Ultra-processed foods comprise a majority of the American diet and have been linked to increased risk for depression. In response, minimally processed dietary interventions are increasingly being evaluated as tools to improve mental health, including within the growing “Food Is Medicine” movement. However, because these approaches emphasize reducing ultra-processed foods, they raise concerns that dietary restriction may inadvertently increase disordered eating–related outcomes. This paper reports an exploratory analysis of data from a randomized pilot trial that tested two minimally processed dietary interventions designed to reduce depressive symptoms among adults with moderate to moderately severe depression. This analysis focused specifically on safety, examining whether these interventions were associated with unintended increases in disordered eating–related outcomes. Participants (N = 31) were randomly assigned to either implement dietary change via self-implemented nutritional guidance or a commercial meal delivery service for 2 weeks. Disordered eating–related outcomes were assessed using the Eating Disorder Examination Questionnaire (EDE-QS) and Dutch Eating Behavior Questionnaire (DEBQ) at intake, pre-intervention, post-intervention, and 1- and 6-month follow-ups. Across dietary conditions, no increases were observed in DEBQ restrained or external eating following the intervention. EDE-QS and DEBQ emotional eating decreased post-intervention, and DEBQ emotional and external eating were lower at follow-up. Changes in outcomes were not moderated by intervention condition. These findings provide preliminary evidence of short-term safety, suggesting that certain dietary interventions emphasizing minimally processed foods are feasible and may not elicit immediate increases in disordered eating–related thoughts and behaviors among adults with depression and without active eating disorders. Larger and longer-term studies are needed to evaluate safety in more diverse and higher-risk populations. Trial registration The parent pilot study is pre-registered on ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT06242665) on January 16th, 2024. “Food is Medicine” programs, which use nutrition to help prevent or treat health conditions, are becoming increasingly popular. Many of these programs encourage people to eat fewer ultra-processed foods and more minimally processed foods. However, some experts have raised concerns that asking people to limit certain foods could unintentionally increase disordered or problematic thoughts and behaviors around eating, especially among people who may already be vulnerable. In a recent study, we tested a Food Is Medicine approach designed to improve mental health by replacing ultra-processed foods with minimally processed foods in adults with depression. This paper reports additional analyses examining whether the program had any unintended effects on disordered eating–related thoughts and behaviors. These outcomes were measured before the intervention, immediately after the two-week intervention, and again one and six months later. No negative effects were found, and some eating-related thoughts and behaviors–for example, eating in response to negative emotions–even decreased after the intervention. These findings provide preliminary evidence that shifting to a more minimally processed diet may be safe and even beneficial in the short term with respect to disordered eating–related thoughts and behaviors. However, larger and longer-term studies are needed to understand long-term effects before these approaches can be widely recommended.
Worth et al. (Sat,) studied this question.
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