Eating Competence in Adults Following Either Intermittent Fasting or Ketogenic Diets

OBJECTIVES: This study seeks to evaluate the level of Eating Competence (EC) among individuals following either intermittent fasting (IF) or ketogenic diets (KD) and determine whether EC relates to orthorexia or reason for following the diet. METHODS: This cross-sectional study is based on an anonymous survey conducted from August 21st through September 2nd 2021. Adults following IF and KD (N = 93) were recruited from online IF/KD social media communities on Facebook and Reddit. Orthorexia and EC were assessed using the validated ORTO-R survey and the Satter Eating Competence Inventory (ecSI 2.0™). Associations between likelihood of having EC and orthorexia were done using binomial logistic regression controlling for age, BMI, gender, education, and prior eating disorders. Additional associations between EC and reasons for following the diets were analyzed through binomial regressions analysis. RESULTS: Among the sample, 68.8% was classified as having EC. Increasing ORTO-R scores were significantly associated with lower EC likelihood (0.003). While the logistic regression model was statistically significant (p = 0.048), no other predictor variables in the model were significant. The top five most frequent reasons for following either diet (% of sample) included: weight loss (86%), metabolic health (61%), mental clarity (52%), increased energy (47%), and decreased hunger dependence (38%). CONCLUSIONS: Adults self-reporting following IF and KD report a high level of eating competence. Within this population, there was an association between eating competence and orthorexia, but not other variables. This data suggests that people following restrictive diets may do so while maintaining eating competence, however, presence of orthorexia attitudes suggest higher risk for lower eating competence. While most participants followed the diet for weight loss, this did not predict eating competence or orthorexia. This study also calls attention to the complexity of eating attitudes among individuals following restrictive diets and a need to consider orthorexia behaviors that might increase risk for poor eating competence. FUNDING SOURCES: None.