Background On the population level, the association of age and other sociodemographic factors with eating disorders (ED) is unclear.
Methods We used cross-sectional data from the French general population-based NutriNet-Santé e-cohort (n=49 603 adults; 76.3% women; mean age=50.4±14.6 years). ED were evaluated in 2014 with the 5-item SCOFF screening questionnaire and the Expali algorithmic tool. Likely cases of restrictive, bulimic, hyperphagic and other ED were the dependent variables. Age, marital status, education, occupation, physical activity and smoking were the independent variables. Associations were estimated via gender-stratified multivariable polytomous logistic regression.
Results Among women, age displayed inverse linear associations with both restrictive and bulimic ED, underscoring 18–25 years as the most vulnerable period (adjusted OR=3.37, 95% CI: 2.24 to 5.08 for restrictive ED; adjusted OR=2.98, 95% CI: 2.37 to 3.74 for bulimic ED, respectively). A similar association was observed in men regarding bulimic ED. In women, age was not associated with hyperphagic ED for which living alone, low education, low physical activity, being a homemaker/disabled/unemployed/retired, a manual worker or a former/current smoker had increased importance. In men, 18–39 years emerged as the least vulnerable period regarding hyperphagic ED (adjusted OR=0.74, 95% CI: 0.56 to 0.99). Across gender, having postsecondary education had significant inverse associations with all except restrictive ED, whereas being a student had a significant positive association with restrictive ED.
Conclusions The findings support gender-specific associations of age with four ED subtypes and could inform future prevention initiatives targeting specific ED among specific age groups.
Trial registration number NCT03335644 ; Pre-results.
- mental health
- public health
- social factors In
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Contributors VAA performed the literature review, the statistical analysis, led the writing and has primary responsibility for the final content; PG and SH designed the NutriNet-Santé study, directed its implementation and coordinated recruitment and data collection; SP coordinated the SCOFF questionnaire administration; M-PT, JL and PD provided methodological and theoretical guidance; VAA, M-PT, PD and CJ developed the study’s analytic strategy; all authors assisted with interpretation of data, read and edited each draft of the manuscript for important intellectual content. All authors read and approved the final manuscript.
Funding The NutriNet-Santé study is supported by the French Ministry of Solidarity and Health, the National Agency for Public Health (Santé Publique France), the National Institute for Health and Medical Research (INSERM), the National Institute for Agricultural Research (INRA), the National Conservatory of Arts and Crafts (CNAM), the Sorbonne-Paris-Cité Centre for Epidemiological Research and Statistics (CRESS), the NutriNet-SU.VI.MAX Association and the University of Paris 13.
Competing interests None declared.
Patient consent Not required.
Ethics approval This study was approved by the French Institute for Health and Medical Research (INSERM) and by the National Commission on Informatics and Liberty (CNIL).
Provenance and peer review Not commissioned; externally peer reviewed.
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