Elsevier

Eating Behaviors

Volume 13, Issue 3, August 2012, Pages 285-288
Eating Behaviors

Alcohol consumption as a function of dietary restraint and the menstrual cycle in moderate/heavy (“at-risk”) female drinkers

https://doi.org/10.1016/j.eatbeh.2012.03.011Get rights and content

Abstract

Previous research suggests that women who report dietary restraint tend to consume alcohol in greater quantities, however most studies use retrospective data collection, which is often unreliable, and no studies have accounted for this relationship with respect to potential changes in alcohol consumption across the menstrual cycle. Therefore, the present study investigated the relationship between prospectively monitored drinking patterns and dietary restraint across the menstrual cycle among females from the general population whose drinking level (7–20 drinks/week) places them at-risk for developing alcohol use disorders. Restrained eaters (RES; N = 51) and unrestrained eaters (UN-RES; N = 55), per the cognitive restraint scale scores from the Three-Factor Eating Questionnaire, provided prospective ratings measuring mood, alcohol consumption, and consequences of alcohol use across one full menstrual cycle. Dysphoric mood increased during the late luteal and menstrual phases in both groups. Although overall the RES group did not drink more than the UN-RES group, the RES group drank less than the UN-RES group during the follicular phase, suggesting that among RES women alcohol consumption may be modulated by hormonal fluctuations across the menstrual cycle. The differences between the present findings and previous research may be due to the cohorts sampled; the majority of previous studies sampled college students, where binge drinking and dietary restraint are more common, whereas this study sampled the general population. Future research should replicate prior studies in a college-aged population using the current design of prospective data collection for greater accuracy of self-reported alcohol consumption.

Highlights

► Restrained eaters consumed less alcohol during the follicular phase. ► Dysphoric mood increased during the late luteal and menstrual phases. ► Prospective data collection was advantageous for greater self-report accuracy.

Introduction

Previous research in non-psychiatric populations has consistently found that women who show patterns of restrictive eating and/or tendencies towards dieting also show greater alcohol consumption (Bradstock et al., 1988, Bryant et al., 2010, Higgs and Eskenazi, 2007, Khaylis et al., 2009, Krahn et al., 2005, Lavik et al., 1991, Stewart et al., 2000, Xinaris and Boland, 1989). However, previous findings have been restricted by sampling only a subset of the female population (i.e., college women), retrospective data collection, which has been associated with underreporting of drinking behavior (Whitty & Jones, 1992), and not assessing the role of the menstrual cycle. In the general population, both an absence of menstrual cycle-related changes in alcohol consumption (Charette et al., 1990, Freitag and Adesso, 1993, Holdstock and deWit, 2000, Nyberg et al., 2004, Terner and de Wit, 2006) and increased alcohol consumption in the menstrual and luteal phases (Mello et al., 1990, Pastor and Evans, 2003) have been found, suggesting that further research on the impact of the menstrual cycle on alcohol use is warranted.

The current study sought to investigate whether menstrual cycle-related changes in alcohol consumption are moderated by dietary restraint among women using a study design addressing previous methodological limitations. Therefore, changes in mood and alcohol consumption were assessed across the menstrual cycle between female restrained (RES) and unrestrained (UN-RES) eaters, who were also all “at-risk” drinkers, from the general population using prospective data collection. Based on previous research, we hypothesized that all women would increase alcohol consumption in the luteal and menstrual phases but there would be a greater increase in RES eaters than the UN-RES eaters.

Section snippets

Participants

Women recruited from advertisements around the New York City area were told that the purpose of the study was to determine changes in mood, patterns of alcohol use and eating behavior across the menstrual cycle. Based on the National Institute of Alcohol Abuse and Alcoholism (2010) guidelines, for women, “at-risk” drinking is defined as ≥ 7 drinks per week and binge drinking is defined as ≥ 4 drinks per day. Women who typically drank more than 20 drinks per week were excluded, similar to our

Results

Table 1 shows demographic characteristics for the UN-RES and RES groups. Overall, there were few differences between the two groups; the RES group reported significantly longer menstrual cycles (p = 0.05), fewer marijuana users (p = 0.02) and higher cognitive restraint (p < 0.0001) and disinhibition (p = 0.01) scores on the TFEQ than the UN-RES group. However, there were no differences between groups on retrospective self-reported weekly alcohol consumption; both groups drank an average of 13 drinks

Discussion

The present study investigated the link between restrictive eating and prospective drinking behavior in female “at-risk” drinkers. In support of our hypotheses, our results showed that dysphoric mood significantly increased in the late luteal and menstrual phases compared to the follicular phase, as shown previously (Gonda et al., 2008, Pastor and Evans, 2003, Reed et al., 2008). In contrast to a previous study where lower dietary restraint was associated with fewer premenstrual symptoms

Conclusions

In summary, these findings suggest that among women in the general population who drink at an “at-risk” level, dietary restraint is not indicative of greater alcohol consumption and may actually be a protective factor, particularly during the follicular phase of the menstrual cycle when dysphoric mood is lower. Therefore, the phenomenon of restrained eating and binge drinking among women may be restricted to the college atmosphere, where irregular eating and drinking patterns are more prevalent

Role of funding sources

Funding for this study was provided by the National Institute on Drug Abuse grant 5R01DA009114. NIDA had no involvement in the study design, collection, analysis, or interpretation of data, writing the manuscript, and the decision to submit the manuscript for publication.

Contributors

Dr. Suzette Evans was involved in the original design of the study. All authors were involved in the data collection and statistical analyses. Julie DiMatteo conducted literature searches and wrote the first draft of the manuscript and subsequent versions. All authors contributed to and have approved the manuscript.

Conflict of interest

All authors declare they have no conflicts of interest.

Acknowledgements

The authors specifically want to acknowledge the assistance of Jennifer Hajinlian and Siena Shundi who were instrumental in initiating this study, as well as the many other research and clinical staff that have been involved.

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