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With Comments by Adriane Fugh-Berman, MD
September 2001; Volume 3; 72
Source: McLean JA, et al. Cognitive dietary restraint is associated with higher urinary cortisol excretion in healthy premenopausal women. Am J Clin Nutr 2001;73:7-12.
Design and Setting: Subjects completed the restraint subscale of the Three Factor Eating Questionnaire (an assessment of dietary restraint). Anthropometric measurements were taken, three-day food records were recorded, and a questionnaire on weight history, exercise, and dietary practices was administered. Urinary cortisol, creatinine, and calcium levels over 24 hours were assayed. The day these measurements were taken, food and beverages were provided, and intake was measured and correlated with high or low dietary restraint scores.
Subjects: Sixty-two young women (ages 21.6 ± 2.5 years) recruited from a group of 666 university students who previously had completed an instrument on eating attitudes and behavior.
Results: Anthropometric measurements and menstrual cycle length were similar between groups. Exercise levels were significantly higher and energy intake significantly lower in the group that scored high on dietary restraint compared to the low dietary restraint group. Ratios of cortisol to creatinine were significantly higher in the high-restraint group (42.9 ± 12.9) compared to the low-restraint group (36.3 ± 8.9). Ratios of urinary calcium to creatinine were lower in the high-restraint group compared to the low-restraint group.
Comments: Death to dieting! "Diet-ary restraint" (or "cognitive dietary restraint") is nutrition-speak for dieting or deliberate limitation of food intake. As the authors point out, stress increases cortisol levels (and subsequent urinary excretion). High cortisol levels may have a negative impact on bone health. In older adults, higher baseline overnight urinary cortisol excretion was an independent predictor of fracture.
Dr. Fugh-Berman, Editor of Alternative Therapies in Women's Health, is Assistant Clinical Professor in the Department of Health Care Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC.