Factors affecting emotional eating and eating palatable food in adults

A systematic review and meta-analysis of cross-sectional questionnaire studies of the relationship between negative and positive emotional eating and body mass index: Valence matters

Questionnaire measures of negative emotional eating (NEE) have been associated with elevated body mass index (BMI). Relatively fewer studies have examined positive emotional eating (PEE) and they report that PEE is associated with lower BMI or is not associated with BMI. To examine whether NEE and PEE are linked to BMI, we conducted a systematic review and meta-analysis of studies that used the Emotional Appetite Questionnaire (EMAQ) and the Salzburg Emotional Eating Scale (SEES), which assess change in eating associated with positive and negative emotions, and measured BMI in adults with a range of BMIs. A search of databases (CINAHL Medline, and PsycINFO), citations (Google Scholar) and dissertations (Proquest), and a preprint registry (Open Science Framework, OSF) was conducted independently by three screeners. Forty-three cross-sectional studies were eligible for inclusion. Correlations between BMI and NEE scales and PEE scales were extracted. Age and sex were examined as potential moderators. We found statistically significant (ps < .001) and small mean effect sizes with random-effects models. Higher EMAQ NEE (d = .152 [.11, .19], N = 18,576) and SEES NEE scales (sadness, d = .209 [.168, .250]; angry, d = .096 [.047, .144]; anxiety, d = .169 [.124, .211], N = 4141) were associated with higher BMI. The EMAQ PEE (d = -.073 [-.106, -.041], N = 18,806) and the SEES happy (d = -.157 [-.100, -.114], N = 4141) scales were associated with lower BMI. There was significant heterogeneity in effect sizes for PEE and NEE; however, there was no statistically significant moderation by age or sex. There was also no evidence for publication bias except for SEES sadness. This analysis is limited to cross-sectional questionnaire-based studies. NEE may be associated more strongly than PEE with emotional regulation difficulties and overeating of energy-dense foods which may be why it is associated with higher BMI.

Evaluating the Association of Sociodemographic, Anthropometric, and Lifestyle Factors with Emotional Eating: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Emotional eating is an eating behavior that is influenced by behaviors, stress, emotions, and individual feelings in relation to eating. For many decades, studies have shown that mental health is the complex outcome of numerous biological, psychological, and social factors, involving contextual factors beyond the individual.

AIM

The objective of this study is to evaluate the interconnections between emotional eating and sociodemographic and anthropometric characteristics and lifestyle factors.

METHODS

This is a cross-sectional study conducted on 328 adults aged between 18 and 75 years. Relevant questionnaires were utilized to evaluate sociodemographic and anthropometric parameters and types of feeding and the expression of emotional food consumption (The Three-Factor Eating Questionnaire).

RESULTS

According to the analyses above, negative correlations between the emotional eating score and waist circumference and Body Mass Index (BMI) were noted. Furthermore, men were more likely to eat emotionally than women. According to a univariable regression analysis, it was also shown that there was an inverse relationship with age up to 35.92 years and a positive relationship for age > 35.92 years. In addition, an inverse relationship with a decrease in the emotional eating score was found with a BMI up to <49.32 kg/m2.

CONCLUSION

Our findings have emphasized the importance of performing large, prospective, well-designed, randomized, interventional, clinical trials to generate data indicating improvements in eating behavior. Moreover, in future studies the researchers must indicate which assessment tool for emotional eating they will use.

Working Memory and Inhibition as Mediators in the Relationship Between Adverse Childhood Experiences and Emotional Eating

Objective: Previous studies have focused on the dual relationship among adverse childhood experiences (ACEs), cognitive abilities, and emotional eating. The current study aims to test the mediating role of executive functioning (working memory and inhibition) between ACEs and emotional eating. Methods: A total of 1105 community-based participants, aged 18-45 (Mean = 26.28, SD = 7.09), were included in the study. Among the participants, 698 (63.16%) were female, and 407 (36.84%) were male. Participants completed the Childhood Trauma Questionnaire; the Adult Executive Functioning Inventory; the Dutch Eating Behaviour Scale; the Life Events Checklist; and the Depression, Anxiety, Stress Scale Short Form. Multiple mediation analyses were employed using MPlus 8.3. Results: Multiple mediation analysis results showed that working memory and inhibition mediate the relationship between ACEs and emotional eating. Furthermore, working memory and inhibition were positively correlated with emotional eating. Discussion: Our findings indicate that difficulties in working memory and inhibition may increase the risk of emotional eating. Early intervention targeting executive functions may prevent emotional eating. Public Significance: Our findings highlight the relationship among ACEs, executive functioning, and emotional eating. Intervening in executive function may have clinical benefits for individuals with ACEs.

The relationship between perceived stress and emotional eating in bus drivers: the effect of shift work

This study discusses the relationship between perceived stress and emotional eating based on shiftwork in city bus drivers. It was conducted with 1403 male city bus drivers working in Istanbul. Questions about the drivers' physical activity and dietary habits, the Healthy Diet Index (HDI), Emotional Appetite Questionnaire and Perceived Stress Scale-10 data were collected and evaluated in two groups: shift and non-shift employees. It was found that the shift workers (SWs) have lower perceived stress, physical activity, HDI and positive emotional appetite averages. In addition, for SWs, a positive correlation was found between negative emotional appetite scores and physical activity and HDI scores. In conclusion, the drivers working in shifts were found to be slightly overweight and had lower physical activity levels, had lower HDI scores, and their nutritional status was more negatively impacted than their counterparts.

Factors affecting food addiction: emotional eating, palatable eating motivations, and BMI

Evaluating the factors leading to adult food addiction should shed light on potential preventive and treatment strategies for obesity and eating disorders. This research aimed to assess the relationship between food addiction, emotional eating, palatable eating motivations, and the factors that affected them. Five hundred twenty-two adults participated in this descriptive, cross-sectional study in Erzurum, Turkey. Participants completed a questionnaire that included a general information form, anthropometric measurements, Palatable Eating Motives Scale (PEMS), Yale Food Addiction Scale (YFAS), and Emotional Eater Questionnaire (EEQ). In total, 181 (34.7%) men and 341 (65.3%) women participated in the study. While 24.7% were overweight or obese, 65.7% had normal BMI (body mass index). Food addiction (FA) was determined in 18.2% of the participants. The FA group had significantly higher PEMS and EEQ scores (p < .001). The risk of FA was 3.18 times higher in women than in men (95% CI = 1.65, 6.13, p = .001). Significant positive associations between FA, BMI (OR = 1.06, 95% CI = 1.00, 1.11, p = .021), and EEQ (OR = 1.31, 95% CI = 1.23, 1.38, p = .000) were found. Emotional eating behavior and palatable eating motivations are more common in individuals with food addiction than nonfood addiction. Female gender, emotional eating, and high BMI values were determined as risk factors for food addiction.

Lack of Association of Acne Severity with Depression, Anxiety, Stress, and Eating Attitudes: A Cross-Sectional Study

BACKGROUND

this study aimed to investigate the relationship between acne severity and depression, anxiety, stress, and negative eating attitudes in patients with acne vulgaris.

METHOD

This study was conducted with 81 patients with acne vulgaris who applied to the dermatology outpatient clinic of Karaman Training and Research Hospital. The patients were asked to complete a sociodemographic data form, the three-factor nutrition questionnaire (TFEQ-21), and the depression anxiety stress scale (DASS-21). Acne severity was assessed using the global acne grading system (GAGS) by an expert dermatologist.

RESULTS

Of the 81 patients, 74.1% were female and the average age of the cohort was 22.86 years. The average body mass index of the patients was 21.78 and the GAGS average score was 24.25. Correlation tests revealed the lack of any relationship between the GAGS score and the DASS-21 and TFEQ-21 scale scores (and their subscales). The DASS-21 depression subscale was correlated with the TFEQ-21 total score, and TFEQ-21 emotional eating and TFEQ-21 uncontrolled eating scores. Additionally, a relationship was identified between the DASS21-stress subscale score and TFEQ-21 uncontrolled Eating and TFEQ-21 total score, as well as between the DASS21-anxiety scale and the TFEQ-21 total score and TFEQ-21 uncontrolled eating subscale score.

CONCLUSIONS

Although no relationship was found between acne severity and depression, anxiety, or eating disorders, these conditions can increase the risk of eating disorders among acne patients. Therefore, it is critical to take the necessary precautions for the treatment of depression and anxiety disorders in this patient population.

Motives and food craving: Associations with frequency of hyper-palatable food intake among college students

BACKGROUND

College food environments provide wide access to hyper-palatable foods (HPF). Palatable eating motives and craving are individual factors that may impact HPF intake. Nevertheless, no study to date has examined the relationship between these factors and frequency of HPF intake in a dormitory all-you-can-eat-style cafeteria meal, a typical college food setting.

METHODS

College students (N = 218) self-reported frequency of HPF intake at a college cafeteria meal and their frequency of HPF intake in the overall diet. Quasipoisson and logistic regression models tested whether palatable eating motives (assessed via the Palatable Eating Motives Scale) and craving (assessed via the Food Craving Inventory) were associated with the rate of HPF intake during the cafeteria meal and excess frequency of HPF intake in the overall diet.

RESULTS

Craving was associated with a 19% higher rate of HPF intake during the cafeteria meal (RR = 1.19; p = .015) and a >2-fold higher likelihood of excess frequency of HPF intake the overall diet (OR = 2.69; p < .001). Coping motive was associated with an 87% higher likelihood of excess frequency of HPF intake in the overall diet (OR = 1.87; p = .002), but not in the cafeteria meal. Reward enhancement, social and conformity motives were not significantly associated with the frequency of HPF intake in either setting.

CONCLUSIONS

Results highlight the role of craving and coping motive in the frequency of HPF intake among college students. Prevention efforts may consider targeting craving and eating to cope to potentially address frequency of HPF intake among college students.

Comparison of eating behaviour by relative weight change status of young adults throughout the COVID-19 pandemic

Background and purpose

The enforcement of nationwide lockdowns has worsened the obesity epidemic in Malaysia. Therefore, this study aims to compare eating behaviour by relative weight change status among young adults in Malaysia throughout the COVID-19 pandemic.

Design/methodology/approach

Socio-demographics, body height, pre-pandemic body weight, and post-lockdown body weight were self-reported by the young adults. The eating behaviour was assessed using the validated Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18). The mean difference in eating behaviour subscales was analysed using MANCOVA with a Bonferroni-adjusted post-hoc test.

Findings

One-third of the young adults put on body weight due to the lockdowns, with an average relative weight gain of 12.44 ± 9.67%. Conversely, about one-fifth of the young adults reported having lighter body weight in the post-lockdown pandemic phase, with an average relative weight loss of 10.10 ± 4.66%. Young adults in the weight loss category had a significantly higher standardised raw score in cognitive restraints than those in the sustained weight and weight gain categories. In addition, young adults in the weight gain category had statistically higher standardised raw scores in uncontrolled eating and emotional eating compared to those in the sustained weight category. Weight trajectory during the COVID-19 pandemic is linked to disordered eating behaviour among young adults in Malaysia.

Originality/value

The findings presented in this study can be potentially valuable in formulating weight management strategies in the post-COVID-19 era.

The effect of bariatric surgery on dietary Behaviour, dietary recommendation Adherence, and micronutrient deficiencies one year after surgery

Bariatric surgery (BS) is associated with vitamin and mineral deficiencies, which might be augmented by low adherence to dietary guidelines and inappropriate dietary behaviours. The aim of this study was to determine the influence of BS on eating behaviour, prevalence of nutrient deficiency, level of commitment to diet, and lifestyle recommendations one-year post-BS. A cross-sectional study was conducted among adult patients who underwent BS in 2019 and had follow-up for a year. Age, gender, and clinical data were collected from the hospital system and other information was obtained from questionnaires during phone interviews. A total of 160 patients participated in the study. At 12 months, a significant increase from the baseline values in plasma levels of vitamin B12, folate, vitamin D, iron, corrected calcium, albumin, CRP, and MCV, as well as a significant decrease in BMI was observed. Adherence to dietary and lifestyle recommendations was moderate to high. Emotional, and restrained eating behaviours were moderate with 64.4%, and 77.5%, respectively. External eating was low at 58.1%. The study concluded that pre-and post-bariatric surgery nutrients should be closely monitored.

The Indicator of Emotional Eating and Its Effects on Dietary Patterns among Female Students at Qassim University

Emotional eating (EE) is considered as the inclination to eat in response to emotions and is associated with certain syndromes. In this sense, we explored the indices of EE and its association with dietary patterns among female students at Qassim University in Saudi Arabia. A cross-sectional study of 380 participants (aged 18-29 years, female students) was performed. Anthropometric measurements of the participants were taken, such as height, body mass index, fat mass and hip-waist circumference as well as the Emotional Eating Scale (EES). The classification of the ESS included the thresholds of 44.7, 43.9 and 11.3% for low, moderate and high EE, respectively. Linear regression after adjustment showed that fat intake was a significant predictor of EE (p = 0.031) as well as feelings of enthusiasm. We also observed an interesting indication: fat intake (p = 0.011) and educational level (p < 0.05) were significantly associated with, and could be significant predictors of, EE. The results highlight the importance of emotional eating, its relationship with the consumption of foods that contain fat and understanding how it develops by raising awareness of the importance of healthy food for a healthy lifestyle.

Relationship between hedonic hunger and subjectively assessed sleep quality and perceived stress among university students: A cross-sectional study

Purpose

This study examined the relationship between hedonic hunger (HH), sleep quality, and stress levels among university students in the United Arab Emirates and the Kingdom of Bahrain.

Methods

We used a cross-sectional design with participants (N = 565) recruited via convenience sampling. Data were collected with a self-administered, standardized, and validated online questionnaire. HH was assessed with the Palatable Eating Motives Scale (PEMS) and Power of Food Scale (PFS), sleep quality and sleep components were assessed with the Pittsburgh Sleep Quality Index (PSQI), stress was evaluated with the Perceived Stress Scale (PSS), and physical activity was examined with the International Physical Activity Questionnaire. Descriptive and analytical statistics were used to assess the relationship between HH and sleep quality and perceived stress.

Results

There were positive associations between total PSQI scores and total PEMS (β = 0.14, 95% confidence interval [CI]: 0.06-0.25, P = 0.001) and PFS (β = 0.21, 95% CI: 0.45-1.04, P < 0.001). The likelihood of poor sleep quality increased by 8% (odds ratio [OR] = 1.08, P = 0.020) and 43% (OR = 1.43, P < 0.001) for each one-unit increase in PEMS and PFS scores, respectively. We also found positive associations between PSS scores and total PEMS (β = 0.19, 95% CI: 0.26-0.63, P < 0.001) and PFS (β = 0.23, 95% CI: 1.04-2.22, P < 0.001) scores.

Conclusion

Reducing HH and stress levels may help to enhance sleep quality among university students. Conversely, improving sleep quality and reducing stress levels could improve HH in this population.

Evaluation of perceived depression, anxiety, stress levels and emotional eating behaviours and their predictors among adults during the COVID-19 pandemic

OBJECTIVE

This study aimed to (1) evaluate the prevalence and predictors of perceived depression, anxiety, stress (DAS) levels and emotional eating behaviours and (2) determine the correlations between DAS levels and emotional eating behaviours during the pandemic.

DESIGN

An online cross-sectional study included questions about demographic and anthropometric characteristics, dietary habits, Emotional Appetite Questionnaire (EMAQ) and Depression Anxiety Stress Scales. The snowball sampling method was used.

SETTING

Türkiye.

PARTICIPANTS

The study population was 2002 adults aged ≥18 years.

RESULT

The mean age was 27·1 ± 9·52 years (72·1 % females and 27·9 % males). The prevalence of moderate to severe DAS was reported as 27·8 %, 30·5 % and 30·7 %, respectively. Skipping meals (OR = 1·32, 95 % CI (1·14, 1·49)) was associated with depression. Weight gain (OR = 1·43, 95 % CI (1·19, 1·66); OR = 1·30, 95 % CI (1·14, 1·49); OR = 1·39, 95 % CI (1·14, 1·64)), weight loss (OR = 1·45, 95 % CI (1·20, 1·70); OR = 1·37, 95 % CI (1·11, 1·62); OR = 1·46, 95 % CI (1·20, 1·72)), exercising at least 150 min/week (OR = 0·64, 95 % CI (0·46, 0·83); OR = 0·73, 95 % CI (0·55, 0·92); OR = 0·83, 95 % CI (0·63, 1·02)), and maintaining an adequate and balanced diet (OR = 0·52, 95 % CI (0·33, 0·71); OR = 0·53, 95 % CI (0·34, 0·73); OR = 0·63, 95 % CI (-0·15, 0·35)) were associated with DAS, respectively. BMI (r = 0·169, P < 0·001), weight (r = 0·152, P < 0·001), number of snacks (r = 0·102, P = 0·011), depression (r = 0·060, P = 0·007), anxiety (r = 0·061, P = 0·006) and stress (r = 0·073, P = 0·001) levels were positively correlated with EMAQ-negative scores.

CONCLUSION

Approximately one out of every three participants reported moderate to severe DAS levels. Emotional eating was significantly correlated with perceived DAS. The predictors obtained in the study suggest that a healthy diet and lifestyle behaviours are part of psychological well-being and emotional eating.

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.

Factors Associated with Dietary Restriction and Emotional and Uncontrolled Eating in Adults from Spanish-Speaking Countries during the COVID-19 Confinement: Results of the CoV-Eat Project

The first COVID-19 confinement has led to changes in the population’s behaviour. However, little has been analysed about the changes in eating behaviour beyond the decrease in adherence to healthy dietary patterns. The aim of the CoV-Eat project was to identify factors related to each of the following eating behaviours (EB): cognitive restraints (CR), uncontrolled eating (UE), and emotional eating (EE) in adults from Spanish-speaking countries. Participants completed an anonymous online survey. EB was assessed using the Three-Factor Eating Questionnaire and the scores were classified into tertiles. Socio-demographic characteristics and lifestyle habits including physical activity, sleep quality, screen use, smoking consumption, and relationship with food were also collected. A total of 9849 participants from 21 countries were included in this study. The median of CR, UE, and EE behaviours was 15, 24, and 9, respectively. We observed that higher age, days of confinement, number of times leaving home in the last week, changes in sleep quality, and their relationship with food were negatively associated with CR, EE, and UE, while being a man was positively associated with an increased in all these EBs. A higher household income was negatively associated with a higher score of CR, and a higher education level (>primary) was positively associated with a medium score of EE. Lower physical activity was a factor negatively associated with a medium score of EE and UE. Higher screen use showed the same negative association for a medium score of EE and UE and a high score of CR. In addition, higher tobacco consumption was found to be a protective factor against having a medium or high score of CR and EE. In conclusion, some sociodemographic characteristics and lifestyle changes may be important factors for EB and should be considered in emergency situations such as confinement to prevent risky eating behaviour.

Emotional eating experiences of individuals with severe mental disorders: A qualitative study

PURPOSE

The aim of this study is to understand the emotional eating experiences of individuals with severe mental disorders.

DESIGN AND METHODS

The study used a descriptive qualitative design. Data were collected from 19 individuals who displayed emotional eating behavior and a severe mental disorder.

FINDINGS

The main themes of this study are "Triggers," "Emotional Eating Process," and "Feelings after Emotional Eating." Participants stated that negative emotions and certain initiating factors were the triggers of their emotional eating; they also experienced feelings of regret and guilt after emotional eating.

PRACTICE IMPLICATIONS

It was concluded that programs for regulating the eating behaviors of individuals with severe mental disorders should be organized and that psychosocial interventions to prevent emotional eating among these individuals should be integrated into the programs' contents.

Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review

Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: “cross addiction” or “addiction transfer”. This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.

Weight-loss interventions for improving emotional eating among adults with high body mass index: A systematic review with meta-analysis and meta-regression

OBJECTIVES

To evaluate the effectiveness of weight-loss interventions on emotional eating among adults with high body mass index (BMI).

METHODS

A systematic review, meta-analysis and meta-regression were performed on randomized controlled trials published from inception until 19 March 2021.

RESULTS

Thirty-one studies were included, representing 1203 participants with mean ages ranging from 21.8 to 57.3 years old and BMI 27.2-43.5 kg/m2 . We found small-to-medium interventional effects on emotional eating (n = 18; Hedges' g = 0.22; p = 0.01, I2  = 61.7%), uncontrolled eating (n = 16; Hedges' g = 0.46; p < 0.001, I2  = 71.6%) and cognitive restraint (n = 18; Hedges' g = 0.42; p < 0.001, I2  = 75.8%). Small-to-medium interventional effects were only found for emotional eating (n = 8; Hedges' g = 0.45; p = 0.02, I2  = 74.3%) 3-month post-intervention, and on BMI (n = 4; Hedges' g = 0.43; p < 0.05, I2  = 33.4%) and weight (n = 6; Hedges' g = 0.36; p < 0.01, I2  < 10.4%) 12-month post-intervention. Age, male proportion, baseline BMI, attrition rate and intervention length were not significant moderators of the heterogeneity between studies.

CONCLUSION

Interventions improved emotional eating and weight loss along a year-long trajectory.

The effects of nurses' perceived stress and life satisfaction on their emotional eating behaviors

PURPOSE

To examine the effects of the nurses' perceived stress and life satisfaction on their emotional eating behaviors.

DESIGN AND METHODS

A cross-sectional study was conducted among a random sample of 297 nurses in a research hospital.

FINDINGS

There is a negative correlation between nurses' emotional eating and life satisfaction (β = -0.192, p < 0.001), and a positive correlation between emotional eating and perceived stress (β = 0.392, p < 0.001). Perceived stress, life satisfaction, and marital status constituted 24% of the factors affecting emotional eating behaviors.

PRACTICE IMPLICATIONS

Psychiatric nurses would benefit from developing effective training programs that support nurses in making healthy lifestyle choices.

Effects of COVID-19 lockdown on weight in a cohort of allergic children and adolescents

BACKGROUND

COVID-19 lockdown caused sudden changes in people's lifestyle, as a consequence of the forced lockdown imposed by governments all over the world. We aimed to evaluate the impact of lockdown on body mass index (BMI) in a cohort of allergic children and adolescents.

METHODS

From the first of June until the end of October 2020, we submitted a written questionnaire to all the patients who, after lockdown, carried out a visit at the Pediatric Allergy Unit of the Department of Mother-Child, Urological Science, Sapienza University of Rome. The questionnaire was composed by 10 questions, referring to the changes in their daily activities. Data were extrapolated from the questionnaire and then analyzed considering six variables: BMI before and BMI after lockdown, sugar intake, sport, screens, sleep, and anxiety.

RESULTS

One hundred fifty-three patients agreed to answer our questionnaire. Results showed a statistically significant increase in the BMI after lockdown (20.97 kg/m2 ± 2.63) with respect to the BMI before lockdown (19.18 kg/m2 ± 2.70). A multivariate regression analysis showed that the two variables that mostly influenced the increase in BMI were sleep and anxiety.

CONCLUSIONS

For the analyzed cohort of allergic children and adolescents we obtained significant gain in BMI as consequences of lockdown, which can be explained by many factors: high consumption of consolatory food, less sport activities, more time spent in front of screens, sleep alteration associated with increased anxiety. All these factors acted together, although sleep alteration and increased anxiety were the most influential factors that led to the worsening or the onset of weight gain, creating the basis for future health problems.

Relationship between Emotional Eating, Consumption of Hyperpalatable Energy-Dense Foods, and Indicators of Nutritional Status: A Systematic Review

People's health is closely linked to their diet. Diet can be defined as the set of foods that are consumed in a day, and it is susceptible to being altered by various factors, such as physiological, environmental, psychological, and social. These, in turn, can be affected by an inadequate diet and/or a dysregulation of emotions. Emotions are an immediate response by the organism informing it of the degree of favorability of a certain stimulus or situation. Moods are similar to emotions but more intense and prolonged. Some studies indicate that the consumption of hyperpalatable energy-dense foods may be related to emotional eating. Emotional eating is characterized by the excessive consumption of hyperpalatable energy-dense foods, rich in sugars and fats, in response to negative emotions. But several reports also indicate that emotional eating may be associated with the presence of positive emotions, so further analysis of the available information is necessary. Consuming higher amounts of hyperpalatable energy-dense foods can lead to the accumulation of energy in the body that results in an increase in body weight, as well as other associated diseases. Obesity is the world's leading diet-related health problem. The objective of this work was to carry out a systematic review of the available literature using the Cochrane methodology, in accordance with the PRISMA guidelines, to evaluate the relationship between emotional eating, the consumption of hyperpalatable energy-dense foods, and indicators of nutritional status. An exhaustive search in different databases yielded 9431 scientific articles, 45 of which met the inclusion criteria. This review underscores the fact that knowing and understanding the reasons why people consume hyperpalatable energy-dense foods and the possible connection with their emotional eating can provide key data for improving and personalizing patients' nutritional treatment. This in turn can encourage compliance with treatment plans to improve people's health and quality of life using an interdisciplinary approach.

Validación psicométrica del Cuestionario de Emociones en la Motivación de la Ingesta

La medición apropiada de la influencia de las emociones en la ingesta de alimentos resulta relevante para encaminar las estrategias de salud en materia de prevención de obesidad y  Trastornos de Conducta Alimentaria. El objetivo del presente estudio fue validar un instrumento para medir la influencia de las emociones en la motivación de la ingesta, desde la construcción hasta su validación. En la construcción participaron 6 jueces expertos en psicología y en la validación participaron 416 adultos mexicanos (56 % mujeres, 44 % hombres, edad M = 39.43 años, DE = 12.56). Se obtuvo una confiabilidad a través del coeficiente alpha de Cronbach de 0.906. La validez de constructo fue a través del análisis factorial de componentes principales con rotación varimax, del cual se obtuvieron 4 factores que explican 50.36% de la varianza, con un KMO de 0.888 un valor χ2 de la prueba de Bartlett de 4418.36 p < 0.001. Una limitación del estudio fue la regionalización de la muestra, por lo que se sugiere replicar el estudio con otras poblaciones. La escala mostró buenas propiedades psicométricas para medir la influencia de las emociones en la motivación de la ingesta.

Is Physical Activity Protective against Emotional Eating Associated Factors during the COVID-19 Pandemic? A Cross-Sectional Study among Physically Active and Inactive Adults

Physical activity levels during the COVID-19 pandemic have been decreasing and this may be a risk factor for development of emotional eating and its associated factors. The aim of the study was to analyze the factors associated with emotional eating among individuals with different physical activity levels during the COVID-19 pandemic. Data relating to the pandemic on physical activity, emotional eating, sociodemographic data, perceptions about lifestyle habits, body satisfaction, and perceptions about eating habits and food consumption were collected. Factors associated with emotional eating in the group of active and inactive individuals were observed using multiple linear regression controlled for age, sex, BMI, and monthly income. Emotional eating for the active group was associated with perceived stress, body dissatisfaction, and increased consumption of sweets and desserts. In addition to these factors found among the active group, working or studying >8 h/day, sleep worsening, increased amount of food consumed, increased purchase of food through delivery, and increased vegetable consumption were also associated with emotional eating for the inactive group. These findings suggest a potential protective role of physical activity in the appearance of factors associated with emotional eating during the COVID-19 pandemic.

Exploring the role of momentary positive and negative affect in overeating and binge eating: Evidence for different associations among men and women

Momentary positive and negative emotions have shown to affect eating behaviour. In this study, we used experience sampling method (ESM) to assess how momentary positive affect (PA) and negative affect (NA) relate to overeating (OE) and binge eating (BE) episodes among men and women compared to no OE/BE episodes. We additionally looked at how situational and social context moderate these relationships. For this purpose, 87 women and 94 men participated in the study where they were instructed to rate their levels of various positive and negative emotions, situational whereabouts, and the presence of OE/BE 7 times a day for 3 consecutive days. We found that men and women greatly differed in how momentary PA and NA relate to OE and BE. In women, NA was highest before BE, followed by OE compared to no OE/BE. Further, an interaction between the type of an eating episode and situational context demonstrated that this relationship was significant when at home, but not away from home. No differences in the momentary NA between the types of eating episodes were found in men. In men, PA was significantly higher before OE compared to BE and no OE/BE. Additionally, an interaction between the type of eating episode and situational context showed that this relationship was significant when at home, but not when away from home. Our results further confirm the role of negative affect in overeating and binge eating in women, whereas also suggesting that the role of positive affect in eating behaviour is warranted more research, particularly in men.

Relationship between emotional eating and coping with stress of nursing students

PURPOSE

This research aims to determine the relationship between the coping skills and emotional eating habits of young adults.

DESIGN AND METHODS

The population consisted of 473 nursing students whom registered in the Faculty of Health Sciences at a state university in Turkey during 2018 and 2019 education terms. Data were collected through the Demographic Form, Turkish Emotional Eating Scale (TEES), and Coping Style Scale (CSS).

FINDINGS

"Eating in anxiety" (r = -.174; P = .000) and "eating in the negative mood" (r = -.123; P = .007) subscale scores of TEES showed a statistically significant, negative correlation with the "self-confident approach" subscale score of CSS.

PRACTICE IMPLICATIONS

In light of the data, it is suggested to increase the frequency of psychological counseling offered for these students and setup behavior change training either an individual or group settings. Besides, the conjoint effort of health professionals and psychiatric nurses would be highly beneficial for the development of effective assessment tools to determine students at risk and engage in appropriate prevention strategies such as training programs that would have a direct impact on the students' habitual diet. Subsequent research is recommended incorporating additional variables such as body perception, ideal female image, expectations of perfection toward the body, and self-worth defined thru the body.

The effect of sociodemographic characteristics of university students on emotional eating behavior

PURPOSE

This descriptive study was conducted for the purpose of determining the effect of sociodemographic characteristics of university students on emotional eating behavior.

DESIGN AND METHODS

The study was completed with a total of 537 students. A descriptive questionnaire and the Emotional Eating Scale were used. Descriptive statistics, correlation, and regression analyses were used.

FINDING

It was found that emotional eating was positively correlated with body mass index and weight. It was determined that variables such as will, anger, body mass index, and weight were predictors of emotional eating.

PRACTICAL IMPLICATIONS

Emotional eating is a coping response with negative emotions. It is suggested that will is the most important factor affecting emotional eating. Thus, psychological dimension of wrong eating habit should definitely be addressed.

Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

Disordered eating includes core eating disorder symptoms present in diverse populations. The extant literature has focused on associations between negative emotional eating and disordered eating to the exclusion of positive emotional eating. Emotion regulation may help explain relationships between emotional eating and disordered eating. Emotion regulation difficulties was examined as a moderator of relationships between negative and positive emotional eating and disordered eating including dietary restraint, eating, weight, and shape concerns, and global scores of disordered eating, a general index of disordered eating. A cross-sectional study was employed using a university student population in the United States. Participants completed surveys assessing negative (Dutch Eating Behavior Questionnaire; Emotional Appetite Questionnaire) and positive (Emotional Appetite Questionnaire) emotional eating, emotion regulation (Difficulties in Emotion Regulation Scale), and disordered eating (Eating Disorder Examination Questionnaire). Moderation analyses were calculated with emotion regulation difficulties as the moderator of relationships between negative and positive emotional eating and disordered eating. Across two separate measures of negative emotional eating, higher negative emotional eating was associated with higher weight concerns and global scores of disordered eating when emotion regulation difficulties was average and increased (+1 SD above average). Higher positive emotional eating was associated with lower dietary restraint and global scores of disordered eating when emotion regulation difficulties was decreased (-1 SD below average). Emotion regulation difficulties strengthened relationships between negative, not positive, emotional eating and disordered eating. Research and clinical implications for the contribution of emotional eating and emotion regulation on disordered eating were discussed.

Physical and Psychological Effects Related to Food Habits and Lifestyle Changes Derived from Covid-19 Home Confinement in the Spanish Population

As a consequence of COVID-19, millions of households have suffered mobility restrictions and changes in their lifestyle over several months. The aim of this study is to evaluate the effects of COVID-19 home confinement on the food habits, lifestyle and emotional balance of the Spanish population. This cross-sectional study used data collected via an anonymous online questionnaire during the month before lockdown finished in Spain, with a total of 675 participants. 38.8% of the respondents experienced weight gain while 31.1% lost weight during confinement. The increase in body weight was positively correlated with age (Rs = 0.14, p < 0.05) and BMI (Rs = 0.20, p < 0.05). We also identified that 39.7% reported poorer quality sleep, positively correlated with BMI (Rs = -0.18, p < 0.05) and with age (Rs = -0.21, p < 0.05). 44.7% of the participants had not performed physical exercise during confinement with differences by sex (p < 0.05), by age (p < 0.05), by BMI (p < 0.05) and by sleep quality (p < 0.05). According to an emotional-eater questionnaire, 21.8% and 11% were classified as an emotional eater or a very emotional eater, respectively. We emphasize the importance of adopting a healthy lifestyle, as the COVID-19 pandemic is ongoing.