NEW YORK (Reuters Health) - People suffering from mild depression or anxiety are more likely to use unhealthy weight-loss tactics, such as binge eating and purging or fasting, and to eat an unhealthy diet.

"There is a relationship between psychological distress and dietary practices," senior author Dr. Alan R. Kristal, a professor of epidemiology at the University of Washington in Seattle, told Reuters Health.

Previous research has found that adults who suffer from severe clinical depression--about 5% of the US population--often have eating disorders. However, the researchers were curious about whether people suffering from general psychological distress, such as mild depression and anxiety, also had less healthy eating practices. About 20% of the US population have such milder psychological problems, the authors note.

"People who have severe psychological problems have very high rates of distorted dietary practices, but no one had said: What about commonplace psychological problems?" Kristal pointed out.

Using data from a nationally representative telephone survey of around 3,500 adults funded by the food company Procter & Gamble, the researchers inquired into the participants' state of mind, eating habits and dieting methods. The findings are published in the May issue of the Journal of the American Dietetic Association.

The investigators found that men and women who reported being psychologically distressed were more than twice as likely to indulge in unhealthy dieting practices such as skipping meals, taking diet pills and binge eating.

Kristal and colleagues also examined the nutritional content of the diets of those who reported being stressed and not stressed. "For both men and women, the more stressed they were, the more calories they consumed," Kristal noted. "For women, the more stressed they were, the less fruits and veggies they ate, while for men, the more stressed they were, the more fat they ate."

One possible reason for the relationship could be that those who are upset use food to comfort themselves. "When you're anxious, it's one way of soothing yourself a little bit," he said.

However, Kristal added that the relationship between distress and dietary practices could also be reciprocal, with those who binge and purge bringing on depression or anxiety as a result. "If you're involved in unhealthy weight control practices like fasting, that could make you anxious or depressed," he explained.

"Poor diets often result from depression. Energy level and drive are much lower than usual and enthusiasm for most things, including meals, is lost," Leslie Bonci, a spokesperson for the American Dietetic Association (ADA) and director of sports medicine at the University of Pittsburgh, noted in an ADA press release accompanying the study.

"Focusing on a well-balanced diet and eating several small meals throughout the day may help to control binge eating and supply nutrients to the body," Bonci added.

SOURCE: Journal of the American Dietetic Association 2002;102:699-703.

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