The relationship between oral Firmicutes/Bacteroides ratio, nutritional status, and eating disorder risk in university students

Authors

  • Nurina Habibah Universitas Gadjah Mada, Indonesia
  • Aisyah Novita Amri Universitas Gadjah Mada, Indonesia
  • Rio Jati Kusuma Universitas Gadjah Mada, Indonesia

DOI:

https://doi.org/10.31101/jhes.3960

Keywords:

eating disorders, oral Firmicutes/Bacteroidetes, F/B ratio, nutritional status, university students

Abstract

University students are a vulnerable population to developing eating disorders due to the lifestyle and psychological changes during their academic years. The oral microbiome, particularly the Firmicutes/Bacteroidetes (F/B) ratio, has been proposed as a potential biomarker for nutritional status, though its relationship in eating disorder risk remains underexplored. This study examined the relationship between the oral F/B ratio, nutritional status, and the risk of eating disorders among university students. A cross-sectional study was conducted on undergraduate students from the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia, from August to October 2024. Saliva samples were analyzed using qPCR to determine the F/B ratio. Nutritional status was assessed via BMI categorization, and eating disorder risk was evaluated using EAT-26 questionnaire. Statistical analyses included Pearson and Spearman correlations. The study included 42 students aged 19-23 years, with the majority (90.5%) being female. Nutritional status was distributed as 11.9% underweight, 52.4% normal, and 35.7% overweight/obese. Eating disorder risk was identified in 38.1% of participants, with all underweight students at risk. The mean oral F/B ratio was 0.704 ± 1.93, significantly associated with nutritional status (p 0.033) but not with eating disorder risk. Higher F/B ratios were observed in overweight/obese participants, whereas lower ratios were observed in underweight status. The oral F/B ratio shows potential as a biomarker for nutritional status among university students but does not directly correlate with eating disorder risk. These findings highlight the complex interplay between microbiome composition, nutrition, and eating behavior related to mental health.

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References

AAMC (Association of American Medical Colleges). (2019). The Majority of U.S. Medical Students are Women, New Data Show. Retrieved on December 10, 2024, from https://www.aamc.org/

Al-Awwad, N. J., Al-Sayyed, H. F., Zeinah, Z. A., & Tayyem, R. F. (2021). Dietary and lifestyle habits among university students at different academic years. Clinical Nutrition ESPEN, 44, 236–242. https://doi.org/10.1016/j.clnesp.2021.06.010

Albedewi, H., Bindayel, I., Albarrag, A., & Banjar, H. (2022). Correlation of Gut Microbiota, Vitamin D Status, and Pulmonary Function Tests in Children With Cystic Fibrosis. Frontiers in Nutrition, 9(June), 1–10. https://doi.org/10.3389/fnut.2022.884104

Allen, K. L., Mountford, V. A., Elwyn, R., Flynn, M., Fursland, A., Obeid, N., Partida, G., Richards, K., Schmidt, U., Serpell, L., Silverstein, S., & Wade, T. (2023). A framework for conceptualising early intervention for eating disorders. European Eating Disorders Review, 31(2), 320–334. https://doi.org/10.1002/erv.2959

Almoraie, N. M., Alothmani, N. M., Alomari, W. D., & Al-Amoudi, A. H. (2024). Addressing nutritional issues and eating behaviours among university students: A narrative review. Nutrition Research Reviews, 18. https://doi.org/10.1017/S0954422424000088

Anton-Păduraru, D. T., Trofin, F., Nastase, E. V., Miftode, R. S., Miftode, I. L., Trandafirescu, M. F., Cojocaru, E., Țarcă, E., Mindru, D. E., & Dorneanu, O. S. (2024). The Role of the Gut Microbiota in Anorexia Nervosa in Children and Adults—Systematic Review. International Journal of Molecular Sciences, 25(1). https://doi.org/10.3390/ijms25010041

Barakat, S., McLean, S. A., Bryant, E., Le, A., Marks, P., Aouad, P., Barakat, S., Boakes, R., Brennan, L., Bryant, E., Byrne, S., Caldwell, B., Calvert, S., Carroll, B., Castle, D., Caterson, I., Chelius, B., Chiem, L., Clarke, S., … Touyz, S. (2023). Risk factors for eating disorders: findings from a rapid review. In Journal of Eating Disorders (Vol. 11, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s40337-022-00717-4

Belibasakis, G. N., Belstrøm, D., Eick, S., Gursoy, U. K., Johansson, A., & Könönen, E. (2023). Periodontal microbiology and microbial etiology of periodontal diseases: Historical concepts and contemporary perspectives. Periodontology 2000, September 2022, 1–17. https://doi.org/10.1111/prd.12473

Berding, K., & Cryan, J. F. (2022). Microbiota-targeted interventions for mental health. Current Opinion in Psychiatry, 35(1), 3–9. https://doi.org/10.1097/YCO.0000000000000758

Bray, M., Heruc, G., Byrne, S., & Wright, O. R. L. (2023). Collaborative dietetic and psychological care in Interprofessional Enhanced Cognitive Behaviour Therapy for adults with Anorexia Nervosa: a novel treatment approach. Journal of Eating Disorders, 11(1), 1–6. https://doi.org/10.1186/s40337-023-00743-w

Brytek-Matera, A. (2021). Negative affect and maladaptive eating behavior as a regulation strategy in normal-weight individuals: A narrative review. Sustainability (Switzerland), 13(24). https://doi.org/10.3390/su132413704

Buková, A., Tomková, P., Uher, I., Kimáková, T., Vojtaško, Ľ., & Salonna, F. (2024). Selected lifestyle factors as students transition from secondary school to university in Slovakia. Frontiers in Public Health, 12(October), 1–9. https://doi.org/10.3389/fpubh.2024.1461989

Chen, X., Xian, B., Wei, J., Chen, Y., Yang, D., Lai, X., Liu, L., Wu, Y., Lin, X., Deng, Y., Zhang, H., Liu, W., Qiao, G., & Li, Z. (2022). Predictive value of the presence of Prevotella and the ratio of Porphyromonas gingivalis to Prevotella in saliva for esophageal squamous cell carcinoma. Frontiers in Cellular and Infection Microbiology, 12(October), 1–11. https://doi.org/10.3389/fcimb.2022.997333

Choirunnisa, R. A., & Harahap, F. (2023). Body image and eating behaviors among university students. Psychological Research and Intervention, 6(2), 75–83. https:/doi.org/10.21831/pri.v6i2.65165

Clemente-Suárez, V. J., Beltrán-Velasco, A. I., Redondo-Flórez, L., Martín-Rodríguez, A., & Tornero-Aguilera, J. F. (2023). Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients, 15(12). https://doi.org/10.3390/nu15122749

Clemente-Suárez, V. J., Ramírez-Goerke, M. I., Redondo-Flórez, L., Beltrán-Velasco, A. I., Martín-Rodríguez, A., Ramos-Campo, D. J., Navarro-Jiménez, E., Yáñez-Sepúlveda, R., & Tornero-Aguilera, J. F. (2023). The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions. Nutrients, 15(11). https://doi.org/10.3390/nu15112594

Conlon, M. A., & Bird, A. R. (2015). The impact of diet and lifestyle on gut microbiota and human health. Nutrients, 7(1), 17–44. https://doi.org/10.3390/nu7010017

Dahlan, M. S. (2016). Sample size in medical and health research (4th ed.). Epidemiologi Indonesia.

Dakanalis, A., Mentzelou, M., Papadopoulou, S. K., Papandreou, D., Spanoudaki, M., Vasios, G. K., Pavlidou, E., Mantzorou, M., & Giaginis, C. (2023). Depression , anxiety / stress , and dietary patterns : A review of the current clinical evidence. Nutrients, 15, 1–18.

De Luca, F., & Shoenfeld, Y. (2019). The microbiome in autoimmune diseases. Clinical and Experimental Immunology, 195(1), 74–85. https://doi.org/10.1111/cei.13158

Deliens, T., Van Crombruggen, R., Verbruggen, S., De Bourdeaudhuij, I., Deforche, B., & Clarys, P. (2016). Dietary interventions among university students: A systematic review. Appetite, 105, 14–26. https://doi.org/10.1016/j.appet.2016.05.003

Dong, L., Yin, J., Zhao, J., Ma, S. rui, Wang, H. rui, Wang, M., Chen, W., & Wei, W. qiang. (2018). Microbial similarity and preference for specific sites in healthy oral cavity and esophagus. Frontiers in Microbiology, 9(JUL), 1–10. https://doi.org/10.3389/fmicb.2018.01603

Drozdz, D., Alvarez-Pitti, J., Wójcik, M., Borghi, C., Gabbianelli, R., Mazur, A., Herceg-čavrak, V., Lopez-Valcarcel, B. G., Brzeziński, M., Lurbe, E., & Wühl, E. (2021). Obesity and cardiometabolic risk factors: From childhood to adulthood. Nutrients, 13(11), 1–20. https://doi.org/10.3390/nu13114176

Eck, K. M., Quick, V., & Byrd-Bredbenner, C. (2022). Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States. Nutrients, 14(18). https://doi.org/10.3390/nu14183876

Eguren-García, I., Sumalla-Cano, S., Conde-González, S., Vila-Martí, A., Briones-Urbano, M., Martínez-Díaz, R., & Elío, I. (2024). Risk Factors for Eating Disorders in University Students: The RUNEAT Study. Healthcare (Switzerland), 12(9). https://doi.org/10.3390/healthcare12090942

Elzayat, H., Malik, T., Al-Awadhi, H., Taha, M., Elghazali, G., & Al-Marzooq, F. (2023). Deciphering salivary microbiome signature in Crohn’s disease patients with different factors contributing to dysbiosis. Scientific Reports, 13(1), 1–15. https://doi.org/10.1038/s41598-023-46714-8

Escolar-Llamazares, M. C., Martínez-Martín, M. Á., Medina-Gómez, M. B., González-Alonso, M. Y., Mercado-Val, E., & Lara-Ortega, F. (2023). Sociodemographic Variables and Body Mass Index Associated with the Risk of Eating Disorders in Spanish University Students. European Journal of Investigation in Health, Psychology and Education, 13(3), 595–612. https://doi.org/10.3390/ejihpe13030046

Faria, S. L., Santos, A., Magro, D. O., Cazzo, E., Assalin, H. B., Guadagnini, D., Vieira, F. T., Dutra, E. S., Saad, M. J. A., & Ito, M. K. (2020). Gut Microbiota Modifications and Weight Regain in Morbidly Obese Women After Roux-en-Y Gastric Bypass. Obesity Surgery, 30(12), 4958–4966. https://doi.org/10.1007/s11695-020-04956-9

Gao, L., Xu, T., Huang, G., Jiang, S., Gu, Y., & Chen, F. (2018). Oral microbiomes: more and more importance in oral cavity and whole body. Protein and Cell, 9(5), 488–500. https://doi.org/10.1007/s13238-018-0548-1

Giordano-Kelhoffer, B., Lorca, C., March Llanes, J., Rábano, A., del Ser, T., Serra, A., & Gallart-Palau, X. (2022). Oral Microbiota, Its Equilibrium and Implications in the Pathophysiology of Human Diseases: A Systematic Review. Biomedicines, 10(8), 1–19. https://doi.org/10.3390/biomedicines10081803

Hariyanti, L. P., & Haryana, N. R. (2021). Factors Related To Body Image and It Correlation With Nutritional Status Among Female Adolescents: a Literature Review. Media Gizi Indonesia, 16(3), 224. https://doi.org/10.20473/mgi.v16i3.224-232

Hasan, N. N., Ahmed, B. M., Mehammed-Aeen, O. H., & Rash, M. Q. H. (2024). Prevalence and Associated Factors of Eating Disorders Among Undergraduate Students at the University of Kirkuk, Iraq: A Cross-Sectional Study. Cureus, 16(7), e6424. http://doi.org/10.7759/cureus.64247

Harshman, S. G., Wons, O., Rogers, M. S., Izquierdo, A. M., Holmes, T. M., Pulumo, R. L., Asanza, E., Eddy, K. T., Misra, M., Micali, N., Lawson, E. A., & Thomas, J. J. (2019). A diet high in processed foods, total carbohydrates and added sugars, and low in vegetables and protein is characteristic of youth with avoidant/restrictive food intake disorder. Nutrients, 11(9). https://doi.org/10.3390/nu11092013

Helal, P., Xia, W., Sardar, P., Conway-Morris, A., ConwayMorris, A., Pedicord, V. A., & Serfontein, J. (2024). Changes in the Firmicutes to Bacteriodetes ratio in the gut microbiome in individuals with anorexia nervosa following inpatient treatment: A systematic review and a case series. Brain and Behavior, 14, e70014. http://doi..org/10.1002/brb3.70014

Islam, M. R., Arthur, S., Haynes, J, Butts, M. R., Nepal, N., & Sundaram, U. (2021). The Role of Gut Microbiota and Metabolites in Obesity-Associated Chronic Gastrointestinal Disorders. Nutrients, 14(624). https://doi.org/10.3390/nu14030624

Jakobsdottir, G., Stefansdottir, R. S., Gestsdottir, S., Stefansson, V., Johannsson, E., Rognvaldsdottir, V., & Gisladottir, T. L. (2023). Changes in health-related lifestyle choices of university students before and during the COVID-19 pandemic: Associations between food choices, physical activity and health. PLoS ONE, 18(6 JUNE), 1–14. https://doi.org/10.1371/journal.pone.0286345

Kato, I., Vasquez, A., moyerbrailean, G., Land, S., Djuric, Z., Sun, J., Lin, H. S., & Ram, J. L. (2017). Nutritional Correlates of Human Oral Microbiome. Journal of American College Nutrition, 36(2), 88-98. http://doi.org/10.1080/07315724.2016.1185386

Kerstens, R., Ng, Y. Z., Pettersson, S., & Jayaraman, A. (2024). Balancing the Oral–Gut–Brain Axis with Diet. Nutrients , 16(18), 1–22. https://doi.org/10.3390/nu16183206

Kunath, B. J., De Rudder, C., Laczny, C. C., Letellier, E., & Wilmes, P. (2024). The oral–gut microbiome axis in health and disease. Nature Reviews Microbiology, 22(December 2024), 791–805. https://doi.org/10.1038/s41579-024-01075-5

Lisnawati, L., & Danefi, T. (2023). Nutritional Status and Lifestyle Factors Contributing to the Regulation of Reproductive Quality in Adolescent Females. Genius Journal, 4(2), 278–290. https://doi.org/10.56359/gj.v4i2.267

Ma, T., Wu, Z., Lin, J., Shan, C., Abasijiang, A., & Zhao, J. (2023) Characterization of the oral and gut microbiome in children with obesity aged 3 to 5 years. Frontiers in Cellular and Infection Microbiology, 13, 1102650. https://doi.org/10.3389/fcimb.2023.1102650

Magne, F., Gotteland, M., Gauthier, L., Zazueta, A., Pesoa, S., Navarrete, P., & Balamurugan, R. (2020). The firmicutes/bacteroidetes ratio: A relevant marker of gut dysbiosis in obese patients? Nutrients, 12(5). https://doi.org/10.3390/nu12051474

Makki, N., Althubyani, S. A., Mobarki, R. Q., Alsayed, J. A., Almohammadi, R. J., & Baabdullah, R. A. (2023). The Effect of Sociocultural Attitudes on Developing Eating Disorders Among Young Females in Almadinah Almunawarah, Saudi Arabia. Cureus, 15(12), 1–11. https://doi.org/10.7759/cureus.50576

Mallaram, G. K., Sharma, P., Kattula, D., Singh, S., & Pavuluru, P. (2023). Body image perception, eating disorder behavior, self-esteem and quality of life: a cross-sectional study among female medical students. Journal of eating disorders, 11, 225. https://doi.org/10.1186/s40337-023-00945-2

Mansour, S. R., Moustafa, M. A. A., Saad, B. M., Hamed, R., & Moustafa, A. R. A. (2021). Impact of diet on human gut microbimoe and disease risk. New Microbiome and New Infection, 41, 100845. https://doi.org/10.1016/j.nmni.2021.100845

Mathunjwa, M. L., Shandu, N. M., Ndwandwe, K., Shongwe, N., Linda, N., Elumalai, V., Syed, K., Avramov, D., Shaw, I., & Shaw, B. (2024). Nutrition and Academic Success : Exploring the Vital Link for University Students. American Journal of Biomedical Science & Research, 769–778. https://doi.org/10.34297/AJBSR.2024.22.003013

Montenegro, J., Armet, A M., Willing, B. P., Deehan, E. C., Fassini, P. G., Mota, J. F., Walter, J., & Prado, C. M. (2023). Exploring the influence of gut microbiome on energy metabolism in humans. Advances in Nutrition, 14, 840-857. https://doi.org/10.101/j.advnut.2023.03.015

Naveed, S., Lakka, T., & Haapala, E. A. (2020). An overview on the associations between health behaviors and brain health in children and adolescents with special reference to diet quality. International Journal of Environmental Research and Public Health, 17(3). https://doi.org/10.3390/ijerph17030953

Niu, C., Tu, Y., Jin, Q., Chen, Z., Yuan, K., Wang, M., Zhang, P., Luo, J., Li, H., Yang, Y., Liu, X., Mao, M., Dong, T., Tan, W., Hu, X., Pan, Y., Hou, L., Ma, R., & Huang, Z. (2023). Mapping the human oral and gut fungal microbiota in patients with metabolic dysfunction-associated fatty liver disease. Frontiers in Cellular and Infection Microbiology, 13(April), 1–12. https://doi.org/10.3389/fcimb.2023.1157368

Noor, J., Chaudhry, A., Batool, S., Noor, R., & Fatima, G. (2023). Exploring the Impact of the Gut Microbiome on Obesity and Weight Loss: A Review Article. Cureus, 15(6). https://doi.org/10.7759/cureus.40948

Noruzpour, A., Gholam-Mostafaei, F. S., Looha, M. A., Dabiri, H., Ahmadipour, S., Rouhani, P., Ciacci, C., & Rostami-Nejad, M. (2024). Assessment of salivary microbiota profile as a potential diagnostic tool for pediatric celiac disease. Scientific Reports, 14(1), 1–9. https://doi.org/10.1038/s41598-024-67677-4

Nugraeni, T. A E., Nai, H. M. E., & Maria, R. F. (2023). The Relationship between the Pattern of Fast Food Consumption and the Frequency of Online Food Ordering with Central Obesity in High School Students in Yogyakarta. Aerta Nutrition, 7(3), 413-420. https://doi.org/ 10.20473/amnt.v7i3.2023.413- 420

Park, S. Y., Hwang, B. O., Lim, M., Ok, S. H., Lee, S. K., Chun, K. S., Park, K. K., Hu, Y., Chung, W. Y., & Song, N. Y. (2021). Oral–gut microbiome axis in gastrointestinal disease and cancer. Cancers, 13(7), 1–20. https://doi.org/10.3390/cancers13071748

Peng, X., Cheng, L., You, Y., Tang, C., Ren, B., Li, Y., Xu, X., & Zhou, X. (2022). Oral microbiota in human systematic diseases. International Journal of Oral Science, 14(1), 1–11. https://doi.org/10.1038/s41368-022-00163-7

Pinart, M., Schlicht, K., Laudes, M., Bouwman, J., Forslund, S. K., Pischon, T., & Nimptsch, K. (2022). Gut Microbiome Composition in Obese and Non-Obese Persons : A Systematic Review and Meta-Analysis. Nutrients, 14(12), 1–41.

Puspita, B. Lestari, A., & Andayani, T. R. (2024). The relationship bteween Fad Diet, Body Image, Stress, Peer Pressure with Eating Disorders in Adolescent Girls Aged 16-18 Years. Amerta Nutrition, 8(1), 49-57. https://doi.org/10.20473/amnt.v8i1.2024.49-57

Rajasekaran, J. J., Krishnamurthy, H. K., Bosco, J., Jayaraman, V., Krishna, K., Wang, T., & Bei, K. (2024). Oral Microbiome: A Review of Its Impact on Oral and Systemic Health. Microorganisms, 12(9), 1797. https://doi.org/10.3390/microorganisms12091797

Razzoli, M., Pearson, C., Crow, S., & Bartolomucci, A. (2017). Stress, overeating, and obesity: Insights from human studies and preclinical models. Neuroscience and Biobehavioral Reviews, 76, 154–162. https://doi.org/10.1016/j.neubiorev.2017.01.026

Reck, M., Tomasch, J., Deng, Z., Jarek, M., Husemann, P., Warner-Dobler, I., and COMBATE consortium. (2015). Stool metatranscriptomics: A technical guideline for mRNA stabilisation and isolation. BMC Genomics, 16, 494. https://doi.org/10.1186/s12864-015-1694-y

Rizzardi, K. F., Indiani, C. M. dos S. P., Mattos-Graner, R. de O., de Sousa, E. T., Nobre-dos-Santos, M., & Parisotto, T. M. (2021). Firmicutes Levels in the Mouth Reflect the Gut Condition With Respect to Obesity and Early Childhood Caries. Frontiers in Cellular and Infection Microbiology, 11(May), 1–8. https://doi.org/10.3389/fcimb.2021.593734

Sadiq, N., Warsi, J., Mahar, B., Shah, T., angi, R., Buriro, A. A, & Memon, A. M. (2023). Screening for Eating Disorder Using Eating Attitudes Test-26 and its Association with Eating Habits in Undergraduate Male University Students. Journal of Shalamar Medical & Dental College, 4, (1), 80–87. https://doi.org/10.53685/jshmdc.v4i1.131

Sampaio-Maia, B., Caldas, I. M., Pereira, M. L., Perez-Mongiovi, D., & Araujo, R. (2016). The Oral Microbiome in Health and Its Implication in Oral and Systemic Diseases. Advance of Applied Microbiology, 97, 171-210. https://doi.org/ 10.1016/bs.aambs.2016.08.002.

Santonocito, S., Giudice, A., Polizzi, A., Troiano, G., Merlo, E. M., Sclafani, R., Grosso, G., & Isola, G. (2022). A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis. Nutrients, 14(12). https://doi.org/10.3390/nu14122426

Sedghi, L., DiMassa, V., Harrington, A., Lynch, S. V., & Kapila, Y. L. (2021). The oral microbiome: Role of key organisms and complex networks in oral health and disease. Periodontology 2000, 87(1), 107–131. https://doi.org/10.1111/prd.12393

Shinde, D. B., Mahore, J. G., Giram, P. S., Singh, S. L., Sharda, A., Choyan, D., & Musale, S. (2024). Microbiota of Saliva: A Non-invasive Diagnostic Tool. Indian Journal of Microbiology, 64(2), 328–342. https://doi.org/10.1007/s12088-024-01219-4

Siddhu, N. S. S. (2024). Impact of Food Intake and Sleep Disturbances on Gut Microbiota. 16(10), 1–7. https://doi.org/10.7759/cureus.70846

Singh, R. K., Chang, H. W., Yan, D., Lee, K. M., Ucmak, D., Wong, K., Abrouk, M., Farahnik, B., Nakamura, M., Zhu, T. H., Bhutani, T., & Liao, W. (2017). Influence of diet on the gut microbiome and implications for human health. Journal of Translational Medicine, 15(1), 1–17. https://doi.org/10.1186/s12967-017-1175-y

Stojanov, S., Berlec, A., & Štrukelj, B. (2020). The influence of probiotics on the firmicutes/bacteroidetes ratio in the treatment of obesity and inflammatory bowel disease. Microorganisms, 8(11), 1–16. https://doi.org/10.3390/microorganisms8111715

Sutoyo, D. A., Atmaka, D. R., & Sidabutar, L. M. G B. (2020). Dietary Factors Affecting Firmicutes and Bacteroidetes Ratio in Solving Obesity Problem: A Literature Review. Media Gizi Indonesia, 15(2), 94-109. https://doi.org/10.204736/mgi.v15i2.94–109

Tavolacci, M. P., Ladner, J., & Déchelotte, P. (2021). Sharp increase in eating disorders among university students since the covid-19 pandemic. Nutrients, 13(10). https://doi.org/10.3390/nu13103415

Tian, S., Ding, T., & Li, H. (2024). Oral microbiome in human health and diseases. MLife, 3(3), 367–383. https://doi.org/10.1002/mlf2.12136

Treasure, J., Duarte, T. A., & Schmidt, U. (2023). Eating disorders. Lancet, 395(10227), 899-911. https://doi.org/10.1016/S0140-6736(20)30059-3

Vaiserman, A., Romanenko, M., Piven, L., Moseiko, V., Lushchak, O., Kryzhanovska, N., Guryanov, V., & Koliada, A. (2020). Differences in the gut Firmicutes to Bacteroidetes ratio across age groups in healthy Ukrainian population. BMC Microbiology, 20(1), 1–8. https://doi.org/10.1186/s12866-020-01903-7

Van Hul, M., Cani, P. D., Petifils, C., De Vos, W. M., Tilg, H., & El Omar, E. M. (2024). What defines a healthy gut microbiome? Gut, 2, 1893–1908. https://doi.org/10.1136/gutjnl-2024-333378

Viljakainen, J., Raju, S. C., Viljakainen, H., Figueiredo, R. A. de O., Roos, E., Weiderpass, E., & Rounge, T. B. (2020). Meal Regularity Plays a Role in Shaping the Saliva Microbiota. Frontiers in Microbiology, 11(April), 1–11. https://doi.org/10.3389/fmicb.2020.00757

Yun T. C., Ahmad, S. R., & Koh, D. S. Q. (2018). Dietary habits and lifestyle practices among university students in universiti Brunei Darussalam. Malaysian Journal of Medical Sciences, 25(3), 56–66. https://doi.org/10.21315/mjms2018.25.3.6

Zhang, Y. X., Wang, S. R., Zhao, J. S., & Chu, Z. H. (2016). Prevalence of overweight and central obesity and their relationship with blood pressure among college students in Shadong, China. Blood Pressure onitoring, 21(4), 251-254. https://doi.org/10.1097/MBP. 0000000000000189

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