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

Abstract

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

Evening chronotype, disordered eating behavior, bipolar disorder, and light therapy

“…We strongly support the suggestion made by Romo‐Nava and colleagues to study chronotherapeutic interventions 1 for disordered eating behavior in BD, and we think that although limitations of the evidence base must be considered, light therapy has a favorable efficacy and safety profile as a treatment option in bipolar depression. It is an interesting candidate to be studied in conjunction with psychoeducation on sleep hygiene and healthy eating behavior in evening chronotype individuals with BD and disordered eating.…”

“…1 Morning light therapy advances circadian phase measured by salivary dim light melatonin onset and may be an interesting therapeutic option to be studied. 1,2 Furthermore, a systematic review has concluded that bright light therapy may be effective for disordered eating behavior. 3 Light therapy has not much been studied in bipolar disorder, but recently five randomized, placebo-controlled trials (RCT) have been published, 4 supporting efficacy for light therapy in bipolar depression.…”

“…In their large cross‐sectional study, Romo‐Nava et al show that in individuals with bipolar disorder (BD), evening chronotype is associated with disordered eating like binge‐eating behavior and bulimia nervosa, as well with unhealthy dietary patterns such as breakfast skipping, lower consumption of fruits and vegetables, and higher consumption of unhealthy foods 1 . Morning light therapy advances circadian phase measured by salivary dim light melatonin onset and may be an interesting therapeutic option to be studied 1,2 . Furthermore, a systematic review has concluded that bright light therapy may be effective for disordered eating behavior 3 …”

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