Survey on Eating Disorder-Related Thoughts, Behaviors, and Their Relationship with Food Intake and Nutritional Status in Female High School Students in Taiwan

Objective: Eating disorders are now a global health problem for adolescents and young female adults. The level of eating disorders among young female adults is growing in Asian countries. Therefore, the purpose of this study was to investigate body image, weight concerns, eating attitudes, dietary intake, and nutritional status related to eating disorders of female high school students in Taiwan. Methods: A total of 1605 female high school students participated in this study. The written questionnaire included respondents' demographics and weight concerns, the Eating Attitudes Test-26 (EAT-26), and 24-hour dietary recall. Blood chemistry data were also collected. The data were analyzed using a Student t test, chi(2) analysis, and logistic regression. Results: Disturbed eating attitudes and behaviors were found in 17.11% of participants (measured by an EAT-26 score >= 20). Logistic regression analyses showed that disturbed eating attitudes/behaviors were significantly associated with overestimation of body weight, unrealistic body weight goal, dissatisfaction with body weight, and weight loss experiences. The reported intakes of energy, protein, carbohydrate, zinc, and vitamins B6 and B12 were significantly lower in participants with disturbed eating patterns than in participants without disturbance issues. Conversely, participants with disturbed eating patterns had higher dietary and crude fiber intake than participants without disturbed eating issues. The percentage of participants with abnormal values of total iron-binding capacity and serum iron was significantly higher in those with disturbed eating patterns than in those without disturbed eating patterns. Conclusion: Disturbed eating attitudes/behaviors exist among female adolescents in Taiwan, and these behaviors jeopardize their nutritional status. The possibility of using the EAT-26 as a reference to predict the quality and quantity of food intake among female adolescents is worthy of further study.