dreams of the rarebit fiend: food and diet as instigators of bizarre and disturbing dreams (2015)

18
001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 016 017 018 019 020 021 022 023 024 025 026 027 028 029 030 031 032 033 034 035 036 037 038 039 040 041 042 043 044 045 046 047 048 049 050 051 052 053 054 055 056 057 058 059 060 061 062 063 064 065 066 067 068 069 070 071 072 073 074 075 076 077 078 079 080 081 082 083 084 085 086 087 088 089 090 091 092 093 094 095 096 097 098 099 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 ORIGINAL RESEARCH ARTICLE published: xx February 2015 doi: 10.3389/fpsyg.2015.00047 Dreams of the Rarebit Fiend : food and diet as instigators of bizarre and disturbing dreams Tore Nielsen 1 * and Russell A. Powell 2 1 Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, Department of Psychiatry, Université de Montreal, Montreal, QC, Canada 2 Department of Psychology, Grant McEwan University, Edmonton, AB, Canada Edited by: Anil K. Seth, University of Sussex, UK Reviewed by: Valdas Noreika, Medical Research Council, UK Tom Froese, Universidad Nacional Autónoma de México, Mexico *Correspondence: Tore Nielsen, Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, 5400 Gouin Blvd West, Montreal, QC, H4J 1C5, Canada e-mail: [email protected] In the early 1900s, the Dream of the Rarebit Fiend comic strip conveyed how the spicy cheese dish Welsh rarebit leads to bizarre and disturbing dreams. Today, the perception that foods disturb dreaming persists. But apart from case studies, some exploratory surveys, and a few lab studies on how hunger affects dreaming, there is little empirical evidence addressing this topic. The present study examines three aspects of the food/dreaming relationship; it attempts to: (1) assess the prevalence of the perception of food-dependent dreaming and the types of foods most commonly blamed; (2) determine if perceived food-dependent dreaming is associated with dietary, sleep or motivational factors; and (3) explore whether these factors, independent of food/dreaming perceptions, are associated with reports of vivid and disturbing dreams. Three hundred and ninety six students completed questionnaires evaluating sleep, dreams, and dietary habits and motivations. Items queried whether they had noticed if foods produced bizarre or disturbing dreams and if eating late at night influenced their dreams. The perception of food-dependent dreaming had a prevalence of 17.8%; with dairy products being the most frequently blamed food category (39–44%). Those who perceived food-dependent dreaming differed from others by reporting more frequent and disturbing dreams, poorer sleep, higher coffee intake, and lower Intuitive Eating Scale scores. Reports of disturbing dreams were associated with a pathological constellation of measures that includes poorer sleep, binge-eating, and eating for emotional reasons. Reports of vivid dreams were associated with measures indicative of wellness: better sleep, a healthier diet, and longer times between meals (fasting). Results clarify the relationship between food and dreaming and suggest four explanations for the perception of food-dependent dreaming: (1) food specific effects; (2) food-induced distress; (3) folklore influences, and (4) causal misattributions. Research and clinical implications are discussed. Keywords: nightmares, dreaming, sleep, food, diet, fasting, internal awareness INTRODUCTION For millennia, people have believed that the foods they eat can influence their dreams. The Dream of the Rarebit Fiend comic strip (see Figure 1), penned by Winsor McCay and published in the New York Herald from 1904 to 1925, is a striking example of how such beliefs have been expressed repeatedly in popular cul- ture. Even today, anecdotes are common about how a recurrent dream, bizarre dream, or nightmare was triggered by eating a par- ticular food or by eating too much or too late at night. Yet there is surprisingly little empirical research that directly addresses the question of food-dependent dreaming. Although evidence exists that sleep may be facilitated or disrupted by different types of foods—for example, foods that are rich in tryptophan, caffeine or alcohol, or even specific foods such as milk, kiwis or tart cherry juice (see review in Peuhkuri et al., 2012)—the effects of food on dreaming remain largely in the realm of specula- tion. Further, common beliefs and traditions about which foods influence dreaming are not well-documented, even though such subjective impressions might provide useful starting points for more objective research on the topic. The present study takes a first step toward investigating this issue by exploring how people perceive food to influence their dreams and whether these percep- tions are associated with sleep characteristics and dietary habits and motivations. Evidence that food directly affects dreaming is scarce. We found, for example, a single correlational study of dietary pref- erences and dreaming (Kroth et al., 2007), conducted with 7 men and 42 women, which revealed that participants who expressed a preference for organic foods reported more frequent dream recall, recurring dreams and meaningful dreams, as well as more dreams containing particular themes such as flying, risk-taking, sex, and water. In contrast, participants who expressed a pref- erence for fast foods reported less frequent dream recall, as well as fewer recurring dreams, nightmares, and sexual dreams. While the authors of this study rightly consider the findings preliminary, the small sample size (especially for males), lack of correction www.frontiersin.org February 2015 | Volume 6 | Article 47 | 1

Upload: umontreal

Post on 03-Mar-2023

1 views

Category:

Documents


0 download

TRANSCRIPT

001

002

003

004

005

006

007

008

009

010

011

012

013

014

015

016

017

018

019

020

021

022

023

024

025

026

027

028

029

030

031

032

033

034

035

036

037

038

039

040

041

042

043

044

045

046

047

048

049

050

051

052

053

054

055

056

057

058

059

060

061

062

063

064

065

066

067

068

069

070

071

072

073

074

075

076

077

078

079

080

081

082

083

084

085

086

087

088

089

090

091

092

093

094

095

096

097

098

099

100

101

102

103

104

105

106

107

108

109

110

111

112

113

114

ORIGINAL RESEARCH ARTICLEpublished: xx February 2015

doi: 10.3389/fpsyg.2015.00047

Dreams of the Rarebit Fiend: food and diet as instigators ofbizarre and disturbing dreamsTore Nielsen1* and Russell A. Powell2

1 Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, Department of Psychiatry, Universitéde Montreal, Montreal, QC, Canada

2 Department of Psychology, Grant McEwan University, Edmonton, AB, Canada

Edited by:

Anil K. Seth, University of Sussex,UK

Reviewed by:

Valdas Noreika, Medical ResearchCouncil, UKTom Froese, Universidad NacionalAutónoma de México, Mexico

*Correspondence:

Tore Nielsen, Dream and NightmareLaboratory, Center for AdvancedResearch in Sleep Medicine, Hôpitaldu Sacré-Coeur de Montreal, 5400Gouin Blvd West, Montreal, QC,H4J 1C5, Canadae-mail: [email protected]

In the early 1900s, the Dream of the Rarebit Fiend comic strip conveyed how thespicy cheese dish Welsh rarebit leads to bizarre and disturbing dreams. Today, theperception that foods disturb dreaming persists. But apart from case studies, someexploratory surveys, and a few lab studies on how hunger affects dreaming, there is littleempirical evidence addressing this topic. The present study examines three aspects of thefood/dreaming relationship; it attempts to: (1) assess the prevalence of the perception offood-dependent dreaming and the types of foods most commonly blamed; (2) determineif perceived food-dependent dreaming is associated with dietary, sleep or motivationalfactors; and (3) explore whether these factors, independent of food/dreaming perceptions,are associated with reports of vivid and disturbing dreams. Three hundred and ninetysix students completed questionnaires evaluating sleep, dreams, and dietary habitsand motivations. Items queried whether they had noticed if foods produced bizarre ordisturbing dreams and if eating late at night influenced their dreams. The perceptionof food-dependent dreaming had a prevalence of 17.8%; with dairy products being themost frequently blamed food category (39–44%). Those who perceived food-dependentdreaming differed from others by reporting more frequent and disturbing dreams, poorersleep, higher coffee intake, and lower Intuitive Eating Scale scores. Reports of disturbingdreams were associated with a pathological constellation of measures that includespoorer sleep, binge-eating, and eating for emotional reasons. Reports of vivid dreamswere associated with measures indicative of wellness: better sleep, a healthier diet, andlonger times between meals (fasting). Results clarify the relationship between food anddreaming and suggest four explanations for the perception of food-dependent dreaming:(1) food specific effects; (2) food-induced distress; (3) folklore influences, and (4) causalmisattributions. Research and clinical implications are discussed.

Keywords: nightmares, dreaming, sleep, food, diet, fasting, internal awareness

INTRODUCTIONFor millennia, people have believed that the foods they eat caninfluence their dreams. The Dream of the Rarebit Fiend comicstrip (see Figure 1), penned by Winsor McCay and published inthe New York Herald from 1904 to 1925, is a striking example ofhow such beliefs have been expressed repeatedly in popular cul-ture. Even today, anecdotes are common about how a recurrentdream, bizarre dream, or nightmare was triggered by eating a par-ticular food or by eating too much or too late at night. Yet thereis surprisingly little empirical research that directly addresses thequestion of food-dependent dreaming. Although evidence existsthat sleep may be facilitated or disrupted by different types offoods—for example, foods that are rich in tryptophan, caffeineor alcohol, or even specific foods such as milk, kiwis or tartcherry juice (see review in Peuhkuri et al., 2012)—the effectsof food on dreaming remain largely in the realm of specula-tion. Further, common beliefs and traditions about which foodsinfluence dreaming are not well-documented, even though such

subjective impressions might provide useful starting points formore objective research on the topic. The present study takes afirst step toward investigating this issue by exploring how peopleperceive food to influence their dreams and whether these percep-tions are associated with sleep characteristics and dietary habitsand motivations.

Evidence that food directly affects dreaming is scarce. Wefound, for example, a single correlational study of dietary pref-erences and dreaming (Kroth et al., 2007), conducted with 7 menand 42 women, which revealed that participants who expresseda preference for organic foods reported more frequent dreamrecall, recurring dreams and meaningful dreams, as well as moredreams containing particular themes such as flying, risk-taking,sex, and water. In contrast, participants who expressed a pref-erence for fast foods reported less frequent dream recall, as wellas fewer recurring dreams, nightmares, and sexual dreams. Whilethe authors of this study rightly consider the findings preliminary,the small sample size (especially for males), lack of correction

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 1

115

116

117

118

119

120

121

122

123

124

125

126

127

128

129

130

131

132

133

134

135

136

137

138

139

140

141

142

143

144

145

146

147

148

149

150

151

152

153

154

155

156

157

158

159

160

161

162

163

164

165

166

167

168

169

170

171

172

173

174

175

176

177

178

179

180

181

182

183

184

185

186

187

188

189

190

191

192

193

194

195

196

197

198

199

200

201

202

203

204

205

206

207

208

209

210

211

212

213

214

215

216

217

218

219

220

221

222

223

224

225

226

227

228

Nielsen and Powell Food and dreams

FIGURE 1 | Sample Dream of the Rarebit Fiend comic strip by

Wilson McCay (aka Silas) that was popular in the early 1900’s

and influenced popular culture for many years. The cartoonsusually ended with the protagonist (who differed from cartoon to

cartoon) regretting having eaten Welsh rarebit, a dish of meltedspiced cheese on toast. In the present study, dairy products, includingcheese, and spicy foods were most often named by participants asfoods that induce disturbing dreams.

for multiple correlations, and other methodological weaknessessuggest caution in interpreting these findings.

We also found evidence of a single, industry-sponsored labo-ratory study on the effects of food on dreaming (British CheeseBoard, 2005). In 2005, the British Cheese Board conducted astudy with 200 volunteers on the effects of eating cheese ondreams. The study purportedly found no evidence for the notionthat eating cheese prior to sleep can induce nightmares, but didfind evidence that different types of cheese can induce different

types of dreams—for example, eating Stilton cheese often ledto crazy or vivid dreams while eating cheddar cheese often ledto dreams of celebrities. But although the results were widelyreported in the media [e.g., “Sweet dreams are made of cheese,”Anonymous (Daily Mail), 2005], they were never published in apeer-reviewed journal, and the available information about thestudy is extremely sparse.

If direct evidence about food-dependent dreaming is lacking,some indirect evidence can be gleaned from studies on the effects

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 2

229

230

231

232

233

234

235

236

237

238

239

240

241

242

243

244

245

246

247

248

249

250

251

252

253

254

255

256

257

258

259

260

261

262

263

264

265

266

267

268

269

270

271

272

273

274

275

276

277

278

279

280

281

282

283

284

285

286

287

288

289

290

291

292

293

294

295

296

297

298

299

300

301

302

303

304

305

306

307

308

309

310

311

312

313

314

315

316

317

318

319

320

321

322

323

324

325

326

327

328

329

330

331

332

333

334

335

336

337

338

339

340

341

342

Nielsen and Powell Food and dreams

of hunger and thirst on dreaming, from how individuals dreamabout food, and from anecdotal information concerning people’sbeliefs about the effects of food on dreams. These three sources ofevidence are considered below.

HUNGER AND THIRST INFLUENCES ON DREAMINGHunger in the form of fasting was a known trigger of vivid dreamsand visions among indigenous peoples of North America (forreview and examples see Lincoln, 1970) and among some earlydream incubation cults such as the Oracles of Trophonius (Meier,1967, p. 109) and Amphiaros (MacCulloch, 1912) in Greece, andin even earlier Egyptian dream temples such as the Imuthes tem-ple in Memphis and the Thoth temple in Khimunu (Foucart,1912). In many of these contexts, fasting formed part of a questfor visionary contact with the spirit world that involved severalforms of privation and sacrifice, e.g., sleep deprivation, social iso-lation, exposure, or threats of animal attack. Causal relationshipsbetween fasting and dreams are not easy to discern from these his-torical and anthropological sources, but it was generally believedthat the absence of food, leading to acute or chronic hunger, cantrigger vivid, sometimes transformative dreams.

On a more prosaic level, hunger was apparently a trigger fora dream of Freud’s daughter, Anna, when she was 19 monthsold (Freud, 1900). Her celebrated “strawberry dream” took placefollowing a day in which she went without food after over-consuming strawberries and vomiting in the morning. In hersleep she called out “Anna F(r)eud, St’awbewy, wild st’awbewy,om’lette, pap!,” which Freud took to indicate that even this youngchild was capable of dreaming of the foods she hungered for.Freud considered the drives of hunger and thirst to constitute thesole somatic sources of very simple dreams of food and drink, thesimplest of wish-fulfillment dreams as it were.

Some support for these ancient beliefs and psychoanalyticimpressions was provided by O’Nell (1965), who examined rela-tionships between chronic food and thirst frustration and theappearance of food and liquids in the dreams of different cul-tural groups. Dream reports were contributed by young malesfrom four cultural groups that differed in “food frustration”scores. These scores were calculated on the basis of the pres-ence and severity of fasting, under-nutrition, and malnutritionin their respective cultures. Evaluation of food and drink themesin the dreams of these four groups revealed a clear correspon-dence between degree of food frustration and dreams of food, i.e.,higher food and thirst frustration was associated with more foodand thirst dreams, respectively.

Following discovery of REM sleep and its link with vividdreaming, further evidence was marshaled from laboratory set-tings that linked the motivational effects of hunger and thirst todreaming (Dement and Wolpert, 1958; Bokert, 1968). Dementand Wolpert (1958) collected a total of 15 REM sleep dreams fromthree subjects who were deprived of fluids for 24 h prior to sleep-ing in the laboratory on each of five nights. Five of the dreams(33%) contained thirst-related content, but these did not depictthe dreamer as thirsty or in the act of drinking. A more exten-sive study was conducted by Bokert (1968) involving 18 femalenurses who were deprived of food and drink for the 8 h prior tocoming to the sleep laboratory where they then ate a highly spiced

meal. Prior to awakenings from REM sleep for dream collection,a recording of the phrase “a cool delicious drink of water” wasplayed repeatedly. Using a detailed grid of drink-related words,dreams about liquids were seen to increase, with some sub-jects even dreaming about the stimulation phrase. Interestingly,those who had dreams of satisfying their thirst drank less uponawakening than did subjects who had dreams of simply beingthirsty.

Together, historical accounts and some systematic studies sup-port the notion that hunger and thirst may produce more vivid,bizarre, and personally significant dreams. The widespread beliefin the intentional use of fasting to stimulate dreaming likelyreflects this influence. Such studies are nonetheless limited inwhat they reveal about direct relationships between food anddreaming.

DREAMS ABOUT FOODClinicians have expressed an interest in dreams about food,frequently in relation to patient symptomatology. Hamburger(1958), for example, collected a large corpus of food and eat-ing dreams from four female analytic patients, two of whomwere normal weight with no eating problems, one of whom wasobese, and another of whom had bulimia. Of 1928 total dreamscollected by the patients, 229 (11.9%; range across patients: 10.6–18.1%) were judged to deal with themes of food, eating, andassociated settings, such as kitchens, dining rooms and restau-rants. In 3 of 4 patients, such dreams tended to diminish infrequency as psychotherapy progressed. In no cases did patientsnotice food dreams arising in response to feelings of hungerduring the preceding day nor did they report waking up fromthese dreams feeling hungry. Hamburger concluded that fooddreams constitute a typical theme that derives from latent “oralneeds,” essentially substituting one type of gratification (sexual,dependency) for another (alimentary).

Several content studies provide some indication of the preva-lence of food and drink themes in dreams. First, the prevalence oftaste and smell in dreams is moderately low; 36.6 and 39.0% ofparticipants retrospectively report having experienced any kindof gustatory or olfactory dream imagery, respectively, and preva-lence estimates from 2 to 3-week home logs are even lower: 13.4and 15.2%, respectively (Zadra et al., 1998). In the latter study,only 0.86 and 1.01%, respectively, of over 3300 dreams containedsuch imagery. Second, the Hall and van de Castle dream con-tent norms (Hall and van de Castle, 1966) indicate that foodas an object occurred in the dreams of only 1.4% of male and1.0% of female college students (1.2% overall), and the broadertheme of orality (including eating/drinking, being in a place of eat-ing/drinking, preparing or securing food/drink) was also relativelyinfrequent, occurring in the dreams of only 16.0% of males and17.0% of females. Third, the typical dream theme of “eating deli-cious foods” has a lifetime prevalence among University studentsof 30.7% (Nielsen et al., 2003). A similar value was found in alarger sample of internet respondents: 26.9% (4307 of 16,030)dreamed this theme at least once, including 23.0% (848 of 3681)of males and 28.0% (3459 of 12,349) of females (χ2

(1) = 35.69,p < 0.000001; unpublished). Among eating disordered patientswhose dreams were sampled in a single laboratory night, dreams

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 3

343

344

345

346

347

348

349

350

351

352

353

354

355

356

357

358

359

360

361

362

363

364

365

366

367

368

369

370

371

372

373

374

375

376

377

378

379

380

381

382

383

384

385

386

387

388

389

390

391

392

393

394

395

396

397

398

399

400

401

402

403

404

405

406

407

408

409

410

411

412

413

414

415

416

417

418

419

420

421

422

423

424

425

426

427

428

429

430

431

432

433

434

435

436

437

438

439

440

441

442

443

444

445

446

447

448

449

450

451

452

453

454

455

456

Nielsen and Powell Food and dreams

of food were much more prevalent. One study found them in 58%of patients with bulimia, 26% of patients with anorexia, and 44%of patients with anorexia and bulimia combined (Dippel et al.,1987). Similarly, patients with a diagnosis of migraine headachewere retrospectively more likely to report taste (31%) and smell(36%) in their dreams than were control subjects (20 and 20%,respectively) (Lovati et al., 2014).

In sum, the few available studies of dreams about food reveala relatively low prevalence of dreams of eating per se, with thepossible exception of individuals with eating disorders and otherhealth conditions, but a higher prevalence of dreams about oralityand food associations. While limited, such findings nonethelessdemonstrate that dreaming about food and eating is not uncom-mon and also suggest that the effects of food on dreaming may beassociated with health and personality factors (see also review byStrickler, 2005).

BELIEFS ABOUT THE EFFECTS OF FOOD ON DREAMSBeliefs that dreams can be influenced by food are widespreadand often circulated—and recirculated—by the media. Dreamresearchers are frequently asked about food effects on dreams,often in advance of food-centric holidays such as Halloween(candy), Easter (chocolate), or Christmas (turkey, general glut-tony). An often-mentioned notion is the classic “Pickled Walnut”theory, of unknown origin, which stipulates that eating spicy orunusual foods before sleep will lead to bizarre dreams or night-mares. These beliefs have also had currency in common medicalopinion. For example, the famous psychoanalyst, Ernest Jones,in his influential treatise, On the Nightmare (1931), noted that“in the current medical view they [nightmares] are ascribed tophysical disturbances in the alimentary, respiratory or circula-tory system, disturbances of either an irritating nature, such asundigested food, or of a mechanical nature, such as a distendedstomach” (p. 344). He also named cucumbers as “the article offood that is most looked askance at in relation to Nightmare”(p. 38). Similar sentiments concerning the relationship of food tonightmares have been voiced by medical practitioners since antiq-uity; Hippocrates (1931), for example, stated that “monstrousbodies that are seen in sleep and frighten a man indicate [amongother possibilities] a surfeit of unaccustomed food....” (p. 443).

Perhaps not surprisingly then, beliefs about the effect of foodon dreams have remained current among the general public. Thiswas strikingly reflected in the recurring food themes of the previ-ously mentioned comic strip, Dream of the Rarebit Fiend, from theearly 1900s. Protagonists in these cartoons had bizarre or disturb-ing dreams that they blamed on their pre-sleep meals of Welshrarebit (a dish of melted spiced cheese on toast) or, less com-monly, mince pie. A similar literary reference is that of EbenezerScrooge attributing one of his ghostly visions to “an undigestedbit of beef, a blot of mustard, a crumb of cheese, a fragment of anunderdone potato” in Charles Dickens’ A Christmas Carol (1843).One journalist’s introduction to a piece about food and dreamsin New Scientist magazine (Jones, 2000) sums up this widespreadcultural belief as follows:

We’ve all heard the story a thousand times: eating too much foodjust before bed can give you bad dreams. Especially if it’s spicy, orfermented, and definitely if it’s cheese that smells like your sock

drawer. I’ve noticed it. My mom’s warned me about it. It’s establishedfact, isn’t it?

A prevailing belief in the power of cheese to induce bad dreamsappears to have also been the motivation behind the aforemen-tioned unpublished study sponsored by the British Cheese Board(2005): “‘Now that our Cheese and Dreams study has finallydebunked the myth that cheese gives you nightmares we hope thatpeople will think more positively about eating cheese before bed,’says Nigel White, British Cheese Board secretary.”

Although the belief that foods can affect one’s dreams appearsto be prevalent, little empirical evidence has been collected onthe issue. An early survey by Laird (1920) assessed 100 par-ticipants’ beliefs about dreaming, hypnosis, telepathy, and thesubconscious. Fifteen participants (15%) indicated that a causeof dreaming was the kind or amount of food eaten. This wasnonetheless a majority of the 28% of participants who gave apositive answer to this question (other causes mentioned were“worry,” “conscience,” and “disturbed sleep”).

In sum, a sampling of medical and popular culture refer-ences, along with an early survey study, indicates that belief inthe ability of food to affect dreams—especially in a negativefashion—has been and continues to be common. The presentstudy examines beliefs about food-dependent dreaming by ask-ing undergraduate students whether and how foods can affecttheir dreams and which foods are most influential. The study alsoassesses whether participants who did and did not report experi-encing food-dependent dreaming differed on measures of sleep,dreams, and diet-related habits and motivations, as well as therelationship of these same variables to reports of vivid and dis-turbing dreams independent of the perception of food-dependentdreaming.

MATERIALS AND METHODSPARTICIPANTSParticipants were 396 undergraduate students—130 males (Mage:21.6 ± 5.28 years), 264 females (Mage: 21.4 ± 5.10 years;t392 = 0.37, p = 0.715), and two for whom age and sex wereunspecified—enrolled in first-year psychology courses at aCanadian university. The study was approved by the university’sResearch Ethics Board. Each participant provided informed con-sent and received partial course credit for their participation.Responses from all 396 respondents were entered into correla-tional analyses. However, 14 participants failed to respond to oneof the food-related dreaming items, leaving a total of 382 par-ticipants for the group comparisons: 126 males (Mage: 21.6 ±5.33 years), 255 females (Mage: 21.4 ± 5.15 years; t379 = 0.39,p = 0.695), and one sex unspecified.

PROCEDURESThe questionnaires used in this study formed part of a largeron-line survey assessing food consumption patterns and variousaspects of behavioral and psychological functioning. Followingthe survey, participants read a thorough debriefing that explainedthe nature and importance of the study. The email address of theprimary researcher was also provided for students who wantedmore information. The survey measures used in the present studyare described below.

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 4

457

458

459

460

461

462

463

464

465

466

467

468

469

470

471

472

473

474

475

476

477

478

479

480

481

482

483

484

485

486

487

488

489

490

491

492

493

494

495

496

497

498

499

500

501

502

503

504

505

506

507

508

509

510

511

512

513

514

515

516

517

518

519

520

521

522

523

524

525

526

527

528

529

530

531

532

533

534

535

536

537

538

539

540

541

542

543

544

545

546

547

548

549

550

551

552

553

554

555

556

557

558

559

560

561

562

563

564

565

566

567

568

569

570

Nielsen and Powell Food and dreams

Sleep Quality Scale (SQS)This 28-item questionnaire (Yi et al., 2006) assesses problems insleep quality over the past month, including daytime dysfunctiondue to sleepiness, restoration from sleep, difficulties in wakingor falling asleep, sleep satisfaction, and awakenings during sleep.Items are rated on a 4-point scale with endpoints labeled 1-neveror rarely (up to 1–3 times a month); 2-sometimes (1–2 timesa week); 3-often (3–5 times a week) and 4-almost always (6–7times a week). The SQS has been shown with college studentsto have strong internal consistency and test-retest reliability, aswell as strong concurrent and construct validity (Yi et al., 2006).In the present study, we used four of the SQS subscales: (1) day-time dysfunction due to sleepiness; (2) difficulty falling asleep; (3)sleep dissatisfaction; and (4) sleep maintenance problems. We alsoadded an in-house measure of sleep time, i.e., the average numberof hours slept per day. (All in-house scales and items used in thisstudy are presented in the Appendix).

Three Factor Eating Questionnaire (TFEQ; Stunkard and Messick,1985)The TFEQ is a 51-item self-report questionnaire that assesseseating-related thoughts and behaviors with three subscales (cogni-tive restraint, disinhibition, hunger). However, because the TFEQfactor structure has been questioned (Karlsson et al., 2000), wecalculated Karlsson et al.’s more psychometrically sound TFEQ18-item revised (TFEQ-18R) questionnaire from participants’raw scores. The three subscales of the TFEQ-18R include: cogni-tive restraint (CR; test-retest r = 0.81–0.93; Cronbach’s alpha =0.93), or the propensity to control eating to influence body weightand body shape; uncontrolled eating (UE; r = 0.80–0.86; CA =0.91), or the propensity to lose control over eating when feelinghungry or when exposed to external stimuli; and emotional eat-ing (EE; r = 0.75–0.83; CA = 0.85), or the tendency to overeatin response to dysphoric mood states, e.g., when feeling lonely,anxious, or depressed.

Intuitive Eating Scale (IES)This 21-item instrument (Tylka, 2006) measures an individual’spropensity to utilize physical hunger/satiety cues, rather than sit-uational and emotional cues, when deciding what, when andhow much to eat. It consists of three subscales: unconditionalpermission to eat (CA = 0.89), eating for physical reasons (CA= 0.86), and reliance on hunger/satiety cues (CA = 0.72). Onlythe latter subscale was used in the present study. IES scores,including reliance on hunger/satiety cues, are associated positivelywith psychological well-being and negatively with eating disor-der symptoms, body dissatisfaction, poor interoceptive aware-ness, pressure for thinness, and internalization of the thin-idealstereotype (Tylka, 2006).

Diet quality questionnaireThis in-house questionnaire was designed to estimate the qualityof participants’ diets by having them retrospectively report theextent to which they ate foods that are prototypically consideredto be “healthy” or “unhealthy,” as well as the amount of coffee theydrank. The questionnaire items were modified versions of scaleitems used by Thompson et al. (2000). Four items (green salads,vegetables, fruit, whole grains) were averaged to form a healthy

foods variable, and two items (non-diet soft drinks, low-nutrientsnacks) were averaged to form an unhealthy foods variable.

Eating Behavior QuestionnaireThis in-house questionnaire assessed select attributes of eatingbehavior that could potentially influence sleep and dreams. Oneitem asked if the participant was currently following a calorie-reducing diet; another assessed the longest time that elapsedbetween eating or drinking during a typical day—which weviewed as a proxy measure of short-term fasting. A third item,drawn from the Eating Disorders Diagnostic Scale (Stice et al.,2000), assessed the tendency to engage in binge-eating behavior.

Perceived Food-Dependent Dreaming (FDD) QuestionnaireThis in-house questionnaire assessed the perceived effects of foodon dreaming with three binary (yes/no) and three open-endedquestions. Two binary questions asked whether participants hadever noticed foods that led to disturbing dreams or bizarre dreamswhile a third asked whether they had ever noticed if eating lateat night had affected their sleep or dreams. [Dreams that areeither disturbing or bizarre may overlap to the extent that bothcan involve negative emotion. But the two are distinct in thatbizarre dreams, which contain impossible (e.g., flying) or improb-able (e.g., winning a lottery) events, are not necessarily negative].For participants who answered “yes” to each of the three binaryquestions, the following open-ended question asked participantsto give specific examples. From the eating late at night items, wecalculated a new variable specific to dreaming that was scored1 if participants mentioned an effect on dreams (rather thansleep) in response to the open-ended question and was scored 0otherwise. We then created a perceived food-dependent dream-ing (FDD) variable in which participants who reported eitherthat eating a particular food led to disturbing or bizarre dreamsor that eating late at night affected their dreams were given ascore of 1 (FDD+) and those who did not were given a score of0 (FDD−).

Dream Characteristics QuestionnaireDisturbing and normal dreams over the past 2 weeks wereassessed with a 7-item in-house questionnaire that assessed threeaspects of disturbing dreams (recall frequency, distress, #wake-ups) and four aspects of non-disturbing dreams (recall frequency,clarity, realism, color). To reduce the number of variables for sub-sequent correlational analyses, responses to the seven questionswere first subjected to a principal components factor analysiswith varimax rotation (Kaiser normalization). A clear two-factorsolution accounting for 58.2% of the variance emerged whichconsisted of a disturbing dreams factor (%variance = 34.7) thatcontained all three disturbing dreams items (component load-ings: DD-distress = 0.865; DD-wakeUp = 0.852; DD-freq =0.752), and a vivid dreams factor (%variance = 23.5) that con-tained the remaining four items (DR-realism = 0.777; DR-clarity= 0.732; DR-freq = 0.677; DR-color = 0.613). Disturbing dreamsand vivid dreams factor scores were used as primary endpoints forsubsequent analyses.

STATISTICAL ANALYSESDistributions of participants as a function of sex and responsesto the three FDD items were evaluated with χ2 analyses. FDD

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 5

571

572

573

574

575

576

577

578

579

580

581

582

583

584

585

586

587

588

589

590

591

592

593

594

595

596

597

598

599

600

601

602

603

604

605

606

607

608

609

610

611

612

613

614

615

616

617

618

619

620

621

622

623

624

625

626

627

628

629

630

631

632

633

634

635

636

637

638

639

640

641

642

643

644

645

646

647

648

649

650

651

652

653

654

655

656

657

658

659

660

661

662

663

664

665

666

667

668

669

670

671

672

673

674

675

676

677

678

679

680

681

682

683

684

Nielsen and Powell Food and dreams

group differences on sleep, dreaming, and other variables werecompared using a series of MANCOVAs with FDD group (FDD+,FDD−) as between groups factors and the multivariable group-ings of dependent measures shown in Table 3. Effects were sub-sequently assessed with univariate statistics and post-hoc t-tests.Significance threshold was set at p < 0.05. To assess whetherdreams and food/diet measures were associated independent ofFDD status, partial correlations were conducted while covary-ing FDD status. Because of strong correlations observed betweendisturbed sleep and other measures, partial correlations thatcovaried relevant sleep disturbance scores were also conducted.

RESULTSDESCRIPTIVEAs shown in Table 1, 68 of 382 (17.8%) participants indi-cated that their dreams were affected either by eating particularfoods (11.5%) or eating late at night (9.5%). Food-dependencieswere observed in approximately equal proportions for disturbingdreams (8.9%) and bizarre dreams (7.6%). Distributions of food-dependencies for males and females did not differ for disturbingdreams (χ2 = 0.735, p = 0.391), bizarre dreams (χ2 = 0.414,p = 0.520), disturbing and bizarre dreams combined (χ2 =0.436, p = 0.606), or dreams affected by either foods or eating late(χ2 = 0.165, p = 0.684). The two sexes were therefore combinedfor all subsequent analyses.

Table 2 lists the categories and frequencies of foods that weregiven in response to the open-ended questions asking for detailsabout foods that influenced disturbing and bizarre dreams. Themost frequent category mentioned (see Figure 2) was dairy, andincluded cheese, milk, hot milk, ice cream, yogurt, pizza, and pou-tine. Other foods typically containing cheese (e.g., pasta) wereexcluded from this category only because they also contained apredominance of other ingredients. It was also unclear from par-ticipants’ mentions of “greasy” foods whether dairy was intended.Sweets and chocolate were the second most frequently mentioned

category of dream-influencing foods, although these were men-tioned more than twice as often for bizarre dreams (30.8%) thanfor disturbing dreams (12.5%; χ2 = 2.92, p = 0.088). The samewas true for vegetables, although these were only infrequentlymentioned. Conversely, spicy and starchy foods and meat wereall mentioned more than twice as often for leading to disturbingdreams as they were for leading to bizarre dreams.

The probability of observing this proportion of dairy-relatedfoods being named as responsible for either disturbing or bizarredreams was calculated with binomial tests using the expected pro-portion of a food type calculated as the likelihood of observingany of the 7 food types being named equally often, or 1/7 =14.28%. Thus, for disturbing dreams, the probability of observ-ing 14 out of 32 (43.8%) instances of dairy-related foods wasZ = 4.762, p < 0.0001. No other food type was statistically sig-nificant. For bizarre dreams, the probability of observing 10 outof 26 (38.5%) instances of dairy-related foods was Z = 3.527,p = 0.0004 while the probability of observing 8 out of 26 (30.8%)instances of sugar-related foods was Z = 2.245, p = 0.025. Noother food types were significant.

The open-ended question about whether eating late influencedsleep and dreams produced a total of 89 responses; of these, 36(40.4%) specifically mentioned changes in dreaming. A majorityof these respondents, 47.2%, indicated that eating late brought onnightmares or disturbing dreams; 22.2% indicated that eating latemade their dreams more bizarre, odd, strange, or crazy; 19.4%that they became more vivid, realistic or creative; 13.9% that theybecame more nonsensical or meaningless; 8.3% that they becamemore abundant; and 8.3% that they related more closely to theprevious day’s experiences.

QUESTIONNAIRE CORRELATIONSPearson correlations between all dependent measures of the studyare shown in Table 3. Measures are grouped by the multivariablescontrasted in the group comparisons in the following section.

Table 1 | Participants perceiving their bizarre or disturbing dreams to be influenced by food or by eating late at night.

Item† Males Females All Total

(N = 126) (N = 255) (N = 382)

Yes No Yes No Yes No

N (%) N (%) N (%) N (%) N (%) N (%)

1. Food causes disturbing dreamsa 9 (7.1) 117 (92.9) 25 (9.8) 230 (90.2) 34 (8.9) 347 (91.1) 381

2. Food causes bizarre dreamsb 8 (6.3) 118 (93.7) 21 (8.2) 235 (91.8) 29 (7.6) 353 (92.4) 382

3. Eating late affects sleep or dreamsc 29 (23.2) 96 (76.8) 71 (28.0) 183 (72.0) 100 (26.4) 279 (73.6) 379

4. Eating late affects dreamsd 12 (9.6) 113 (90.4) 24 (9.4) 230 (90.6) 36 (9.5) 343 (90.5) 379

5. 1 or 2 (Food causes bizarre ordisturbing dreams)

13 (10.3) 113 (89.7) 31 (12.1) 225 (87.9) 44 (11.5) 338 (88.5) 382

6. 1 or 2 or 4 (FDD+: above item pluseating late affects dreams)

21 (16.7) 105 (83.3) 47 (18.4) 209 (81.6) 68 (17.8) 314 (82.2) 382

† One participant failed to complete item 1; three participants failed to complete items 3 and 4.aHave you ever noticed certain foods that seemed to lead you to have a disturbing dream? (no/yes).bHave you ever noticed certain foods that seemed to lead you to have a bizarre dream? (no/yes).cHave you ever noticed that eating late at night seems to affect your dreams or your sleep? (no/yes)d Dream-related comment given to “In what way does eating late at night affect your dreams or your sleep?” (no/yes).

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 6

685

686

687

688

689

690

691

692

693

694

695

696

697

698

699

700

701

702

703

704

705

706

707

708

709

710

711

712

713

714

715

716

717

718

719

720

721

722

723

724

725

726

727

728

729

730

731

732

733

734

735

736

737

738

739

740

741

742

743

744

745

746

747

748

749

750

751

752

753

754

755

756

757

758

759

760

761

762

763

764

765

766

767

768

769

770

771

772

773

774

775

776

777

778

779

780

781

782

783

784

785

786

787

788

789

790

791

792

793

794

795

796

797

798

Nielsen and Powell Food and dreams

FOOD-DEPENDENT DREAMING GROUP COMPARISONSFDD status was used to compare participants who did and didnot perceive food to influence their dreams. FDD+ and FDD−groups differed significantly in age (t380 = 3.82, p = 0.004) with

Table 2 | Foods identified as influencing disturbing and bizarre

dreams.

Disturbing dreams Bizarre dreams

(N = 32) (N = 26)

N % N %

Dairy products 14 43.8 10 38.5

Cheese 4 12.5 2 7.7

Any dairy 4 12.5 4 15.4

Milk 2 6.3 1 3.8

Pizza 3 9.4 3 11.5

Poutine 1 3.1

Sugar 4 12.5 8 30.8

Sugar, sweets, candy 2 6.3 5 19.2

Chocolate 2 6.3 3 11.5

Spicy 6 18.8 2 7.7

Any spicy food 3 9.4 1 3.8

Pickles 3 9.4 1 3.8

Starch 5 15.6 1 3.8

Pasta 4 12.5

Noodles 1 3.1 1 3.8

Meat (inc. steak,hamburger, hot dog)

4 12.5 1 3.8

Vegetables (beans,peanut butter, carrots,mushrooms)

2 6.3 4 15.4

Generic 5 15.6 5 19.2

Junk, fast foods 2 6.3 3 11.5

Greasy or deep-fried 3 9.4 2 7.7

Because some participants identified more than one food type, the totals in each

column exceed 100%.

FDD+ participants being about 2.5 years older (M = 23.6 ± 7.0years) than FDD− participants (21.0 ± 4.6 years) on average.Due to this Age discrepancy, Age was examined as a covariate insubsequent comparisons.

Results for multivariate assessments with Age as a covari-ate are shown in Table 4. Three of the five multivariate effectswere significant (p < 0.05): Dreams/Nightmares (T = 0.020;F2,363 = 3.69, p = 0.026), Sleep Disturbance (Hotelling’s T =0.043; F5, 371 = 3.19, p = 0.008), and Eating Motivation (T =0.026; F4, 375 = 2.42, p = 0.048). The Dreams/Nightmares mul-tivariate main effect was due to the FDD+ group havinggreater scores on the disturbing dreams factor (F1, 364 = 5.35,p = 0.020). The Sleep Disturbance effect was due primar-ily to the FDD+ group having greater difficulty falling asleep(F1, 375 = 11.22, p = 0.001) and fewer hours of sleep per day(F1, 375 = 7.11, p = 0.008), but also to greater daytime dys-function (F1, 375 = 4.41, p = 0.036) and greater sleep dissatis-faction (F1, 375 = 4.42, p = 0.036). A single univariate differ-ence from the Diet Quality multivariable was that FDD+ par-ticipants reported drinking more coffee than did FDD− par-ticipants (F1, 373 = 5.73, p = 0.017). Finally, the multivariateEating Motivation effect was due primarily to FDD+ partic-ipants scoring lower than FDD− participants on IES relianceon hunger/satiety cues (F1, 378 = 8.16, p = 0.005), but theyalso scored marginally higher on TFEQ-18R emotional eating(F1, 378 = 3.10, p = 0.079).

To assess the extent to which late eating accounted for a por-tion of these main effects, we examined whether the distributionsof participants who reported late eating effects on dreams differedas a function of whether they thought that eating certain foodsinfluenced their dreams. This analysis revealed that 26.5% (9/34)of participants who claimed that eating certain foods affectedtheir dreams (category 5 in Table 1) also claimed that eating lateaffected their dreams, whereas only 9% (32/347) of participantswho did not claim that eating specific types of foods affectedtheir dreams did so (χ2 = 9.59, p < 0.006, Fisher exact test, 2-tailed). Thus, several participants who described specific, dream-altering foods also attributed dream changes to eating late atnight.

Following this, we reproduced the previous MANCOVAcomparisons while treating the effect of eating late on dreamingas a covariate. This changed the pattern of results in several

FIGURE 2 | Proportions of participants who identified specific food types as influencing disturbing and bizarre dreams.

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 7

799

800

801

802

803

804

805

806

807

808

809

810

811

812

813

814

815

816

817

818

819

820

821

822

823

824

825

826

827

828

829

830

831

832

833

834

835

836

837

838

839

840

841

842

843

844

845

846

847

848

849

850

851

852

853

854

855

856

857

858

859

860

861

862

863

864

865

866

867

868

869

870

871

872

873

874

875

876

877

878

879

880

881

882

883

884

885

886

887

888

889

890

891

892

893

894

895

896

897

898

899

900

901

902

903

904

905

906

907

908

909

910

911

912

Nielsen and Powell Food and dreams

Tab

le3

|P

ears

on

co

rrela

tio

ns

for

all

part

icip

an

tsb

etw

een

all

stu

dy

vari

ab

les,

gro

up

ed

as

for

mu

lti-

vari

ab

les

inTab

le4.

12

34

56

78

910

11

12

13

14

15

16

17

Dis

turb

ing

drea

ms

1–

0.87

010.0

00

00.0

00

00.0

00

00.0

00

00.

4607

0.55

770.

9292

0.05

790.0

005

0.85

850.0

00

00.0

026

0.0

017

0.01

120.0

018

Vivi

ddr

eam

s2

−0.0

09–

0.02

120.

3584

0.02

280.

4141

0.02

930.0

045

0.0

036

0.45

340.

4403

0.0

005

0.14

530.

1018

0.0

039

0.09

330.

1264

SQ

S:D

aytim

edy

sfun

ctio

n3

0.3

49

−0.1

20–

0.0

00

00.0

00

00.0

00

00.0

00

00.

9601

0.01

900.0

004

0.0

00

00.

1076

0.0

00

00.

4870

0.0

00

00.0

00

00.0

00

0

SQ

S:D

ifficu

ltyfa

lling

asle

ep4

0.3

22

−0.0

480.5

22

–0.0

00

00.0

00

00.0

00

00.

0564

0.55

330.

0357

0.0

004

0.32

960.0

073

0.08

070.

1386

0.08

290.

0192

SQ

S:S

leep

diss

atis

fact

ion

50.2

50

−0.1

190.5

69

0.4

21

–0.0

00

00.0

00

00.

0180

0.38

290.

1671

0.04

900.

8151

0.0

034

0.51

330.0

073

0.0

031

0.0

002

SQ

S:S

leep

mai

nten

ance

60.2

93

0.04

30.3

20

0.4

98

0.2

74

–0.0

044

0.37

690.

5854

0.0

010

0.0

041

0.42

400.

2291

0.04

280.

2797

0.03

160.

3650

Hou

rsof

slee

p7

−0.0

390.

114

−0.3

15

−0.2

47

−0.3

85

−0.1

45

–0.

8423

0.74

450.0

065

0.04

960.

7556

0.65

380.

9926

0.63

240.

0983

0.01

09

Hea

lthy

food

s8

0.03

10.1

48

0.00

3−0

.098

−0.1

21−0

.045

0.01

0–

0.0

00

00.

3930

0.04

010.

0480

0.44

680.0

007

0.78

730.

8244

0.32

34

Unh

ealth

yfo

ods

90.

005

−0.1

52

0.12

00.

031

0.04

50.

028

−0.0

17−0

.275

–0.

2599

0.32

130.

0153

0.17

110.0

00

00.

0220

0.90

610.

2076

Cof

fee

100.

099

0.03

90.1

82

0.10

80.

071

0.1

67

−0.1

39

0.04

40.

058

–0.

0377

0.55

540.

2102

0 .45

060.

2032

0.0

091

0.0

002

Cur

rent

lyon

diet

11−0

.181

−0.0

40−0

.246

−0.1

82

−0.1

01−0

.146

0.10

1−0

.105

0.04

1−0

.106

–0.

8396

0.0

00

00.0

00

00.0

002

0.0

014

0.0

00

0

Tim

ebe

twee

nm

eals

12−0

.009

0.1

81

−0.0

83−0

.050

−0.0

12−0

.041

0.01

6−0

.102

−0.1

25−0

.030

0.01

0–

0.01

890.

0371

0.0

00

00.

0194

0.02

25

Bin

geea

ting

130.2

13

−0.0

760.2

47

0.1

37

0.1

49

0.06

2−0

.023

−0.0

390.

070

0.06

4−0

.230

−0.1

20–

0.59

540.0

00

00.0

00

00.0

00

0

TFE

Q:C

ogn

rest

rain

t14

0.1

56

0.08

50.

035

0.08

80.

033

0.10

2−0

.001

0.1

72

−0.3

37

0.03

9−0

.324

0.10

70.

027

–0.0

011

0.07

680.

2447

TFE

Q:U

ncon

trol

led

eatin

g15

0.1

63

−0.1

50

0.2

72

0.07

50.1

35

0.05

50.

025

0.01

40.

117

0.06

5−0

.187

−0.2

31

0.4

75

−0.1

64

–0.0

00

00.0

00

0

TFE

Q:E

mot

iona

leat

ing

160.

132

−0.0

880.2

05

0.08

80.1

49

0.10

9−0

.085

−0.0

11−0

.006

0.1

33

−0.1

63

−0.1

200.3

23

0.08

90.4

05

–0.0

00

0

IES

:Hun

ger/

satie

tycu

es17

−0.1

62

0.08

0−0

.244

−0.1

19−0

.186

−0.0

460.

130

0.05

0−0

.065

−0.1

87

0.2

10

0.11

7−0

.387

−0.0

59−0

.305

−0.2

14

Low

erle

fttr

iang

leof

tabl

e:Pe

arso

nco

rrel

atio

ns(b

old

coef

ficie

nts

are

sign

ifica

ntat

p<

0.01

);up

per

right

tria

ngle

:exa

ctp-

valu

es.B

ecau

seso

me

part

icip

ants

did

not

give

valid

resp

onse

sfo

rso

me

mea

sure

s,N

s

vary

betw

een

357

and

396.

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 8

913

914

915

916

917

918

919

920

921

922

923

924

925

926

927

928

929

930

931

932

933

934

935

936

937

938

939

940

941

942

943

944

945

946

947

948

949

950

951

952

953

954

955

956

957

958

959

960

961

962

963

964

965

966

967

968

969

970

971

972

973

974

975

976

977

978

979

980

981

982

983

984

985

986

987

988

989

990

991

992

993

994

995

996

997

998

999

1000

1001

1002

1003

1004

1005

1006

1007

1008

1009

1010

1011

1012

1013

1014

1015

1016

1017

1018

1019

1020

1021

1022

1023

1024

1025

1026

Nielsen and Powell Food and dreams

Table 4 | Mean (±SD) scores, multivariate and univariate main effects for participants saying “yes” (FDD+) or “no” (FDD−) to items querying if

particular foods or eating late at night affected their dreams.

Item FDD+ FDD−a Groupb (FDD comparison Groupc (FDD comparison with

(SD) (SD) with age covaried) age and late eating covaried)

F d p F d p

Multi-variable 1. Dreams/nightmares 3.69 0.026* 1.00 0.369

Disturbing dreams 0.25 ± 1.00 −0.06 ± 0.99 5.35 0.020* 1.57 0.211Vivid dreams 0.09 ± 0.97 −0.02 ± 1.02 1.84 0.176 0.41 0.524

Multi-variable 2. Sleep Disturbance 3.19 0.008** 2.52 0.029 *

SQS: daytime dysfunction 1.89 ± 0.70 1.73 ± 0.55 4.41 0.036 * 4.13 0.043 *

SQS: difficulty falling asleep 2.06 ± 0.78 1.74 ± 0.69 11.22 0.001*** 8.55 0.004**

SQS: sleep dissatisfaction 2.85 ± 0.86 2.62 ± 0.79 4.42 0.036* 0.32 0.571SQS: sleep maintenance 2.13 ± 0.77 2.01 ± 0.84 0.61 0.437 0.02 0.898Hours of sleep 6.81 ± 1.26 7.36 ± 1.29 7.11 0.008 ** 1.24 0.267

Multi-variable 3. Diet Quality 1.93 0.124 0.78 0.507

Healthy foods 5.10 ± 1.20 5.10 ± 1.38 0.03 0.861 0.00 0.982Unhealthy foods 3.15 ± 1.50 3.20 ± 1.43 0.03 0.869 0.49 0.486Regular coffee 4.05 ± 2.56 3.12 ± 2.21 5.73 0.017 * 1.66 0.199

Multi-variable 4. Eating Behavior 0.28 0.843 1.03 0.380

Currently on diete 1.85 ± 0.36 1.82 ± 0.38 0.50 0.478 0.75 0.387Time between meals 3.63 ± 1.11 3.72 ± 1.04 0.27 0.607 1.66 0.198Binge-eating 2.87 ± 1.67 2.92 ± 1.78 0.12 0.732 0.21 0.646

Multi-variable 5. Eating motivation 2.42 0.048* 1.96 0.105

TFEQ-18R: Cognitive restraintf 1.89 ± 0.47 1.88 ± 0.44 0.45 0.504 0.44 0.509TFEQ-18R: Uncontrolled eatingf 1.64 ± 0.36 1.58 ± 0.33 1.86 0.174 1.21 0.272TFEQ-18R: Emotional eatingf 1.47 ± 0.42 1.35 ± 0.39 3.10 0.079 5.82 0.016*

IES:Hunger/satiety cuesg 3.47 ± 0.69 3.69 ± 0.56 8.16 0.005** 3.38 0.067

F and p scores are shown for age-covaried main effects for FDD comparisons as well as for FDD comparisons with late eating effect also covaried.aFDD+/FDD−, participants reported “yes” or “no”, respectively to food-dependent dreaming (dreams were influenced by particular foods or by eating late).bFDD+.cFDD+ cohort while covarying perception of dreams being affected by “eating late”.d Multivariate F- and p-values are shown for rows in bold font, univariate statistics for all other rows.e1, yes; 2, no.f TFEQ−18R, Three-factor Eating Questionnaire 18-item Revised version.g IES, Intuitive Eating Scale.

***p < 0.001; **p < 0.01; *p < 0.05.

respects. Most importantly, the Dreams/Nightmares multi-variate group difference was no longer significant (T = 0.006,F2, 327 = 1.00, p = 0.369) and the groups no longer differed onthe disturbing dreams univariable (F1, 328 = 1.57, p = 0.211).The Sleep Disturbance multivariate effect was also diminishedbut remained significant (T = 0.034, F5, 335= 2.52, p = 0.029),as did univariate effects for daytime dysfunction (F1, 339 = 4.13,p = 0.043) and difficulty falling asleep (F1, 339 = 8.55, p = 0.004),but not for hours of sleep (F1, 339 = 1.24, p = 0.267). For DietQuality, the univariate difference for drinking coffee was elim-inated (F1, 330 = 1.67, p = 0.199). For Eating Motivation, themultivariate effect was diminished (T = 0.021, F4, 339 = 1.96,p = 0.105), and the reliance on hunger/satiety cues difference wasreduced to a trend (F1, 342 = 3.38, p = 0.067); the emotionaleating difference, however, became significant (F1, 342 = 5.82,p = 0.016).

RELATIONSHIPS BETWEEN DREAMING AND OTHER FACTORSTo assess general relationships between the two dreaming factorscores and other variables, independent of whether participantsreported food-dependent dreaming, we re-examined the correla-tions between disturbing dreams and vivid dreams and the othervariables reported in Table 3 after covarying Age and FDD sta-tus. As shown in Table 5, disturbing dreams were associated with alargely pathological constellation of variables. There was a strongrelationship with sleep disturbance as indicated by highly signif-icant correlations with all four SQS subscales (all p < 0.00001)but not with hours of sleep. Disturbing dreams were also pos-itively associated with being currently on a diet (p < 0.0004)and engaging in binge-eating (p < 0.00003), as well as withgreater cognitive restraint (p < 0.004), more uncontrolled eating(p < 0.003), more emotional eating (p < 0.020), and less relianceon hunger/satiety cues (p < 0.005). Disturbing dreams were not,

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 9

NIELTORE
Inserted Text
sleep dissatisfaction (F1, 339 = 0.32, p=0.571) or

1027

1028

1029

1030

1031

1032

1033

1034

1035

1036

1037

1038

1039

1040

1041

1042

1043

1044

1045

1046

1047

1048

1049

1050

1051

1052

1053

1054

1055

1056

1057

1058

1059

1060

1061

1062

1063

1064

1065

1066

1067

1068

1069

1070

1071

1072

1073

1074

1075

1076

1077

1078

1079

1080

1081

1082

1083

1084

1085

1086

1087

1088

1089

1090

1091

1092

1093

1094

1095

1096

1097

1098

1099

1100

1101

1102

1103

1104

1105

1106

1107

1108

1109

1110

1111

1112

1113

1114

1115

1116

1117

1118

1119

1120

1121

1122

1123

1124

1125

1126

1127

1128

1129

1130

1131

1132

1133

1134

1135

1136

1137

1138

1139

1140

Nielsen and Powell Food and dreams

Table 5 | Pearson correlations between Disturbing Dreams and Vivid Dreams factor scores and sleep, diet, and eating measures for sample

with Age and FDD status covaried (columns 2,3), and with sleep disturbance measures also covaried (columns 4,5).

Disturbing Dreams Vivid Dreams Disturbing Dreams Vivid Dreams

Partial ra Partial ra Partial rb Partial rc

Sleep disturbance

SQS: daytime dysfunction 0.340**** −0.133*SQS: difficulty falling asleep 0.308**** −0.064SQS: sleep dissatisfaction 0.241**** −0.127*SQS: poor sleep maintenance 0.291**** 0.055Hours of sleep −0.023 0.104*

Diet quality

Healthy foodsb 0.030 0.141** 0.056 0.137**Unhealthy foodsc 0.006 −0.158** −0.034 −0.147**Coffee 0.087† 0.067 0.015 0.093†

Eating behavior

Currently on diet (1 = yes; 2 = no) −0.185*** −0.043 −0.096† −0.079Longest time between meals −0.005 0.188*** 0.026 0.183***Binge eating 0.217*** −0.070 0.151** −0.041

Eating motivation

TFEQ-18R: CR 0.155** 0.074 0.133* 0.080TFEQ-18R: UE 0.156** −0.164** 0.089† −0.144**TFEQ-18R: EE 0.122* −0.080 0.058 −0.054IES: Hunger/satiety cues −0.147** 0.090† −0.084 0.057

****p < 0.00001; ***p < 0.001; **p < 0.01; *p < 0.05; †p < 0.10; Abbreviations as in Table 4.aCovariates: Age, FDD status.bCovariates: Age, FDD status, all SQS subscales.cCovariates: Age, FDD status, SQS daytime dysfunction, SQS sleep dissatisfaction, Hours of sleep.

however, significantly related to the quality of participants’ diets,having only a marginal positive correlation with drinking coffee(p = 0.097). To determine if these relationships with disturbingdreams might be due to a mediating effect of sleep disturbances,correlations were recalculated with the SQS subscale scores par-tialed out. The relationship of disturbing dreams to being cur-rently on a diet was reduced to marginal significance (p = 0.070),while the relationship with binge-eating remained significant (p <

0.005). Among the motivational factors, however, only cognitiverestraint remained significant (p < 0.012), while emotional eat-ing (p = 0.276) and reliance on hunger/satiety cues (p = 0.111)became nonsignificant and uncontrolled eating was reduced tomarginal significance (p = 0.090).

The vivid dreams factor showed a profile of correlations largelyopposite to that for disturbing dreams, being associated withbetter sleep and more adaptive diet-related behaviors and moti-vations. More specifically, vivid dreams correlated negatively withdaytime dysfunction (p < 0.012) and sleep dissatisfaction (p <

0.016) and positively with hours of sleep (p < 0.051). Vivid dreamswere also associated with eating more healthy foods (p < 0.007)and fewer unhealthy foods (p < 0.003), and with longer timesbetween meals (p < 0.0004). There was also a negative associa-tion with uncontrolled eating (p < 0.002) and a marginal posi-tive association with reliance on hunger/satiety cues (p < 0.086).Covarying the relevant sleep measures (SQS daytime dysfunc-tion, SQS sleep dissatisfaction, and hours of sleep) had little effect

on the results for the remaining variables. The positive corre-lation with healthy foods (p < 0.009) and negative correlationwith unhealthy foods (p < 0.006) remained, while a marginallypositive correlation with drinking coffee (p < 0.077) emerged.The positive correlation with longer times between meals (p <

0.0006) and negative correlation with uncontrolled eating (p <

0.006) also remained; however, the marginally positive corre-lation with reliance on hunger/satiety cues was eliminated (p =0.280).

DISCUSSIONAmong a large sample of university undergraduates, we foundevidence supporting two general ideas about how food influencesdreams. First, results show that a substantial proportion ofindividuals (17.8%) perceive that food can render their dreamsmore bizarre or disturbing. These individuals are able to provideexamples—some quite specific—of foods that they believe affecttheir dreams; as well, many of them perceive that eating late atnight can affect their dreams. Second, we found evidence thatdisturbing dreams and vivid dreams are, in general, associatedwith several factors related to food consumption, such as differentmotivations for eating, with the effects for disturbing dreamsbeing largely mediated by sleep quality. In both sets of results,we found evidence that degree of psychopathology vs. wellnessmight mediate the relationship between food and the types ofdreams one has.

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 10

1141

1142

1143

1144

1145

1146

1147

1148

1149

1150

1151

1152

1153

1154

1155

1156

1157

1158

1159

1160

1161

1162

1163

1164

1165

1166

1167

1168

1169

1170

1171

1172

1173

1174

1175

1176

1177

1178

1179

1180

1181

1182

1183

1184

1185

1186

1187

1188

1189

1190

1191

1192

1193

1194

1195

1196

1197

1198

1199

1200

1201

1202

1203

1204

1205

1206

1207

1208

1209

1210

1211

1212

1213

1214

1215

1216

1217

1218

1219

1220

1221

1222

1223

1224

1225

1226

1227

1228

1229

1230

1231

1232

1233

1234

1235

1236

1237

1238

1239

1240

1241

1242

1243

1244

1245

1246

1247

1248

1249

1250

1251

1252

1253

1254

Nielsen and Powell Food and dreams

PERCEPTIONS OF FOOD-DEPENDENT DREAMINGOur finding that 16.7% of males reported food-dependentdreaming is surprisingly similar to the early estimate by Laird(Laird, 1920) that 15% of males believed dreaming can be affectedby the type or amount of food eaten. Females were not studied byLaird but our estimate of 18.4% for females suggests that they donot differ substantially from males. It is noteworthy that our esti-mates of perceived food-dependent dreaming among universityjuniors are very similar to previous estimates of the prevalenceof food and orality themes in the dreams of college students inboth the US (16% males; 17% females; Hall and van de Castle,1966) and Japan (22%; Yamanaka et al., 1982). These similaritiesraise the intriguing possibility that participants who report food-dependent dreaming are also those who dream most about foodthemes.

While we consider the present findings preliminary andin need of further replication and extension, there are sev-eral reasons to expect that our relatively modest prevalenceestimates of perceived food-dependent dreaming are, in fact,underestimations. We queried participants about food in relationto only two common types of dreams, disturbing and bizarre,but details about other dream types or dream attributes couldprove even more informative. Probes about sex dreams, flyingdreams, lucid dreams, dreams of falling, or especially dreamsabout eating, drinking, and procuring or preparing food mightwell trigger other memories or attributions about the influenceof foods. Further, the present sample was restricted to primarilyyoung undergraduates who may have had less experience observ-ing the influence of food on their dreams or have had feweropportunities to be exposed to commonly held beliefs aboutrelationships between food and dreaming. Consistent with thispossibility, we found that FDD+ participants were on average 2.5years older than FDD− participants. A more thorough evaluationof the many possible influences of food on dreams, especially witholder participants, may well produce higher estimates of perceivedfood-dependent dreaming.

Although our exploratory use of open-ended responses forclassifying foods led to varying levels of descriptive detail, andthus limited comparability among participants, some trends nev-ertheless emerged. Dairy products were the foods most frequentlyidentified as influencing both disturbing (44%) and bizarre(39%) dreams. These proportions might be even higher in thatsome of the foods referred to by participants as “greasy” or“starchy” (e.g., pasta) may well have included cheese as a majoringredient. Sweet foods were also frequently mentioned as influ-encing dreams, but primarily in relation to bizarre (31%) ratherthan disturbing (13%) dreams. In contrast, spicy foods werepredominantly mentioned as a precursor to disturbing dreams(19%) as were starchy foods (16%) and meat (13%). It is note-worthy that dairy and spicy foods were the two categories mostoften named as affecting disturbing dreams; together they con-stitute a striking parallel to the spiced cheese dish of Welshrarebit. Cucumbers, which Jones (1931) described as the foodmost commonly believed to be a precursor of nightmares, wasmentioned once within this category in the form of pickles. Eatinglate was also perceived to affect dreams—primarily disturbingdreams (47%) but also dreams that participants characterized as

“bizarre,” “vivid,” “odd,” “strange,” or “crazy” (22%). A quar-ter of participants who perceived that specific foods affectedtheir dreams also reported that eating later affected their dreams(which is likely an underestimation given that some of those whogave an example of late eating affecting a change in sleep mayalso have been able to give an example of a change in dreaming);this effect of late eating may reflect the possibility that specificfoods eaten just before bed are those to which dream changes aremost likely to be attributed. But it may also reflect the fact thateating late negatively impacts sleep (Crispim et al., 2011) whichmay, in turn, influence dreaming. Thus, whereas dairy productswere seen as the most common instigators of both disturbing andbizarre dreams, other types of foods were mentioned as affectingpredominantly either disturbing dreams (spicy, starchy, meat) orbizarre dreams (sweets), with late eating in many instances possi-bly mediating the perceived relationship between particular typesof food and dreaming.

Comparisons of FDD+ and FDD− groups produced a set ofdifferences consistent with the possibility that FDD+ is associatedwith higher levels of psychopathology which may in turn playa role in the tendency to perceive food-dependent dreaming.FDD+ participants reported having more disturbed sleep anddisturbing dreams and, in a possibly related vein, drank morecoffee. The FDD+ group was also somewhat more likely to eatfor emotional reasons and was less sensitive to internal hungerand satiety cues. Tendencies toward emotional eating and lowsensitivity to hunger/satiety cues are interrelated (van Strienet al., 2005)—as they were in the present study (r = −0.214,p < 0.0001)—and have been associated with other pathologicalsymptoms. For example, high emotional eaters are characterizedby eating more when distressed (van Strien et al., 2012) and havemore blunted cortisol stress response (van Strien et al., 2013),poorer coping skills (Spoor et al., 2007), poorer interoceptivesensitivity (Herbert et al., 2013), and higher alexithymia and dif-ficulty in identifying feelings (Larsen et al., 2006; van Strien andOuwens, 2007). Emotional eating is also associated with posttrau-matic stress disorder (PTSD), with degree of emotional eatingbeing predictive of symptom severity (Talbot et al., 2013). Lateeating may play a role in mediating some of these effects insofar ascovarying the perceived effect of late eating on dreams somewhatdiminished the differences in pathology between the two groups.

The observed relationship between FDD+ and higher psy-chopathology is not generally consistent with the findings ofthe British Cheese Board (2005), i.e., that eating cheese priorto sleep does not induce nightmares. While our findings donot demonstrate empirically that nightmares result from eatingdairy, the fact that subjects themselves reported observing thisphenomenon, as well as our finding that such observations arecorrelated with psychopathological measures, together tend tosupport the opposite conclusion: that eating cheese may, in someindividuals, adversely influence subsequent dreaming.

Although the present results for perceived food-dependentdreaming are clearly limited by their correlational nature andby our use of subjective and retrospective reports, and shouldtherefore be considered as exploratory in nature, we nonethe-less suggest that they provide sufficient grounds for consideringfour possible explanations for why changes in dreams are often

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 11

1255

1256

1257

1258

1259

1260

1261

1262

1263

1264

1265

1266

1267

1268

1269

1270

1271

1272

1273

1274

1275

1276

1277

1278

1279

1280

1281

1282

1283

1284

1285

1286

1287

1288

1289

1290

1291

1292

1293

1294

1295

1296

1297

1298

1299

1300

1301

1302

1303

1304

1305

1306

1307

1308

1309

1310

1311

1312

1313

1314

1315

1316

1317

1318

1319

1320

1321

1322

1323

1324

1325

1326

1327

1328

1329

1330

1331

1332

1333

1334

1335

1336

1337

1338

1339

1340

1341

1342

1343

1344

1345

1346

1347

1348

1349

1350

1351

1352

1353

1354

1355

1356

1357

1358

1359

1360

1361

1362

1363

1364

1365

1366

1367

1368

Nielsen and Powell Food and dreams

attributed to foods. Because our results are preliminary, we framethese explanations in the form of hypotheses for future study.

Food specificity hypothesisAccording to this hypothesis, many participants who report food-dependent dreaming are accurately describing cause-and-effectrelationships between specific foods or food categories and thecontent or quality of their dreams. In this context, FDD+ par-ticipants may differ from FDD− participants simply in havinga greater “dream sensitivity” to certain foods or in being moreaccurate observers of food-dream relationships. The purportedresults of the aforementioned unpublished study sponsored bythe British Cheese Board (2005)—which claimed, for example,that eating cheddar cheese led to dreams about celebrities—would, if valid, constitute an extreme example of this type ofeffect. The British Cheese Board report noted that cheese con-tains high levels of tryptophan which has been shown to reducestress and promote sleep. But although this might account for atendency for cheese to induce more pleasant or relaxing dreams,which the present results would dispute, it seems insufficientto account for a certain type of cheese (e.g., cheddar) lead-ing to a specific change in dream content (e.g., celebrities).Nevertheless, as previously noted, several foods contain nutrientsthat have been shown to impact sleep, and it is possible that cer-tain foods could potentially also impact dreaming—though onesuspects such effects would be of a more general nature (e.g.,calm vs. exciting dreams) than of a specific change in dreamcontent.

Food distress hypothesisClosely related to the above, this hypothesis proposes that theperception of food-dependent dreaming may result from non-specific effects of food intolerances and other adverse reactionsto food, the symptoms of which result in bizarre and disturbingdreams. As noted earlier, this notion dates back to antiquity, withHippocrates himself believing it to be a significant cause of night-mares. It differs from the food specificity hypothesis in proposingthat the effect on dreams is not the result of a specific link betweena particular food or type of food (or food nutrient) and dream-ing; rather, the effect is the result of an adverse change in one’ssomatic condition, especially in the alimentary system, whichcould potentially also have been induced by a non-food eventsuch as illness or other stressor. The adverse change in conditioncould either directly impact dreaming or indirectly affect dream-ing through the disruption of sleep patterns (Bohn et al., 2013;Dominguez-Ortega et al., 2014). In fact, sleep disruption is cor-related with a number of food items commonly known to inducegastrointestinal symptoms (Bohn et al., 2013). Among the morecommon are dairy products (e.g., 49% of patients with irritablebowel syndrome), beans/lentils, chocolate, and wheat (Benton,2007; Bohn et al., 2013). The fact that dairy products were byfar the most frequently named instigator of both bizarre and dis-turbing dreams in the present study supports this hypothesis,especially in view of the relatively high prevalence of lactose intol-erance among Canadians (20% of females and 12.3% of males;Barr, 2013). Also consistent with this possibility, many of thephysical symptoms of lactose intolerance (gas, bloating, cramps,

diarrhea) were reported spontaneously in response to our open-ended question about how eating late at night influences sleep anddreams.

Spicy foods were also singled out in our study as influencingdreams, particularly disturbing dreams (18.8%). Some pungentspices are known to affect sleep and might thus also alter dream-ing. For example, a meal containing a combination of Tabascosauce and hot English mustard caused healthy male athletes tosleep fewer hours and less efficiently (e.g., more time awake)than did a meal without these spices (Edwards et al., 1992).Moreover, rectal temperature was significantly higher duringthe first REM period of the night following the spiced meal, achange that might directly alter dream formation processes sinceREM sleep is the stage most conducive to copious, vivid dreamcontent.

In sum, food sensitivities and intolerances, especially lac-tose intolerance, could play a significant role in food-dependentdreaming. Assessment of food allergies, sensitivities, and intoler-ances in future work should clarify this potential explanation.

Folklore hypothesisThis hypothesis stipulates that an individual’s tendency to per-ceive particular foods as affecting their dreams originates in theassimilation of beliefs about food that have been transmittedinter-generationally within families, groups, or the broader cul-ture. While not incompatible with the previous hypotheses—acultural belief that, e.g., spicy foods can lead to bad dreamsmay in fact be accurate—the folklore hypothesis does not dependupon an individual’s accurate assessment of a food-dream rela-tionship. That is, some members of a culture may falsely believethat a prevalent folktale about, say, pickles causing bizarredreams applies to them when it does not. Thus, our find-ing that dairy products are the most frequently mentionedtype of food deemed to be responsible for inducing disturb-ing (43.7%) and bizarre (38.5%) dreams, while plausible froma lactose intolerance perspective, may also be consistent withthe folklore hypothesis. As previously mentioned, there appearsto be a belief prevalent in certain populations that dairy prod-ucts can affect dreams; this belief dates back at least to theearly 1900s, as exemplified by McCay’s Dream of the RarebitFiend cartoon series. While it is doubtful that contemporaryuniversity students are familiar with the Rarebit Fiend series,its wide influence at the time (see review in Wikipedia, 2014,http://en.wikipedia.org/wiki/Dream_of_the_Rarebit_Fiend) mayhave ensured that its central message (“eating spicy cheese leads tobizarre dreams”) would continue in common folklore for gener-ations. As earlier noted, the persistent prevalence of this belief inBritain, whatever its source, appears to have been the motivationbehind the unpublished study on the effect of cheese on dreamsby the British Cheese Board (2005).

A related notion is that cultural beliefs about the effectsof particular foods may interact with the ingestion of thosefoods such that the interaction brings about the culturallysanctioned belief. Thus, eating a lot of cheese before goingto bed while being reminded that this will surely causebizarre dreams may enhance the likelihood that bizarre dreamswill occur.

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 12

1369

1370

1371

1372

1373

1374

1375

1376

1377

1378

1379

1380

1381

1382

1383

1384

1385

1386

1387

1388

1389

1390

1391

1392

1393

1394

1395

1396

1397

1398

1399

1400

1401

1402

1403

1404

1405

1406

1407

1408

1409

1410

1411

1412

1413

1414

1415

1416

1417

1418

1419

1420

1421

1422

1423

1424

1425

1426

1427

1428

1429

1430

1431

1432

1433

1434

1435

1436

1437

1438

1439

1440

1441

1442

1443

1444

1445

1446

1447

1448

1449

1450

1451

1452

1453

1454

1455

1456

1457

1458

1459

1460

1461

1462

1463

1464

1465

1466

1467

1468

1469

1470

1471

1472

1473

1474

1475

1476

1477

1478

1479

1480

1481

1482

Nielsen and Powell Food and dreams

Misattribution hypothesisThis hypothesis proposes that some perceived linkages betweenfood and dreams may be false, with the connection to food, or aparticular food, being a misattribution of the real cause. As shownin the preceding section, folklore may have a particularly stronginfluence on this type of misattribution. For example, studentswho are taught to believe that cheese can induce nightmares maybe highly prone to attributing bad dreams to a pizza they ate thenight before a stressful exam rather than to their worries about theexam. Interestingly, FDD+ participants may be especially proneto misattributing the cause of a dream in this way if their lowreliance on hunger/satiety cues is representative of a more gen-eral lack of internal awareness which then leads them to seek anexternal explanation for their dreams.

As should be clear from the above discussion, these four expla-nations for the perception of food-dependent dreaming are notmutually exclusive. Any particular instance of a perceived food-dream relationship may result from a combination of two or moreof these factors.

GENERAL RELATIONSHIPS BETWEEN FOOD AND DREAMINGIndependent of participants’ beliefs in food-dependent dreaming,the present study also found evidence of at least two relationshipsbetween food and dreaming. The first relationship, which was alsonoted for the perception of food-dependent dreaming, reflects apathological constellation of variables that are uniquely associ-ated with disturbing dreams. In addition to disordered sleep, thesevariables include being on a diet, binge-eating, cognitive restraint,uncontrolled eating, emotional eating, and reduced reliance onhunger/satiety cues. The association of these variables with dis-turbing dreams could not be attributed uniquely to disorderedsleep because correlations with the other measures persisted evenwhen disordered sleep was covaried.

In contrast to the above, the second type of relationshipbetween food and dreaming reflects a constellation of wellnessmeasures uniquely associated with vivid dreams. These measuresinclude better sleep, a healthier diet, longer daily intervals with-out eating, and less uncontrolled eating. Again, the relationshipsheld even when the sleep measures were covaried, thus excludingbetter sleep as a unique explanation for the relationship.

These two opposing patterns of correlations partially replicatethe preliminary findings of Kroth et al. (2007). Whereas the lat-ter authors reported that dream recall, recurrence, pleasantnessand incidence of several specific themes, such as sexuality, risk-taking and flying, were all positively correlated with the frequencyof eating organic foods, we found a positive correlation between amore general measure of dream vividness that overlaps conceptu-ally with their measures (dream recall especially) and a measureof eating healthy foods. Similarly, whereas Kroth et al. found anegative correlation between dream recall and a preference foreating junk foods, we too found a negative correlation betweenvivid dreams and eating unhealthy foods. One finding reportedby Kroth et al. that we failed to replicate was a negative correlationbetween nightmares and a preference for eating junk foods; thatis, they found that less frequent nightmares were associated with apreference for unhealthy foods, whereas we found no associationbetween disturbing dreams and diet quality.

The present findings further demonstrate relationshipsbetween dietary patterns and disturbing and vivid dreams. In par-ticular, cognitive restraint, emotional eating, and reduced relianceon hunger/satiety cues were associated with disturbing dreamswhereas uncontrolled eating was associated with both disturb-ing dreams (higher scores) and vivid dreams (lower scores). Atleast two of these measures, emotional eating and reliance onhunger/satiety cues, may reflect individual differences in visceralor affective awareness. If this is the case, these findings, in additionto the general findings about food-dependent dreaming, could berelevant to an understanding of how consciousness in the formof interoceptive awareness may contribute to dream formation.For example, alexithymia, and the alexithymia component fac-tor difficulty in identifying feelings, are both elevated in severaltypes of eating disorders (Troop et al., 1995), as well as in sub-jects who report more disturbing dreams (Nielsen et al., 2011).This, and the fact that individuals with eating disorders frequentlyreport disturbing dreams, e.g., increased ineffectuality, feelings ofimpending doom, hostility, anxiety, anger (Brink and Allan, 1992;for review see Lauer and Krieg, 2004), suggests that a chronicinability to access interoceptive sensations may be a factor com-mon to both eating disorders and disturbing dreams. This furthersuggests that therapeutic approaches that promote a general-ized awareness and identification of feelings—which may includefeelings within one’s dreams (e.g., Gendlin, 1986)—may be par-ticularly helpful in the treatment of both disturbed dreaming andeating disorders.

Particularly intriguing is our finding that participants whoreported experiencing longer daily intervals without eating alsoreported more vivid dreams. As noted earlier, fasting has beenutilized since ancient times as a means of inducing vivid dreams.The present results suggest that even brief periods of food depri-vation within a day may be sufficient to produce a similar effect.This possibility is interesting in view of growing research indicat-ing that intermittent fasting—consisting of periodic intervals of12–24 h with little or no food—can have beneficial effects on bothphysical health and cognitive abilities (e.g., Longo and Mattson,2014). These findings are especially relevant if the longer intervalswithout eating reported in the present study typically occurredeither following sleep (resulting in a skipped breakfast) and/orpreceding sleep (after an early supper), in which case these partic-ipants may have regularly experienced extended periods of fooddeprivation consistent with an intermittent fasting protocol. Ifso, then the relationship of food deprivation with vivid dreamsfound in the present study may be associated with, or the resultof, a general improvement in cognitive functioning resulting fromexposure to periods of intermittent fasting. (See also Zilberter andZilberter, 2013, for a discussion of empirical evidence concerningthe benefits vs. adverse effects of skipping breakfast). This pos-sibility is further supported by the fact that our scores on vividdreams and longest time between meals were both positively cor-related with scores on the Attentional Function Index (r = 0.181,p = 0.001; r = 0.157, p = 0.004, respectively), a standardizedself-report measure of cognitive functioning (Cimprich et al.,2011) that was included in the survey as part of a questionnaire setfor a different study. If replicated, this relationship between briefperiods of fasting and vivid dreams might be useful in helping

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 13

1483

1484

1485

1486

1487

1488

1489

1490

1491

1492

1493

1494

1495

1496

1497

1498

1499

1500

1501

1502

1503

1504

1505

1506

1507

1508

1509

1510

1511

1512

1513

1514

1515

1516

1517

1518

1519

1520

1521

1522

1523

1524

1525

1526

1527

1528

1529

1530

1531

1532

1533

1534

1535

1536

1537

1538

1539

1540

1541

1542

1543

1544

1545

1546

1547

1548

1549

1550

1551

1552

1553

1554

1555

1556

1557

1558

1559

1560

1561

1562

1563

1564

1565

1566

1567

1568

1569

1570

1571

1572

1573

1574

1575

1576

1577

1578

1579

1580

1581

1582

1583

1584

1585

1586

1587

1588

1589

1590

1591

1592

1593

1594

1595

1596

Nielsen and Powell Food and dreams

individuals to procure vivid dreams for use in creative pursuits orpsychotherapy. It is noteworthy, however, that intervals of fastingmay be confounded by a tendency to sleep late in the morning;“sleeping-in” may facilitate more vivid dreams because it takesplace closer to the peak of the circadian REM sleep propensityrhythm (for review see Nielsen, 2011).

It is perhaps ironic that one of the earliest theories of disturb-ing dreams—that it is often the result of foods we have eaten—hasgenerated such little empirical research. Moreover, when the pos-sibility has been considered, it has often been in the form of whatJones (1931) aptly referred to as a “half-jocular remark concern-ing the assimilable capacity of the evening meal” (p. 13). Theimpact of food on dreams may, however, be deserving of moreserious consideration. For example, as previously noted, PTSDhas been found to be associated with emotional eating (Talbotet al., 2013); in view of the present results, this might mean thatthe disordered eating patterns associated with PTSD play a rolein exacerbating or maintaining the chronic nightmares that con-stitute a major symptom of PTSD. This in turn suggests thattargeting the development of healthier patterns of eating may bea useful adjunct in the treatment of PTSD. The present resultsalso suggest that dreams, and perceived food-dream relationships,may be useful indicators of food intolerances and maladaptivepatterns of eating.

Further research on the topic seems warranted. This shouldinclude additional survey research using a more refined set ofitems as informed by the present findings, as well as experimen-tal research which directly manipulates foods eaten and assessestheir effects on dreaming. Of interest would be assessments ofthe extent to which certain foods—especially those, like Welshrarebit, combine dairy and spiciness—and particular eating pat-terns play a role in the exacerbation of chronic nightmares, aswell as of the relationship of vivid dreams to intermittent periodsof food deprivation and improvements in cognitive functioning.Such studies may even cast light on how a seeming relic fromcartoon history, the Dream of the Rarebit Fiend, achieved suchpopularity and continues to portray a common belief about foodand dreams today.

ACKNOWLEDGMENTSNatural Sciences and Engineering Research Council of Canada(Grant #312277) and Canadian Institutes of Health Research(Grant #MOP-115125).

SUPPLEMENTARY MATERIALThe Supplementary Material for this article can be found onlineat: http://www.frontiersin.org/journal/10.3389/fpsyg.2015.

00047/abstract

REFERENCESAnonymous (Daily Mail). (2005). Sweet Dreams are Made of Cheese. Available

online at: http://www.dailymail.co.uk/health/article-362101/Sweet-dreams-cheese.html (Accessed Sep 12, 2005).

Barr, S. I. (2013). Perceived lactose intolerance in adult Canadians: a nationalsurvey. Appl. Physiol. Nutr. Metab. 38, 830–835. doi: 10.1139/apnm-2012-0368

Benton, D. (2007). The impact of diet on anti-social, violent andcriminal behaviour. Neurosci. Biobehav. Rev. 31, 752–774. doi:10.1016/j.neubiorev.2007.02.002

Bohn, L., Storsrud, S., Tornblom, H., Bengtsson, U., and Simren, M. (2013).Self-reported food-related gastrointestinal symptoms in IBS are common andassociated with more severe symptoms and reduced quality of life. Am. J.Gastroenterol., 108, 634–641. doi: 10.1038/ajg.2013.105

Bokert, E. (1968). The Effects of Thirst and a Related Verbal Stimulus on DreamReports. Doctoral dissertation, New York University.

Brink, S. G., and Allan, J. A. (1992). Dreams of anorexic and bulimicwomen. A research study. J. Anal. Psychol. 37, 275–297. doi: 10.1111/j.1465-5922.1992.00275.x

British Cheese Board. (2005). Sweet dreams are made of cheese. Unpublisheddocument.

Cimprich, B., Visovatti, M., and Ronis, D. L. (2011). The attentional func-tion index–a self-report cognitive measure. Psychooncology 20, 194–202. doi:10.1002/pon.1729

Crispim, C. A., Zimberg, I. Z., dos Reis, B. G., Diniz, R. M., Tufik, S., and de Mello,M. T. (2011). Relationship between food intake and sleep pattern in healthyindividuals. J. Clin. Sleep Med. 7, 659–664. doi: 10.5664/jcsm.1476

Dement, W., and Wolpert, E. (1958). The relationship of eye movements, bodymotility, and external stimuli to dream content. J. Exp. Psychol. 55, 543–553.doi: 10.1037/h0040031

Dickens, C. (1843). A Christmas Carol. London: Chapman & Hall.Dippel, B., Lauer, C., Riemann, D., Majer-Trendel, K., Krieg, J. C., and Berger,

M. (1987). Sleep and dreams in eating disorders. Psychother. Psychosom. 48,165–169. doi: 10.1159/000288048

Dominguez-Ortega, G., Borrelli, O., Meyer, R., Dziubak, R., De Koker, C.,Godwin, H., et al. (2014). Extraintestinal manifestations in children with gas-trointestinal food allergy. J. Pediatr. Gastroenterol. Nutr. 59, 210–214. doi:10.1097/MPG.0000000000000391

Edwards, S. J., Montgomery, I. M., Colquhoun, E. Q., Jordan, J. E., and Clark,M. G. (1992). Spicy meal disturbs sleep: an effect of thermoregulation? Int. J.Psychophysiol. 13, 97–100. doi: 10.1016/0167-8760(92)90048-G

Foucart, G. (1912). “Dreams and sleep: Egyptian,” in Encyclopedia of Religion andEthics, Vol 5, ed J. Hastings (New York: Charles Scribner’s Sons), 34–37.

Freud, S. (1900). The Interpretation of Dreams. New York, NY: Basic Books.Gendlin, E. T. (1986). Let Your Body Interpret Your Dreams. Wilmette, IL: Chiron

Publications.Hall, C., and van de Castle, R. I. (1966). The Content Analysis of Dreams. New York,

NY: Appleton-Century-Crofts.Hamburger, W. W. (1958). The occurrence and meaning of dreams of food and

eating: I. Typical food and eating dreams of four patients in analysis. Psychosom.Med. 20, 1–16. doi: 10.1097/00006842-195801000-00001

Herbert, B. M., Blechert, J., Hautzinger, M., Matthias, E., and Herbert, C. (2013).Intuitive eating is associated with interoceptive sensitivity. Effects on body massindex. Appetite 70, 22–30. doi: 10.1016/j.appet.2013.06.082

Hippocrates. (1931). “Dreams,” in Hippocrates, On the Universe, Vol. IV, edsHippocrates, W. H. S. Jones, and Heraclitus (Boston, MA: Harvard UniversityPress), 421–447.

Jones, E. (1931). On the Nightmare. New York, NY: Liveright.Jones, N. (2000). The nightmare before Christmas. New Sci. 44–45.Karlsson, J., Persson, L. O., Sjostrom, L., and Sullivan, M. (2000). Psychometric

properties and factor structure of the Three-Factor Eating Questionnaire(TFEQ) in obese men and women. Results from the Swedish ObeseSubjects (SOS) study. Int. J. Obes. Relat. Metab. Disord. 24, 1715–1725. doi:10.1038/sj.ijo.0801442

Kroth, J., Briggs, A., Cummings, M., Rodriguez, G., and Martin, E. (2007).Retrospective reports of dream characteristics and preferences for organic vs.junk foods. Psychol. Rep. 101, 335–338. doi: 10.2466/pr0.101.1.335-338

Laird, D. A. (1920). The duty of the psychopathologist to the man on the street.J. Abn. Psychol. 14, 406–410. doi: 10.1037/h0073678

Larsen, J. K., van Strien, T., Eisinga, R., and Engels, R. C. (2006). Gender differ-ences in the association between alexithymia and emotional eating in obeseindividuals. J. Psychosom. Res. 60, 237–243. doi: 10.1016/j.jpsychores.2005.07.006

Lauer, C. J., and Krieg, J. C. (2004). Sleep in eating disorders. Sleep Med. Rev. 8,109–118. doi: 10.1016/S1087-0792(02)00122-3

Lincoln, J. S. (1970). The Dream in Primitive Cultures. Baltimore, MD: The Williams& Wilkins Co.

Longo, V. D., and Mattson, M. P. (2014). Fasting: molecular mechanisms andclinical applications. Cell Metab. 19, 181–192. doi: 10.1016/j.cmet.2013.12.008

Frontiers in Psychology | Consciousness Research February 2015 | Volume 6 | Article 47 | 14

NIELTORE
Inserted Text
that

1597

1598

1599

1600

1601

1602

1603

1604

1605

1606

1607

1608

1609

1610

1611

1612

1613

1614

1615

1616

1617

1618

1619

1620

1621

1622

1623

1624

1625

1626

1627

1628

1629

1630

1631

1632

1633

1634

1635

1636

1637

1638

1639

1640

1641

1642

1643

1644

1645

1646

1647

1648

1649

1650

1651

1652

1653

1654

1655

1656

1657

1658

1659

1660

1661

1662

1663

1664

1665

1666

1667

1668

1669

1670

1671

1672

1673

1674

1675

1676

1677

1678

1679

1680

1681

1682

1683

1684

1685

1686

1687

1688

1689

1690

1691

1692

1693

1694

1695

1696

1697

1698

1699

1700

1701

1702

1703

1704

1705

1706

1707

1708

1709

1710

Nielsen and Powell Food and dreams

Lovati, C., DeAngeli, F., D’Amico, D., Giani, L., D’Alessandro, C. M., Zardoni, M.,et al. (2014). Is the brain of migraineurs "different" even in dreams? Neurol. Sci.35(Suppl. 1), 167–169. doi: 10.1007/s10072-014-1762-0

MacCulloch, J. A. (1912). “Fasting (Introductory and non-Christian),” inEncyclopedia of Religion and Ethics, Vol 5, ed J. Hastings (New York, NY: CharlesScribner’s Sons), 759–765.

Meier, C. A. (1967). Ancient Incubation and Modern Psychotherapy. Evanston, IL:Northwestern University Press.

Nielsen, T. (2011). “Ultradian, circadian, and sleep-dependent features of dream-ing,” in Principles and Practice of Sleep Medicine, 5th Edn., eds M. Kryger, T.Roth, and W. C. Dement (New York, NY: Elsevier), 576–584.

Nielsen, T. A., Zadra, A. L., Simard, V., Saucier, S., Stenstrom, P., Smith, C., et al.(2003). The typical dreams of Canadian university students. Dreaming 13,211–235. doi: 10.1023/B:DREM.0000003144.40929.0b

Nielsen, T., Levrier, K., and Montplaisir, J. (2011). Dreaming correlates ofalexithymia among sleep-disordered patients. Dreaming 21, 16–31. doi:10.1037/a0022861

O’Nell, C. W. (1965). A cross-cultural study of hunger and thirst manifested indreams. Hum. Dev. 8, 181–193. doi: 10.1159/000270303

Peuhkuri, K., Sihvola, N., and Korpela, R. (2012). Diet promotes sleep duration andquality. Nutr. Res. 32, 309–319. doi: 10.1016/j.nutres.2012.03.009

Spoor, S. T., Bekker, M. H., van Strien, T., and van Heck, G. L. (2007). Relationsbetween negative affect, coping, and emotional eating. Appetite 48, 368–376.doi: 10.1016/j.appet.2006.10.005

Stice, E., Telch, C. F., and Rizvi, S. L. (2000). Development and validation of the eat-ing disorder diagnostic scale: a brief self-report measure of anorexia, bulimia,and binge-eating disorder. Psychol. Assess. 12, 123–131. doi: 10.1037/1040-3590.12.2.123

Strickler, R. D. (2005). Dreams about food and eating: a literature review. SleepHypn. 7, 1–21.

Stunkard, A. J., and Messick, S. (1985). The three-factor eating questionnaireto measure dietary restraint, disinhibition and hunger. J. Psychosom. Res. 29,71–83. doi: 10.1016/0022-3999(85)90010-8

Talbot, L. S., Maguen, S., Epel, E. S., Metzler, T. J., and Neylan, T. C. (2013).Posttraumatic stress disorder is associated with emotional eating. J. Trauma.Stress 26, 521–525. doi: 10.1002/jts.21824

Thompson, F. E., Kipnis, V., Subar, A. F., Krebs-Smith, S. M., Kahle, L. L.,Midthune, D., et al. (2000). Evaluation of 2 brief instruments and a food-frequency questionnaire to estimate daily number of servings of fruit andvegetables. Am. J. Clin. Nutr. 71, 1503–1510.

Troop, N. A., Schmidt, U. H., and Treasure, J. L. (1995). Feelings and fantasy ineating disorders: a factor analysis of the Toronto Alexithymia Scale. Int. J. Eat.Disord. 18, 151–157. doi: 10.1002/1098-108X(199509)18:2<151::AID-EAT2260180207>3.0.CO;2-E

Tylka, T. L. (2006). Development and psychometric evaluation of a measure ofintuitive eating. J. Couns. Psychol. 53, 226–240. doi: 10.1037/0022-0167.53.2.226

van Strien, T., Engels, R. C., Van Leeuwe, J., and Snoek, H. M. (2005). The Sticemodel of overeating: tests in clinical and non-clinical samples. Appetite 45,205–213. doi: 10.1016/j.appet.2005.08.004

van Strien, T., Herman, C. P., Anschutz, D. J., Engels, R. C., and deWeerth, C. (2012). Moderation of distress-induced eating by emo-tional eating scores. Appetite 58, 277–284. doi: 10.1016/j.appet.2011.10.005

van Strien, T., and Ouwens, M. A. (2007). Effects of distress, alexithymia andimpulsivity on eating. Eat. Behav. 8, 251–257. doi: 10.1016/j.eatbeh.2006.06.004

van Strien, T., Roelofs, K., and de Weerth, C. (2013). Cortisol reactivity anddistress-induced emotional eating. Psychoneuroendocrinology 38, 677–684. doi:10.1016/j.psyneuen.2012.08.008

Yamanaka, T., Morita, Y., and Matsumoto, J. (1982). Analysis of the dream contentsin Japanese college students by REMP-awakening technique. Folia Psychiatr.Neurol. Jpn. 36, 33–52.

Yi, H., Shin, K., and Shin, C. (2006). Development of the sleep quality scale. J. SleepRes. 15, 309–316. doi: 10.1111/j.1365-2869.2006.00544.x

Zadra, A. L., Nielsen, T. A., and Donderi, D. C. (1998). Prevalence of auditory,olfactory, and gustatory experiences in home dreams. Percept. Mot. Skills 87,819–826. doi: 10.2466/pms.1998.87.3.819

Zilberter, T., and Zilberter, E. Y. (2013). Breakfast and cognition: sixteen effectsin nine populations, no single recipe. Front. Hum. Neurosci. 7:631. doi:10.3389/fnhum.2013.00631

Conflict of Interest Statement: The authors declare that the research was con-ducted in the absence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.

Received: 23 September 2014; accepted: 09 January 2015; published online: xxFebruary 2015.Citation: Nielsen T and Powell RA (2015) Dreams of the Rarebit Fiend: food anddiet as instigators of bizarre and disturbing dreams. Front. Psychol. 6:47. doi: 10.3389/fpsyg.2015.00047This article was submitted to Consciousness Research, a section of the journal Frontiersin Psychology.Copyright © 2015 Nielsen and Powell. This is an open-access article distributed underthe terms of the Creative Commons Attribution License (CC BY). The use, distributionor reproduction in other forums is permitted, provided the original author(s) or licen-sor are credited and that the original publication in this journal is cited, in accordancewith accepted academic practice. No use, distribution or reproduction is permittedwhich does not comply with these terms.

www.frontiersin.org February 2015 | Volume 6 | Article 47 | 15

Supplemental Material Appendix: In-house survey items

Item Response choices

Dream characteristics

1. A disturbing dream is any dream that contains very

negative or unpleasant emotions. How many

disturbing dreams did you recall during the past two

weeks?

a. None

b. 1-2

c. 3-4

d. 5-6

e. 7-8

f. 9-10

g. 11-12

h. 13-14

i. 15 or more (that is, on average, more than one

per night)

2. How distressed were you by these disturbing

dreams?

Not at all Moderately Extremely

1 2 3 4 5 6 7

3. In general, what percentage of these disturbing

dreams were so bothersome that you were forced to

wake up (as opposed to just naturally waking up at

that time)?

a. 0%

b. 10%

c. 20%

d. 30%

e. 40%

f. 50%

g. 60%

h. 70%

1. 80%

J. 90%

k. 100%

4. How many dreams that were NOT disturbing did

you recall over the past two weeks?

a. None

b. 1-2

c. 3-4

d. 5-6

e. 7-8

f. 9-10

g. 11-12

h. 13-14

i. 15 or more (that is, on average, more than one

per night)

5. In general, how clearly were you able to recall your

non-disturbing dreams from the past two weeks?

Not at all Very

1 2 3 4 5 6 7

6. In general, how realistic were your non-disturbing

dreams from the past two weeks (that is, your dreams

made sense even if some of the elements were unusual

or impossible, such as having an ability to fly)?

Not at all Very

1 2 3 4 5 6 7

7. How often were these dreams in colour? Never Half the time Always

1 2 3 4 5 6 7

Perception of food-dependent dreaming

1. Have you ever noticed certain foods that seemed to

lead you to have a disturbing dream?

a. No b. Yes

2. What foods have you noticed that seemed to lead

you to have a disturbing dream (please be as specific

as possible)?

Open-ended

3. Have you ever noticed certain foods that seemed to

lead you to have a bizarre dream?

a. No b. Yes

4. What specific foods have you noticed that seemed

to lead to bizarre dreams?

Open-ended

5. Have you ever noticed that eating late at night

seems to affect your dreams or your sleep?

a. No b. Yes

6. In what way does eating late at night affect your

dreams or your sleep (please be as specific as

possible)?

Open-ended

Sleep length On average, how many hours do you sleep per day

(including sleeping that occurs both at night and during

the day)?

a) 3 hrs or less

b) 4 hrs

c) 5 hrs

d) 6 hrs

e) 7 hrs

f) 8 hrs

g) 9 hrs

h) 10 hrs

i) 11 hrs or more

Diet quality

1. How often do you eat green salad (with or without

other vegetables)?

1 = Never

2 = 1 to 3 times per month

3 = 1 to 2 times per week

4 = 3 to 4 times per week

5 = 5 to 6 times per week

6 = 1 time per day

7 = 2 times per day

8 = 3 times per day

9 = 4 times per day

10 = 5 or more times per day

2. How often do you eat vegetables (raw, cooked,

canned or frozen), NOT COUNTING potatoes and

salad?

same

3. How often do you eat fruit (raw, cooked, canned or

frozen), including berries?

same

4. How often do you eat whole grain foods, such as

whole grain bread or pasta, brown rice, oatmeal

porridge, or wheaties?

same

5. How often do you consume NON-diet soft drinks

(e.g., Coke, Pepsi, Dr. Pepper, etc.)?

same

6. How often do you eat low nutrient snacks like

cookies, potato chips, and candy bars?

same

7. How often do you drink regular coffee (coffee that

contains caffeine)?

same

Eating Behavior

1. Are you presently on a calorie restricting diet to

lose weight?

A = yes; B = no

2. During a typical day, from when you get up in the

morning to when you go to bed, what is the longest

amount of time that passes during which you do not

eat anything or have any calorie-containing drink

(such as a non-diet soft drink or coffee with cream

and/or sugar)?

a. less than 1 hour

b. 1 to 2 hours

c. 2 to 3 hours

d. 3 to 4 hours

e. 4 or more hours

3. How many DAYS per week on average over the

past 6 MONTHS have you eaten an unusually large

amount of food and experienced a loss of control

(you feel that you couldn’t stop eating or control

what or how much you were eating)?

# days/week:

0 1 2 3 4 5 6 7