Orthorexia Profiles in Athletes: A Multidimensional Analysis Using the Eating Habits Questionnaire (EHQ) and the Teruel Orthorexia Scale (TOS)

运动员健康食品强迫症特征:基于饮食习惯问卷(EHQ)和特鲁埃尔健康食品强迫症量表(TOS)的多维度分析

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Abstract

Background: Orthorexia nervosa (OrNe) and healthy orthorexia (HeOr) are two distinct but related dimensions of interest in eating behavior research. Evidence regarding their associations with sociodemographic, dietary, and sport-related variables in physically active young adults remains limited. Methods: A cross-sectional study was conducted in 190 physically active young adults (53.2% women; mean age = 23.16 ± 5.13 years). Participants practiced a variety of sports including fitness (25.3%), soccer (13.7%), handball (10.5%), athletics, martial arts, cycling, and other individual or team sports. Although all participants belonged to organized sports teams or structured training groups, 38.9% were not actively competing at the time of data collection. Participants completed validated instruments assessing OrNe, HeOr, and eating-related cognitions, alongside questionnaires on sociodemographic data, dietary habits, sport discipline, training frequency, and supplement use. Hierarchical and K-means clustering were applied using the standardized scores of HeOr, OrNe, and the EHQ total score. Group differences were assessed using t-tests and ANOVA with effect sizes (η(2)p) reported. Results: Age correlated positively with OrNe, HeOr, and eating-related cognitions, indicating greater consolidation of rigid eating patterns in young adulthood. BMI was associated with OrNe only among men. Vegetarian participants showed higher nutritional knowledge but lower overall orthorexia scores. Supplement users in fitness-related sports reported higher OrNe, whereas participants in collective sports reported lower scores. Three distinct orthorexia profiles were identified, characterized by lower, slightly above-average, and higher scores on orthorexia-related variables. Participants in the higher-scoring profile showed significantly higher EHQ total, OrNe, and HeOr scores compared with the other groups (η(2)p range = 0.11-0.19). Correlations among orthorexia dimensions were positive and moderate to large. Differences between clusters in sport modality, training frequency, and supplement use underscored the influence of the sporting context. Conclusions: Orthorexia in young physically active adults reflects heterogeneous patterns shaped by the interplay of individual (age, sex, BMI), dietary, and sport-related factors. The identification of differentiated profiles reinforces the multidimensional nature of orthorexia and underscores the relevance of considering specific sport environments when interpreting orthorexic tendencies. Longitudinal research is warranted to examine the stability or variability of these patterns over time and to enable the use of more robust multivariate approaches that further clarify the characterization of orthorexia.

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