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  1. Argyrides M, Anastasiades E, Maïano C, Swami V
    Appetite, 2024 Mar 01;194:107180.
    PMID: 38145878 DOI: 10.1016/j.appet.2023.107180
    The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.
    Matched MeSH terms: Feeding and Eating Disorders*
  2. Czepczor-Bernat K, Swami V, Modrzejewska A, Modrzejewska J
    Nutrients, 2021 Apr 20;13(4).
    PMID: 33924010 DOI: 10.3390/nu13041384
    To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women (N = 671, Mage = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 (N = 269), healthy body weight and low COVID-related stress (M = 3.06) and anxiety (M = 2.96); (b) Cluster 2 (N = 154), healthy body weight and high COVID-related stress (M = 5.43) and anxiety (M = 5.29); (c) Cluster 3 (N = 127), excess body weight and high COVID-related stress (M = 5.23) and anxiety (M = 5.35); (d) Cluster 4 (N = 121), excess body weight and low COVID-related stress (M = 2.69) and anxiety (M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk.
    Matched MeSH terms: Feeding and Eating Disorders/epidemiology*; Feeding and Eating Disorders/psychology
  3. Ahmedy F, Loo JL, Mazlan M
    Indian J Psychiatry, 2020 12 12;62(6):732-733.
    PMID: 33896983 DOI: 10.4103/psychiatry.IndianJPsychiatry_334_19
    A case of persistent aphagia in frontal lobe syndrome after traumatic brain injury (TBI) with successful use of olanzapine to improve the eating disorder is presented. A 20-year-old man suffered a severe TBI with right frontal intracerebral haemorrhage At four-month post-TBI, he had agitation, concurrent apathy with constant refusal for oral swallow despite gustatory sensory stimulation, hence the needs for nasogastric tube (NGT) feeding. He was diagnosed with frontal lobe syndrome and prescribed olanzapine 5mg daily that was optimised to 10mg due to worsened aggression. One month later, the aggression reduced with gradual improvement in oral intake. Percutaneous enterogastrostomy (PEG) tube insertion was cancelled and the NGT was sucessfully removed. Olanzapine prescription in this case improved aggression and aphagia simultaneously. Although olanzapine is proven beneficial and surgical intervention for long-term enteral feeding was avoided in this case, its usage requires judicious judgement.
    Matched MeSH terms: Feeding and Eating Disorders
  4. Vintilă M, Todd J, Goian C, Tudorel O, Barbat CA, Swami V
    Body Image, 2020 Dec;35:225-236.
    PMID: 33157397 DOI: 10.1016/j.bodyim.2020.09.009
    The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2). Here, we examined the psychometrics of a Romanian translation of the IES-2. Eight-hundred-and-thirty Romanian adults completed the IES-2 along with measures of positive body image, symptoms of disordered eating, and psychological well-being. Exploratory factor analyses (EFAs) with a split-half subsample (n = 420) indicated that IES-2 scores reduced to three factors in women and four in men, both of which diverged from the parent model. Confirmatory factor analysis with a second split-half sample (n = 410) indicated that the parent model had poor fit indices, whereas fit of the EFA-derived models were acceptable but not uniformly ideal. Scores on the 3-factor model - which had comparatively better fit of the models tested - had adequate internal consistency and evidenced scalar invariance across gender. However, evidence of test-retest reliability after four weeks (n = 205) was poor and evidence of construct validity, assessed through correlations with additional measures included in the survey, was weak at best. Based on these results, we question the degree to which the construct of intuitive eating can be applied to nations undergoing nutrition transitions.
    Matched MeSH terms: Feeding and Eating Disorders/diagnosis*; Feeding and Eating Disorders/psychology
  5. Wahab F, Rahman RA, Yaacob LH, Noor NM, Draman N
    Korean J Fam Med, 2020 Sep;41(5):359-362.
    PMID: 32961047 DOI: 10.4082/kjfm.18.0181
    We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing's syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.
    Matched MeSH terms: Feeding and Eating Disorders
  6. Chan YL, Samy AL, Tong WT, Islam MA, Low WY
    Asia Pac J Public Health, 2020 08 13;32(6-7):334-339.
    PMID: 32787612 DOI: 10.1177/1010539520947879
    Eating disorder is highly prevalent among university students worldwide. However, in Malaysia, studies on eating disorder is scanty and were mostly conducted among medical students. A stratified cluster sampling was used to recruit participants in a university based in Kuala Lumpur. This cross-sectional study was conducted among 1017/1132 students (response rate: 89.8%). The questionnaires administered was a combination of the Eating Attitude Test-26 and items related to perceived body weight, body mass index, trying to weight loss, tobacco use, posttraumatic stress disorder, and depression. Descriptive analyses were performed to provide background information of at-risk students by gender. Multiple logistic regressions were used to identify associated factors of eating disorder. The results showed that 13.9% of the university students were at risk of eating disorder. Students who were trying to lose weight and had posttraumatic stress disorder predicted eating disorder. Hence, eating disorder among university students merits attention and requires implementations of public health policies.
    Matched MeSH terms: Feeding and Eating Disorders/epidemiology*
  7. Sien PLM, Jamaludin NIA, Samrin SNA, S NS, Ismail R, Anuar Zaini A, et al.
    J Health Psychol, 2020 08;25(9):1310-1318.
    PMID: 31755316 DOI: 10.1177/1359105319890397
    Adolescents with type 1 diabetes mellitus are prone to have eating problems. This study aimed to determine factors of eating problems among this population in University Malaya Medical Centre. Fifteen adolescents who scored more than 20 marks in the Diabetes Eating Problem Survey - Revised questionnaire were invited for an in-depth interview. Questions were asked based on their questionnaire's response. The interview sessions were recorded, transcribed verbatim, and thematic analysis was used. Five main themes emerged: pressure, physiological factor, psychological factor, patient's low compliances to insulin intake and food control and fear. Early referral to child psychologist would prevent it from developing.
    Matched MeSH terms: Feeding and Eating Disorders/etiology*; Feeding and Eating Disorders/epidemiology*; Feeding and Eating Disorders/psychology
  8. Swarna Nantha Y, Kalasivan A, Ponnusamy Pillai M, Suppiah P, Md Sharif S, Krishnan SG, et al.
    Public Health Nutr, 2020 Feb;23(3):402-409.
    PMID: 31538554 DOI: 10.1017/S1368980019002684
    OBJECTIVE: The development of a second version of the Yale Food Addiction Scale (YFAS) coincides with the latest updates in the diagnosis of addiction as documented in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. The objective of the present study was to translate the YFAS 2.0 into the Malay language and test its psychometric properties in a primary-care population.

    DESIGN: Patients were assessed for food addiction utilizing the Malay YFAS 2.0. The participants were also assessed for eating disorder using the validated Malay Binge Eating Scale. The psychometric properties of the YFAS 2.0 were determined by analysing factor structure, overall item statistics, internal consistency and construct validity.

    SETTING: Between 2017 and 2018, participants were chosen from a regional primary-care clinic in the district of Seremban, Malaysia.

    PARTICIPANTS: Patients (n 382) from a regional primary-care clinic.

    RESULTS: The prevalence of food addiction was 5·0%. A two-factor structure of the YFAS was confirmed as the most optimal solution for the scale via confirmatory factor analysis. In both its diagnostic and symptom count version, the YFAS 2.0 had good internal consistency (Kuder-Richardson α > 0·80 and McDonald's ω > 0·9).

    CONCLUSIONS: We validated a psychometrically sound Malay version of the YFAS 2.0 in a primary-care population. Both diagnostic and symptom count versions of the scale had robust psychometric properties. The questionnaire can be used to develop health promotion strategies to detect food addiction tendencies in a general population.

    Matched MeSH terms: Feeding and Eating Disorders
  9. Chin YS, Appukutty M, Kagawa M, Gan WY, Wong JE, Poh BK, et al.
    Nutrients, 2020 Jan 25;12(2).
    PMID: 31991785 DOI: 10.3390/nu12020318
    Disordered eating is prevalent among university students, especially females. Whilst literature suggests that factors associated with disordered eating may differ according to gender, such an association has not been studied in Malaysia. This cross-sectional study aims to compare factors associated with disordered eating between male and female university students. A total of 716 university students (male: 27.4%; female: 72.6%) were recruited in Kuala Lumpur and Selangor, Malaysia. All participants completed a set of self-administered questionnaires and their body weight and height were recorded. About one in five of the university students (20.3%) were found to have disordered eating. There were more female students (22.9%) disordered eating compared to males (13.3%, χ² = 8.16, p < 0.05). In male students (β = 0.228, p < 0.01), depressive symptoms were the only significant predictor for disordered eating. In females, the strongest predictor was depressive symptoms (β = 0.214, p < 0.001), followed by body size satisfaction (β = -0.145, p < 0.01) and body appreciation (β = -0.101, p < 0.05). These findings suggest that there are gender differences in the factors associated with disordered eating among Malaysian university students. Intervention programmes that address disordered eating should take into account these sex differences and its contributing factors.
    Matched MeSH terms: Feeding and Eating Disorders/diagnosis; Feeding and Eating Disorders/epidemiology*; Feeding and Eating Disorders/psychology
  10. NIK RUSELINDA YUSOFF, MADIHAH SHUKRI
    MyJurnal
    This study examined the predictive effect of self – esteem and perfectionism on eating disorders among university students. A total of 327 respondents (15.4% male and 84.6% female) participated in this research, recruited using simple random sampling method. Self – esteem was measured using Rosenberg Self-Esteem Scale, perfectionism was measured using Multidimensional Perfectionism Scale and eating disorder was measured using Eating Attitudes Test. There was a significant gender difference in eating disorders, t(376) = -2.909, p
    Matched MeSH terms: Feeding and Eating Disorders
  11. Lee WS, Tee CW, Tan AG, Wong SY, Chew KS, Cheang HK, et al.
    Pediatr Neonatol, 2019 12;60(6):676-683.
    PMID: 31056340 DOI: 10.1016/j.pedneo.2019.04.004
    BACKGROUND: Parents often express concerns about feeding difficulties in their child. We hypothesized that these parental concerns were associated with adverse growth status in early childhood. We aimed to determine the prevalence of such concerns and whether these concerns were associated with adverse growth status in early childhood.

    METHODS: We performed a cross-sectional study among healthy children aged 12-36 months attending three well-baby clinics in three urban areas in Malaysia and Singapore between December 2016 and February 2017. Parents were interviewed for concerns about their child's feeding and presence of behavioral and organic red flags for feeding difficulties. We defined growth faltering as weight-for-age < 3rd centile and short stature as height-for-age < 3rd centile according to World Health Organization Growth Standards.

    RESULTS: Of the 303 children studied (boys = 160, 52.8%; mean [± SD] chronological age at interview 21.3 [± 4.0] months), 13% (n = 38/292) had growth faltering and 19.5% (n = 50/256) had short stature. Overall, 36.3% (n = 110) of parents expressed concerns about their child's feeding behavior. Sixty-eight percent (n = 206) of parents reported presence of at least one behavioral and 18.5% (n = 56) had at least one organic red flag for feeding difficulties, respectively. 9.9% (n = 30) had both behavioral and organic red flags for feeding difficulties. Growth faltering was significantly associated with parental concern about feeding (odds ratio [OR] 3.049, p 

    Matched MeSH terms: Feeding and Eating Disorders of Childhood/complications*
  12. Manaf H, Nor NM, Azhari NAM, Ismut NRA
    Malays J Med Sci, 2019 May;26(3):129-134.
    PMID: 31303857 MyJurnal DOI: 10.21315/mjms2019.26.3.11
    Background: Nutrition has always been associated with eating behaviour. The eating behaviour can impact not only the normal population but also athletes' population including disabled athletes too. Athletes have a higher tendency to unhealthy eating behaviour due to intense pressure and competitive environment in sports. It is important to identify the types of eating behaviour among disabled athletes to prevent eating disorder that could affect their performance. Thus, this study aims to identify the types of eating behaviour among disabled athletes in Malaysia.

    Methods: This study involved 93 disabled athletes in Malaysia. The setting of the study is at National Sports Council, Malaysia. The data obtained are analysed using chi-square test using SPSS.

    Results: This study shows that the most common types of eating behaviour among disabled athletes are emotional eating (37.6%), followed by uncontrolled eating (34.3%) and cognitive restraint (28%). Most of the overweight and obese disabled athletes are prone to emotional eating (19.4%) as compared to non-overweight athletes (18.3%).

    Conclusion: As a conclusion, recognising the eating behaviour in disabled athletes is important as more effective and innovative interventions and measures can be undertaken to prevent eating disorder which can enhance sports performance.

    Matched MeSH terms: Feeding and Eating Disorders
  13. Shagar PS, Donovan CL, Loxton N, Boddy J, Harris N
    Appetite, 2019 03 01;134:59-68.
    PMID: 30586595 DOI: 10.1016/j.appet.2018.12.025
    Despite growing research investigating prevalence rates of BD among Malaysian women, there has been limited research conducted in Malaysia with respect to factors contributing to its development and consequences. This study tested a subsection of the Tripartite Influence Model, investigating whether sociocultural influences (family, peers, media) lead to thin ideal internalization, which in turn lead to body dissatisfaction (BD) and subsequently restrained eating and bulimic behaviours in both Australian and Malaysian women. Participants were 421 Australian and 399 Malaysian female emerging adults aged between 18 and 25 years, (M = 20.76; SD = 2.86) who completed questionnaires assessing sociocultural influences, thin ideal internalization, body dissatisfaction, restrained eating and bulimic behaviours. The model, largely supported in both cultures, had two points of difference. For Malaysian but not Australian women, family influence was significantly linked with internalization of the thin ideal. Although BD was significantly linked with restrained eating as predicted for Australian women (albeit rather weakly), it was not significantly linked with restrained eating for Malaysian women. The striking similarity of results across both cultures, suggests that Western body ideals, with their corresponding negative sequelae, have infiltrated the collectivist and developing nation of Malaysia.
    Matched MeSH terms: Feeding and Eating Disorders
  14. Tung SEH, Mohd Nasir MT, Chin YS, Zalilah MS, Zubaidah JO, Yim HS
    Child Obes, 2019 01;15(1):56-62.
    PMID: 30339034 DOI: 10.1089/chi.2018.0066
    BACKGROUND: Recent research suggests that a negative relationship exists between adiposity and cognitive function in children. However, limited information is known on how they are related. This study aimed to examine the mediators of the relationship between overweight/obesity and cognitive function among school children in Kuala Lumpur, Malaysia.

    METHODS: This is a cross-sectional comparison study whereby 225 overweight/obese children matched for age, sex, and ethnicity with 225 normal weight children participated in this study. Body image dissatisfaction, disordered eating, and depressive symptoms were assessed through a self-administered questionnaire. Blood pressure was measured, whereas blood was drawn to determine insulin, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid profiles. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated using glucose and insulin levels. Wechsler's Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess cognitive function in children. Ordinary least square regression analysis was conducted to determine the direct and indirect relationships between weight status and cognitive function.

    RESULTS: A negative relationship was found between overweight/obesity with cognitive function. Overweight/obese children were on average 4.075 units lower in cognitive function scores compared to normal weight children. Such difference was found through mediators, such as body image dissatisfaction, disordered eating, depression, systolic blood pressure, triglycerides, HOMA-IR, and hs-CRP, contributing 22.2% of the variances in cognitive function in children.

    CONCLUSION: Results highlight the important mediators of the relationship between overweight/obesity and cognitive function. Consequently, future interventions should target to improve psychological well-being and reduce cardiovascular disease risk for the prevention of poorer cognitive performance in overweight/obese children.

    Matched MeSH terms: Feeding and Eating Disorders/epidemiology; Feeding and Eating Disorders/psychology
  15. TUAN NOR ATIQAH SYAFIQAH TUAN ABD AZIZ, MADIHAH SHUKRI
    MyJurnal
    This study examined the relationship between body dissatisfaction and eating disorder of undergraduate students in University Malaysia Terengganu (UMT). Using stratified random sampling technique, data from 299 respondents was gathered. Body dissatisfaction was measured using Body Shape Questionnaire while eating disorders were assessed using Eating Attitudes Test. Descriptive statistics showed thatthe majority of the respondents reported no symptom of body dissatisfaction. With regard to eating disorders, respondents reported low levels of dieting, bulimia and oral control, indicating that an eating disorder in this sample was somewhat low. T-test analyses showed that there were no significant gender differences in body dissatisfaction as well as in eating disorders. However, there was evidence to suggest that female respondents had slightly higher level of eating disorder than males. Results of Pearsoncorrelations showed there was significant relationship between body dissatisfaction and total score of eating disorders, dieting, bulimia and oral control subtypes (r = .58, p
    Matched MeSH terms: Feeding and Eating Disorders
  16. Pengpid S, Peltzer K
    Eat Weight Disord, 2018 Jun;23(3):349-355.
    PMID: 29681011 DOI: 10.1007/s40519-018-0507-0
    PURPOSE: Since there is a lack of information on eating disorders attitudes in Association of Southeast Asian Nations (ASEAN), the aim of this study was to explore the prevalence of eating disorder attitude and its relation to mental distress among university student populations in Indonesia, Malaysia, Myanmar, Thailand and Vietnam.

    METHODS: A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate university students that were randomly recruited. The Eating Attitudes Test (EAT-26) was utilized to determine the prevalence of disordered eating attitudes. The sample included 3148 university students, with a mean age of 20.5 years, SD = 1.6.

    RESULTS: Using the EAT-26, 11.5% of the students across all countries were classified as being at risk for an eating disorder, ranging from below 10% in Indonesia, Thailand and Vietnam to 13.8% in Malaysia and 20.6% in Myanmar. In multivariable logistic regression analysis, sociodemographic factors (wealthier subjective economic status, and living in a lower middle income country), underweight and overweight body weight perception, psychological factors (depression symptoms and pathological internet use), and being obese were associated with eating disorder risk.

    CONCLUSIONS: Relatively high rates of eating disorder risk were found. This result calls for increased awareness, understanding of eating disorders and related risk factors and interventions in university students in ASEAN.

    LEVEL OF EVIDENCE: Level V, descriptive cross-sectional survey.

    Matched MeSH terms: Feeding and Eating Disorders/psychology*
  17. Swami V, Tudorel O, Goian C, Barron D, Vintila M
    Body Image, 2017 Dec;23:61-68.
    PMID: 28863282 DOI: 10.1016/j.bodyim.2017.08.001
    We examined the psychometric properties of a Romanian translation of the 10-item Body Appreciation Scale-2 (BAS-2). A total of 453 university students from Romania completed the BAS-2, along with measures of disordered eating, self-esteem, satisfaction with life, and subjective happiness. In addition, a separate sample of university students (N=109) completed only the BAS-2 at two time-points three weeks apart. Principal-axis factor analysis indicated that BAS-2 scores had a one-dimensional factor structure in both women and men. Confirmatory factor analysis indicated that this factor structure had adequate fit, but invariance across sex was not supported. Further analyses indicated that BAS-2 scores evidenced internal consistency, convergent validity, and test-retest reliability in both women and men. These results suggest that BAS-2 scores reduce to one dimension in Romanian adults, but the lack of sex invariance may indicate that the same latent construct is not being measured in women and men.
    Matched MeSH terms: Feeding and Eating Disorders/psychology
  18. Swami V
    Body Image, 2017 Jun;21:30-33.
    PMID: 28285176 DOI: 10.1016/j.bodyim.2017.02.001
    The present study compared the rates of negative body image and risk for disordered eating in young women who identify as part of goth subculture and a matched sample. Participants were 80 women who identified as part of goth subculture and a matched sample of 82 women from London, United Kingdom. Participants completed measures of self-ideal body size discrepancy, body appreciation, appearance investment, and eating disorder symptomatology. Between-group comparisons indicated that goth women reported significantly higher drive for thinness (d=0.51), body dissatisfaction (d=0.62), and dysfunctional appearance investment (d=0.52), as well as lower body appreciation (d=0.55), than the matched sample. Heightened expectations about appearance and self-presentation, alongside appearance competitiveness, may result in more negative body image and disordered eating in young women who identify with goth subculture, but further research is necessary on this under-studied youth subculture.
    Matched MeSH terms: Feeding and Eating Disorders/epidemiology*; Feeding and Eating Disorders/psychology*
  19. Sha'ari N, Manaf ZA, Ahmad M, Rahman FN
    Pediatr Int, 2017 Apr;59(4):408-415.
    PMID: 27805287 DOI: 10.1111/ped.13196
    BACKGROUND: Children with attention deficit-hyperactivity disorder (ADHD) may be at risk of nutrient deficiency due to the inability to sit through meals. This comparative cross-sectional study was therefore carried out to determine the nutritional status and feeding problems of ADHD children aged 4-12 years.

    METHODS: Sociodemographic data, anthropometric measurements and 3 day dietary intake record were collected from 54 ADHD children and 54 typical development (TD) children. The Behavioral Pediatrics Feeding Assessment Scale was used to assess feeding problems.

    RESULTS: Mean subject age was 8.6 ± 2.1 years. On anthropometric assessment, 11.1% of the ADHD children had wasting, while 1.9% had severe wasting. In contrast, none of the TD children had wasting. Approximately 5.6% of the ADHD children had stunting, as compared with 3.7% of the TD children, while none of the TD children had severe stunting compared with 3.7% of the ADHD children. More than half of the ADHD children had mid-upper arm circumference (MUAC) below the 5th percentile, indicating undernutrition, compared with only 35.2% of TD children. More than one-third of the ADHD children had feeding problems compared with 9.3% of TD children. There was a significant negative relationship between the ADHD children's feeding problems and bodyweight (r = -0338, P = 0.012), body mass index (r = -0322, P = 0.017) and MUAC (r = -0384, P = 0.004).

    CONCLUSION: Almost half of the ADHD children had suboptimal nutrition compared with 11.1% of the TD children. It is imperative to screen ADHD children for nutritional status and feeding problems to prevent negative health impacts later on.

    Matched MeSH terms: Feeding and Eating Disorders of Childhood/diagnosis; Feeding and Eating Disorders of Childhood/etiology*; Feeding and Eating Disorders of Childhood/epidemiology
  20. Wan Wahida WMZ, Lai PSM, Abdul Hadi H
    Clin Nutr ESPEN, 2017 Apr;18:55-58.
    PMID: 29132739 DOI: 10.1016/j.clnesp.2017.02.001
    BACKGROUND & AIMS: Several questionnaires to screen for eating disorders have been validated in Malaysia. However, these tools are lengthy, and require specialist interpretation. The sick, control, one stone, fat, food (SCOFF) is easy to administer by non-specialists, but has not been validated in Malaysia. Therefore, the aim of our study was to validate the SCOFF on a non-clinical sample of tertiary students to determine if it could identify individuals with an eating disorder.
    METHODS: We recruited second year tertiary students from five faculties in a university in Malaysia, from June-November 2014, who could understand English. The SCOFF and the EAT-26 were administered at baseline. Two weeks later, the SCOFF was re-administered to assess for reliability.
    RESULTS: A total of 292 students were approached, and all agreed to participate (response rate = 100%). There was moderate correlation between the total SCOFF score with the EAT-26's dieting domain (spearman's rho = 0.504, p < 0.001), bulimia and food preoccupation domain (spearman's rho = 0.438, p < 0.001), and total score (spearman's rho = 0.483, p < 0.001). The internal consistency of the SCOFF was low (Cronbach alpha = 0.470). At retest, kappa scores ranged from 0.211 to 0.591. The sensitivity of the SCOFF was 77.4%, and its specificity was 60.5%. The positive predictive value was 18.9%, and its negative predictive value was 95.8%.
    CONCLUSIONS: The SCOFF was found to have adequate convergent validity and stable reliability. However, its internal consistency was low. The SCOFF can still be used in clinical practice. However, its positive results should be interpreted with caution due to its low positive predictive value.
    KEYWORDS: Eating disorder; Malaysia; SCOFF; Sensitivity; Specificity; Validation
    Matched MeSH terms: Feeding and Eating Disorders/diagnosis*; Feeding and Eating Disorders/prevention & control
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