A narrower choice meant less success in one group.
Reprinted from Eating Disorders Review
July/August 2011 Volume 22, Number 4
©2011 Gürze Books
The English poet William Cowper wrote, “Variety’s the very spice of life.” For weight-restored anorexia nervosa (AN) patients, dietary variety may be one key to successful recovery.
As Janet Schebendach, PhD, RD, and Laurel E. Mayer MD and colleagues at Columbia University discovered, differences in variety of foods chosen by 41 weight-restored patients may have helped or hurt their recovery efforts (J Am Diet Assoc 2011; 111:732). The women were hospitalized between June 2000 and July 2005, and completed a 4-day food record before discharge; they were then followed for up to 1 year. Patient outcomes were categorized as a success (n=29) or failure (n=12) using Morgan-Russell criteria.
Although the total number of foods selected did not differ between the success and failure groups (73 vs. 74 foods), a significant difference in the total number of different foods was observed. The researchers noted that those in the failure group selected fewer and the success group selected more.
Less energy from fat forecast failure
And what other patterns did the researchers see? Before hospital discharge, energy intake was similar between the success and failure groups but not statistically significant (2415 kcal vs. 2175 kcal, respectively). The failure group consumed significantly less total fat than did the success group. Accordingly, the percentage of energy from fat was also significantly lower in the failure group compared to the success group. The treatment success group selected a different food 71% of the time, while the failure group selected a different food only 58% of the time.
The treatment groups also differed significantly in the variety of foods chosen from five major food groups: added fats, added sugars, caloric beverages, starchy carbohydrates, and miscellaneous foods. The success group selected considerably more, and the failure groups considerably fewer, foods from the added fats group, and the caloric beverage group. The successful group was more likely to included added sugars and miscellaneous foods (such as pasta sauce) than was the failure group.
First, changes in eating behaviors, then in body weight
The authors surmise that eating behavior changes precede changes in body weight. Despite the substantial difference in variety of foods, no substantial difference in body mass index (BMI) or total energy intake was seen before patients were discharged from the hospital. The authors speculate that continued restriction of overall dietary variety, purposeful restriction of highly palatable food groups, and food monotony resulting from repeated exposure to the same foods, culminated in decreased energy intake and weight loss during the year after hospital discharge.