Perceived stress and eating behaviors by sex, obesity status, and stress vulnerability: findings from the vitamins and lifestyle (VITAL) study

Electrophysiological and behavioral differences of general and food-specific inhibitory control in people with different levels of intuitive eating

Intuitive eating influences health-related behaviors (including calorie and nutritional intake) that are modulated by inhibitory control, producing implications for physical, mental, and emotional health. However, little is known about the relationship between intuitive eating habits and inhibitory control. Therefore, we tested intuitive eating's influence on measures of general and food-related inhibitory control using behavioral and event-related potentials (N2 and P3 components). We included 40 healthy participants: 23 had a higher level of intuitive eating, and 17 had a lower level. They participated in food-specific go/no-go and general go/no-go tasks for which we recorded electroencephalogram data. As expected, in the food-specific go/no-go task, the P3 component amplitude in the lower intuitive eating group was significantly larger than in the higher intuitive eating group; there were no significant between-group differences in the N2 amplitudes or behavioral measures. Moreover, there were no ERP or behavioral difference between groups in the general go/no-go task. Further research is needed to understand the role of positive eating behaviors in food-specific inhibitory control.

Did a workplace sugar-sweetened beverage sales ban reduce anxiety-related sugar-sweetened beverage consumption during the COVID-19 pandemic?

OBJECTIVE

Workplace sugar-sweetened beverage (SSB) sales bans can reduce SSB consumption. Because stress and anxiety can promote sugar consumption, we examined whether anxiety among hospital employees during the COVID-19 pandemic was associated with changes in SSB consumption and explored whether this relationship varied by exposure to a workplace SSB sales ban.

DESIGN

In a prospective, controlled trial of workplace SSB sales bans, we examined self-reported anxiety (generalised anxiety disorder-7) and self-reported SSB consumption (fluid ounces/d) before (July 2019) and during (May 2020) the COVID-19 pandemic.

SETTING

Hospital sites in two conditions (four with SSB sales bans and three without sales bans) in Northern California.

PARTICIPANTS

We sampled 580 participants (hospital employees) from a larger trial of sales bans; all were regular consumers of SSB (minimum 3/week at main trial enrollment). This subsample was chosen based on having appropriately timed data for our study questions.

RESULTS

Across conditions, participants reduced SSB consumption over the study period. However, participants with higher pandemic-era anxiety scores experienced smaller reductions in SSB consumption after 9 months compared with those with lower anxiety scores (β = 0·65, P < 0·05). When the sample was disaggregated by sales ban condition, this relationship held for participants in the control group (access to SSB at work, β = 0·82, P < 0·05), but not for those exposed to an SSB sales ban (β = 0·42, P = 0·25).

CONCLUSIONS

SSB sales bans likely reduce SSB consumption through multiple pathways; buffering stress-related consumption may be one mechanism.

Nutrition Knowledge, Attitudes, and Lifestyle Practices That May Lead to Breast Cancer Risk Reduction among Female University Students in Lebanon

Research has identified both nonmodifiable and modifiable risk factors for breast cancer (BC), with accumulating evidence showing that adopting adequate dietary practices could decrease the risk of this disease. This study aimed to assess nutrition knowledge, attitudes, and lifestyle practices (KAP) that may lead to BC risk reduction among female university students in Lebanon and examine the determinants of their practices. A cross-sectional survey was conducted using a convenience sampling method, comprising 356 (response rate: 71.2%) female students at the American University of Beirut aged 18 to 25 years with no history of BC. Participants completed a pre-tested questionnaire addressing the objectives of the study. The modified Bloom's cut-off of 75% was used to categorize knowledge and practice scores as poor or good and attitudes as negative or positive. Large proportions of students had poor knowledge (68.3%), negative attitudes (65.4%), and poor practices (98.0%) scores. Pursuing a health-related major and having a higher GPA were associated with better knowledge and attitudes while being older and having a lower degree of stress were associated with positive attitudes only. Having a lower body mass index (BMI) was associated with better practice scores. Better knowledge significantly predicted higher intake of fruits and vegetables. Overall knowledge and attitudes were significantly correlated with each other, but neither was significantly correlated with overall practice. These findings underscore the importance of implementing public health programs geared towards improving nutrition KAP that may lead to BC risk reduction.

Dietary Adherence Is Associated with Perceived Stress, Anhedonia, and Food Insecurity Independent of Adiposity

We examined whether perceived stress, anhedonia, and food insecurity were associated with dietary adherence during a 6-week intervention. Sixty participants (23 m; 53 ± 14 y) completed psychosocial measures and were provided with full meals. Individuals with obesity were randomized to a weight-maintaining energy needs (WMENs) (n = 18; BMI 33 ± 4) or a 35% calorie-reduced diet (n = 19; BMI 38 ± 9); normal-weight individuals (n = 23; BMI 23 ± 2) were assigned to a WMENs diet. Adherence scores were determined via weekly assessments and daily ecological momentary assessments (EMAs) of real-time behavior in a natural environment. Perceived stress and anhedonia were associated with % body fat (all r-values > 0.25, all p-values < 0.05), but food insecurity and adherence were not. Higher perceived stress (r = -0.31, p = 0.02), anhedonia (r = -0.34, p = 0.01), and food insecurity (r = -0.27, p = 0.04) were associated with lower adherence scores, even after adjusting for age, sex, and % body fat. In all adjusted models, % body fat was not associated with adherence. Higher measures of stress, anhedonia, and food insecurity predicted lower adherence independently of body fat, indicating that psychosocial factors are important targets for successful adherence to dietary interventions, regardless of body size.

Limited Cheese Intake Paradigm Replaces Patterns of Behavioral Disorders in Experimental PTSD: Focus on Resveratrol Supplementation

Currently, the efficacy of drug therapy for post-traumatic stress disorder or PTSD leaves much to be desired, making nutraceutical support a promising avenue for treatment. Recent research has identified the protective effects of resveratrol in PTSD. Here, we tested the behavioral and neurobiological effects of combining cheese consumption with resveratrol supplements in an experimental PTSD model. Using the elevated plus maze test, we observed that cheese intake resulted in a shift from anxiety-like behavior to depressive behavior, evident in increased freezing acts. However, no significant changes in the anxiety index value were observed. Interestingly, supplementation with cheese and resveratrol only led to the elimination of freezing behavior in half of the PTSD rats. We further segregated the rats into two groups based on freezing behavior: Freezing+ and Freezing0 phenotypes. Resveratrol ameliorated the abnormalities in Monoamine Oxidize -A and Brain-Derived Neurotrophic Factor gene expression in the hippocampus, but only in the Freezing0 rats. Moreover, a negative correlation was found between the number of freezing acts and the levels of Monoamine Oxidize-A and Brain-Derived Neurotrophic Factor mRNAs in the hippocampus. The study results show promise for resveratrol supplementation in PTSD treatment. Further research is warranted to better understand the underlying mechanisms and optimize the potential benefits of resveratrol supplementation for PTSD.

Dietary acid load, depression, and anxiety: results of a population-based study

BACKGROUND

Dietary acid load seems to be associated with psychological disorders through several mechanisms, and may barricade their treatment and recovery. The aim of current study was to evaluate the relationship between dietary acid load, using potential renal acid load (PRAL) and dietary acid load (DAL) scores, with the severity of depression and anxiety among Iranian adults.

METHODS

A total of 6531 participants aged 35-65 years were recruited in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using PRAL and DAL scores. Depression and anxiety were screened using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).

RESULTS

In the fully adjusted model, women with the highest DAL or PRAL had higher odds of more severe depression compared to those in the lowest category (OR = 1.20; 95% CI = 1.03-1.42 and OR = 1.20; 95% CI = 1.03-1.39, respectively). No significant association was observed between DAL and PRAL and depression severity in men and in the population as a whole. Regarding the association between PRAL and anxiety severity, there was no significant association when separated by sex. However, in the fully adjusted model for the whole population, participants in the highest tertile of PRAL had 13% greater odds of more severe anxiety than the lowest tertile (OR: 1.13, 95% CI: 1.01-1.13). No significant association was observed between DAL and anxiety severity in women, men or in the whole population.

CONCLUSION

Women, but not men, with higher dietary acid load had significantly higher odds of having more severe depression. A significant positive association was also observed between dietary acid load and anxiety in the whole population.

Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey

BACKGROUND

Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of "self-rewarding food", thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs.

METHODS

Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity.

RESULTS

Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292-0.336), age (OR: 1.742-2.334, 95%CI: 1.544-2.858), education (OR: 0.620-0.728, 95%CI: 0.445-0.973), living and working area (OR: 1.271, 95%CI: 1.192-1.355), breakfast (OR: 0.898, 95%CI: 0.839-0.960), fried food (OR: 1.133, 95%CI: 1.048-1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017-1.214) were factors for overweight/obesity. All of the aforementioned results were significant (P < 0.05).

CONCLUSIONS

The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.

Time-Varying Food Retail and Incident Disease in the Cardiovascular Health Study

INTRODUCTION

Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food retail presence on incident disease.

METHODS

The Cardiovascular Health Study recruited adults aged 65+ years in 1989-1993. Analyses conducted in 2021-2022 included those in good baseline health, with addresses updated annually through the year of death (restricted to 91% who died during >2 decades of cohort follow-up). Baseline and annually updated presence of 2 combined food retail categories (supermarkets/produce markets and convenience/snack focused) was characterized using establishment-level data for 1-km and 5-km Euclidean buffers. Cox proportional hazards models estimated associations with time to each incident outcome (cardiovascular disease, diabetes), adjusting for individual and area-based confounders.

RESULTS

Among 2,939 participants, 36% with baseline supermarket/produce market presence within 1 km had excess incident cardiovascular disease (hazard ratio=1.12; 95% CI=1.01, 1.24); the association was attenuated and no longer statistically significant after adjustment for sociodemographic characteristics. Adjusted associations were robustly null for time-varying supermarket/produce market or convenience/fast food retail presence across analyses with outcomes of cardiovascular disease or diabetes incidence.

CONCLUSIONS

Food environment changes continue to be studied to provide an evidence base for policy decisions, and null findings in this longitudinal analysis add literature that casts doubt on the sufficiency of strategies targeting food retail presence alone of an elderly cohort for curtailing incident events of clinical importance.

Mediating effect of negative perceived stress on the relationship between premenstrual syndrome and emotional eating

BACKGROUND/OBJECTIVES

Emotional eating is one of the eating behaviors in which negative emotions affect eating. During the luteal phase, premenstrual syndrome (PMS) and its associated psychological and physical symptoms can appear in some women, and a few of them suffer from premenstrual dysphoric disorder (PMDD), a severe form of PMS. Some women diagnosed with PMS/PMDD experience emotional eating during the luteal phase, which may be a coping mechanism for psychological stress. This study aimed to investigate how PMS/PMDD and negatively perceived stress are related to emotional eating.

SUBJECTS/METHODS

A total of 409 women aged 20 to 39 yrs with a body mass index (BMI) ranging from 18.5 to 29.9 kg/m2 participated in this study. Participants who responded to all the questions of the Shortened Premenstrual Assessment Form, Negative Perceived Stress Scale, and Emotional Eater Questionnaire were divided into a PMDD and a non-PMDD group according to the cut-off value for PMDD diagnosis. Independent t-tests and mediation analyses were performed to compare the 2 groups.

RESULTS

No significant differences between the 2 groups were found in terms of BMI; however, the average values for emotional eating, PMS, and negative perceived stress of the PMDD group were significantly higher than those of the non-PMDD group. Only negative perceived stress had a significant effect on emotional eating in the non-PMDD group. In the PMDD group, PMS was statistically significant for both negative perceived stress and emotional eating mediated by negative perceived stress. Consequently, it appeared to have a partial or complete mediation depending on the independent variable for the PMDD group.

CONCLUSIONS

This study highlights the importance of managing negative perceived stress to control emotional eating in PMS/PMDD for improved women's health.

Age-related differences in food-specific inhibitory control: Electrophysiological and behavioral evidence in healthy aging

The number of older adults in the United States is estimated to nearly double from 52 million to 95 million by 2060. Approximately 80-85% of older adults are diagnosed with a chronic health condition. Many of these chronic health conditions are influenced by diet and physical activity, suggesting improved diet and eating behaviors could improve health-related outcomes. One factor that might improve dietary habits in older adults is food-related inhibitory control. We tested whether food-related inhibitory control, as measured via behavioral data (response time, accuracy) and scalp-recorded event-related potentials (ERP; N2 and P3 components), differed between younger and older adults over age 55. Fifty-nine older adults (31 females [52.5%], M_age = 64, SD_age = 7.5) and 114 younger adults (82 females [71.9%], M_age = 20.8) completed two go/no-go tasks, one inhibiting to high-calorie stimuli and one inhibiting to low-calorie stimuli, while electroencephalogram (EEG) data were recorded. Older adults had slower overall response times than younger adults, but this was not specific to either food task. There was not a significant difference in accuracy between younger and older adults, but both groups' accuracy and response times were significantly better during the high-calorie task than the low-calorie task. For both the N2 and P3 ERP components, younger adults had larger no-go ERP amplitudes than older adults, but this effect was not food-specific, reflecting overall generalized lower inhibitory control processing in older adults. P3 amplitude for the younger adults demonstrated a specific food-related effect (greater P3 amplitude for high-calorie no-go than low-calorie no-go) that was not present for older adults. Findings support previous research demonstrating age-related differences in inhibitory control though those differences may not be specific to inhibiting towards food.

Daily stress and eating behaviors in adolescents and young adults: Investigating the role of cortisol reactivity and eating styles

Stress-related eating has been well documented in previous literature. However, there is limited research investigating the role of cortisol reactivity in daily stress-eating associations in samples of adolescents and young adults. 123 participants completed a baseline questionnaire and the Trier Social Stress Test in groups. Four saliva samples were taken at - 10, + 00, + 10 and + 40 min during the stress-induction task. Following this, participants completed an online daily diary each evening for 14 consecutive days to record daily stress and between-meal snack consumption. Multilevel modelling indicated that daily stress was positively associated with daily snack intake, particularly for ego-threatening and work/academic stressors. Emotional and external eating styles were found to moderate the stress-snacking relationship. Cortisol reactivity also moderated stress-eating associations, such that as cortisol reactivity levels increased from lower to higher levels, the impact of stress on eating decreased. The current findings highlight the importance of cortisol reactivity status and eating styles in understanding the complex relationship between daily stress and eating behavior in adolescents and young adults. Future research should continue investigating stress-eating associations in these groups and explore the role of other aspects of hypothalamic-pituitary-adrenal axis functioning.

Stress, trauma, and perception of eating behavior changes during the first weeks of the COVID-19 outbreak

OBJECTIVE

The COVID-19 pandemic is one of the largest collective stressors in recent history. Consistent with prior research, this stress has led to impactful eating behavior change. While prior life traumas also impact eating behavior, it is unclear whether the current stress experienced during COVID-19, and prior life traumas (overall, socially relevant, and nonsocially relevant), interact to influence eating behavior changes. Moreover, it is unclear whether current stress and prior traumas impact how eating behavior changes are perceived (i.e., in magnitude, valence, or both) by the individuals experiencing the changes. Therefore, this study sought to examine both the relationship between current stress and perception of eating behavior changes, as well as the moderating impact of prior life traumas on this relationship.

METHODS

Between March and April 2020, participants completed a subjective, self-report online assessment of current stress, prior life traumas, pandemic-related changes in eating behaviors, and the perceived impact of eating behavior changes.

RESULTS

Higher current stress was associated with larger, more negative perceptions of eating behavior changes. This relationship was moderated by prior life traumas. Specifically, the association between current stress and perceived negative impact of eating behavior change was potentiated among those with more prior socially relevant (but not nonsocially relevant) traumas.

DISCUSSION

These results suggest eating behavior changes occurred early in the pandemic and were uniquely impacted by the cumulative effect of present stress and socially relevant prior life traumas.

PUBLIC SIGNIFICANCE

Changes in eating behaviors and pathology have been prevalent during COVID-19. We examined how stress and prior life traumas interacted during the first weeks of COVID-19 to influence perceptions of eating behavior change. As altered perception of eating behaviors is a notable feature of eating pathology, these results will help inform development of intervention targets for those at risk for developing disordered eating during future- and post-pandemic recovery.

Sundararajan E, Asadi S, Nilashi M, Ab Aziz MJ, Saravanan MS, Abdelhaq M, Alsaqour R. A Hybrid MCDM Approach Based on Fuzzy-Logic and DEMATEL to Evaluate Adult Obesity

Obesity and its complications is one of the main issues in today's world and is increasing rapidly. A wide range of non-contagious diseases, for instance, diabetes type 2, cardiovascular, high blood pressure and stroke, numerous types of cancer, and mental health issues are formed following obesity. According to the WHO, Malaysia is the sixth Asian country with an adult population suffering from obesity. Therefore, identifying risk factors associated with obesity among Malaysian adults is necessary. For this purpose, this study strives to investigate and assess the risk factors related to obesity and overweight in this country. A quantitative approach was employed by surveying 26 healthcare professionals by questionnaire. Collected data were analyzed with the DEMATEL and Fuzzy Rule-Based methods. We found that lack of physical activity, insufficient sleep, unhealthy diet, genetics, and perceived stress were the most significant risk factors for obesity.

High fat diet blunts stress-induced hypophagia and activation of Glp1r dorsal lateral septum neurons in male but not in female mice

OBJECTIVE

While stress typically reduces caloric intake (hypophagia) in chow-fed rodents, presentation of palatable, high calorie substances during stress can increase caloric consumption (i.e. "comfort feeding") and promote obesity. However, little is known about how obesity itself affects feeding behavior in response to stress and the mechanisms that can influence stress-associated feeding in the context of obesity.

METHODS

We assessed food intake and other metabolic parameters in lean and obese male and female mice following acute restraint stress. We also measured real-time activity of glucagon-like peptide-1 (Glp1) receptor (Glp1r)-expressing neurons in the dorsal lateral septum (dLS) during stress in lean and obese mice using fiber photometry. Glp1r activation in various brain regions, including the dLS, promotes hypophagia in response to stress. Finally, we used inhibitory Designer Receptors Activated Exclusively by Designer Drugs (DREADDs) to test whether activation of Glp1r-expressing neurons in the LS is required for stress-induced hypophagia.

RESULTS

Lean male mice display the expected hypophagic response following acute restraint stress, but obese male mice are resistant to this acute stress-induced hypophagia. Glp1r-positive neurons in the dLS are robustly activated during acute restraint stress in lean but not in obese male mice. This raises the possibility that activation of dLS Glp1r neurons during restraint stress contributes to subsequent hypophagia. Supporting this, we show that chemogenetic inhibition of LS Glp1r neurons attenuates acute restraint stress hypophagia in male mice. Surprisingly, we show that both lean and obese female mice are resistant to acute restraint stress-induced hypophagia and activation of dLS Glp1r neurons.

CONCLUSIONS

These results suggest that dLS Glp1r neurons contribute to the hypophagic response to acute restraint stress in male mice, but not in female mice, and that obesity disrupts this response in male mice. Broadly, these findings show sexually dimorphic mechanisms and feeding behaviors in lean vs. obese mice in response to acute stress.

Direct and indirect effects on child neurocognitive development when maternal cancer is diagnosed during pregnancy: What do we know so far?

Cancer during pregnancy threatens the lives of mother and foetus and its incidence is rising, making it an emerging medical challenge. Evidence on the direct impact of cancer therapies on neonatal outcomes resulted in general guidelines for maternal treatment that safeguards foetal development. Less focus has been placed on indirect factors, in pre- and postnatal periods, that may exert long-term impacts specifically on child neurocognition. Foetal development, in the context of maternal cancer during pregnancy, may be influenced directly by exposure to cancer diagnostics and (co-)treatment, or indirectly through maternal inflammation, malnutrition, hormonal fluctuations, prematurity, and psycho-biological stress. Maternal stress and insecure mother-infant bonding related to postpartum cancer treatment may further impact child cognitive-behavioural development. Understanding the independent and synergistic effects of the factors impacting neurocognitive development creates the opportunity to intervene during the oncological treatment to improve the child's long-term outcome, both by medical and psychosocial care and support.

Direct Yet Opposite Effects of Stress-related and Mindful Eating on Diet Quality

OBJECTIVE

Examine the relationships among dietary quality, mindful eating, and constructs of the Transactional Model of Stress and Coping.

METHODS

In this cross-sectional study, women (n = 67) aged 25-50 years, with a body mass index of 25-40 kg/m² completed 3 days of 24-hour recalls and a survey that included the Perceived Stress Scale, Eating and Appraisal Due to Emotions and Stress Questionnaire, and the Mindful Eating Questionnaire. Structural equation modeling assessed relationships among all constructs with the dependent variable, the Healthy Eating Index-2015.

RESULTS

Mindful Eating Questionnaire (β = 0.60, P = 0.001) and Emotion and Stress-related Eating scores from Eating and Appraisal Due to Emotions and Stress Questionnaire (β = -0.69, P < 0.001) (r² = 0.50) were directly associated with Healthy Eating Index-2015, but no indirect effects were identified.

CONCLUSIONS AND IMPLICATIONS

Overall dietary quality is associated with greater mindful eating but more emotion and stress-related eating scores among women who were overweight or obese. Future studies could assess model constructs using other diet quality scores and including additional coping mechanisms such as substance use, physical activity, and meditation.

Beyond the Individual -A Scoping Review and Bibliometric Mapping of Ecological Determinants of Eating Behavior in Older Adults

Objectives: The objective of this scoping review was to summarize and provide a visual overview of the present-day knowledge on ecological determinants of eating behavior in community-dwelling elderly persons in relation with nutrition communication, considering the evolution of the field. The second objective was to integrate results in recommendations for the development of nutrition communication strategies.

Methods: A literature review was performed on Medline, PubMed and Google Scholar, according with the PRISMA protocol for scoping reviews. An a-priori analysis was executed by categorizing determinants from the literature according with the different levels represented in the ecological framework and an a-posteriori analysis by using VosViewer for a chronological bibliometric mapping analysis.

Results: Of 4029 articles retrieved, 77 were selected for analysis. Initial publications focused more on individual determinants of eating behavior. Over time, there was a shift towards a holistic view of eating behavior considering the “food environment”, including social networks, physical settings and public policy.

Conclusion: Beyond the individual, all ecological levels are relevant when targeting eating behavior in the elderly. Nutrition communication strategies should be structured considering these influences.

The associations among psychological distress, stressors of the COVID-19 pandemic, and disinhibited eating of parents of three- to five-year-old children

Individuals' psychological distress is associated with disinhibited eating (external and emotional eating). The aim of the current study was to examine the moderating associations of COVID-19-related stress on parents' psychological distress (anxiety, hostility, depression) and external and emotional eating. One hundred and sixty U.S. parents of three- to five-year-old children (M_age = 34.08, SD = 6.76; 89 females) completed an online survey. After accounting for participant characteristics (i.e., age, BMI, sex), regression analyses showed that COVID-19 stress moderated the effects of anxiety, hostility, and depression on external eating. Additionally, findings showed that COVID-19 stress moderated hostility (but not anxiety or depression) on emotional eating. These findings suggest that unexpected stressors from the COVID-19 pandemic may exacerbate disinhibited eating among those individuals who experience psychological distress. This presents support for providing interventions that focus on healthy coping strategies and family well-being, support groups, and community resources (e.g., financial assistance) to alleviate external pressures during unprecedented times.

Neuropeptide Y interaction with dopaminergic and serotonergic pathways: interlinked neurocircuits modulating hedonic eating behaviours

Independent from homeostatic needs, the consumption of foods originating from hyperpalatable diets is defined as hedonic eating. Hedonic eating can be observed in many forms of eating phenotypes, such as compulsive eating and stress-eating, heightening the risk of obesity development. For instance, stress can trigger the consumption of palatable foods as a type of coping strategy, which can become compulsive, particularly when developed as a habit. Although eating for pleasure is observed in multiple maladaptive eating behaviours, the current understanding of the neurobiology underlying hedonic eating remains deficient. Intriguingly, the combined orexigenic, anxiolytic and reward-seeking properties of Neuropeptide Y (NPY) ignited great interest and has positioned NPY as one of the core neuromodulators operating hedonic eating behaviours. While extensive literature exists exploring the homeostatic orexigenic and anxiolytic properties of NPY, the rewarding effects of NPY continue to be investigated. As deduced from a series of behavioural and molecular-based studies, NPY appears to motivate the consumption and enhancement of food-rewards. As a possible mechanism, NPY may modulate reward-associated monoaminergic pathways, such as the dopaminergic and serotoninergic neural networks, to modulate hedonic eating behaviours. Furthermore, potential direct and indirect NPYergic neurocircuitries connecting classical homeostatic and hedonic neuropathways may also exist involving the anti-reward centre the lateral habenula. Therefore, this review investigates the participation of NPY in orchestrating hedonic eating behaviours through the modulation of monoaminergic pathways.

Associations between antenatal maternal diet and other health aspects with infant temperament in a large multiethnic cohort study: a path analysis approach

OBJECTIVES

The aim of this study was to assess the association of antenatal maternal dietary patterns (DPs) and other health aspects with infant temperament in a large multiethnic cohort, taking maternal personality and prenatal stress into account.

DESIGN AND METHODS

Using data from 3968 children born in 2009/2010 and their mothers from the Growing Up in New Zealand cohort, infant temperament was assessed at 9 months using the Infant Behavior Questionnaire-Revised Very Short Form. Maternal antenatal diet and other health aspects were assessed antenatally. Maternal DPs (n=4) were derived using principal components analysis based on food intake reported on a 44-item food frequency questionnaire. Path analyses investigated factors associated with infant temperament, namely maternal personality, prenatal maternal stress, DPs and other health aspects, including potential inter-relations and mediating effects.

RESULTS

Women who scored higher in the fusion DP (standardised beta (β)=0.05; 95% CI 0.02 to 0.09) and healthy DP (β=0.05; 95% CI 0.02 to 0.09), who exercised more (β=0.04; 95% CI 0.01 to 0.07), and who drank less alcohol (β=-0.05; 95% CI -0.08 to -0.02) were more likely to have infants with an overall less difficult temperament. Sex-specific differences were found in the associations between maternal DP and infant temperament. Maternal personality and prenatal stress were significantly associated with all dimensions of infant temperament. The strongest predictors for a more difficult temperament were prenatal stress (β=0.12; 95% CI 0.08 to 0.15) and the personality dimensions neuroticism (β=0.10; 95% CI 0.07 to 0.14) and extraversion (β=-0.09; 95% CI -0.12 to -0.06).

CONCLUSIONS

Associations of antenatal maternal diet and health aspects with infant temperament were statistically significant but small. While they should not be overinterpreted as being deterministic, the findings of this study support the link between maternal modifiable health-related behaviours and infant temperament outcomes.

Distinct Roles of Distress and Coping Capacity in the Effects of Psychological Stress on Energy Intake and Percentage of Energy from Macronutrients

The aim of this study was to explore the association of perceived stress on energy intake and percentage of energy from macronutrients. We examined cross-sectional data from the China Health and Nutrition Survey among Chinese adults. Perceived stress scale was used to assess psychological stress, and confirmatory factor analysis was used to calculate the two latent variable scores: distress factor and coping factor of perceived stress. Combined two-level random effect model and structural equation modeling were used to explore the association between distress, coping, and energy intake. The study involved 6865 adults with an average age of 46.9 years. The intake of energy was 2047.9 ± 666.6 kcal/d, 51.1% from carbohydrate and 35.2% from fat. Neither distress nor coping capacity had an association with energy intake. The coping factor score was positively associated with the sum of percentage of energy intake from carbohydrate and fat (%C&F) in females (β = 0.149, p = 0.015) but not in males. Compared to the lowest tertile, %C&F of females with a coping factor score in the medium and top tertiles were 0.44 and 0.81 significantly higher, respectively (pmedium = 0.0013, ptop < 0.0001). Psychological stress was positively associated with %C&F in females. It was insufficient capacity to cope with stress that led to unhealthy eating behavior.

Stressed females, rather than males, tend to eat away from home

OBJECTIVES

The aim of this study is to examine the association between perceived stress and multifarious eating away from home among Chinese adults in different genders.

METHODS

We examined cross-sectional data from the China Health and Nutrition Survey conducted in 2018 among Chinese adults aged 18-59 years. A self-reported questionnaire involving the perceived stress scale with 10 items (PSS-10), and the food frequency questionnaire about eating away from home were used. Adjusted two-level zero-inflated Poisson regression models were used to explore the association.

RESULTS

There were 3161 males and 3599 females in the study. The median PSS-10 score was 16.0 and the frequencies of eating 1) breakfast, 2) lunch or supper, and 3) three main meals away from home were 12, 10, and 49 times per year, respectively. In males, PSS-10 score was not associated with eating away from home. In females, PSS-10 score was significantly positively associated with eating 1) lunch or supper, 2) three main meals, 3) Chinese food away from home, and 4) eating at stalls/restaurants (β₁ = 0.016, P₁ = 0.006; β₂ = 0.014, P₂ = 0.002; β₃ = 0.015, P₃ = 0.013; β₄ = 0.014, P₄ = 0.015 respectively). But there was not association between PSS-10 score and the frequency of eating breakfast away from home in females (β = 0.006, P = 0.325).

CONCLUSIONS

Stressed females tend to eat away from home, but the effects are very small.

Nurses' eating habits in Lebanon during the economic and health crises: a cross-sectional study

BACKGROUND

Nurses face multiple stressors that can influence their lifestyle, thus affecting their health status. Scarce are the scientific data on the nutritional status of nurses, especially during health crises. The aim of this study was to assess the impact of the COVID-19 pandemic on the eating habits of hospital nurses in the context of an exceptional economic situation in Lebanon.

METHODS

A cross-sectional study was conducted using a web-based questionnaire, targeting a non-random sampling of frontline nurses using the snowball technique. Descriptive and bivariate analyses were carried out. The population of the study included all registered nurses working in the Lebanese hospitals. A total of 533 nurses completed the questionnaire; 500 surveys were selected after excluding the ones presenting conditions that may affect their eating behavior.

RESULTS

The majority of the respondents were women (78.6%) with a mean age of 33 years [18-60] [SD,7.44 years]. Most of them (57.6%) had a crowding index ≥1. The consumption of different food groups decreased during these crises. There was a significant correlation between stress and deterioration of healthy food consumption, which provides beneficial nutrients and minimizes potentially harmful elements, especially for meat (OR 2.388, CI 1.463 to 3.898, P < 0.001). The decrease in monthly income showed a real impact on the consumption of healthy food such as meat (OR 2.181, CI 1.504 to 3.161, P < 001), fruits (OR 1.930, CI 1.289 to 2.888, P = 0.001), and milk and dairy products (OR 1.544, CI 1.039 to 2.295, P = 0.031).

CONCLUSIONS

The pandemic and in particular the economic crisis has changed the consumption of healthy food among hospital nurses in Lebanon. Similar research and support may be extended to include other frontline health care workers.

Stress-induced hyperphagia: empirical characterization of stress-overeaters

Background

Stressful situations can have an impact on an individual’s eating behavior. People vulnerable to the influence of stress tend to change the quantity and quality of their food intake. Variables such as sex and body mass index (BMI) seem to be related to this stress-eating behavior, but it is rather unclear what factors account to the parameters associated with stress-eating behavior. The aim of this survey was to identify further characteristics of adults in Germany related to stress-overeating, focusing on stress perception, coping, eating motives and comfort foods as well as personality types.

Methods

This online survey was performed throughout Germany and comprised a 38-item pre-tested questionnaire. Stress-induced overeating was classified based on the Salzburg Stress Eating Scale (SSES). Moreover, validated questionnaires were used to identify additional characteristics of stress eaters. Participants were recruited using a convenience sampling approach, and data were collected between January and April 2021.

Results

The overall sample consisted of 1222 participants (female 80.8%, aged 31.5±12.8). 42.1% of participants were identified as stress-overeaters. Among the remaining group, 78.9% stated to eat less, 21.1% to eat equally when stressed. Female participants had a higher mean SSES score compared to male participants. The BMI was positively correlated to SSES, r(1220)=0.28, p>0.005. ‘Agreeableness’ (BigFive) was found to be a negative predictor of stress-overeating. The most pronounced difference in eating motives (The Eating Motivation Survey, TEMS) was found for ‘Affect Regulation’ and ‘Weight Control’.

Conclusions

The results indicate that stress-overeating affects a large proportion of the surveyed population. BMI, personality and eating motives additionally characterize stress-overeaters and may contribute to develop new approaches to address unhealthy stress-related eating patterns.

The relationship between acute stress and neurophysiological and behavioral measures of food-related inhibitory control: An event-related potential (ERP) study

Stress influences many health-related behaviors including diet and nutrition intake, often resulting in increased calorie intake, fewer healthy eating behaviors, and poorer nutrition. Food intake is modulated by inhibitory control and has important implications for our physical, mental, and emotional health. Yet, little is known about the relationship between stress and food-related inhibitory control. We tested the influence of a short-term experimental stressor on behavioral and event-related potential (ERP; N2 and P3 components) measures of food-related inhibitory control. Ninety-seven healthy participants were randomly assigned to complete the Trier Social Stress Test (TSST) (n = 48, 27 females [52.9%]) or a neutral control condition (n = 49, 35 females [70%]) immediately followed by food-specific go/no-go and neutral go/no-go tasks while electroencephalogram (EEG) data were recorded. Stress levels were successfully manipulated, with heightened self-report and physiological measures (heart rate and systolic blood pressure) of the stress response in individuals who completed the TSST compared to control. As expected, the high calorie food-specific go/no-go task elicited larger N2 amplitude than the neutral task. N2 component amplitude was also significantly larger following the TSST relative to the control task. There were no significant between-group or task differences for P3 amplitude or behavioral measures. Findings suggest heightened N2 amplitude following psychological stress that is not specific to food or inhibition processes and may reflect heightened arousal following stress. Future research in individuals with overweight/obesity or experiencing chronic stress will further clarify the role of stress in food-related inhibitory control.

Limited cheese intake reduces HPA axis and behavioral stress responses in male rats

Eating palatable foods reduces behavioral and hypothalamic-pituitary-adrenocortical (HPA) axis responses to stress - an idea referred to by the colloquial term "comfort" food. To study the underlying stress-relieving mechanisms of palatable foods, we previously developed a paradigm of limited sucrose feeding in which male rats are given twice-daily access to a small amount of sucrose drink and subsequently have reduced stress responses. Prior research in humans and rodents implicates high dietary sugars/carbohydrates with reduced stress responsivity. However, it is not clear whether the stress-relieving effects of the limited sucrose paradigm depend upon its macronutrient content. To test this idea, the current work measures stress responses in male rats following the limited intermittent intake of cheese - a highly palatable food that is low in sugar and other carbohydrates. The data show that a history of limited cheese intake (LCI) reduced HPA axis responses to acute psychological (restraint) and physiological (hypoxia) stressors. LCI also reduced behavioral struggling during restraint, increased sociability during a social interaction test, and increased open arm activity in the elevated plus-maze test. Z-score analyses evaluated the extent to which these behavioral effects extended within and across assays, and indicated that there was an overall reduction in stress-related behaviors following LCI. Finally, LCI increased immunolabeling for FosB/deltaFosB (a protein associated with repeated or chronic neuronal activation) in the nucleus accumbens. These results indicate that palatable foods can provide stress blunting regardless of their sugar/carbohydrate composition, and support the idea that food reward per se contributes to stress relief.

Systemic and Environmental Contributors to Obesity Inequities in Marginalized Racial and Ethnic Groups

Obesity is a multifactorial disease that disproportionally affects diverse racial and ethnic groups. Structural racism influences racial inequities in obesity prevalence through environmental factors, such as racism and discrimination, socioeconomic status, increased levels of stress, and bias in the health care delivery system. Researchers, clinicians, and policy makers must work to address the environmental and systematic barriers that contribute to health inequities in the United States. Specifically, clinicians should quantitatively and qualitatively assess environmental and social factors and proactively engage in patient-centered care to tailor available treatments based on identified needs and experiences.

PaLS Study: How Has the COVID-19 Pandemic Influenced Physical Activity and Nutrition? Observations a Year after the Outbreak of the Pandemic

The restrictions implemented to prevent the spread of the SARS-CoV-2 virus have impacted the majority of life domains. To evaluate their potential consequences on physical activity (PA) and dietary habits among Polish undergraduates, a survey consisting of the IPAQ-SF, authors' questions based on the Polish National Institute of Public Health recommendations, and authors' questions scaled -5/0/5 on personal opinion was created and administered between 22 February and 3 April 2021. A total of 1323 students met the study conditions (1021 females, 297 males, 5 did not specify gender, mean age: 22 years old (SD = 4), mean BMI = 22.27 kg/m² (SD = 3.87)). A total of 27.21% of students were in the low, 48.53% in the moderate, and 24.26% in the high PA group. A total of 71.94% estimated that the pandemic had a negative impact on their PA, 8.16% no impact, and 19.9% a positive impact. A total of 35.5% had an insufficient intake of vegetables, 34.3% declared adding salt to meals, and 31.6% ate animal-based products the majority of days in a week or every day. A total of 51.02% assessed the impact of the pandemic on their nutrition as negative, 20.11% did not notice changes, and 28.87% reported a positive impact on their dietary habits. Most of the students saw harmful pandemic effects on their diet and PA compared to the times before restrictions. This can lead to a higher prevalence of non-communicable diseases (NCDs) in the future.

Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015

BACKGROUND/OBJECTIVES

This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI).

SUBJECTS/METHODS

This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality.

RESULTS

The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51-0.92), 0.73 (0.58-0.82), and 0.52 (0.33-0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all).

CONCLUSIONS

Poor adherence to dietary recommendations is associated with psychological distress, especially in women.

Effect of Healing Meditation on stress and eating behavior in overweight and obese women: A randomized clinical trial

BACKGROUND

A randomized, parallel-controlled, blinded clinical trial was conducted to evaluate the effect of Healing Meditation on stress and eating behavior of women undergoing standard weight-loss treatment.

MATERIALS AND METHODS

An outpatient clinic in Brazil, 55 women with overweight and obesity were included and randomized: 27 for the Meditation Group, and 28 for the Control Group. Randomization was stratified by body mass index category and based on blocks of four. For eight weeks, in addition to the standard weight loss treatment, the Intervention Group underwent a Healing Meditation program, and the Control Group participated in a round table to observe compliance. Reduction in stress and changes in eating behavior were assessed at baseline, and in the 8th, and 16th week using the Perceived Stress Scale, the Dutch Eating Behavior Questionnaire, and Binge Eating Scale.

RESULTS

The sample mean age was 49 ± 11 years, 72.7% were obese, with a predominance of mixed (49.1%) and black (41.8%) ethnicity. After eight weeks, the Meditation Group showed a mean reduction in total stress of -17.4 (IC 95% -19.5 to -15.3 p < 0.001). In eating behavior, a mean reduction of -7.9 (p < 0.001) in external eating, of -11.4 (p < 0.0001) in emotional eating, and a rise of 9.6 (p < 0.0001) in restrained eating were found. Score levels remained stable between the 8th and 16th week. Binge eating had a mean variation of -22.2%(p = 0.011).

CONCLUSION

The addition of Healing Meditation to the standard weight-loss treatment may significantly reduce stress and produce positive changes in the eating behavior of overweight and obese women.

TRIAL REGISTRATION

RBR-7564FD.

Stress and eating behaviours in healthy adults: a systematic review and meta-analysis

Stress leads to detrimental health outcomes through direct biological and indirect behavioural changes. Stress can lead to disruption to normal eating behaviours, although the strength of these associations is unknown. This is the first meta-analysis to determine the strength of the stress-eating relationship in healthy adults and to explore the impact of potential moderators. Studies included had a clearly defined measure of stress (i.e., any noxious event or episode in one's environment with the exclusion of emotional distress) that was linked to non-disordered eating. Key terms were searched in Medline, PsycInfo and Ovid databases (23,104 studies identified). 54 studies (combined N = 119,820) were retained in the meta-analysis. A small, positive effect size was found for the stress-overall food intake relationship (Hedges' g = 0.114). Stress was associated with increased consumption of unhealthy foods (Hedges' g = 0.116) but decreased consumption of healthy foods (Hedges' g = -0.111). Only one significant moderator (restraint on stress-unhealthy eating) was identified. This meta-analysis identified the magnitude of the effect of stress on eating behaviour outcomes. Significant heterogeneity was observed that was not explained by the moderators examined. Further research on moderators of the stress-eating relationship is required and should distinguish effects for healthy versus unhealthy eating.

Changes in food intake during the COVID-19 pandemic in New York City

The COVID-19 pandemic and stay-at-home orders across the nation have had substantial consequences on access to food and dietary behaviors. We investigated the dietary intake of adults in NYC, before and during the COVID-19 period. A subset of participants (n = 31) from an NIH-funded multi-level discount supermarket study were assessed. In this study, the experimental groups received a 0% (control), 15%, or 30% discount on fruits, vegetables, and noncaloric beverages for 8 months. The discount level for the participants who were selected for this study did not change from the pre-COVID to during COVID periods. Dietary intake data was collected using three unannounced 24-h dietary recalls (2 weekdays, 1 weekend) during each period. Changes in total daily kcal of food and beverages, total g of solid food, energy density of solid food (kcal/g), and g of fruit and vegetables, soda, non-caloric beverages, and snack foods were analyzed using multivariate linear regression. Energy density (ED) increased during COVID (+0.02 ± 0.5 [SD], F[4,26] = 3.0, p = 0.038). There was an interaction by gender (t = -3.2, p = 0.0035) such that ED increased for females (+0.27 ± 0.46, p = 0.037) and decreased for males (-0.22 ± 0.32, p = 0.012). The change in ED is likely due to the circumstances surrounding COVID-19, e.g. being at home, stress, and food shortages.

Associations between insecurity and stress among Chinese university students: The mediating effects of hope and self-efficacy

BACKGROUND

In the context of the pandemic, exploration on the association between insecurity and stress among university students is limited. The current study aims to investigate the parallel mediation role of hope and self-efficacy in the relationship between insecurity and stress among university students during the COVID-19 pandemic.

METHODS

We employed a cross-sectional research design in a university by distributing questionnaires online. 5286 participants were recruited (mean age = 19.65; SD = 1.13). Items were from the Security Questionnaire, Depression Anxiety and Stress Scale-21, and the Positive Psychology Capital (Psycap) Questionnaire (PPQ). Parallel mediation analysis was performed using PROCESS macro in SPSS.

RESULTS

The results indicate that insecurity predicted students' stress positively and that students with high-level perceived insecurity are more likely to perceive stress. Moreover, hope and self-efficacy mediated the relationship between insecurity and stress, indicating that hope and self-efficacy could buffer the negative effects of insecurity on stress.

LIMITATIONS

This study examines the mediating model between insecurity and stress among Chinese university students. The generalizability of the findings in other regions remains to be explored. Additionally, the roles of other positive self-beliefs including optimism and resilience in relieving stress can be further explored in future research.

CONCLUSIONS

This research provides direct evidence of insecurity effects on stress among university students, enriching relevant theories in the field of stress. Moreover, this research suggests that enhancing positive self-beliefs such as hope, and self-efficacy helps to relieve students' stress during COVID-19.

Poor Mental Health Is Related to Excess Weight via Lifestyle: A Cross-Sectional Gender- and Age-Dependent Mediation Analysis

Within mental health as risk factor for excess weight, prevention-relevant questions remain: does the relation persist after considering lifestyle, which lifestyle parameters might be most important to target, which gender or age subgroups are most at risk? The cross-sectional Belgian health survey 2013 (n = 4687; ≥15 years) measured mental health via anxiety and depression symptoms (Symptom Check List 90-R) and distress (General Health Questionnaire-12). Logistic regression, multiple mediation and moderated mediation were applied. Poor mental health was significantly related to a higher excess weight prevalence (odds ratio (OR) = 1.18 with 95% confidence interval (0.17-1.19)) and an unhealthier lifestyle i.e., more smoking, sleep problems, disordered eating, soft-drink, and alcohol consumption; while less fruit/vegetables and physical activity and even lower snack intake. Associations were often gender- and age-specific e.g., poor mental health was only related to less snacking in men and middle-adulthood, while an association with more snacking appeared in youth (<25 years). Disordered eating, physical activity and smoking were significant mediators explaining 88% of mental-weight associations, after which the association became negative (OR = 0.92 (0.91-0.93)). Mediation by snacking and disordered eating was stronger in the youngest and mediation by smoking was stronger in women. Thus, especially youth has high mental health associated behavioral and weight risks and gender or age differences can explain conflicting literature results on lifestyle.

Association between perceived stress and health-risk behaviours in workers

Individuals who experience stress can engage in health-risk behaviours that may decrease work performance. The aim of this study was to determine perceived stress levels in Brazilian workers and verify whether perceived stress was associated with health-risk behaviours. Stress levels of 1,270 workers (1,019 men, 251 women) were assessed using the Perceived Stress Scale. The health-risk behaviours investigated were low intake of vegetables and fruits, daily smoking, high-risk alcohol consumption, physical inactivity, and the presence of obesity. The Student's t-test or one-way analysis of variance was used to assess differences in stress levels. Ordinal regression was used to determine the association between the degrees of stress and health-risk behaviours. Women had higher perceived stress levels than men. In addition, perceived stress levels were higher in those who had low socioeconomic status, were unmarried, had a negative perception of their health, were smokers, or had obesity. Smoking and the presence of two or more health-risk behaviours were associated with 1.84 (95% CI: 1.24-2.73) times and 1.49 (95% CI: 1.18-1.89) times higher odds of experiencing higher degrees of stress, respectively. In women, such an association was observed with the presence of obesity (odds ratio: 2.0; 95% CI: 1.01-3.98).

Psychiatric morbidities of female obesity before and after dieting: an Egyptian sample

Background

The rate of occurrence of psychiatric morbidities like anxiety, depression, perceived stress, and the overall quality of life are very high among female patients with obesity; therefore, our study investigates such variables before and after weight loss in female patients on diet restriction; this can help obesity-multidisciplinary teams target these psychiatric correlates to reach a more satisfactory outcome.

Results

Anxiety, depression, and perceived stress scores decreased significantly in parallel to the weight loss reported (p < 0.0001). Except for social functioning, all other domains of quality of life improved significantly after weight loss. Those with higher education level showed significantly lower stress, anxiety, and depression scores before weight loss compared to married and highly educated ones respectively. After weight loss, highly educated participants showed lower perceived stress and depression scores than those with middle education.

Conclusions

Anxiety, depression, and perceived stress factors are significantly decreased after weight reduction with an improved quality of life as well compared to their scores prior.

Relationship between Dispositional Mindfulness, Psychological Health, and Diet Quality among Healthy Midlife Adults

Mindfulness, a practice of non-judgmental awareness of present experience, has been associated with reduced eating psychopathology and emotion-driven eating. However, it remains unclear whether mindfulness relates to diet quality. Thus, the purpose of this study was to examine whether dispositional mindfulness is associated with diet quality and to explore psychological factors relating dispositional mindfulness to diet quality. Community-dwelling adults (N = 406; M_age = 43.19, SD = 7.26; M_{body mass index [BMI]} = 27.08, SD = 5.28; 52% female) completed ratings of dispositional mindfulness, depressive symptoms, perceived stress, positive affect (PA), and negative affect (NA). Dietary intake was assessed using the Block Food Frequency Questionnaire, from which the 2015 Healthy Eating Index was derived. Analyses were conducted using the "lavaan" package in R with bias-corrected bootstrapped confidence intervals (BootCI). Age, sex, race, education, and BMI were entered as covariates in all models. Higher dispositional mindfulness was associated with higher diet quality (β = 0.11, p = 0.03), and this effect was mediated through lower depressive symptoms (indirect effect β = 0.06, p = 0.02, BootCI = 0.104-1.42, p = 0.03). Dispositional mindfulness was negatively correlated with perceived stress (β = -0.31, p < 0.01) and NA (β = -0.43, p < 0.01), as well as positively correlated with PA (β = -0.26, p < 0.01). However, these factors were unrelated to diet quality. These cross-sectional data provide initial evidence that dispositional mindfulness relates to diet quality among midlife adults, an effect that may be explained in part by less depressive symptomatology. Given that lifestyle behaviors in midlife are leading determinants of risk for cardiovascular disease and neurocognitive impairment in late life, interventions to enhance mindfulness in midlife may mitigate disease risk. Additional research assessing the impact of mindfulness interventions on diet quality are warranted.

The association between subjective impact and the willingness to adopt healthy dietary habits after experiencing the outbreak of the 2019 novel coronavirus disease (COVID-19): a cross-sectional study in China

To investigate the associations between subjective perception of impacts and willingness to change dietary habits in China after experiencing the outbreak of the 2019 novel coronavirus disease (COVID-19), an online questionnaire survey was carried out and 22,459 respondents in mainland China participated in the study, with an average age of 27.9±7.8 years old. Of them, 84.5% self-reported epidemic concern (middle or above), and 60.2%, 66.3% and 66.8% self-reported impact (middle or above) on psychology, life, work respectively. 31.9%, 46.0% and 41.0% of respondents reported their willingness to reduce their dietary intakes of salt, fried foods, and sugary foods, respectively. The stratified analysis of multinomial logistic regression models showed that, respondents with higher psychological impact were more likely to increase their dietary intake of salt, fried foods, sugary foods. Except as aforesaid, most respondents with higher epidemic concerns and higher impacts on psychology, life, work were more likely to reduce eating salt, fried foods, sugary foods. After the epidemic, early stage of positive improvement to a proper diet was observed, whereas the opposite tendency was also found in some respondents with higher impact on psychology. Thus, there is an urgent need for health care and lifestyle intervention policies for different subgroups.

A Laboratory-Based Study of the Priming Effects of Food Cues and Stress on Hunger and Food Intake in Individuals with Obesity

OBJECTIVE

This study aimed to assess the effects of exposures to food cues and stress on hunger and food intake and examine whether cue responses differ by weight status.

METHODS

In a laboratory-based experimental study, participants (n = 138) were exposed to stress, neutral, and food cues delivered using an individualized script-driven imagery task on three separate days. After each cue exposure, participants ate high- and low-calorie snack foods ad libitum (Food Snack Test). Hunger was measured by visual analog scales.

RESULTS

Food cues elicited significantly greater increases in hunger compared with neutral and stress stimuli. Cue-induced hunger did not differ by weight status. Participants consumed a similar number of total calories across stimuli. In response to food cue provocation, participants with obesity consumed [mean (SE)] 81.0% (4.0%) of calories from high-calorie foods, which was significantly greater than participants with normal weight (63.5%  [3.6%]; P = 0.001). After the stress cue, participants with obesity consumed 81.4% (4.0%) of calories from high-calorie foods, which was significantly more than participants with normal weight (70.2% [3.6%]; P = 0.04). Energy intake from high-calorie foods did not differ by weight status after the neutral cue.

CONCLUSIONS

Among individuals with obesity, exposure to food and stress cues shifted consumption to high-calorie snack foods within a well-controlled experimental setting.

State-level income inequality and the odds for meeting fruit and vegetable recommendations among US adults

Background

Previous research indicates that income inequality is associated with risk for mortality, self-rated health status, chronic conditions, and health behavior, such as physical activity. However, little is known about the relationship between income inequality and dietary intake, which is a major risk factor for common chronic diseases including heart disease, stroke, diabetes, and certain types of cancers. The objective of this study is to determine the association between US state income inequality and fruit and vegetable consumption among adults.

Methods

Cross-sectional data on 270,612 U.S. adults from the U.S. 2013 Behavioral Risk Factor Surveillance System was used. Fruit and vegetable consumption was assessed from the six-item fruit and vegetable frequency questionnaire, which is part of the Behavioral Risk Factor Surveillance System. Multilevel modeling was used to determine whether US state-level income inequality (measured by the z-transformation of the Gini coefficient) was associated with fruit and vegetable consumption adjusting for individual-level and state-level covariates.

Results

In comparison to men, women were more likely to consume fruits and vegetables ≥5 times daily, fruits ≥2 times daily, vegetables ≥3 times of daily, and less likely to consume fruit juice daily. Among both men and women, a standard deviation increase in Gini coefficient was associated with an increase in consuming fruit juice daily (OR = 1.07, 95% CI = 1.03, 1.11). However, among women, a standard deviation increase in Gini coefficient was associated with a decreased likelihood in meeting daily recommended levels of both fruits and vegetables (OR = 0.93; 0.87–0.99), fruits only (OR = 0.95; 95% CI, 0.92–0.99) and vegetables only (OR = 0.92; 95% CI, 0.89–0.96).

Conclusions

This study is one of the first to show the relationship between income inequality and fruit and vegetable consumption among U.S. adults empirically. Women’s health is more likely to be detrimentally affected when living in a state with higher income inequality.

Identifying stress-related eating in behavioural research: A review

Stress is a commonly reported precipitant of overeating. Understanding the relationship between stress and food intake is important, particularly in view of the increasing prevalence of obesity. The purpose of this review is to examine how stress-related eating has been defined and measured in the literature to date. There are no established diagnostic criteria or gold standards for quantification of stress-related eating. Questionnaires relying on the accuracy of self-report are the mainstay of identifying people who tend to eat in response to stress and emotions. There is a paucity of clinical research linking objective measurements of stress and appetite with self-reported eating behaviour. Limitations of the methodological approaches used and the heterogeneity between studies leave significant knowledge gaps in our understanding of the mechanism of stress related eating, and how best to identify it. These issues are discussed, and areas for further research are explored.

Effectiveness of Natural Frequency Technology® on cognition, sleep, and mood of adults with high perceived stress: A randomized, double-blind, placebo-controlled crossover study

INTRODUCTION

NexQuest Natural Frequency Technology^® (NFT^® ), intended to enhance biological function using naturally occurring frequencies, may be a nonpharmacological intervention to improve stress and health. The study purpose was to determine the effectiveness of NFT^® for improving stress, sleep quality, mood, and cognition in adults.

METHODS

Using a double-blind placebo-controlled crossover design, participants with high perceived stress (N = 42, M age = 43.8) were assessed at baseline (BL) and assigned to either the Placebo Watch (PW) or Wellness Watch (WW) condition for 2 weeks, and then 2 weeks in the alternate condition. Participants completed the following self-report surveys of Perceived Stress Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Food Craving Questionnaire, and Profile of Mood States, as well as the CNS Vital Signs neurocognitive test at BL and following each condition.

RESULTS

The WW condition had significant improvements in sleep duration and Complex Attention compared to the PW group. Compared to BL, both conditions had significant improvements for perceived stress, food cravings, mood, sleep quality, and several cognitive tests, p's < .05.

CONCLUSION

Despite the placebo effect, NFT^® may be a natural alterative for improving stress and health. Research is needed examining the efficacy of NFT^® in a variety of populations and environments.

The association of work stress and night work with nutrient intake - a prospective cohort study

Objectives:

In a prospective study among workers in an airline company, we explored whether change in work stress symptoms or night shifts was associated with nutrient intake.

Methods:

Participants in a workplace type 2 diabetes (T2D) prevention study completed a questionnaire on lifestyle, work stress symptoms, work schedule, and food intake at baseline and after 2.4-years follow-up (211 men and 155 women, 93% with increased risk for T2D). Multiple linear regression models with covariates were used to explore the associations between change in work stress symptoms or night shifts and change in nutrient intake during the follow-up.

Results:

Among men, an increase in stress and a decrease in perceived workability was associated with a higher proportion of energy (E%) from fat [β 0.6, 95% confidence interval (CI) 0.07–1.11, β 1.3, 95% CI 0.57–2.05] and saturated fat (β 0.3, 95% CI 0.02–0.58, β 0.5, 95% CI 0.14–0.90), respectively. Furthermore, a decrease in workability was associated with lower vitamin C intake (β -9.2, 95% CI -16.56– -1.84) and an increase in sleepiness with higher E% from saturated fat (β 0.7, 95% CI 0.00–0.15). Among women, an increase in work-related fatigue was associated with higher alcohol intake (β 7.5, 95% CI 1.25–13.74) and an increase of night shifts was associated with higher E% from fat (β 0.24, 95% CI 0.00–0.47) and saturated fat (β 0.17, 95% CI 0.04–0.29).

Conclusions:

Work stress symptoms were associated with a reduction in diet quality especially among men. The possible impact of work stress symptoms on workers’ dietary habits should be acknowledged and the assessment of dietary habits should consequently be incorporated into occupational health examinations.

Plasma lipid profile associates with the improvement of psychological well-being in individuals with perceived stress symptoms

Psychological stress is a suggested risk factor of metabolic disorders, but molecular mediators are not well understood. We investigated the association between the metabolic profiles of fasting plasma and the improvement of psychological well-being using non-targeted liquid chromatography-mass spectrometry (LC-MS) platform. The metabolic profiles of volunteers participating in the face-to-face intervention group (n = 60) in a randomised lifestyle intervention were compared to ones of controls (n = 64) between baseline and 36-week follow-up. Despite modest differences in metabolic profile between groups, we found associations between phosphatidylcholines (PCs) and several parameters indicating stress, adiposity, relaxation, and recovery. The relief of heart-rate-variability-based stress had positive, while improved indices of recovery and relaxation in the intervention group had an inverse association with the reduction of e.g. lysophosphatidylcholines (LPC). Interleukin-1 receptor antagonist and adiposity correlated positively with the suppressed PCs and negatively with the elevated plasmalogens PC(P-18:0/22:6) and PC(P-18:0/20:4). Also, we found changes in an unknown class of lipids over time regardless of the intervention groups, which also correlated with physiological and psychological markers of stress. The associations between lipid changes with some markers of psychological wellbeing and body composition may suggest the involvement of these lipids in the shared mechanisms between psychological and metabolic health.

A test of the stress-buffering hypothesis of social support among bariatric surgery patients

BACKGROUND

The buffering effect of social support against a range of stress-related health outcomes has been well-documented; however, no previous work has examined the applicability of this model to bariatric surgery outcomes.

OBJECTIVES

The present study sought to address whether social support interacts with stress in predicting postsurgical outcomes, as well as whether these associations may vary by sex.

SETTING

Teaching hospital, United States.

METHODS

Data were collected using retrospective chart review (n = 548). Stress, patient sex, and social support were explored as predictors of curvilinear weight loss trajectories during the first year after surgery using growth curve modeling.

RESULTS

Attendance at follow-up appointments was poor, with 250 patients at 6 months and 187 at 12 months. On average, these patients lost 27% of their total weight between baseline and the 12-month follow-up. Overall, weight-related emotional support appeared to be most relevant to weight loss/maintenance in this population; cohabitating with a spouse or significant other and attendance at support group meetings did not predict weight loss or show any significant interactions with stress.

CONCLUSIONS

The present study found only partial support for the stress-buffering model of social support among bariatric surgery patients. Such findings have important implications for assessment and follow-up care after bariatric surgery, as well as for future research in this area.

Are perceived bad working conditions and perceived workplace bullying associated with doctor visits? Results of the nationally representative German General Social Survey

BACKGROUND

The reason for doctor visits associated with bad working conditions (and workplace bullying) remains unknown. Therefore, the aim of this study was to examine the association between perceived working conditions as well as workplace bullying and the number of doctor visits as well as the reason for seeing a doctor.

METHODS

Data were derived from the German General Social Survey, a representative cross-section of the population in the year 2014. Self-reported doctor visits in the last 3 months were used as outcome measure. Self-rated working conditions (noise, bad air; time/performance pressure; bad working atmosphere; overtime; shifts/night work; hard physical labour) and workplace bullying were assessed. The reason for seeing a doctor was also recorded (acute illness; chronic illness; feeling unwell; requesting advice; visit to the doctor's office without consulting the doctor (e.g., need to get a prescription); preventive medical check-up/vaccination). Regression analysis stratified by sex was conducted.

RESULTS

Adjusting for various potential confounders, Poisson regressions showed that workplace bullying was associated with increased doctor visits in men, but not in women. Contrarily, time/performance pressure at work was only associated with increased doctor visits in women, but not in men. Furthermore, the probability of visiting the doctor for reasons of acute illness or feeling unwell increased with workplace bullying in men. The probability of visiting the doctor because of feeling unwell increased with time/performance pressure in women.

CONCLUSIONS

Our findings stress the association between adverse working conditions (workplace bullying as well as time/performance pressure at work) and doctor visits, with remarkable gender differences. Longitudinal studies are required to confirm the present findings and to obtain further insights into this relationship.

Characteristics of patients seeking a health promotion and weight reduction program in primary care

Purpose

An important task in primary health care (PHC) is to address lifestyle-related diseases. Overweight (OW) individuals make up a large proportion of PHC patients, and they increasingly have lifestyle-related illnesses that influence their quality of life. Structured health promotion and weight reduction programs could help these patients. The objective of this study was to explore the characteristics, lifestyle habits, and health conditions of individuals seeking a health promotion and weight reduction program in PHC.

Patients and methods

The study involved a comparative cross-sectional design performed in PHC in southwestern Sweden. The study population comprised 286 participants (231 women, aged 40–65 years, body mass index [BMI] 28–35 kg/m²) who were recruited between March 2011 and April 2014 to the 2-year program by adverts in local newspapers and recruitment from three PHC centers. Two reference populations were used: a general population group and an OW group. The study population data were collected using a questionnaire, with validated questions regarding health, lifestyle, illnesses, and health care utilization.

Results

People seeking a health promotion and weight reduction program were mostly women. They had a higher education level and experienced worse general health than the OW population, and they visited PHC more frequently than both reference groups. They also felt more stressed, humiliated, had more body pain, and smoked less compared to the general population. However, they did not exercise less or had a lower intake of fruits and vegetables than either reference population.

Conclusion

Individuals seeking a weight reduction program were mostly women with a higher education level and a worse general health than the OW population. They used more health care services compared to the reference groups.

Gender-specific correlates of perceived life stress: a population-based study, Montreal, Canada, 2012

OBJECTIVES

To identify the gender-specific correlates of perceived life stress in a representative sample of the Montreal population.

METHOD

Data were extracted from the Local Health Survey Program (called "TOPO") collected in 2012. TOPO-2012 provided information on chronic diseases, their determinants and risk factors, as well as lifestyle and health services utilization. Poisson regression was used to identify significant correlates of perceived life stress.

RESULTS

Single-parent females were 21% more likely (RR = 1.21; 95% CI = 1.04-1.42) to report stressful life compared to females living alone. Females born in Canada or established female immigrants were significantly more likely to report stressful life (respectively RR = 1.34; 95% CI = 1.12-1.60 and RR = 1.31; 95% CI = 1.08-1.58) than recent female immigrants. Furthermore, females living in a privileged material neighbourhood reported significantly higher perceived life stress (14% higher) than females living in a deprived neighbourhood. On the other hand, males with higher annual household income were 9% more likely (OR = 1.09; 95% CI = 1.05-1.14) to perceive life stress than males reporting a lower income. Also, overweight males reported higher stress (RR = 1.13; 95% CI = 1.01-1.26) than their normal weighted counterparts. Additionally, males who were diagnosed with a physical health problem were more likely to report stressful life (RR = 1.44; 95% CI = 1.28-1.61) than males who did not report any physical health problem.

CONCLUSION

Identifying correlates of stress at the population level may help researchers characterize people vulnerable to daily stress, provide health agencies the advantage to forecast and prevent its occurrence and diseases associated with it, as well as offer policy advocates a pivotal edge to reduce disparities in population health.

Psychosocial stress impairs health behavior in patients with mental disorders

BACKGROUND

It has been shown, that in the general population psychosocial stress affects health behaviors. However similar studies of high risk populations are sparse. Therefore, the aim of this cross-sectional study is to analyze the association between common psychosocial stressors and health behavior in a sample of patients with mental disorders.

METHODS

We analyzed data of n = 2326 outpatients from a mental health care department. Severity of psychosocial stress was assessed by the PHQ-stress module of the Patient Health Questionnaire (PHQ). Health behaviors included obesity, uncontrolled eating, smoking and physical inactivity. Multiple binary regression models were conducted for the PHQ-stress score and for each of the ten PHQ-stress items as independent variables.

RESULTS

'Financial stress' and 'having no one to turn to with problems' were mainly associated with adverse health behaviors after adjustment for multivariate effects. The most affected health behaviors were uncontrolled eating in both sexes and obesity in women.

CONCLUSION

Our findings indicate specific influences of psychosocial stressors on unhealthy behaviors in a clinical sample. Patients with financial strain and lack of social support might need specific support for improving their health behavior.