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. 2020 Jul;142(1):58-65.
doi: 10.1111/acps.13179. Epub 2020 May 30.

Evening chronotype, disordered eating behavior, and poor dietary habits in bipolar disorder

F Romo-Nava  1   2 , T J Blom  1   2 , A Guerdjikova  1   2 , S J Winham  3 , A B Cuellar-Barboza  4 , N A Nunez  5 , B Singh  5 , J M Biernacka  3   5 , M A Frye  5 , S L McElroy  1   2
Affiliations

Evening chronotype, disordered eating behavior, and poor dietary habits in bipolar disorder

F Romo-Nava et al. Acta Psychiatr Scand. 2020 Jul.

Abstract

Objective: Our aim was to evaluate the relationship between evening chronotype, a proxy marker of circadian system dysfunction, and disordered eating behavior and poor dietary habits in individuals with bipolar disorder (BD).

Methods: In this cross-sectional study, we evaluated 783 adults with BD. Chronotype was determined using item 5 from the reduced Morningness-Eveningness Questionnaire. The Eating Disorder Diagnostic Scale (EDDS) and the Rapid Eating Assessment for Participants-Shortened Version (REAP-S) were used to assess disordered eating behavior and dietary habits respectively. General linear models and logistic regression models were utilized to evaluate differences between chronotype groups.

Results: Two hundred and eight (27%) BD participants self-identified as having evening chronotypes. Compared to non-evening types, evening types were younger (P < 0.01) and, after controlling for age, had higher mean EDDS composite z-scores (P < 0.01); higher rates of binge-eating (BE) behavior (P = 0.04), bulimia nervosa (P < 0.01), and nocturnal eating binges (P < 0.01); and a higher body mass index (P = 0.04). Compared to non-evening types, evening chronotypes had a lower REAP-S overall score (P < 0.01) and scored lower on the 'healthy foods' and 'avoidance of unhealthy food' factors. Evening types also skipped breakfast more often (P < 0.01), ate less fruit (P = 0.02) and vegetables (P = 0.04), and consumed more fried foods (P < 0.01), unhealthy snacks (P = 0.02), and soft drinks (P = 0.01).

Conclusions: Our findings suggest that the circadian system plays a role in the disordered eating and unhealthy dietary behaviors observed in BD patients. The circadian system may therefore represent a therapeutic target in BD-associated morbidity that warrants further investigation.

Keywords: binge eating; bipolar disorder; bulimia; chronotype; diet; evening; food.

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References

    1. Challet E. The circadian regulation of food intake. Nat Rev Endocrinol2020;15:393-405.
    1. Scheer FA, Morris CJ, Shea SA. The internal circadian clock increases hunger and appetite in the evening independent of food intake and other behaviors. Obesity (Silver Spring) 2013;21:421-423.
    1. Kanerva N, Kronholm E, Partonen T et al. Tendency toward eveningness is associated with unhealthy dietary habits. Chronobiol Int 2012;29:920-927.
    1. McElroy SL, Crow S, Blom TJ et al. Clinical features of bipolar spectrum with binge eating behaviour. J Affect Disord 2016;201:95-98.
    1. Segura-Garcia C, Caroleo M, Rania M et al. Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities. J Affect Disord 2017;208:424-430.

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