title: Adherence to the Mediterranean diet is inversely related to binge eating disorder in patients seeking a weight loss program.
abstract: OBJECTIVE
  The key factors influencing the development of Binge Eating Disorder (BED) are not well known. Adherence to the Mediterranean diet (MD) has been suspected to reduce the risk of several mental illnesses such as depression and anxiety. There are no existing studies that have examined the relationships between BED and MD.
  
  
  METHODS
  Cross-sectional study of 1472 participants (71.3% women; mean age: 44.8 ± 12.7) at high risk of BED. A MD score (MED-score) was derived from a validated food frequency questionnaire and BED by Binge Eating Scale questionnaire (BES). Body mass index, waist circumference and total body fat (%) were assessed by anthropometric measurements.
  
  
  RESULTS
  376 (25.5%) cases of self reported BED were identified. 11.1% of participants had a good adherence to MD (MED-score ≥ 9). After adjustments for age, gender, nutritional status, education, and physical activity level, high MED-score was associated with lower odds for BED (odds ratios and 95% confidence intervals of a BED disorder for successive levels of MED-score were 1 (reference), 0.77 (0.44, 1.36), 0.66 (0.37, 1.15), 0.50 (0.26, 0.96), and 0.45 (0.22, 0.55) (P for trend: <0.01). Olive oil and nut consumption were associated with low risk of BED development whereas butter, cream, sweets and commercial bakery/sweets/cakes consumption increased the risk. We did not find a cumulative effect of depression and anxiety on MED-score in binge eaters.
  
  
  CONCLUSIONS
  These results demonstrate an inverse association between MD and the development of BED in a clinical setting among subjects at risk of BED. Therefore, we should be cautious about generalizing the results to the whole population, although reverse causality and confounding cannot be excluded as explanation. Further prospective studies are warranted.
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy. Electronic address: simona.bertoli@unimi.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Bertoli
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Spadafranca
authors.affiliation: Department of Preventive Medicine and Public Health, University of Navarra, Spain.
authors.forename: Maira
authors.initials: M
authors.lastname: Bes-Rastrollo
authors.affiliation: Department of Preventive Medicine and Public Health, University of Navarra, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martinez-Gonzalez
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Ponissi
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Beggio
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Leone
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Battezzati
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000178:diet therapy* / Q000209:etiology / Q000523:psychology; D001823:Body Composition; D015992:Body Mass Index; D002182:Candy; D003430:Cross-Sectional Studies; D003611:Dairy Products; D004032:Diet; D038441:Diet, Mediterranean; D004040:Dietary Carbohydrates; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts; D000069463:Olive Oil; D010349:Patient Compliance; D010938:Plant Oils; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs
chemical_list: D004040:Dietary Carbohydrates; D000069463:Olive Oil; D010938:Plant Oils
keywords: Anxiety; Binge eating disorder; Depression; Mediterranean diet