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  • 1.
    Donini, Lorenzo M.
    et al.
    Sapienza University of Rome, Rome, Italy.
    Barrada, Juan Ramón
    Universidad de Zaragoza, Zaragoza, Spain.
    Barthels, Friederike
    Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany.
    Dunn, Thomas M.
    University of Northern Colorado, Greeley, United States.
    Babeau, Camille
    École de Psychologues Praticiens, Paris, France.
    Brytek-Matera, Anna
    University of Wrocław, Wroclaw, Poland.
    Cena, Hellas
    University of Pavia, Pavia, Italy; Salvatore Maugeri Foundation, Pavia, Italy.
    Cerolini, Silvia
    Sapienza University of Rome, Rome, Italy.
    Cho, Hye hyun
    Chung-ang University, Seoul, South Korea.
    Coimbra, Maria
    University of Coimbra, Coimbra, Portugal.
    Cuzzolaro, Massimo
    Sapienza University of Rome, Rome, Italy.
    Ferreira, Claudia
    University of Coimbra, Coimbra, Portugal.
    Galfano, Valeria
    Sapienza University of Rome, Rome, Italy.
    Grammatikopoulou, Maria G.
    University of Thessaly, Volos, Greece.
    Hallit, Souheil
    Holy Spirit University of Kaslik, Jounieh, Lebanon; Effat University, Jeddah, Saudi Arabia.
    Håman, Linn
    Halmstad University, School of Health and Welfare.
    Hay, Phillipa
    University of Western Sydney, Penrith, Australia.
    Jimbo, Masahito
    University of Michigan, Ann Arbor, United States.
    Lasson, Clotilde
    Université de Toulouse-le Mirail, Toulouse, France.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    McGregor, Renee
    The En:spire Clinic, Bengaluru, India.
    Minnetti, Marianna
    Sapienza University of Rome, Rome, Italy.
    Mocini, Edoardo
    Sapienza University of Rome, Rome, Italy.
    Obeid, Sahar
    Lebanese American University, Beirut, Lebanon.
    Oberle, Crystal D.
    Texas State University, San Marcos, United States.
    Onieva-Zafra, Maria Dolores
    Universidad de Castilla-la Mancha, Ciudad Real, Spain.
    Opitz, Marie Christine
    University of Edinburgh, Edinburgh, United Kingdom.
    Parra-Fernández, María Laura
    Universidad de Castilla-la Mancha, Ciudad Real, Spain.
    Pietrowsky, Reinhard
    Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany.
    Plasonja, Natalija
    Université de Bordeaux, Bordeaux, France.
    Poggiogalle, Eleonora
    Sapienza University of Rome, Rome, Italy.
    Rigó, Adrien
    Eötvös Loránd University, Budapest, Hungary.
    Rodgers, Rachel F.
    Northeastern University, Boston, United States; Hôpital Lapeyronie, Montpellier, France.
    Roncero, Maria
    Universitat de València, Valencia, Spain.
    Saldaña, Carmina
    Universitat de Barcelona, Barcelona, Spain.
    Segura-Garcia, Cristina
    Magna Graecia University, Catanzaro, Italy.
    Setnick, Jessica
    International Federation of Eating Disorder Dietitians, Dallas, United States.
    Shin, Ji Yeon
    Chung-ang University, Seoul, South Korea.
    Spitoni, Grazia
    Sapienza University of Rome, Rome, Italy.
    Strahler, Jana
    University of Freiburg, Freiburg im Breisgau, Germany.
    Stroebele-Benschop, Nanette
    University of Hohenheim, Stuttgart, Germany.
    Todisco, Patrizia
    Casa di Cura Villa Margherita, Vicenza, Italy.
    Vacca, Mariacarolina
    Sapienza University of Rome, Rome, Italy.
    Valente, Martina
    Università Del Piemonte Orientale, Vercelli, Italy.
    Varga, Màrta
    Semmelweis University, Budapest, Hungary.
    Zagaria, Andrea
    Sapienza University of Rome, Rome, Italy.
    Zickgraf, Hana Flynn
    Emory University, Atlanta, United States.
    Reynolds, Rebecca C.
    University of New South Wales, Sydney, Australia.
    Lombardo, Caterina
    Sapienza University of Rome, Rome, Italy.
    Correction: A consensus document on definition and diagnostic criteria for orthorexia nervosa2023In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 28, article id 76Article in journal (Other academic)
    Abstract [en]

    In this article Rebecca C. Reynolds was missing from the author list. The complete correct author group is given below. Lorenzo M. Donini, Juan Ramón Barrada, Friederike Barthels, Thomas M. Dunn, Camille Babeau, Anna Brytek-Matera, Hellas Cena, Silvia Cerolini, Hye-hyun Cho, Maria Coimbra, Massimo Cuzzolaro, Claudia Ferreira, Valeria Galfano, Maria G. Grammatikopoulou, Souheil Hallit, Linn Håman, Phillipa Hay, Masahito Jimbo, Clotilde Lasson, Eva-Carin Lindgren, Renee McGregor, Marianna Minnetti, Edoardo Mocini, Sahar Obeid, Crystal D. Oberle, Maria-Dolores Onieva-Zafra, Marie-Christine Opitz, María-Laura Parra-Fernández, Reinhard Pietrowsky, Natalija Plasonja, Eleonora Poggiogalle, Adrien Rigó, Rachel F. Rodgers, Maria Roncero, Carmina Saldaña, Cristina Segura-Garcia, Jessica Setnick, Ji-Yeon Shin, Grazia Spitoni, Jana Strahler, Nanette Stroebele-Benschop, Patrizia Todisco, Mariacarolina Vacca, Martina Valente, Màrta Varga, Andrea Zagaria, Hana Flynn Zickgraf, Rebecca C. Reynolds & Caterina Lombardo. The original article [1] has been corrected. © 2023, Springer Nature Switzerland AG.

  • 2.
    Donini, Lorenzo M
    et al.
    Sapienza University, Rome, Italy.
    Barrada, Juan Ramón
    Universidad de Zaragoza, Zaragoza, Spain.
    Barthels, Friederike
    Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
    Dunn, Thomas M
    University of Northern Colorado, Greeley, USA.
    Babeau, Camille
    Ecole de Psychologues Praticiens, Lyon, France.
    Brytek-Matera, Anna
    University of Wroclaw, Wroclaw, Poland.
    Cena, Hellas
    University of Pavia, Pavia, Italy; ICS MAUGERI IRCCS, Pavia, Italy.
    Cerolini, Silvia
    Sapienza University, Rome, Italy.
    Cho, Hye-hyun
    Chung-Ang University, Seoul, South Korea.
    Coimbra, Maria
    University of Coimbra, CINEICC, Coimbra, Portugal.
    Cuzzolaro, Massimo
    Sapienza University, Rome, Italy.
    Ferreira, Claudia
    University of Coimbra, Coimbra, Portugal.
    Galfano, Valeria
    Sapienza University, Rome, Italy.
    Grammatikopoulou, Maria G
    University of Thessaly, Larissa, Greece.
    Hallit, Souheil
    Holy Spirit University of Kaslik, Jounieh, Lebanon; Effat University (KSA), Jeddah, Saudi Arabia.
    Håman, Linn
    Halmstad University, School of Health and Welfare.
    Hay, Phillipa
    Western Sydney University, Sydney, Australia.
    Jimbo, Masahito
    University of Michigan, Ann Arbor, United States.
    Lasson, Clotilde
    University of Toulouse-Jean Jaurès, Toulouse, France.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    McGregor, Renee
    The EN:SPIRE Clinic, Bengaluru, India.
    Minnetti, Marianna
    Sapienza University, Rome, Italy.
    Mocini, Edoardo
    Sapienza University, Rome, Italy.
    Obeid, Sahar
    Lebanese American University, Beirut, Lebanon.
    Oberle, Crystal D
    Texas State University, San Marcos, United States.
    Onieva-Zafra, Maria-Dolores
    University of Castilla-La Mancha, Ciudad Real, Spain.
    Opitz, Marie-Christine
    The University of Edinburgh, Edinburgh, United Kingdom.
    Parra-Fernández, María-Laura
    University of Castilla-La Mancha, Ciudad Real, Spain.
    Pietrowsky, Reinhard
    Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
    Plasonja, Natalija
    University of Bordeaux, Bordeaux, France.
    Poggiogalle, Eleonora
    Sapienza University, Rome, Italy.
    Rigó, Adrien
    ELTE Eötvös Loránd University, Budapest, Hungary.
    Rodgers, Rachel F
    Northeastern University, Boston, United States; Lapeyronie Hospital, CHRU Montpellier, Montpellier, France.
    Roncero, Maria
    University of Valencia, Valencia, Spain.
    Saldaña, Carmina
    Universitat de Barcelona, Barcelona, Spain.
    Segura-Garcia, Cristina
    University of Catanzaro, Catanzaro, Italy.
    Setnick, Jessica
    International Federation of Eating Disorder Dietitians, Dallas, United States.
    Shin, Ji-Yeon
    Chung-Ang University, Seoul, South Korea.
    Spitoni, Grazia
    Sapienza University, Rome, Italy.
    Strahler, Jana
    University of Freiburg, Freiburg, Germany.
    Stroebele-Benschop, Nanette
    University of Hohenheim, Stuttgart, Germany.
    Todisco, Patrizia
    Casa Di Cura Villa Margherita, Vicenza, Italy.
    Vacca, Mariacarolina
    Sapienza University, Rome, Italy.
    Valente, Martina
    Amedeo Avogadro University of Eastern Piedmont, Vercelli, Italy.
    Varga, Màrta
    Semmelweis University, Budapest, Hungary.
    Zagaria, Andrea
    Sapienza University, Rome, Italy.
    Zickgraf, Hana Flynn
    Emory University, Atlanta, United States.
    Lombardo, Caterina
    Sapienza University, Rome, Italy.
    A consensus document on definition and diagnostic criteria for orthorexia nervosa2022In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 27, p. 3695-3711Article in journal (Refereed)
    Abstract [en]

    Purpose: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included.

    Methods: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A–Definition, Clinical Aspects, Duration; B–Consequences; C–Onset; D–Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants.

    Results: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON.

    Conclusions: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel.

    Level of evidence: Level V: opinions of expert committees.

    © 2022, The Author(s).

  • 3.
    Eriksson, Linn
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    Primary Health Care Research and Development, Council Halland, Falkenberg, SwedenPrimary Health Care Research and Development, Council Halland, Falkenberg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ambition of a perfect body: a risk factor of body dissatisfaction2009Conference paper (Other (popular science, discussion, etc.))
    Download (pdf)
    SUMMARY01
  • 4.
    Eriksson, Linn
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    Primary Health Care Research and Development, Halland County Council, Falkenberg.
    Lindgren, Eva-Carin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ett generellt skolbaserat hälsopromotivt program: en studie om skolungdomars mat- och rörelsevanor, tilltro till egen förmåga och syn på kroppsligt utseende2010In: Aktuell beteende- och samhällsvetenskaplig idrottsforskning, ISSN 0284-4672, p. 54-80Article in journal (Refereed)
    Abstract [en]

    This study is a one year case study of a programme promoting physical activity and healthy eating habits in a secondary school. The aim was to describe and evaluate a school-based health promoting programme on interest in and participation in physical education (PE), eating habits and physical exercise habits, Sociocultural Attitudes Towards Appearance and self-efficacy for boys and girls before and after the programme. One hundred and sixty-four participants completed questionnaires in December 2007 and December 2008. The results showed increased interest and active participation in PE in girls and an opposite among boys at the post-test. Fewer boys reported regular eating habits after the programme. Girls scored higher on the Sociocultural Attitudes Towards Appearance Questionnaire subdomain awareness of a slimness ideal, and boys on the subdomain awareness of a muscular body as well as on the subdomain muscular appearance at the post-test. The results from this study cannot be generalized. Instead, the findings can be used for future research and to develop school-based health promotion programs. Conclusions and implications are discussed in the article.

  • 5.
    Eriksson, Linn
    et al.
    Göteborgs universitet.
    Baigi, Amir
    Göteborgs universitet.
    Marklund, Bertil
    Göteborgs universitet.
    Lindgren, Eva-Carin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Obsession with diet among fitness center participants in relation to body ideal and social physique anxiety2009Conference paper (Refereed)
    Abstract [en]

    Several studies indicate that women are more likely than men to exercise for appearancerelated reasons, but today, even men have become more concerned about how they look. Exercise and/or diets are sometimes used in an attempt to develop a more attractive physique. Strict diets such as an obsession with healthy food, sometimes termed orthorexia nervosa (ON), are controversial and have been questioned by researchers. This study investigates how scores on the Social Physique Anxiety Scale (SPAS) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) relate to Bratman’s orthorexia test (BOT) scores with regard to age, sex, and self-reported exercise frequency and duration. The fitness participants (n=251, 166 women and 85 men, 21% dropout) were consecutively selected from five fitness centers in Sweden. They completed the BOT, SPAS, SATAQ, and a questionnaire focusing on exercise frequency and duration. Multiple stepwise regression analysis was used and the significance level set at 5%. In men, the results indicated that the SATAQ subdomain internalization could itself explain the variation in BOT results. In women, the results demonstrated that exercise frequency, in combination with the SPAS score and the SATAQ subdomains of internalization and awareness, could explain the variation in BOT results. Internalization of a slimness ideal (for women) and a muscular body (for men) can be a risk factor for obsession with diet. In the same way, higher exercise frequency, a higher level of social physique anxiety and awareness of Western body ideals seem to be predictors of obsession with diet among women. It is possible that the fitness center environment emphasizes a body ideal that leads to an increased obsession with diet. On the other hand, it may be that people who are aware of the body ideal and are obsessed with diet are the ones who engage in fitness center activities.

  • 6.
    Eriksson, Linn
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    Primary Health Care Research and Development, Council Halland, Falkenberg, Sweden.
    Marklund, Bertil
    Primary Health Care Research and Development, Council Halland, Falkenberg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants2008In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 18, no 3, p. 389-394Article in journal (Refereed)
    Abstract [en]

    This study investigates how scores on the Social Physique Anxiety Scale (SPAS) and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) relate to Bratman's orthorexia test (BOT) scores with regard to age, sex, and self-reported exercise frequency and duration in a sample of Swedish participants in fitness center activities. A total of 251 participants (166 women and 85 men) completed the SPAS, the SATAQ, and a questionnaire focusing on exercise frequency and duration. The results indicated that the SATAQ subdomain internalization could itself explain the variation in BOT results. In women, the results indicated that exercise frequency, followed by SPAS score and the SATAQ subdomains internalization and awareness, could together explain the variation in BOT results. Fitness centers could make a point of emphasizing that some physical ideals are neither healthy nor realistic, thus strengthening member self-image and preventing social physique anxiety, eating disorders, and negative attitudes toward appearance.

  • 7.
    Eriksson, Linn
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Marklund, Bertil
    Primary Health Care Research and Development, Council Halland, Falkenberg, Sweden.
    Baigi, Amir
    Primary Health Care Research and Development, Council Halland, Falkenberg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    On the concept of orthorexia nervosa: a rebuttal: Letter to the Editor2008In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 18, no 3, p. 397-397Article in journal (Refereed)
  • 8.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Barker Ruchti, Natalie
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Patriksson, Göran
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Orthorexia nervosa: An integrative literature review of a lifestyle syndrome2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 26799Article in journal (Refereed)
    Abstract [en]

    Bratman first proposed orthorexia nervosa in the late 1990s, defining it an obsession with eating healthy food to achieve, for instance, improved health. Today, in the Swedish media, excessive exercising plays a central role in relation to orthorexia. A few review articles on orthorexia have been conducted; however, these have not focused on aspects of food and eating, sport, exercise, or a societal perspective. The overall aim of this study was to provide an overview and synthesis of what philosophies of science approaches form the current academic framework of orthorexia. Key questions were: What aspects of food and eating are related to orthorexia? What role do exercise and sports play in relation to orthorexia? In what ways are orthorexia contextualized? Consequently, the concept of healthism was used to discuss and contextualize orthorexia. The method used was an integrative literature review; the material covered 19 empirical and theoretical articles published in peer-reviewed journals. This review demonstrates a multifaceted nature of orthorexia research; this field has been examined from four different philosophies of science approaches (i.e., empirical-atomistic, empirical-atomistic with elements of empirical-holistic, empirical-holistic, and rational-holistic) on individual, social, and societal levels. The majority of the articles followed an empirical-atomistic approach that focused on orthorexia as an individual issue, which was discussed using healthism. Our analysis indicates a need for (a) more empirical-holistic research that applies interpretive qualitative methods and uses a social perspective of health, e.g., healthism and (b) examining the role of sports and exercise in relation to orthorexia that takes the problematizing of “orthorexic behaviours” within the sports context into account.

  • 9.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Barker-Ruchti, Natalie
    University of Gothenburg, Gothenburg, Sweden.
    Patriksson, Göran
    University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    University of Gothenburg, Gothenburg, Sweden.
    Orthorexia is framed as exercise dependence in Swedish daily newspapers2015Conference paper (Refereed)
  • 10.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Barker-Ruchti, Natalie
    University of Gothenburg, Gothenburg, Sweden.
    Patriksson, Göran
    University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    University of Gothenburg, Gothenburg, Sweden.
    The framing of orthorexia nervosa in Swedish daily newspapers: A longitudinal qualitative content analysis2016In: Scandinavian Sport Studies Forum, E-ISSN 2000-088X, Vol. 7, p. 27-46Article in journal (Refereed)
    Abstract [en]

    This study explored and elucidated how orthorexia is framed in Swedish daily newspapers with a focus on characteristics of orthorexia. Key questions include: 1) how do the newspaper articles connect exercise with orthorexia? and 2) what trends in depicting exercise in relation to orthorexia do the newspaper articles represent over time? The method used was a longitudinal qualitative content analysis guided by the framing theory. We analyzed 166 articles published between 1998 and 2013. Our analysis revealed that orthorexia originally was framed as an eating disorder and subsequently included unhealthy exercise. Two trend shifts could be identified: in 2004, exercise was added as an element and in 2013 extreme exercise trends were described to influence the increase of orthorexia. The findings indicate that Swedish newspapers extend Bratman’s definition and depict orthorexia indiscriminately to describe a range of different behavioral characteristics. These results are discussed in terms of the idea of “healthism” and general health trends in society.

  • 11.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare.
    Katarina, Haraldsson
    Department of Research and Development Within Education, Halmstad, Sweden; University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    Physical Education Teacher’s Professional Learning of Implementing a Health Promotion Intervention in the Practice of a Research Circle2022In: Health Promotion / [ed] Mukadder Mollaoğlu, London: IntechOpen , 2022, p. 75-94Chapter in book (Refereed)
    Abstract [en]

    Scholars recommend that health promotion researchers engage practitioners in the analysis and reporting phase and expand their ability to share their research beyond academia. The purpose of this study was to draw benefit from physical education (PE) teachers’ discussions and reflections of the implementation of a health promotion intervention in school during research circle meetings. The health promotion intervention ‘Pulse for Health and Learning’ (PuLH) focused on moderate-to-vigorous physical activity, incorporating a child-centred coaching approach. This study has an action research approach. The research circle consisted of PE teachers (N = 22, approximately 18 per meeting) from eight primary and middle schools (from grades 4 to 9) in eight municipalities in Sweden and three researchers. The theory of ‘practice architectures’ was employed to interpret, discuss, and clarify what enables and constrain PE teachers’ implementation of the health promotion intervention. During the analysis, three discourses were identified: technical-rational discourse, participating discourse, and steering and supporting discourse. The practice architectures both enabled and constrained the implementation of PuLH. The research circle meetings stimulated critically conscious acting and decision-making through collaboration between PE teachers and together with researchers which improved the implementation of PuLH and contributed to PE teachers’ professional development.

  • 12.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. University of Gothenburg, Gothenburg, Sweden.
    Prell, Hillevi
    University of Gothenburg, Gothenburg, Sweden.
    “If it’s not Iron it’s Iron f*cking biggest Ironman”: personal trainers’s views on health norms, orthorexia and deviant behaviours2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no Suppl. 2, article id 1364602Article in journal (Refereed)
    Abstract [en]

    Orthorexia nervosa (ON) describes a pathological obsession with healthy eating to avoid ill health. In the Swedish context, ON is also understood in terms of unhealthy exercise. Fitness gyms are popular health-promoting places, but exercise-related problems, disordered eating and ON-like behaviour are increasing. Personal trainers (PTs) play an important role in detecting unhealthy behaviours. The aim of the present study was to illuminate PTs’ understandings of healthy and unhealthy exercise and eating behaviours in relation to orthorexia nervosa in a fitness gym context. Five focus groups with 14 PTs were conducted. These were analysed using interpretative qualitative content analysis and Becker’s model “Kinds of Deviance.” In contrast to PTs’ health norms (practicing balanced behaviours and contributing to well-being), ON was expressed mainly in terms of exercise behaviour and as being excessive and in total control. The PTs maintain that extreme behaviours are legitimized by an aggressive exercise trend in society and that they fear to falsely accuse clients of being pathological. Certain sport contexts (bodybuilding, fitness competitions and elite sports) and specific groups (fitness professionals) contribute to complicating PTs’ negotiations due to a competition, performance and/or profession norm, making it difficult to determine whether or not to intervene. © 2017 The Author(s)

  • 13.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Prell, Hillevi
    Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    The challenges in responding to unhealthy eating and exercise behaviours among clients: From personal trainers’ views2017In: Proceedings of the Nordic Sport Science Conference – ‘The Double-Edged Sword of Sport: Health Promotion Versus Unhealthy Environments’ / [ed] Krister Hertting & Urban Johnson, Halmstad: Halmstad University Press, 2017, p. 57-58Conference paper (Refereed)
  • 14.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundin, Ida
    Halmstad University, School of Health and Welfare.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, POBox 300, SE-405 30 Gothenburg, Sweden.
    ”Appearance, that’s the only thing that matters” Personal trainers’ negotiations of valued bodies in a gym context2019Conference paper (Refereed)
  • 15.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Prell, Hillevi
    Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Personal trainer´s health advice to clients in the fitness gym2019Conference paper (Refereed)
    Abstract [en]

    Fitness gyms have become popular places for physical activity. Several individuals exercise at gyms and an increasing number hire a personal trainer (PT). PTs have an important role in offering advice and exercise programs as well as detecting unhealthy behaviors among their clients. Norms regarding exercise habits in the gyms appear to be strongly gendered, which may influence PTs’ advice. The purpose of this presentation is to describe PTs’ health advice to clients. In total, 19 PTs, nine women and ten men, aged 23 – 47 years were recruited through purposive sampling. An explorative design was employed and seven focus group discussions were carried out. These were analyzed using a qualitative content analysis guided by a gender perspective. The findings suggest that PTs had a gendered health advice approach towards women regarding exercise and diet. The PTs gave reactive health advice especially to women showing unhealthy exercise and eating behaviors in order to correct these unhealthy behaviors. The specific advice involved a) eating more and exercising less, b) focusing on performance rather than appearance and c) avoiding heavy weight lifting. However, the PTs avoided to advise men showing similar unhealthy training and eating behaviors. The PTs also had a transgressive health advice approach. They advised both women and men to a) adopt a relaxed attitude to exercise and diet, b) to prioritize and rationalize their exercise and diet and c) to eat a natural diet. The gendered health advice approach might give women and men different opportunities to improve their physical fitness, health and well-being. Men with unhealthy behaviors might not be supported by the PTs, which adversely can affect men's health. We recommend that gym managers and PT-educators increase their awareness about the importance of providing equal opportunities for women and men to improve their physical fitness and health.

  • 16.
    Håman, Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Yring, Helena
    Halmstad University, School of Health and Welfare.
    Prell, Hillevi
    Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Personal trainers’ health advice in the fitness gym space from a gender perspective2020In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 15, no sup1, article id 1794364Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to describe and problematize the advice on exercise and diet that personal trainers (PTs) provide to their clients from a gender perspective. Method: The present study had an explorative design, and the interviews were analysed using an interpretative qualitative approach. Seven focus group discussions were conducted with 19 PTs (aged 23–47 years). Results: The findings indicated that the PTs had a gender-neutral health advice approach to both women and men, guiding them towards a relaxed attitude to exercise and diet, prioritizing and rationalizing their exercise and diet and eating a natural diet. PTs also had a gendered health advice approach as regards women who showed unhealthy exercise and eating behaviours; advising them to eat more and exercise less, to focus on performance rather than appearance and to avoid heavy weightlifting. Some PTs acted evasively and did not give advice to men. Conclusions: Both approaches include advice that reflect health as control and health as release. From a gender perspective, PTs health advice both challenged and reproduced the stereotypical male norm in the fitness gym space. However, PTs gendered health advice may create different opportunities for men and women to promote their health and well-being in the fitness gym. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 17.
    Håman (née Eriksson), Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Barker-Ruchti, Natalie
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Patriksson, Göran
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Research ethics within the study: Fitness professionals’ talk of health and orthorexia nervosa2014In: 4th International Conference on Qualitative Research in Sport & Exercise, 2014, p. 37-37Conference paper (Refereed)
    Abstract [en]

    Fitness center activities have gained popularity. One central role fitness staff members have is to help participants to become or maintain health and fitness. In recent years, a new phenomenon – orthorexia nervosa, which M.D. Bratman coined in the late 1990s – has emerged. He termed orthorexia as "a fixation on eating healthy food". Research has mentioned that participants in sports and fitness activities may be at higher risk of becoming orthorexic. Since the late 1990s, orthorexia has been noticed, also in Swedish newspaper articles. In so doing, the 'condition' has evolved to include fanatic exercise and eating behaviours. Fitness professionals might thus work with individuals that are considered to suffering from orthorexia. The purpose of this presentation is to elucidate and problematize ethical issues that are raised during the research that deals with personal trainers and group fitness instructors talk of health and orthorexia. The material will consist of four focus groups with 18 fitness professionals that work in Swedish fitness centers. It will be carried out as a qualitative study. This study raises ethical issues, including for instance: a) by focusing and giving attention to orthorexia, the study may contribute to categorizing "the problem", as well as enlarge it. This paradoxical situation as the aim is to contribute scientific knowledge that can problematize orthorexia; b) the challenge to manage and balance a critical approach without causing harm (e.g. introduce orthorexia to fitness professionals who might have an erroneous perspective of and/or have little knowledge about orthorexia) (cf. Halse & Honey, 2005).

  • 18.
    Håman (née Eriksson), Linn
    et al.
    Halmstad University, School of Health and Welfare.
    Katarina, Haraldsson
    Halmstads kommun Forsknings- och utvecklingsavdelningen Resurscentrum, Kärnhuset BUF, barn- och ungdomsförvaltningen.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    Research circle in a health promotion intervention: Developing physical education teacher’s child-centred coaching approach2023Conference paper (Refereed)
  • 19.
    Håman (née Eriksson), Linn
    et al.
    Halmstad University, School of Health and Welfare.
    Kristén, Lars
    Halmstad University, School of Health and Welfare.
    Alftberg, Åsa
    Department of Social Work, Faculty of Health and Society, Malmö University.
    Jeanette, Källstrand
    Halmstad University, School of Health and Welfare.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    Empowering older people with age-related macular degeneration: An Empowerment-Based Physical Activity Intervention2023Conference paper (Refereed)
  • 20.
    Håman (née Eriksson), Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF). University of Gothenburg, Gothenburg, Sweden.
    Patriksson, Göran
    University of Gothenburg, Gothenburg, Sweden.
    Barker-Ruchti, Natalie
    University of Gothenburg, Gothenburg, Sweden.
    Lindgren, Eva-Carin
    University of Gothenburg, Gothenburg, Sweden.
    Disordered eating outside the sport setting: Contextualizing representations of orthorexia nervosa in Swedish daily newspapers2014Conference paper (Refereed)
    Abstract [en]

    In the late 1990s, Bratman coined the term orthorexia nervosa to mean an unhealthy obsession of only eating healthy foods (Bratman & Knight, 2000). The research is limited and orthorexia has rarely been researched in sport settings (e.g. Eriksson et al., 2008; Segura-García et al., 2012). At this stage, this concept is considered under establishment and negotiation – a process of formation where it is not clear what orthorexia is. How orthorexia is contextualized and represented influences the establishment and understanding of the condition and concept. The aim of this study is to analyze representations of orthorexia in articles printed in Swedish newspapers, with a special view on how the articles refer to sport as a social setting. Notions of healthy and disordered eating are influenced by cultural ideas in society. The language is central in this process as it creates and organizes beliefs about social reality. Perceptions and knowledge about orthorexia are created through, for example, newspaper texts. The material included in this study was limited to national, regional and local Swedish daily newspaper articles published between January 2004 and June 2011. A total of 102 articles were included as they explicitly dealt with orthorexia. The articles were analyzed using a discourse analytical approach through a qualitative content analysis. The articles represented orthorexia in different ways: a) (un)controlled and obsessive patterns of behavior; b) sacrificing social situations; c) an eating disorder in new clothes; d) a painful existence; and e) an invisible problem. Within the last category, the way orthorexia is represented in relation to sport points to how different norms and values apply in and outside this setting. Orthorexia is only considered as disordered eating in non-sport settings. In sport, orthorexic behaviours are considered standard practice. These findings thus further problematize disordered eating in and outside sport settings.

  • 21.
    Håman (née Eriksson), Linn
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF). Institutionen för kost- och idrottsvetenskap, Göteborgs universitet, Göteborg, Sverige.
    Patriksson, Göran
    Institutionen för kost- och idrottsvetenskap, Göteborgs universitet, Göteborg, Sverige.
    Barker-Ruchti, Natalie
    Institutionen för kost- och idrottsvetenskap, Göteborgs universitet, Göteborg, Sverige.
    Lindgren, Eva-Carin
    Institutionen för kost- och idrottsvetenskap, Göteborgs universitet, Göteborg, Sverige.
    “Men do not want to be associated with medical conditions that are perceived women-only issues”: gendered constructions of orthorexia nervosa in Swedish daily newspapers2012In: Perspektiv på idrottens prestationssystem – från debut till avslut: Abstracts: SVEBI 2012, 2012Conference paper (Refereed)
  • 22.
    Lindgren, Eva-Carin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Eriksson, Linn
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fanatiska levnadsvanor för hälsa eller kroppsligt utseende?2010In: Hälsa & Livsstil: Forskning & praktiska tillämpningar / [ed] Lillemor Hallberg, Lund: Studentlitteratur , 2010, p. 227-240Chapter in book (Other academic)
  • 23.
    Lindgren, Eva-Carin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Haraldsson, Katarina
    Department of Research and Development within Education, Region Jönköping County, Jönköping, Sweden & Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Håman, Linn
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    ‘Pulse for learning and health [PuLH]’ in primary school; pupil’s experiences2019Conference paper (Refereed)
    Abstract [en]

    To improve academic performance and health in schoolchildren, the program Pulse for learning and health [PuLH] in Sweden has introduced moderate to vigorous physical activities [MVPA] three times a week (á 30 minutes). The teachers used a child-centered coaching approach, which has the child’s best interests in mind and focused on having fun. The objective of this contribution is to describe what Swedish pupils convey, using their own voices, about their experiences of participating in the school-based program PuLH. We have taken on children’s perspectives in order to be able to understand the children’s own culture. Eight schools in the Region of Jönköping, Sweden, have implemented PuLH. In total, 73 pupils (34 girls, 39 boys, grades 4-9) were recruited through purposive sampling. Thirteen focus group interviews (n=71) and individual interviews (n=2) were carried out. An explorative design was employed, in which data were categorized using qualitative content analysis. The analysis resulted in four major themes, which we classify as ‘promotes academic performance’, ‘promotes a learning school environment’, ‘promotes health and well-being’, and ‘individual and structural barriers’. The pupils stated that they increased their working capacity, the classroom environment became more calm and peaceful, they got more cohesion and new friends, their needs and interest were in focus, they felt more alert and got in a better mood, they increased their physical competence, their habits became healthier and illness decreased. However, some of the pupils revealed individual and structural barriers, which reduced pleasure and motivation to participate in MVPA due to; poor planning and that they felt time pressure, felt uncomfortable showing their bodies and digital challenges. We recommend that schools take pupils’ interests and needs into consideration when planning for and implementing MVPA activities and not use MVPA as a 'quick fix' i.e. to solve complex problems regarding pupil's learning.

  • 24.
    Lindgren, Eva-Carin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Håman, Linn
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Haraldsson, Katarina
    Department of Research and Development within Education, Region Jönköping County, Jönköping, Sweden & Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Voices from Pupil Participation in the Health Promotion Intervention “Pulse for Learning and Health [PuLH]” in Primary and Middle School2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 22, article id 4543Article in journal (Refereed)
    Abstract [en]

    In order to improve the learning conditions and health of schoolchildren, the Pulse for Learning and Health [PuLH] program in Sweden has introduced additional mandatory moderate to vigorous physical activity [MVPA] that lasts for 30 min three times a week. The PE teachers used a child-centered coaching approach to support all pupils. The aim of this study was to explore pupils’ perception and experience of PuLH that has been implemented in primary and middle schools in Sweden. We have taken into account children’s rights perspectives and adopted an exploratory and interpretive approach. In total, 73 pupils (34 girls, 39 boys, grades 4–9) were recruited through purposive sampling. 13 focus group interviews (n = 71) and individual interviews (n = 2) were carried out. All interviews were analyzed using qualitative content analysis. The analysis resulted in three major themes: ‘promotes academic performance and a learning school environment’, ‘promotes health and well-being’, and ‘individual and structural barriers’. From children’s perspective, the results highlight the importance of teachers and principals taking into account the interests and needs of all pupils, to have a well-planned MVPA intervention and to deal with issues regarding body ideals. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

    Download full text (pdf)
    Voices from Pupil Participation in the Health Promotion Intervention “Pulse for Learning and Health [PuLH]” in Primary and Middle School
  • 25.
    Lindgren, Eva-Carin
    et al.
    Halmstad University, School of Health and Welfare.
    Källstrand Eriksson, Jeanette
    Halmstad University, School of Health and Welfare.
    Alftberg, Åsa
    Malmö University, Malmö, Sweden.
    Johansson, Pia
    Halmstad University, School of Health and Welfare.
    Kristén, Lars
    Halmstad University, School of Health and Welfare.
    Håman, Linn
    Halmstad University, School of Health and Welfare.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare.
    Empowerment-Based Physical Activity Intervention for People with Advanced Dry Age-Related Macular Degeneration: Mixed-Methods Protocol2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 1, article id 643Article in journal (Refereed)
    Abstract [en]

    Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. These impacts include loss of social activities, decreased functional independence, and reduced physical activity. This protocol aims to describe a prospective, mixed-methodology for studying a population with AMD before, during, and after an empowerment-based physical activity intervention (EPI). A study framework was also developed for EPI. The intervention will include 20 older individuals (age 65+ years) with AMD recruited in Sweden. The intervention period is six months and comprises adapted physical activity and social activities in a group twice a week and individual health coaching on three occasions. The quantitative pre-test and three follow-ups include physical functional tests, an accelerometer that monitors physical activity continuously for one week, and questionnaires. Individual and focus-group interviews and ethnographic observations will explore the experience of living with AMD and what it means to participate in the EPI for individuals with AMD. The chosen methodology offers a structured way for researchers to explore the experiences and factors that may provide insights into the potential of creative supervised, adapted physical activity in groups, health coaching, and socialising that are significant to enable well-being among older individuals with AMD. © 2022 by the authors.

  • 26.
    Svedberg, Petra
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Källstrand Eriksson, Jeanette
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Håman, Linn
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Utvärdering - Välmående ger Resultat2019Report (Other (popular science, discussion, etc.))
    Download full text (pdf)
    Utvärdering - Välmående ger Resultat
  • 27.
    Zimmerman Nilsson, Marie-Helene
    et al.
    University West.
    Lydell, Marie
    Halmstad University, School of Health and Welfare.
    Håman (née Eriksson), Linn
    Halmstad University, School of Health and Welfare.
    Health and Well-being Among Immigrated Women in Higher Education: An Integrative Literature Review2023Conference paper (Refereed)
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