Negative affect is associated with increased stress-eating for women with high perceived life stress

Changes in the choice motive and emotional perception of chocolates in response to stress

Although chocolates are often chosen for sensory pleasure, they are also selected to enhance mood and relieve emotional stress, or potentially chosen for its perceived health benefits if stress adversely affects physical well-being. This study aimed to investigate whether emotional stress influenced the motivations behind chocolate selection, subsequent liking, and emotional response. Participants were divided into a control group (n = 76) and a group with induced acute stress (n = 74). Stimuli were presented as dark chocolate packaging, each evoking sensory appeal, health, and emotional stress relief. Participants chose one stimulus from three options that they were most inclined to consume and evaluated the overall liking and emotional attributes of the stimuli. They also rated the overall liking and emotional attributes of three types of chocolates, each identical but paired with distinct stimuli. Their food attitudes were also assessed. Stress did not change the choice of stimuli, indicating that stress did not influence the motivation for chocolate selection. Instead, the choice of stimuli aligned with participants' food attitudes; those favoring sensory appeal and emotional stress relief prioritized pleasure in their usual food choices. Stress tended to increase liking and chocolate-associated positive emotions with sensory appeal, as opposed to others, to immediately alleviate negative emotions. The most robust motivation to consume chocolates was sensory pleasure, irrespective of stress, because of a preestablished association between sensory pleasure and mood enhancement.

The influence of stress on the neural underpinnings of disinhibited eating: a systematic review and future directions for research

Disinhibited eating involves overconsumption and loss of control over food intake, and underpins many health conditions, including obesity and binge-eating related disorders. Stress has been implicated in the development and maintenance of disinhibited eating behaviours, but the mechanisms underlying this relationship are unclear. In this systematic review, we examined how the impact of stress on the neurobiological substrates of food-related reward sensitivity, interoception and cognitive control explains its role in disinhibited eating behaviours. We synthesised the findings of functional magnetic resonance imaging studies including acute and/or chronic stress exposures in participants with disinhibited eating. A systematic search of existing literature conducted in alignment with the PRISMA guidelines identified seven studies investigating neural impacts of stress in people with disinhibited eating. Five studies used food-cue reactivity tasks, one study used a social evaluation task, and one used an instrumental learning task to probe reward, interoception and control circuitry. Acute stress was associated with deactivation of regions in the prefrontal cortex implicated in cognitive control and the hippocampus. However, there were mixed findings regarding differences in reward-related circuitry. In the study using a social task, acute stress associated with deactivation of prefrontal cognitive control regions in response to negative social evaluation. In contrast, chronic stress was associated with both deactivation of reward and prefrontal regions when viewing palatable food-cues. Given the small number of identified publications and notable heterogeneity in study designs, we propose several recommendations to strengthen future research in this emerging field.

Between- and within-person effects of stress on emotional eating in women: a longitudinal study over 49 days

BACKGROUND

Stress is associated with binge eating and emotional eating (EE) cross-sectionally. However, few studies have examined stress longitudinally, limiting understanding of how within-person fluctuations in stress influence EE over time and whether stress is a risk factor or consequence of EE. Additionally, little is known regarding how the biological stress response relates to EE.

METHODS

We used an intensive, longitudinal design to examine between-person and within-person effects of major life stress, daily stress, and cortisol on EE in a population-based sample of women (N = 477; ages 15-30; M = 21.8; s.d. = 3.0) from the Michigan State University Twin Registry. Participants reported past year major life stress, then provided daily ratings of EE and stress for 49 consecutive days. Hair cortisol concentration (HCC) was collected as a longitudinal biological stress measure.

RESULTS

Women reported greater EE when they experienced greater mean stress across days (between-person effects) or greater stress relative to their own average on a given day (within-person effects). Daily stress was more strongly associated with EE than major life stress. However, the impact of daily stress on EE was amplified in women with greater past year major life stress. Finally, participants with lower HCC had increased EE.

CONCLUSIONS

Findings confirm longitudinal associations between stress and EE in women, and highlight the importance of within-person shifts in stress in EE risk. Results also highlight HCC as a novel biological stress measure that is significantly associated with EE and may overcome limitations of prior physiological stress response indicators.

Lifetime stressor exposure, eating expectancy, and acute social stress-related eating behavior: A pre-registered study of the emotional eating cycle

Eating behaviors in response to acute stressors are highly variable: whereas many individuals eat more following stressors, others eat less or show no change in food consumption. Understanding factors that predict individual differences in eating behaviors may help elucidate the psychosocial mechanisms underlying obesity, yet few experimental studies on this topic have been conducted to date. To address this issue, we conducted the present pre-registered study, where we investigated how lifetime stressor exposure moderates the extent to which eating expectancies enhance the learned association between stress-induced negative affect and snack intake. Participants were 44 women (30% non-White) between 18 and 50 years old (M = 27.9), with a mean body mass index of 25.6, who completed assessments of lifetime stressor exposure, eating behaviors, and eating expectancies (eating helps manage negative affect); in a subsequent visit, they were given snacks after an acute social stress task (TSST). The moderated moderation model (PROCESS model 3) yielded a significant three-way interaction. When eating expectancies were high, acute social stress-induced negative affect predicted greater M&M intake for women with very high total lifetime stressor exposure but less M&M intake for women with fewer lifetime stressors. These data thus highlight how lifetime stressor exposure interacts with eating expectancies and acute stress-induced negative affect to predict eating behavior. Replications in larger samples may help explain variability in stress-eating as well as how lifetime stressors contribute to obesity.

Chinese university students showed less disordered eating during the COVID-19 campus lockdown

OBJECTIVE

The rapid spread of the Omicron variant of COVID-19 in China had resulted in campus lockdown in many universities since February 2022, profoundly affecting students' daily lives. Campus lockdown conditions differ considerably from home quarantine, so that the eating patterns of university students may be different. Thus, the current study aimed to: (1) investigate university students' eating patterns during campus lockdown; (2) identify factors associated with their disordered eating.

METHOD

An online survey about recent life changes, disordered eating, stress, depression, and anxiety was carried out from April 8th to May 16th, 2022. A total of 2541 responses from 29 provinces/cities of China were received.

RESULTS

2213 participants were included in the main analysis, and other 86 participants were analyzed separately as a subgroup due to their diagnosis of eating disorder. Participants who were undergoing campus lockdown (the lockdown group) showed less disordered eating than those who had never been in campus lockdown (the never-lockdown group), as well as those who had experienced campus lockdown before (the once-lockdown group). However, they perceived more stress and felt more depressed. Being female, higher BMI, gaining weight, increasing exercise, spending more time on social media, higher level of depression and anxiety were all related to disordered eating in the lockdown group.

CONCLUSIONS

Disordered eating among Chinese university students was less prevalent during campus lockdown due to the strict and regular diet. However, there is a potential risk of "revenge eating" after campus lockdown ends. Thus, there should be further tracking and related prevention.

LEVEL OF EVIDENCE

IV, uncontrolled trials without any interventions.

The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence

(1) Background: Emotional eating is considered as the propensity to eat in response to emotions. It is considered as a critical risk factor for recurrent weight gain. Such overeating is able to affect general health due to excess energy intake and mental health. So far, there is still considerable controversy on the effect of the emotional eating concept. The objective of this study is to summarize and evaluate the interconnections among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns; (2) Methods: This is a thorough review of the reported associations among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns. We compressively searched the most precise scientific online databases, e.g., PubMed, Scopus, Web of Science and Google Scholar to obtain the most up-to-date data from clinical studies in humans from the last ten years (2013-2023) using critical and representative keywords. Several inclusion and exclusion criteria were applied for scrutinizing only longitudinal, cross-sectional, descriptive, and prospective clinical studies in Caucasian populations; (3) Results: The currently available findings suggest that overeating/obesity and unhealthy eating behaviors (e.g., fast food consumption) are associated with emotional eating. Moreover, the increase in depressive symptoms seems to be related with more emotional eating. Psychological distress is also related with a greater risk for emotional eating. However, the most common limitations are the small sample size and their lack of diversity. In addition, a cross-sectional study was performed in the majority of them; (4) Conclusions: Finding coping mechanisms for the negative emotions and nutrition education can prevent the prevalence of emotional eating. Future studies should further explain the underlying mechanisms of the interconnections among emotional eating and overweight/obesity, depression, anxiety/stress, and dietary patterns.

How Lifestyle Changes during the COVID-19 Global Pandemic Affected the Pattern and Symptoms of the Menstrual Cycle

This research investigated the implications that the COVID-19 pandemic had on the menstrual cycle and any contributing factors to these changes. A questionnaire was completed by 559 eumenorrheic participants, capturing detail on menstrual cycle symptoms and characteristics prior to and during the COVID-19 pandemic lockdown period. Over half of all participants reported to have experienced lack of motivation (61.5%), focus (54.7%) and concentration (57.8%). 52.8% of participants reported an increase in cycle length. Specifically, there was an increase in the median cycle length reported of 5 days (minimum 2 days, maximum 32 days), with a median decrease of 3 days (minimum 2 days and maximum 17 days). A lack of focus was significantly associated with a change in menstrual cycle length (p = 0.038) reported to have increased by 61% of participants. Changes to eating patterns of white meat (increase p = 0.035, decrease p = 0.003) and processed meat (increase p = 0.002 and decrease p = 0.001) were significantly associated with a change in menstrual cycle length. It is important that females and practitioners become aware of implications of environmental stressors and the possible long-term effects on fertility. Future research should continue to investigate any long-lasting changes in symptoms, as well as providing education and support for females undergoing any life stressors that may implicate their menstrual cycle and/or symptoms.

Everyday discrimination is a stronger predictor of eating competence than food insecurity or perceived stress in college students amidst COVID-19

Stress is a common experience of college students, which has been exacerbated by COVID-19. Perceived stress may help predict students’ eating behaviors. Eating competence is an adaptive model of eating characterized as being flexible, comfortable, and positive with food and eating, and reliable about getting enough nourishing and enjoyable food to eat. Eating competence is associated with numerous health benefits and may be developing and/or disrupted as young adults transition to college. No prior research has explored the associations of everyday discrimination and food insecurity with eating competence, and there is limited research on the eating competence of trans and gender nonconforming (TGNC) college students. This cross-sectional study sought to examine the associations of everyday discrimination, food insecurity, and perceived stress with eating competence in a sample of 1996 undergraduate students. Participants completed an online survey comprised of validated tools assessing socio-demographics, eating competence, everyday discrimination, food insecurity, and perceived stress and stress management. After accounting for covariates (gender, stress management), multivariate regression analyses were conducted, and the coefficients of partial determination revealed that everyday discrimination was the strongest predictor of eating competence. Results demonstrated that lower experience of everyday discrimination, less stress, and being food secure were associated with greater likelihood of being eating competent (EC). Men were more likely to be EC than women or TGNC identities. Since the experience of everyday discrimination was the strongest, inverse predictor of eating competence, addressing discrimination must be considered in future efforts to improve eating competence.

The dynamic network associations of food craving, restrained eating, hunger and negative emotions

OBJECTIVE

Food craving, restrained eating, hunger, and negative emotions may predict and reinforce one another. However, less is known about how they interact together as a complex system in daily life. Therefore, we used a dynamic network approach to examine the associations between food craving, restrained eating, hunger and negative emotions in daily life.

METHODS

Food craving, restrained eating, hunger and negative emotions were measured using ecological momentary assessment three times a day over ten days in a community sample in Israel (n = 123). A two-step multilevel vector auto-regression network analysis was used to estimate temporal, contemporaneous and between-persons networks.

RESULTS

In the temporal network, restrained eating was the most central predictor of eating behaviors and negative emotions, predicting food craving and hunger as well as sadness and loneliness. Food craving was also predicted by hunger and stress, and hunger predicted loneliness. In the contemporaneous network, food craving was associated with hunger and feeling bored, and higher anger was associated with lower restrained eating. Stress and sadness were central negative emotions in the models.

DISCUSSION

This study suggests possible temporal and contemporaneous relationships between food craving, restrained eating, hunger and negative emotions, emphasizing their complex interactions in daily life. Restrained eating and stress should be investigated as potential targets for interventions addressing food craving and overeating.

The Impact of the COVID-19 Epidemic on the Mood and Diet of Patients Undergoing Bariatric Surgery

Limited social contacts, lack of professional activities, economic insecurity, and a sense of threat, as well as boredom during the COVID-19 pandemic, contributed to tension and stress. All of these increase the risk of an inappropriate diet. The aim of this cross-sectional study was to assess the impact of the COVID-19 pandemic on the mood and nutrition of patients undergoing bariatric surgery. A group of 312 patients (both before and after bariatric surgery) completed a questionnaire about their diet and mood during COVID-19 lockdown. About 70% of all respondents reacted to the epidemiological situation: irritability, anxiety about their own health, and eating without being hungry. A total of 74% of all of the subjects snacked between meals (especially sweets). The respondents who believed that obesity and its complications had a negative impact on the prognosis of the coronavirus infection had a statistically significant higher prevalence of health anxiety, feeling that important life issues were out of control, irritability, need for psychological support, and need for dietary consultation. Patients after bariatric surgery had e.g., a statistically significant lower incidence of feeling hungry, eating after meals, and eating fatty foods. The COVID-19 pandemic has been shown to negatively affect the mood and diet of bariatric patients, which may affect their health status and worsen the prognosis of COVID-19.

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.

Mental Health and Obesity During the COVID-19 Pandemic

PURPOSE OF REVIEW

The COVID-19 pandemic is associated with increased levels of stress, anxiety and depression in the population. These are associated with unhealthy eating patterns and sedentary behaviour. In turn, this may increase risk of obesity or aggravate it. This narrative review discusses the link between adverse mental health states and weight related behaviours. We present emerging evidence for this phenomenon during the COVID-19 pandemic in individuals with and without pre-existing obesity.

RECENT FINDINGS

A sizeable proportion of the population exhibits deterioration in mental health during the pandemic and those affected often report unhealthy weight-related behaviours such as "junk food" consumption and physical inactivity. Women, individuals with obesity, and those with pre-existing mental health conditions seem to be particularly at risk for overeating in response to stress (i.e. emotional eating). A number of psychological interventions including cognitive behavioural therapy and self-compassion may be effective in improving mental health and emotional eating patterns among the general population and particularly in individuals living with obesity. There is a need to complement efforts to improve mental health in the general population during the COVID-19 pandemic with targeted action to improve physical activity levels and healthy eating particularly among groups at-risk. This may be achieved by reducing disruptions to specialist and primary healthcare services and facilitating access to psychological interventions that address stress-related eating behaviours. Additional studies that examine such interventions, especially those that are delivered remotely, are urgently needed.

The Universal Eating Monitor (UEM): objective assessment of food intake behavior in the laboratory setting

The Universal Eating Monitor was a term used to describe a device used in a laboratory setting that enabled investigators to measure, with the same instrument, the rate of eating either solids or liquids, hence the term “universal”. It consisted of an electronic balance placed in a false panel under a table cloth on which could be placed a food reservoir that contained either solid or liquefied food. The device was created in order to determine whether rates of eating differed in pattern between solid and liquid foods. An acceptable mixture of foods of identical composition that could be served as either solid or blended as a liquid was used to test the hypothesis that eating rate and intake were affected by physical composition. A best-fitting mathematical function (intake was quadratic function of time, with coefficients varying among foods used and experimental conditions), quantified intake rates. The device was used to test a variety of mechanisms underlying food intake control. Eating rates were linear when solid foods were used, but negatively accelerated with liquids. Overall, intake did not differ between solid and liquefied food of identical composition. Satiation on a calorie for calorie basis was different among foods, but physical composition interacted with energy density. Hormones and gastric distension were strong influences on food intake and rate of eating. Individuals with bulimia nervosa and binge eating disorder ate more than individuals without these disturbances. Intake in social and individual contexts was identical, but the rate of eating was slower when two individuals dined together. The eating monitor has been a useful instrument for elucidating controls of food intake and describing eating pathology.

Stress eating: an online survey of eating behaviours, comfort foods, and healthy food substitutes in German adults

BACKGROUND

In many people, stress is associated with changes in eating behaviour. Food products consumed during stress (comfort foods) are often unhealthy. It is rather unknown what comfort foods are consumed in Germany and what healthier food products are considered as alternatives to support stress-eaters in making healthier food choices.

METHODS

This online survey was conducted in spring 2021 throughout Germany. Participants were digitally recruited by newsletters, homepages, social media, and mailing lists. The survey included a standardized questionnaire with items concerning e.g. sociodemography, stress, and nutrition. Comfort foods were pre-selected through literature search and food substitutes were defined and discussed by experts. Analyses examined comfort food consumption and substitute preferences dependent on sex, age, body mass index (BMI), and being a self-identified stress-eater. The statistical analysis was performed using R.

RESULTS

Survey participants were mostly female (80.6%, 994/1234), had a mean age of 31.4 ± 12.8 years and a mean BMI of 23.4 ± 4.3 kg/m². Participants stated, that the two favourite comfort foods were chocolate (consumed often/very often by 48.3%, 596/1234) and coffee (consumed often/very often by 45.9%, 566/1234). Regarding food substitutes, the most frequently named alternative food for chocolate and cookies was fresh fruits (for chocolate: 74.4%, 815/1096, for cookies: 62.6%, 565/902). Tea without added sugar (64.4%, 541/840) was the preferred substitute for coffee. Almost 50% of participants (48.1%, 594/1234) identified themselves as stress-eaters, of which 68.9% (408/592) stated to eat (very) often more than usual in subjective stress situations.

CONCLUSIONS

The results from this work suggest that specific comfort foods and substitutes are preferred by the participants in stressful situations. This knowledge about food choices and substitutes should be investigated in further studies to improve eating behaviour in stressful situations.

TRIAL REGISTRATION

The survey was registered in the German Register of Clinical Studies (Registration number: DRKS00023984 ).

Self-reported emotional eaters consume more food under stress if they experience heightened stress reactivity and emotional relief from stress upon eating

Group data means from individuals who self-assess as emotional eaters do not reliably show increased food intake in response to stress or negative emotions. This inconsistency in predictive validity of self-reported emotional eating (EE) could be attributable to unconsidered moderation of the relationship between self-reported EE and behavioral measures of EE. Greater emotional relief from stress by eating may provide enhanced negative reinforcement and promote future EE in response to stress as a form of self-medication. Thus, we predicted that greater emotional relief from stress by eating (decrease in negative affect from stress to post-eating) would moderate the extent to which heightened stress reactivity (measured by systolic blood pressure, SBP) moderates the relationship between self-reported EE and food intake post-stress. We also hypothesized that self-reported EE would not predict greater food consumption on the rest day. 43 undergraduate women completed online assessments of eating behaviors. Participants were given snacks to eat after a mental stress task (TSST) or rest period on separate days in counterbalanced order. Our prediction was supported, as the moderated moderation model (PROCESS model 3) was highly significant on the stress day. Self-reported EE predicted increased food intake post-stress only under conditions of high stress reactivity and high emotional relief. On the rest day, self-reported EE predicted greater snack food intake only when SBP was high. This conditional increased intake substantiates stress as a promoter of snack food consumption for women with greater EE. Overall, our findings identified factors that may distinguish the subset of self-reported emotional eaters who are more likely to display EE behaviors in a laboratory setting, yet further studies are needed to directly test whether negative reinforcement via emotional relief from stress by eating drives enhanced EE following stress.

External food cue responsiveness and emotional eating in adolescents: A multimethod study

Eating in response to external food cues (i.e., external eating) and internal emotional experiences (i.e., emotional eating) are associated with obesity. While external and emotional eating co-occur, little is known about how external food cue responsiveness may interact with internal emotional cues to influence eating episodes in adolescents. The current study examined how trait-level external food cue responsiveness modulates momentary associations between affective states and eating in adolescents. Participants were drawn from a prior study of siblings (N = 78; ages 13-17) who completed an ecological momentary assessment protocol to assess eating episodes and affective states. External food cue responsiveness was determined by comparing energy consumption following presentation of an appetizing food (pizza) on one day and a control activity (reading) on another day. Generalized linear mixed models examined positive and negative affective states, cue responsiveness, and their interactions as predictors of the likelihood of eating. The relationship between affective states and likelihood of eating was stronger among adolescents with higher versus lower external food cue responsiveness. Among adolescents with higher cue responsiveness, endorsing negative affect was associated with a lower likelihood of eating, whereas endorsing positive affect was associated with a higher likelihood of eating (within-person effects). Findings suggest that high sensitivity to external food cues and greater proclivity for emotional eating may be likely to coincide such that any cue, internal or external, is likely to disrupt sensitivity to internal hunger and satiety signals. Future studies are needed to elucidate how sensitivities to internal and external cues may interact to influence obesity risk.

Violent suicide attempt history in elderly patients with bipolar disorder: The role of sex, abdominal obesity, and verbal memory: Results from the FACE-BD cohort (FondaMental Advanced center of Expertise for Bipolar Disorders)

BACKGROUND

Bipolar disorder (BD) is a chronic, lifelong condition, associated with increased risk of obesity, cognitive impairment, and suicidal behaviors. Abdominal obesity and a higher risk of violent suicide attempt (SA) seem to be shared correlates with older age, BD, and male sex until middle age when menopause-related female body changes occur. This study aimed at assessing the role of abdominal obesity and cognition in the violent SA burden of individuals with BD.

METHODS

From the well-defined nationwide cohort FACE-BD (FondaMental Advanced center of Expertise for Bipolar Disorders), we extracted data on 619 euthymic BD patients that were 50 years or older at inclusion. Cross-sectional clinical, cognitive, and metabolic assessments were performed. SA history was based on self-report.

RESULTS

Violent SA, in contrast to non-violent and no SA, was associated with higher waist circumference, abdominal obesity and poorer California Verbal Learning Test short-delay free recall (CVLT-SDFR) (ANOVA, p < .001, p = .014, and p = .006). Waist circumference and abdominal obesity were associated with violent SA history independently of sex, BD type and anxiety disorder (Exp(B) 1.02, CI 1.00-1.05, p = .018; Exp(B) 2.16, CI 1.00-4.64, p = .009, accordingly). In an exploratory model, waist circumference and CVLT-SDFR performance mediated the association between male sex and violent SA.

LIMITATIONS

Cross-sectional design and retrospective reporting.

CONCLUSIONS

Violent SA history was associated with abdominal obesity and poorer verbal memory in older age BD patients. These factors were interlinked and might mediate the association between male sex and violent SA.

Recalled and momentary virtual portions created of snacks predict actual intake under laboratory stress condition

Virtual portion tasks have been used to predict food intake in healthy individuals, severity of illness in individuals with anorexia nervosa, and weight loss in bariatric surgery patients. Whether portion creation in response to a recalled interpersonal stress ("recalled stress portions") could be used as a proxy for ad lib intake, after a stressor, remains untested, and the mechanism supporting this relationship is unclear. The present study's goals were: 1) to validate virtual portion tasks as proxies for actual food intake in a stressful context and 2) to test a causal pathway in which these virtual stress portions predict ad lib intake after stress. We proposed that this relationship is mediated by virtual portions created the moment after laboratory stress or rest manipulation (momentary portions), and before the participant actually ate food. At screening, 29 healthy undergraduate white women created virtual portions of eight snacks (apples, olives, potato chips, pretzels, caramel popcorn, milk chocolate) that they typically eat and also portions they recall eating in response to a stressful interpersonal situation. In addition, after a Trier Social Stress Test, or a rest period, on separate days in counterbalanced order, participants created 'momentary' virtual portions of the same snacks presented during screening, and then were given potato chips, mini golden Oreos, and M&Ms to eat. Recalled stress (b = 0.07 ± 0.02, p = 0.003), and momentary stress (b = 0.12 ± 0.02, p = 0.00001), portions of milk chocolate accounted for 29% and 51%, respectively, of the variance in ad lib stress intake of M&Ms. Typical (b = 0.15 ± 0.07, p = 0.03), and momentary rest (b = 0.21 ± 0.06, p = 0.002), portions of chips accounted for 16% and 31%, respectively, of the variance in ad lib rest intake of chips. The causal pathway from recalled stress portion to ad lib stress snack intake was completely mediated by momentary stress portion for milk chocolate and M&Ms (β = 0.04 ± 0.02, z = 2.4, p = 0.0154). These findings illustrate the planning and recall components of eating in response to stress, but not necessarily under rest conditions. This recalled stress virtual portion paradigm has clinical and research value in that it can detect those who overconsume in response to stress.

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.

Emotional Eating in Relation to Worries and Psychological Distress Amid the COVID-19 Pandemic: A Population-Based Survey on Adults in Norway

Population-based studies have revealed a high occurrence of self-reported psychological distress symptoms during the early phases of the coronavirus disease 2019 (COVID-19) pandemic. Stress and negative affect can lead to emotional eating, which in turn can have negative outcomes on health. In this population-based study, 24,968 Norwegian inhabitants participated in an electronic questionnaire including structured questions on dietary habits, emotional eating, psychological distress symptoms, and COVID-19-related worries. The study took place during April 2020 after around six weeks of interventions to tackle the first wave of the COVID-19 pandemic. Overall, emotional eating was reported in 54% of the population and was markedly more frequent in female participants. Worries related to consequences of the pandemic were associated with increased emotional eating, and the association was stronger for worries related to personal economy—odds ratios (OR) 1.7 (95% confidence interval (CI95%) 1.5–1.9)—compared to worries related to health—OR 1.3 (CI95% 1.2–1.5). Psychological distress had a strong association with emotional eating—OR 4.2 (CI95% 3.9–4.4). Correspondingly, the intake of high-sugar foods and beverages was higher for those with substantial COVID-19-related worries and those with psychological distress compared to the overall population.

The Effect of a Maternal Mediterranean Diet in Pregnancy on Insulin Resistance is Moderated by Maternal Negative Affect

There is inconsistent evidence that healthy dietary interventions can effectively mitigate the risk of adverse outcomes associated with elevated insulin resistance in pregnancy, suggesting that other moderating factors may be at play. Maternal psychological state is an important factor to consider in this regard, because stress/mood state can directly influence glycemia and a bidirectional relationship may exist between nutrition and psychological state. The objective of this study was to examine the interaction between maternal negative affect and diet quality on third trimester insulin resistance. We conducted a prospective longitudinal study of N = 203 women with assessments in early and mid-pregnancy, which included an ecological momentary assessment of maternal psychological state, from which a negative affect score (NAS) was derived, and 24-h dietary recalls, from which the Mediterranean Diet Score (MDS) was computed. The homeostasis model assessment of insulin resistance (HOMA-IR) was computed from third trimester fasting plasma glucose and insulin values. Early pregnancy MDS was inversely associated with the HOMA-IR, but this did not maintain significance after adjusting for covariates. There was a significant effect of the mid-pregnancy MDS*NAS interaction term with the HOMA-IR in the adjusted model, such that a higher negative affect was found to override the beneficial effects of a Mediterranean diet on insulin resistance. These results highlight the need to consider nutrition and affective state concurrently in the context of gestational insulin resistance.

The role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach

BACKGROUND

Depression comprises common psychological problems, and has been strongly related to neuroticism and perceived stress. While neuroticism has been shown to have a direct effect on depression, it also has an indirect effect via perceived stress. Among the elderly, cognitive function produces influences that should not be overlooked when investigating depression. This study aimed to determine the role of mediating effects of perceived stress as well as cognitive function on neuroticism and depression among elderly patients.

METHODS

This research constituted a secondary analysis, with data collected during the pre-operative period of 429 elderly individuals undergoing elective, noncardiac surgery. The evaluation included the Perceived Stress Scale, the Neuroticism Inventory, the Montreal Cognitive Assessment, and the Geriatric Depression Scale. Structural equation modeling was used to investigate the hypothesized model.

RESULTS

Neuroticism exhibited a significant indirect effect on perceived stress via depression and cognition (β = 0.162, 95% CI 0.026, 0.322, p = .002). Neuroticism initially had a direct effect on depression (β = 0.766, 95% CI 0.675, 0.843 p = 0.003); thereafter, it was reduced after covariates were added (β = 0.557, 95% CI 0.432, 0.668 p = 0.002). Based on this model, the total variance explained by this model was 67%, and the model showed an acceptable fit with the data.

CONCLUSIONS

Both perceived stress and cognitive function partially mediated the effect of neuroticism on depression, with perceived stress exhibiting a greater effect.

TRIAL REGISTRATION

The study protocol has been registered at Clinicaltrials.gov under registered number: NCT02131181.