The effect of illness anxiety on adherence to the mediterranean diet and eating attitude behaviors in adults

This study was conducted to examine the effect of illness anxiety on adherence to the Mediterranean diet and eating attitude behaviors in adults. This research was carried out with 204 (64 male, 140 female) adult individuals aged 18-64 who volunteered to participate in the study, living in Ankara between May 2021 and July 2021, using the online survey method over Google forms. In the questionnaire, questions were asked about the personal information, nutrition and sleep habits of the individuals. The Mediterranean Diet Adherence Scale (MEDAS) was used to measure their adherence to Mediterranean diets, the Short Health Anxiety Inventory (SHAI) to determine illness anxiety and the Eating Attitude Test-26 (YTT-26) was used to examine eating attitude behaviors. The ages of 204 individuals participating in this study were between 18 and 64 years and the mean age was 36.7 ± 11.56 years. The average height of the subjects is 167.2 ± 9.41 cm and their average body weight is 71.4 ± 15.31 kg. Body mass index (BMI) was found to be 21.2 7± 4.01 kg/m² on average. The sum of the MEDAS scores ranged from 1 to 10, and the mean score was 5.2 ± 1.72. There were 46 subjects with acceptable adherence to the Mediterranean diet (MD). It was found that 3 of the individuals with acceptable adherence to the MD had a high school diploma, 36 had a college degree, and 7 had a postgraduate degree. A significant correlation was found between educational status and MEDAS score results (p<0.05). Of the individuals who have acceptable adherence to the MD, 41 skip meals, and a large proportion of 75.6% skip lunch. 14.6% of the remaining individuals skip breakfast and 9.8% skip dinner. Of those not compatible with MD, 150 skipped meals, 53.3% skipped lunch, 39.3% skipped breakfast, and 7.3% skipped dinner. The correlation between skipping the main meal and the MEDAS scores was statistically significant (p <0.05). The total scores of the Eating Attitude Test-26 (YTT-26) ranged from 1 to 73, and the mean score was 18.2±14.48. There are 128 (62.7%) individuals with a score of less than 20 and normal eating behavior and 76 (37.3%) individuals with a score of 20 or more and abnormal eating behavior. The largest percentage of individuals scoring 20 and above on the YTT-26 scale consisted of adults aged 25-34 years (43.3%). When the distribution of individuals with eating disorders by age group was examined, it was found that the correlation was statistically significant (p<0.05). When comparing by sleep duration of individuals with abnormal eating behaviors, half (50%) and 64.8% of individuals with normal eating behaviors slept less than 7 hours. It was found that individuals with normal eating behaviors had a higher rate of sleeping less than 7 hours (p<0.05). The total score of the Short Health Anxiety Inventory (SHAI) ranged from 0 to 39, with a mean of 14.8±6.81. There were 107 (52.5%) healthy individuals (with less than 15 points), 31 (15.2%) only in the group with severe health anxiety (between 15-17 points), 66 (32.4%) in the group with hypochondria (with 18 points or more). It can be seen that 56.1% of the individuals without health anxiety are women, while 80.3% of the hypochondriacal individuals are women. When SHAI scores were compared by gender, this correlation was found to be statistically significant (p<0.05). 18.7% of individuals in the healthy group and 37.9% of hypochondriacal individuals have at least one diagnosed disease. The correlation between the presence of the disease and SHAI scores was found to be statistically significant (p<0.05). A significant negative correlation was found between the SHAI scores of the individuals and their age (r=-0.185) (p<0.05). There is a significant positive correlation between SHAI and EAT -26 (r=0.236) (p<0.05). The effects of gender and EAT-26 scores were found to be significant in the occurrence of hypochondriasis in individuals (p<0.05). The risk of hypochondriasis in women was 2.247 times higher than in men. The risk of hypochondriasis was found to be 2.964 times higher in those with abnormal eating behavior. There is a negative correlation between MEDAS scores and the other two scales, but this correlation was not statistically significant (r=-0.003) (p>0.05). In conclusion, this study is a pioneer study investigating the relationship between disease anxiety and Mediterranean diet adherence and eating behavior. No relationship was found between disease anxiety and adherence to the MD. Since the MD has a positive effect on anxiety, further studies are recommended in this area as well. A significant positive correlation was found between illness anxiety and eating behaviors. However, more research is needed to establish a clear relationship between hypochondria and eating disorders.