Standard treatment for substance use disorders (SUDs) rarely incorporates a dietary intervention. The purpose of this research is to explore how nutrition might influence early recovery outcomes. Participants (N = 33) self-selected into the 10-week treatment (whole food, plant-based diet) or control group (standard treatment center diet). Both received weekly nutrition education lessons to complement the diet. At baseline, week 3, and week 10, participants completed assessments to track mental health markers. Mean values were calculated for Healthy Eating Index-2015 (HEI-2015) and Plant-based Diet Indices (PDI). Semi-structured interviews were gathered and analyzed using grounded theory. The intervention group had significantly higher scores for HEI-2015 and PDI scores (all P’s < .001). For all psychosocial outcomes, there was a statistically significant effect of time (P’s < .001-.02), but not by condition. A significant condition by time interaction was seen with the Rosenberg Self-Esteem outcome (P = .043). Resilience at 10-weeks was significantly higher in the high PDI group (P = .031). Qualitative data showed that all participants found meaning and value in the experience. Early addiction treatment outcomes show modest but important effects of whole food plant-based nutrition and suggest value in further exploration of its use in SUD treatment.
JeynesKDGibsonEL. The importance of nutrition in aiding recovery from substance use disorders: a review. Drug Alcohol Depend. 2017;179:229-239. doi:10.1016/j.drugalcdep.2017.07.006.
2.
HimmelgreenDAPérez-EscamillaRSegura-MillánSRomero-DazaNTanasescuMSingerM. A comparison of the nutritional status and food security of drug-using and non-drug-using Hispanic women in Hartford, Connecticut. Am J Phys Anthropol. 1998;107(3):351-361.
3.
AlvesDCostaAFCustódioDNatárioLFerro-LebresVAndradeF. Housing and employment situation, body mass index and dietary habits of heroin addicts in methadone maintenance treatment. Heroin Addict Relat Clin Probl. 2011(1):11-14.
4.
NabipourSSaidMAHabilMH. Burden and nutritional deficiencies in opiate addiction-systematic review article. Iran J Public Health. 2014;43(8):1022. 1032, https://pubmed.ncbi.nlm.nih.gov/25927032/
5.
TangAMForresterJESpiegelmanD, et al. Heavy injection drug use is associated with lower percent body fat in a multi-ethnic cohort of HIV-positive and HIV-negative drug users from three US cities. Am J Drug Alcohol Abuse. 2010;36(1):78-86. doi:10.3109/00952990903544851.
6.
TolliverBKAntonRF. Assessment and treatment of mood disorders in the context of substance abuse. Dialogues Clin Neurosci. 2015;17(2):181, 190. doi:10.31887/DCNS.2015.17.2/btolliver.
7.
RaoTSAshaMRameshBRaoKJ. Understanding nutrition, depression and mental illnesses. Indian J Psychiatr. 2008;50(2):77.
8.
GrantLPHaughtonBSachanDS. Nutrition education is positively associated with substance abuse treatment program outcomes. J Am Diet Assoc. 2004;104(4):604-610. doi:10.1016/j.jada.2004.01.008.
9.
CowanJDevineC. Food, eating, and weight concerns of men in recovery from substance addiction. Appetite. 2008;50(1):33-42.
10.
CowanJADevineCM. Diet and body composition outcomes of an environmental and educational intervention among men in treatment for substance addiction. J Nutr Educ Behav. 2013;45(2):154-158. doi:10.1016/j.appet.2007.05.006.
11.
Quintero-PlattGGonzález-ReimersEMartín-GonzálezMC, et al. Vitamin D, vascular calcification and mortality among alcoholics. Alcohol Alcohol. 2015;50(1):18-23. doi:10.1093/alcalc/agu076.
12.
NelsonSZhangPBagbyGJHappelKIRaaschCE. Alcohol abuse, immunosuppression, and pulmonary infection. Curr Drug Abuse Rev. 2008;1(1):56-67.
13.
BarnardNDCohenJJenkinsDJA, et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-week clinical trial. Am J Clin Nutr. 2009;89(5):1588S-1596S. doi:10.3945/ajcn.2009.26736H.
WrightNWilsonLSmithMDuncanBMcHughP. The BROAD study: a randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes. 2017;7:e256. doi:10.1038/nutd.2017.3.
16.
LassaleCBattyGDBaghdadliA, et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatr. 2018;24:965, 986. doi:10.1038/s41380-018-0237-8.
17.
JafariSHezavehEJalilpiranY, et al. Plant-based diets and risk of disease mortality: a systematic review and meta-analysis of cohort studies. Crit Rev Food Sci Nutr. 2021:1-13.
18.
HaiAHFranklinCParkSDiNittoDMAurelioN. The efficacy of spiritual/religious interventions for substance use problems: a systematic review and meta-analysis of randomized controlled trials. Drug Alcohol Depend. 2019;202:134-148. doi:10.1016/j.drugalcdep.2019.04.045.
NathJ. ‘God is a vegetarian’: the food, health and bio-spirituality of Hare Krishna, Buddhist and Seventh-Day Adventist devotees. Health Sociol Rev. 2010;19(3):356-368. doi:10.5172/hesr.2010.19.3.356.
21.
TyreeSBakerBRWeatherspoonD. On veganism and pregnancy. Int J Childbirth Educ. 2012;27(3).
22.
McNeill BrownABrennan NanniMLaBelleOP. Self-esteem in 12-step recovery; theoretical history, evidence, and implications for future research. Alcohol Treat Q. 2021;39(2):210-224. doi:10.1080/07347324.2020.1846478.
23.
YangCZhouYXiaM. How resilience promotes mental health of patients with DSM-5 substance use disorder? The mediation roles of positive affect, self-esteem, and perceived social support. Front Psychiatr. 2020;11:1281. doi:10.3389/fpsyt.2020.588968.
KumpferKL. Factors and processes contributing to resilience. In: Resilience and Development. Springer; 2002:179-224.
26.
MastenASCoatsworthJD. The development of competence in favorable and unfavorable environments: lessons from research on successful children. Am Psychol. 1998;53(2):205-220.
27.
MartinezSJonesJDBrandtL, et al. Factor structure and psychometric properties of the Connor–Davidson resilience scale (CD-RISC) in individuals with opioid use disorder. Drug Alcohol Depend. 2021;221:108632. doi:10.1016/j.drugalcdep.2021.108632.
28.
WingoAPResslerKJBradleyB. Resilience characteristics mitigate tendency for harmful alcohol and illicit drug use in adults with a history of childhood abuse: a cross-sectional study of 2024 inner-city men and women. J Psychiatr Res. 2014;51:93-99. doi:10.1016/j.jpsychires.2014.01.007.
29.
McGuireAPMotaNPSippelLMConnollyKMLyonsJA. Increased resilience is associated with positive treatment outcomes for veterans with comorbid PTSD and substance use disorders. J Dual Diagn. 2018;14(3):181-186.
30.
Von EssenE. Young adults’ transition to a plant-based diet as a psychosomatic process: a psychoanalytically informed perspective. Appetite. 2021;157:105003. doi:10.1016/j.appet.2020.105003.
31.
O‘NeilAQuirkSEHousdenS, et al. Relationship between diet and mental health in children and adolescents: a systematic review. Am J Publ Health. 2014;104(10):e31-e42. doi:10.2105/AJPH.2014.302110.
32.
FirthJMarxWDashS, et al. The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosom Med. 2019;81(3):265-280. doi:10.1097/PSY.0000000000000673.
33.
WindleGBennettKMNoyesJ. A methodological review of resilience measurement scales. Health Qual Life Outcome. 2011;9(1):1-18.
34.
ConnorKMDavidsonJR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.
35.
KroenkeKSpitzerRLWilliamsJB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613.
RosenbergM.Society and the Adolescent Self-Image. Princeton University Press; 2015. doi:10.1515/9781400876136.
38.
FisherJ.Development and application of a spiritual well-being questionnaire called SHALOM. Religions. 2010;1:105-121. doi:10.3390/rel1010105.
39.
SubarAFKirkpatrickSIMittlB, et al. The Automated Self-Administered 24-hour dietary recall (ASA24): a resource for researchers, clinicians, and educators from the National Cancer Institute. J Acad Nutr Diet. 2012;112(8):1134-1137. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721511/
40.
GlaserBG. Conceptualization: on theory and theorizing using grounded theory. Int J Qual Methods. 2002;1(2):23-38. doi:10.1177/160940690200100203.
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