The four seasons: food intake frequency in seasonal affective disorder in the course of a year.

Patients with seasonal affective disorder (SAD) report atypical symptoms of increased appetite, particularly "carbohydrate craving," increased body weight, and sleepiness, during their winter depression. To document feeding behavior in detail, a Food/Drink Frequency Questionnaire (FDFQ) was given to female control subjects and SAD patients at each of the four seasons. SAD patients consumed carbohydrate-rich foods (starch and not sweets) more often than controls (annual mean) and also showed a seasonal rhythm with maximum values in winter and minimum values in summer. In contrast, protein-rich food intake was identical in both groups and did not show seasonal variation. Fiber-rich food intake was also increased in SAD patients. SAD patients ate more meals per day, both at breakfast and in the second half of the day. Again, SAD patients showed seasonal changes of meal number with a minimum in summer. Body weight and body mass index did not undergo significant seasonal changes in the group as a whole, nor did SAD patients differ from controls. These atypical symptoms in SAD can be interpreted as a "medial hypothalamus syndrome" involving alpha 2-noradrenergic and serotonergic mechanisms.