grand scheme’; 6) Pregnancy and next generation. Findings highlight a lack of knowledge in relation to UPFs and therefore participants consumed more UPFs than they thought. The need for upskilling/re-learning cooking skills was emphasised as essential to be able to purchase alternatives to and reproduce UPFs. Generally cooking was considered cheaper, although an upfront ingredient cost was acknowledged. Convenience products and UPFs were seen as a way to negate participant time pressures. Health was not a strong driver to deter use of these products. Further education around convenience/UPF products alongside upskilling/re-learning cooking skills would empower individuals with the knowledge and skills for informed food choices. Wider environmental considerations such as fresh produce price and accessibility could be considered in policy to increase opportunities for cooking behaviours.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"214 ","pages":"Article 108231"},"PeriodicalIF":4.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is the hand scale an appropriate tool for guiding and estimating food portions? An evaluation among free-living adults","authors":"Nana Shinozaki , Kentaro Murakami , Shizuko Masayasu , Satoshi Sasaki","doi":"10.1016/j.appet.2025.108232","DOIUrl":"10.1016/j.appet.2025.108232","url":null,"abstract":"<div><div>The hand scale, which uses the number of hands (e.g., fists and palms) to estimate portion size, is widely used in practice. However, evidence regarding its appropriateness in free-living settings is limited. This study aimed to examine the relationship between actual food consumption (g/meal) and the self-reported number of hands used for estimating portion size and to develop and evaluate models for estimating food consumption per meal based on the self-reported number of hands. In this cross-sectional study, 1081 free-living Japanese adults aged 20–69 years completed a 4-day weighed dietary record, documenting food consumption in grams alongside the number of hands used to estimate portion size (fists for grain foods and fruits, palms for protein foods, and handfuls for vegetables) at breakfast, lunch, and dinner (12,148 meals in total). Correlations between the actual food consumption and the self-reported number of hands were examined. Models for estimating food consumption, incorporating the self-reported number of hands and participant characteristics, were developed and evaluated using a randomized 1:1 split-sample approach. Spearman correlation coefficients between the actual food consumption (g/meal) and self-reported number of hands were 0.59 for grain foods, 0.85 for fruits, 0.72 for protein foods, and 0.76 for vegetables. In the development group, models using the self-reported number of hands explained 34 %–65 % of the variance in food consumption per meal. In the evaluation group, despite wide limits of agreement, actual and model-estimated food consumptions were comparable (mean difference: −2.5 to −0.3 g/meal), with moderate to strong correlations (Spearman correlation coefficient: 0.61–0.75). In conclusion, the hand scale can serve as an appropriate portion size estimation tool. Further research is warranted to evaluate its applicability across different foods and populations.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"215 ","pages":"Article 108232"},"PeriodicalIF":3.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AppetitePub Date : 2025-07-12DOI: 10.1016/j.appet.2025.108227
Elina Mitrofanova , Hilda Mulrooney , Elizabeth Pummell , Andrea Petróczi
{"title":"Tracking the shift from health to harm: Development and validation of a short screening tool for orthorexia nervosa (STONE)","authors":"Elina Mitrofanova , Hilda Mulrooney , Elizabeth Pummell , Andrea Petróczi","doi":"10.1016/j.appet.2025.108227","DOIUrl":"10.1016/j.appet.2025.108227","url":null,"abstract":"<div><div>Orthorexia Nervosa (ON), a problematic fixation on healthy eating, has captured researchers' attention for over a decade. We aimed to develop a brief screening tool for ON that captures physical appearance as a motivating factor, behavioural aspects (rigid control over food selection, consumption and preparation), and nutritional aspects (avoidance of foods considered “impure”). Using a sequential, iterative design, 687 participants completed a self-reported survey across four studies: item identification and selection through exploratory factor analysis (n = 248), testing factorial construct validity with confirmatory factor analysis (n = 127), discriminant validity via known group differences (n = 241), and test-retest reliability of two subsequent administrations of the selected items (n = 71). The final unidimensional version of the short Screening Tool for Orthorexia Nervosa (STONE) comprises eight items. It demonstrated excellent known-group validity and ability to differentiate ON from other types of strict dietary control (e.g., health-based or religious restrictions). Consistent with the view of ON as behaviours aimed at rigid dietary control, avoidance of \"impure\" foods, and motivation to enhance physical appearance, STONE scores positively related to measures of eating pathology and appearance orientation, while only weakly correlating with obsessive-compulsive tendencies. Based on its psychometric properties, STONE is recommended as a first-level screening tool for ON in research contexts and epidemiology studies among adults. Due to its brevity, it can be easily combined with other scales to explore ON or related phenomena. Future studies should examine convergent validity and test it among adolescents and in different cultural contexts.</div></div>","PeriodicalId":242,"journal":{"name":"Appetite","volume":"214 ","pages":"Article 108227"},"PeriodicalIF":4.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}