Intermittent fasting and disordered eating

There are various methods of intermittent fasting and it has been reported to have many health benefits (1).

A recent study points out potential risks of intermittent fasting in young adults (2).

What was the study? (2)

  • A national study of Canadian adolescents and young adults (N = 2762) were analyzed (2).
  • Intermittent fasting participants reported on average 100 days of intermittent fasting over a 12 month period (2).
  • Multiple modified Poisson regression analyses were conducted to determine the association between intermittent fasting (past 12 months and 30 days) and eating disorder behaviors measured using the Eating Disorder Examination Questionnaire (2).

What were the results? (2)

  • 47 % of women, 38.4 % of men, and 52.0 % of transgender/gender non-conforming (TGNC) participants reported engaging in intermittent fasting in the past 12 months.
  • Intermittent fasting in the past 12 months and 30 days was significantly associated with eating disorder psychopathology (2)
  • Varying patterns of association between intermittent fasting and eating disorder behaviors were found across genders, with the most consistent relationships between intermittent fasting and ED behaviors in women (2)
  • Women engaging in intermittent fasting were more likely to report disordered eating behaviors (2)
  • Men engaging in intermittent fasting were more likely to report compulsive exercise (2)

Additional thoughts

  • Even with good food choices, it is important to get enough calories; and not engage in restriction or disordered eating behaviors.
  • TDEE calculators and this chart may be helpful in estimating daily calorie needs.
  • Individuals with eating disorders should seek professional assistance via nutritionist, eating disorder specialist, etc. when considering nutritional adjustments.
  • Further research is needed to better understand the risks and benefits of intermittent fasting particularly in adolescents and young adults.

Any other resources to improve nutrition?

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Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://newsinhealth.nih.gov/2019/12/fast-or-not-fast
  2. Ganson KT, Cuccolo K, Hallward L, Nagata JM. Intermittent fasting: Describing engagement and associations with eating disorder behaviors and psychopathology among Canadian adolescents and young adults. Eat Behav. 2022 Dec;47:101681. doi: 10.1016/j.eatbeh.2022.101681. Epub 2022 Nov 4. PMID: 36368052.
  3. https://u.osu.edu/emotionalfitness/2018/06/28/food-choices-to-improve-depression/

 

Mindfulness meditation vs escitalopram for anxiety

Mindfulness meditation has been shown to have various mental health benefits. For example, a review of 13 studies showed improvement in ADHD symptoms with mindfulness meditation (1).

Also, 41 trials show mindfulness meditation helped improve stress related outcomes such as anxiety, depression, stress, positive mood, etc. (2)

A review of 14 clinical trials shows meditation being more effective than relaxation techniques for anxiety (3).

A recent study looked at whether mindfulness based stress reduction (MBSR) was as effective as an anti-anxiety medication Lexapro (escitalopram) (4).

Who was in the study? (4)

  • 102 participants in MBSR and 106 participants in the escitalopram group, with a mean age of 33 years (4).
  • Participants were mostly female (4).

How was anxiety measured (4)?

  • Clinical Global Impression of Severity scale (CGI-S) was performed by blinded clinical interviewer at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks (4).
  • Primary patient reported measure was the Overall Anxiety Severity and Impairment Scale (OASIS) (4).

What was the intervention? (4)

  • Participants were randomized 1:1 to 8 weeks of the weekly MBSR course or the antidepressant escitalopram, flexibly dosed from 10 to 20 mg (4).
  • MBSR group was taught MBSR as a manualized 8-week protocol with 45 minute daily home practice exercises, weekly 2.5-hour long classes, a day-long retreat weekend class during the fifth or sixth week (5).
  • Participants were taught several forms of mindfulness meditation, such as breath awareness (focusing attention on the breath and other physical sensations), a body scan (directing attention to one body part at a time and observing how that body part feels), and mindful movement (stretching and movements designed to bring awareness to the body and increase interoceptive awareness) (4,5).

What were the results? (4)

Participants who completed the trial at week 8 showed noninferiority for CGI-S score improvement with MBSR compared with escitalopram (4)—meaning MBSR was as effective as escitalopram.

What are some caveats?

  • This is the first study to compare MBSR to medication (4).
  • The study did not use commonly used instruments to measure anxiety in clinical settings such as GAD-7, Hamilton rating scale for anxiety or the Beck anxiety inventory, etc.
  • Participants had any anxiety disorder, not a specific type of anxiety disorder such as generalized anxiety disorder, panic disorder etc (4) which make it difficult to generalize results for other populations.
  • Participants (4) were mostly female in the 30’s which makes it difficult to generalize results for other populations.
  • MBSR is a specific type of manualized meditation taught by qualified instructors (5) and it may be difficult to find qualified instructors or qualified classes in your area.
  • In addition to work, school, and life obligations, people may find it difficult to schedule 45 minutes of daily meditation plus 2.5 hours of weekly class plus a day long retreat.
  • Different people may benefit from different types of meditation, and this area is being further researched.
  • Practicing meditation regularly may lead to improved benefits, and some people may see benefits with shorter duration of meditation.
  • Some people may find that mindfulness or too much mindfulness may worsen their symptoms (6), so you should check with your mental health professional if MBSR is appropriate for you.
  • Some mental health conditions may not be appropriate for MBSR, check with your mental health professional.

Want to learn more about meditation?

If you would like to be notified about future posts on strategies to improve your mental health, enter your email above.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Poissant, H., Mendrek, A., Talbot, N., Khoury, B., & Nolan, J. (2019). Behavioral and Cognitive Impacts of Mindfulness-Based Interventions on Adults with Attention-Deficit Hyperactivity Disorder: A Systematic Review. Behavioural neurology2019, 5682050. doi:10.1155/2019/5682050
  2. Goyal M, Singh S, Sibinga EMS, et al. Meditation Programs for Psychological Stress and Well-Being [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. (Comparative Effectiveness Reviews, No. 124.)Available from: https://www.ncbi.nlm.nih.gov/books/NBK180102/
  3. Montero-Marin, J., Garcia-Campayo, J., Pérez-Yus, M., Zabaleta-del-Olmo, E., & Cuijpers, P. (n.d.). Meditation techniques v. relaxation therapies when treating anxiety: A meta-analytic review. Psychological Medicine,1-16. doi:10.1017/S0033291719001600
  4. Hoge, Elizabeth A et al. “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial.” JAMA psychiatry, e223679. 9 Nov. 2022, doi:10.1001/jamapsychiatry.2022.3679
  5. Santorelli  SF, Kabat-Zinn  J, Blacker  M, Meleo-Meyer  F, Koerbel  L. Mindfulness-Based Stress Reduction (MBSR) Authorized Curriculum Guide. Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Revised 2017. Accessed December 14, 2017. https://www.bangor.ac.uk/mindfulness/documents/mbsr-curriculum-guide-2017.pdf
  6. Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and Measuring Meditation-Related Adverse Effects in Mindfulness-Based Programs. Clinical Psychological Science9(6), 1185–1204. https://doi.org/10.1177/2167702621996340

Social media and mental health

Many college aged students use social media on a regular basis (1).

A study published in January 2022, looked at positive and negative impact of social media and mental health (2).

What was the study?

  • A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3,474) reported extent of and motives for social media use and completed the 12-item General Health Questionnaire.
  • The participants were of various age groups.

What were the results?

Across the 4 countries:

  • Poorer mental health was associated with using social media to decrease loneliness and for entertainment motives.
  • Better mental health was associated with using social media for personal contact and maintaining relationships.
  • Overall increased daily time on social media was associated with poorer mental health.

Additional thoughts:

  • This is just one study and further research is needed.
  • This study was cross sectional in design, and discusses association, not causation.
  • For strategies on healthy ways of using technology, go here.
  • For additional strategies on digital wellness, go here.

If you would like to be notified about future posts on strategies to improve your mental health, enter your email above.

Various resources for mental health support can be found here.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.expressvpn.com/blog/gen-z-social-media-survey/?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=generalhealth&utm_content=2022-11-04&apid=25401407&rvid=1dcd8f7dc878fb52201e1fd1f55c0629b91ea15502eedae5c8cd1d1fcf53d560#key
  2. Thygesen H, Bonsaksen T, Schoultz M, Ruffolo M, Leung J, Price D and Geirdal AØ (2022) Social Media Use and Its Associations With Mental Health 9 Months After the COVID-19 Outbreak: A Cross-National Study.  Public Health9:752004. doi: 10.3389/fpubh.2021.752004