Food choice in disorders of eating behavior: correlations with the psychopathological aspects of the diseases

Abstract

Eating disorders (ED) are characterized by alterations in food choice and in the quantity and quality of nutrient intake. In a population of 124 female patients with ED (anorexia nervosa restricting subtype [AN-R, n=37]; AN bingeing-purging subtype [AN-BP, n=18]; bulimia nervosa purging subtype [BN-P, n=40]; and binge eating disorder [BED, n=29]) and healthy age-matched controls ([C], n=20) we compared food choice and macronutrient intake with psychopathologic symptoms of the disorders. Data were collected from the probands' 7-day food diaries and the scores from two assessment scales (Eating Disorder Inventory-2 [EDI-2] and Temperament and Character Inventory-revised [TCI-R]) that measure symptom domains, dimensions of personality and character dimensions, respectively. Multiple regression analysis was applied to the nutritional data and scale scores. When compared to the values for the control group, intake of animal proteins (grams) was significantly lower for all patient groups, intake of lactoproteins was lower for the AN-R and AN-BP than BN-P and BED groups, intake of vegetal proteins was higher for the AN-R, AN-BP, BN-P and BED groups, intake of dietary fats was lower for the AN-R and AN-BP subtype groups, and intake of total carbohydrates and oligosaccharides was lower for the AN-R and AN-BP groups, and oligosaccharides also for the BED, when calculated in grams but not when expressed in percent. When studied as percent values animal proteins were lower in patients than in controls, lactoprotein in BN-P and BED, vegetal proteins higher in all the patients, fat lower in AN-R and AN-BP, while carbohydrates did not differ between patients and controls. Significant correlations emerged between food choice and TCI-R and EDI-2 scale scores. Food choice in ED might depend on alterations in neurotransmitter peptides, neuropeptides, and peripheral peptides, which regulate and are regulated by macronutrient intake and underlie psychological and temperamental alterations.