An examination of the relationship between anxiety levels and nutritional attitudes and eating behavior among elite basketball referees

This study examined associations between state/trait anxiety, healthy eating attitudes, eating behaviors, and referee classification among elite basketball referees. The study included 170 active referees affiliated with the Turkish Basketball Federation during the 2024–2025 season. The data collection instruments used were the Demographic Information Form, the Healthy Eating Attitude Scale (HEAS), the Three-Factor Eating Questionnaire (TFEQ-R18), and the State–Trait Anxiety Inventory (STAI). Group differences were tested with ANOVA or Kruskal-Wallis analyses, associations with correlation analyses, and variables independently associated with emotional and uncontrolled eating with multiple linear regression. Compared with Class C referees, Classes A and B showed higher cognitive restraint and unhealthy eating scores, whereas Class A had higher nutrition knowledge scores than Classes B and C, and positive eating scores were highest in Class A, followed by Class B, with both higher than Class C. In contrast, the total score for healthy eating attitudes, as well as levels of uncontrolled eating, emotional eating, and anxiety, did not differ significantly across classes ( p > .05). Among male referees, there was a positive correlation between trait anxiety and both uncontrolled eating ( r = .252; p = .002) and emotional eating ( r = .227; p = .005). Among female referees, a positive relationship was also found between trait anxiety and both uncontrolled eating ( r = .493; p = .038) and emotional eating ( r = .472; p = .048); however, these findings should be considered exploratory due to the small female subgroup. In addition, a moderate positive relationship was found between nutritional knowledge and cognitive restraint ( r = .449; p < .001). In regression analyses, trait anxiety was positively associated with both emotional eating and uncontrolled eating, whereas age was negatively associated with both outcomes. Gender was associated only with emotional eating, whereas referee classification was associated only with uncontrolled eating. State anxiety was not independently associated with either outcome in the regression models. Among elite basketball referees, higher trait anxiety was associated with emotional and uncontrolled eating, whereas top-tier referees showed better nutrition-related knowledge and stronger cognitive restraint, despite some unhealthy eating-related tendencies.