Quantification of diet quality utilizing the rapid eating assessment for participants-shortened version in bipolar disorder: Implications for prospective depression and cardiometabolic studies

Manuel Gardea-Resendez, Stacey J. Winham, Francisco Romo-Nava, Alfredo Cuellar-Barboza, Matthew M. Clark, Ana Cristina Andreazza, Alejandra Cabello-Arreola, Marin Veldic, David J. Bond, Balwinder Singh, Miguel L. Prieto, Nicolas A. Nunez, Hannah Betcher, Katherine M. Moore, Thomas Blom, Colin Colby, Richard S. Pendegraft, Sydney S. Kelpin, Aysegul Ozerdem, Alessandro MiolaEleanna De Filippis, Joanna M. Biernacka, Susan L. McElroy, Mark A. Frye*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Recognizing bipolar disorder as a multi-system metabolic condition driven, in part, by binge eating behavior and atypical depressive symptoms, this study aimed to quantify diet quality and evaluate clinical correlates in a bipolar disorder cohort. Methods: Participants from the Mayo Clinic Bipolar Disorder Biobank (n = 734) completed the Rapid Eating Assessment for Participants – Shortened version (REAP-S) to determine diet quality. The average REAP-S score for a U.S. omnivorous diet is 32 (range 13 to 39) with higher scores indicating healthier diet. Demographic variables were collected in a standardized clinical questionnaire. Depressive symptoms were assessed by the Bipolar Inventory of Symptoms Scale. Cardiometabolic variables were retrieved from the electronic health record. Associations between continuous variables and REAP-S scores (total, ‘healthy foods’ and ‘avoidance of unhealthy foods’) were assessed using linear regression. Results: Overall, our sample had a mean REAP-S score of 27.6 (4.9), suggestive of a lower diet quality than the average general population in the US. There was a significant inverse relationship between mean REAP-S lower scores with increased BMI, waist circumference, disordered eating and depression. All these associations were significantly stronger in female participants. Limitations: EHR cross-sectional data. Conclusions: Our data suggest unhealthy diet quality in bipolar disorder is associated with depression, obesity and cardiometabolic abnormalities. Additional work is encouraged to prospectively track mood and diet quality to further understand the bidirectional relationship and clarify if dietary interventions can positively impact mood. Further delineating potential sex differences in diet quality and depression may provide greater appreciation of modifiable risk factors for future cardiometabolic burden.

Original languageEnglish
Pages (from-to)150-155
Number of pages6
JournalJournal of Affective Disorders
Volume310
Early online date8 May 2022
DOIs
StateE-pub ahead of print - 8 May 2022

Bibliographical note

Copyright © 2022. Published by Elsevier B.V.

Keywords

  • Bipolar depression
  • Bipolar disorder
  • Cardiometabolic markers
  • Diet quality
  • Obesity

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