ABSTRACT
Background
This study aimed to examine the changes in orthorexia nervosa (ON) tendencies among dancers at different levels before and during the COVID-19 pandemic.
Methods
This retrospective repeated-measures observational study included 128 professional, semi-professional, and amateur dancers (86 females, 42 males; 19–40 years) from various dance styles. Orthorexia nervosa tendencies before and during COVID-19 were assessed using ORTO-11 and ORTO-15. Physical activity and anthropometric data were collected for both recalled pre-pandemic and pandemic periods, while energy and macronutrient intakes were assessed using a retrospective 24-h dietary recall. Data were analyzed using paired tests, effect sizes (ES), and multivariate linear regression.
Results
During the pandemic, dancers reported approximately 50% lower weekly dance frequency and daily dance duration than recalled pre-pandemic values, with large and significant effect sizes. Significant decreases were observed in ORTO-11 and ORTO-15 scores, indicating an increase in orthorexic tendencies. Pandemic-period self-reported body weight was higher than pre-pandemic body weight, whereas BMI did not differ significantly between the recalled pre-pandemic and pandemic-period assessments. In multivariate analyses, female sex remained an independent predictor for both ORTO-11 and ORTO-15 scores.
Conclusions
Compared with recalled pre-pandemic scores, pandemic-period ORTO-11 and ORTO-15 scores were lower, suggesting higher ORTO-measured health-oriented eating tendencies among dancers. Given the retrospective self-report design and the methodological limitations of ORTO-based instruments, these findings should not be interpreted as evidence of clinical ON prevalence or precise longitudinal change. Nevertheless, these ORTO-measured tendencies appeared to differ not only behaviorally but also in relation to nutrient intake patterns. Female sex was associated with pandemic-period ORTO scores, but this finding should be interpreted cautiously because psychological, sociocultural, and clinical variables were not assessed.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 4, August 2026. Read More