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