Food for thought: The relationship between poor eating habits, delay discounting, and quality of life in substance use recovery

Background: Research on poor eating habits among individuals recovering from substance use disorders (SUD) is limited. This study examines the relationship between poor eating habits, delay discounting (DD), quality of life (QOL), and remission status, in addition to examining DD as a mediator of the relationship between poor eating and QOL. Methods: Participants (n = 257) in recovery from SUD, completed the Health Behaviors Questionnaire (poor eating was measured using the food domain), a DD task, the World Health Organization QOL questionnaire, demographics, and SUD-related questions. Multivariate linear regression was used to test associations between poor eating and DD, as well as each QOL domain. Mediation analyses were conducted to evaluate the role of DD in the relationship between poor eating and QOL. A binary logistic regression was used to test associations between poor eating and remission status, as well as DD and remission status. Results: Poor eating habits were significantly associated with higher rates of DD (beta = 0.08, p < .001) and lower QOL across psychological (beta = -0.88, p < .001, only for those in remission), physical (beta = -0.58, p < .001), and environmental (beta = -0.75, p < .001) domains. Additionally, DD significantly mediated the relationship between poor eating habits and reduced QOL in these domains (beta(s) < -0.08, ps < 0.003). Poor eating (beta = 0.05, p = .014; OR = 1.05, p = .012) and high DD rates (beta = 0.12, p = .049; OR = 1.12, p = .038) were associated with a lower likelihood of remission from SUD. Conclusions: Our findings highlight the integral role of dietary habits in the recovery trajectory of individuals with SUD. The study supports the need for holistic treatment approaches that consider the impacts of nutrition on both psychological and physiological aspects of recovery.