The impact of stress on eating habits for teens -
A total of 13 studies were included in the final review and data were analysed using Comprehensive Meta-Analysis. Using random-effects modelling, overall stress was not associated with a change in overall eating behaviors. The current findings are concerning as they suggest the impact of stress on unhealthy eating may begin as early as 8 or 9 years old.
Future research ought to investigate further the role of psychological, behavioral and endocrine factors in the development of stress-related eating in children.
Keywords: Adolescents; Children; Eating behavior; Moderators; Snacking; Stress; Unhealthy foods. Abstract It is well established that stress is linked to changes in eating behaviors. Discussion: These results stress the importance of looking into the daily relationship between stress and eating behavior parameters, as both are related with change over and within days.
More research is needed to draw firm conclusion on the moderating role of ER strategies and emotional eating.
Pediatric overweight and obesity are growing problems, as the prevalence of obesity is tripled since Parallel to the global rise in pediatric obesity, metabolic, psychological and social health problems are beginning to appear in childhood; and positive associations between these phenomena are found Braet et al.
Moreover, these diseases are known to track into adulthood Ferraro and Kelley-Moore, ; Reilly et al. This progress and the assumed comorbidities emphasize the importance of studying the underlying mechanisms leading to childhood obesity. Psychological and psychophysiological research in this field emphasizes the influence of stress on eating and weight regulation.
Psychological stress occurs when a person appraises a situation as significant for his or her welfare and when the situation exceeds his or her available coping resources Lazarus and Folkman, This definition implicates a subjective component that can be captured only through self-report Krohne, Besides, the emotional value of the stressor needs to be taken into account.
Lazarus states that stress is closely related to the conceptualization of emotions because higher levels of stress are consistently associated with higher negative affect but so far, specifically in childhood, this link is less studied in the context of emotional eating Cohen et al.
Stress is associated with the development of different medical and psychological disorders Salim, Pertinent to the current study, research in children and adolescents proved that the experience of negative affect and stress is associated with weight gain, a higher waist circumference, a higher BMI and in the long term obesity Goodman and Whitaker, ; Koch et al.
Psychological research shows that stress is associated with overweight and obesity through changes in weight-related health behavior, as stress activates emotional brain networks and elevates the secretion of glucocorticoids and insulin.
First, regarding food intake, stress may result in under- or overeating depending on the stress source and stress intensity Willenbring et al. Concerning undereating, adults and children are often found to eat less after heavy stressful events and, specifically, family stress is associated with underweight BMI Popper et al.
However, evidence for overeating after experiencing stress is also found. Next to the detected underweight after family stress, Stenhammar et al. Besides, Evers et al. Second, concerning food choice, stressor intensity is an important factor. In adults, chronic life stress is associated with the intake of more energy-dense food Steptoe et al.
In a systematic review and meta-analysis on children, Hill et al. Third, concerning eating motives, De Vriendt et al. Here, a recent EMA study in adults finds that time pressure is associated with more hunger eating Reichenberger et al.
Goldschmidt et al. Besides, as eating behaviors are a daily occupation, and appear in different contexts, a diary study can further help to capture the relationship between daily hassles and different indicators of eating behavior. However, this research in children and adolescents is lacking, but highly needed and relevant as 1 adolescence is an important developmental stage Giedd et al.
Emotion regulation refers to the actions by which persons try to influence their emotions, more specifically which emotions they experience, when and how they experience the emotions and how they show their emotions to others Gross, Emotion regulation strategies are studied most often in contexts in which persons upregulate their stress related negative emotions.
Emotion regulation strategies influence eating behavior and health behavior Whiteside et al. This association is stronger when maladaptive emotion regulation strategies are used to deal with the stressor in comparison with the use of adaptive emotion regulation strategies Aparicio et al.
In a longitudinal perspective, toddlers with lower levels of emotion regulation skills i. Using maladaptive emotion regulation strategies is found to mediate the association between the stressor of maternal rejection and emotional eating measured as a trait, with the DEBQ-questionnaire in obese youngsters Vandewalle et al.
On the other hand, adaptive emotion regulation strategies are related with positive health behaviors such as a higher intake of fruits and vegetables and more physical activity Isasi et al. Emotional eating is highly prevalent in community-wide youth samples Michels et al.
Besides, emotional eating is treatment resistant, as it often persists after obesity treatment Vandewalle et al. Emotional eating can occur in the presence of a lot of different emotions Faith et al. In children, high scores on emotional eating have been associated with both negative feelings on physical competencies Braet and Van Strien, and experienced stress Nguyen-Rodriguez et al.
Emotional eating has a short term reinforcing effect, by reducing stress-related arousal and negative affect Popless-Vawter et al. Even more important, emotional eating will not solve the stress origins: as long as people only cope with their stress by means of emotional eating, the stressor will remain and cause psychological discomfort Stice et al.
This way, emotional eating can be seen as a proxy of maladaptive emotion regulation Michopoulos et al. Emotional eating is associated with more calorie-intake Braet and Van Strien, This is of concern as emotional eating seems to evolve toward a stable trait component later in life and is of greater importance compared with other life style behaviors for explaining longitudinal weight gain Koenders and Van Strien, Persons with a high emotional eating style who are confronted with a stressor eat more high-fat food and more energy-dense meals in comparison with persons who have a low emotional eating style Oliver et al.
Interesting, the presence of negative emotions decreases the desire eating in individuals with a low emotional eating style; while the negative emotions do not affect the desire eating in individuals with a high emotional eating style Reichenberger et al.
This suggests that emotional eating evolves toward a stable trait that might be a moderator in the stress-eating relation. The current study is innovative in different ways: 1 by including children and adolescents, 2 by using a daily diary design during seven consecutive days and 3 by including three indicators of eating behavior; daily hunger eating motives, desire to eat motives and snacking; and their moderating factors, emotion regulation and emotional eating.
However, as using a cellphone during school time is often forbidden, the eating motives and snacking during the day will be reported after school time, which is a well-known critical phase with both school related and peer related stress Sotardi, The research question is shown in Figure 1.
First, we hypothesize that emotional eating will be a proxy of maladaptive emotion regulation based on Michopoulos et al.
Second, we state that daily stress will be significantly associated with 1 the trajectories in desire to eat 2 the trajectories of hunger-eating and 3 the trajectories of snacking Based on De Vriendt et al. Dutch- speaking children and adolescents were recruited in Belgium, Aalter and Deinze.
These youngsters already participated in two previous studies: Generation study Van Beveren et al. These are both longitudinal studies with different data collection waves over time on the emotional wellbeing of children and adolescents.
During a follow-up data collection in both cohorts, participants were recruited for the current study. Before the diary study, the participants were asked to fill out questionnaires on eating behavior and emotion regulation.
EMA measures were similar to the study of Reichenberger et al. The diary was filled out before breakfast, after school time, when the participants came home from school and before bedtime.
In the current study, only the data time point after school was used, which was in most cases filled in between 5 PM and 6 PM.
At 5 PM the participants received a reminder message to fill out the diary. Participants were asked to report on their snacking behavior since breakfast.
The Fragebogen Zur Erhebung der Emotionsregulation Bei Kindern und Jugendlichen FEEL-KJ, Grob and Smolenski, ; A Questionnaire on Emotion Regulation Strategies in Children and Adolescents is translated from German to Dutch and can be used in children and adolescents between 8 and 18 years old Braet et al.
The questionnaire measures ER strategies for three emotions: anger, anxiety and sadness. The emotion regulation strategies for every emotion are captured by 30 items, thus the total amount of items is The 15 emotion regulation strategies are divided in three categories of strategies: adaptive, maladaptive and external regulation.
The adaptive emotion regulation strategies are distraction, recall a positive emotion, forget, acceptance, problem solving, re-evaluation of the situation, and cognitive reappraisal.
The maladaptive strategies are giving up, withdrawing, self- devaluation, rumination and aggression. Looking for social support, controlling your emotions and expressing your emotions are the external strategies. For the Dutch and Flemish population, representative norms are available Braet et al.
The psychometric qualities of the FEEL-KJ are drawn from a large sample of Dutch speaking Belgian children and adolescents between 8 and 18 years old. A good reliability and validity was found by Cracco et al.
The Dutch Eating Behavior Questionnaire DEBQ, van Strien et al. The DEBQ contains 33 items, and is a self-report questionnaire. The DEBQ has been shown useful in research with children and adolescents between 7 and 17 years Braet et al. Also, good psychometric qualities are reported, such as a good reliability and external validity Ricciardelli and McCabe, ; Braet et al.
By asking about the period since breakfast until after school, we wanted to capture stress related to school performances and peer-related stress social stress.
Using the Nobelguide, two researchers scored and discussed until agreement on the amount of Kcal, and this was double checked by a dietitian, in the case of non-accordance. In the analysis, a calculated mean score on the amount of snacks kcal and a calculated mean score on hunger and desire eating motives was used.
It is important to know if the act of completing the daily diary impacted the behavior of the participant reactivity, e. Therefore, at the end of the current study, reactivity was measured with a single question regarding the influence the diary had on their eating behavior.
Children and adolescents between 10 and 17 years old were recruited as part of a larger research project Emotion Regulation in the prevention and treatment of obesity in young adolescents. When participants and their parents agreed on participating in the diary-study, a home visit was planned.
During the first home visit the informed consents were signed by the youngsters and their parents, the trait questionnaires were explained and a smartphone was given to the participants to fill out the diary. Together with them, an example of 1 diary assessment point was filled out.
Participants had to fill out the diary for 7 days, with the assessment points after breakfast, after school and before bedtime. In the current study, only the measurement point after school time is used to answer the research questions.
Collecting data during this limited window of time, seven consecutive days, was based on other recent studies in youth Hruska et al. During the diary- data collection, the participants received at every assessment point an e-mail with the link to the diary questions as a reminder for filling in the diary.
To log in on the website, every participant received a unique code, which guaranteed the anonymity of the participants. The diary questions were also given in a written format; in case the online version would give problems.
When the participant did not fill in the diary three consecutive times, e-mails with the links were not sent any more to this person. At the fourth day of the diary-study, the participants received a phone call to ask how the study went, if there were difficulties and to encourage them to carry on until day 7 including an integrity check whereby the snack registration of that day was asked.
After the study, a second home visit was planned to collect the trait questionnaires and smartphones. During the second home visit, the reactivity measure was asked to the participants; and they received a film ticket as reward.
Data were analyzed within a multilevel framework using MLwiN Rasbash et al. Predictors at Level 2 reflecting between-youth predictors were centered around the grand mean grand-mean centered to improve the interpretation of the intercept values Nezlek, As proposed by Singer and Willet , we fitted two initial models, namely the random intercept-only model and the unconditional growth model for daily desire to eat, hunger eating, and snacking prior to our main analyses.
First, random-intercept-only models Null Models were used to estimate the variance partitioning coefficient VPC , which reflects the proportion of variance in the dependent variable situated between youth Level 2.
In a second step, unconditional growth models Singer and Willet, were built stepwise from the Null Models by adding Time as a Level 1 predictor, reflecting whether on average there was change over time.
Furthermore, we tested whether the growth rate varied between individuals by modeling the coefficient of Time random at Level 2 i. The likelihood ratio test LRT was used to compare the goodness of fit of nested models.
To evaluate the significance of the fixed and random effects the Wald test was used. Gender, age, and adjusted BMI were included as covariates of no interest in all undermentioned analyses.
To test whether daily stress and trait maladaptive emotion regulation interact in explaining trajectories of desire to eat, hunger eating, and snacking respectively we extended the baseline growth models for these variables by adding daily stress, trait maladaptive emotion regulation, and their interaction to the unconditional growth models.
Throughout the week, a decreasing compliance for filling out the online diary was observed, with respectively 96, 83, and 77 youngsters filling out the diary at day 1, day 4, and day 7.
Means, standard deviations, and correlations between all variables are shown in Table 1. Mean scores of all variables in the current sample are comparable to findings of previous studies in youth samples Braet and Beyers, ; Braet et al.
Comparing the daily mean score for kcal-intake of snacking with previous research in girls and boys between 9 and 14 years Field et al. Additionally, all daily measurements were significantly and positively correlated, except for daily stress with daily snacking.
Concerning the hunger eating motives and desire to eat motives, the multicollinearity was checked by the variance inflation factor VIF. Concerning the reactivity measures, 98 participants filled out this question at the second home visit. Unfortunately, in 11 participants the reactivity measure was missing, due to the fact that the participants were not at home at the time of the second home visit.
We first fitted random intercept-only models i. Variance estimates and standard errors SE are depicted in Table 3 desire to eat , Table 4 hunger eating , and Table 5 snacking. For all variables, the between-youth and within-youth variance components were significant.
The VPC indicated that Before running the main analyses, we fitted unconditional growth models for core study variables. These models revealed that levels of desire to eat, hunger eating, as well as snacking generally decreased as the week progressed. Table 3. Daily desire to eat as a function of stress, maladaptive emotion regulation, and trait emotional eating.
Table 4. Daily hunger eating as a function of stress, maladaptive emotion regulation, and trait emotional eating.
Table 5. Daily snacking as a function of stress, maladaptive emotion regulation, and trait emotional eating. In addition, we fitted a random intercept-only model for the independent variable stress.
Furthermore, the unconditional growth model for stress revealed that stress-levels generally decreased as the week progressed. To test our hypothesis, we extended the unconditional growth model for daily desire to eat Model 1; Table 3 by adding stress and emotion regulation, as well as their interaction, to the model.
We extended the unconditional growth model for daily hunger eating Model 1; Table 4 by adding stress and emotion regulation, as well as their interaction, to the model. We extended the unconditional growth model for daily snacking Model 1; Table 5 by adding stress and emotion regulation, as well as their interaction, to the model.
We extended the unconditional growth model for daily desire to eat Model 1; Table 3 by adding stress and emotional eating, as well as their interaction, to the model. We extended the unconditional growth model for daily hunger eating Model 1; Table 4 by adding stress and emotional eating, as well as their interaction, to the model.
We extended the unconditional growth model for daily snacking Model 1; Table 5 by adding stress and EE, as well as their interaction, to the model. The current study aimed to investigate the relationship between daily stress and eating behavior in children and adolescents 10—17 years old using a daily diary-design.
Combining a daily diary-design with the use of self-report trait questionnaires allowed us to look into the moderating role of emotion regulation and emotional eating.
First, we found that maladaptive emotion regulation was positively correlated with emotional eating, meaning emotional eating can be seen as a proxy of maladaptive emotion regulation, which is in line with Evers et al.
Besides, daily stress was positively correlated with daily desire to eat and hunger eating; but not with daily snacking; and these three indicators of daily eating behavior were all significantly positively correlated.
The correlations are in line with the reported positive associations between levels of stress and levels of desire to eat- and hunger eating motives by De Vriendt et al. Children and youngsters might not have the autonomy to decide what they will eat, especially snacks. Gevers et al. All three indicators of eating behavior showed bilateral significant positive correlations, which is in line with our expectations.
Although the motivation differs in desire and hunger eating, a positive correlation is not unexpected since in both hedonic and homeostatic eating the ghrelin secretion hunger hormone is elevated, and the cholecystokinin secretion satiety hormone is decreased Monteleone et al.
Concluding, variables measured on trait questionnaires FEEL-KJ and DEBQ correlated bilateral; and the variables measured on a daily basis daily stress and the indicators of eating behavior correlated with each other, but no correlations between the trait variables and daily measurements were found.
For this, a potential explanation could be found in that the used questionnaires were not sensitive enough for capturing these momentary daily fluctuations.
Second, we found evidence for the hypothesis that daily stress was significantly associated with the trajectories of desire to eat and hunger eating motives, which is in line with De Vriendt et al. With higher levels of daily stress, desire to eat and hunger eating motives showed a less steep decrease throughout the week.
As the trajectories of the eating behavior indicators decreased significantly throughout the week for every participant, the steepness of these decreases were of interest.
The decreases of the hunger eating motives trajectories and of the desire to eat motives trajectories were significantly less steep in persons reporting higher levels of stress than in persons reporting lower levels of stress.
This effect was not found for snacking. Third, for both eating motives and snacking, no effect of maladaptive emotion regulation nor an interaction between daily stress and maladaptive emotion regulation was found.
These findings are in contradiction with Evers et al. A possible explanation is the methodology of the study, as above mentioned studies are longitudinal, cross-sectional questionnaires or experimental studies while the current research is a diary study. Still, the moderating factor, maladaptive emotion regulation, was measured as a trait variable and therefore might not be sensitive enough to capture momentary daily effects.
Next, the participants only filled out the diary during 7 days, three times a day, but only the measurement point after school was taking into account in the analysis. We could question if using one data time point a day during 7 days is enough to capture the momentary daily fluctuations.
To approach these methodological shortcomings, it is recommended to include a daily measurement of emotion regulation and to include signal- or event-contingent sampling.
Fourth, we found marginally significant evidence for the hypothesis that daily stress in interaction with trait emotional eating is associated with the trajectories of desire to eat and snacking; but not for hunger eating. These results mean that in youngsters with a high emotional eating style, when experiencing high stress, a less steep decrease in desire to eat and snacking occurs in comparison with youngsters with a lower emotional eating style.
Fifth, analyses of the daily diary data also revealed that daily stress and daily eating behavior decreased as the week progressed. This was not expected and has to be explored in the future.
One of the explanations can be the possibility of the contributing factor of the stress-levels fitting the day of the week. These stress-levels may play a role in the findings in this study Areni et al. In future research, it is recommended to start the diary study on different days, to control for this order effect.
This study has several notable strengths. First, we used a daily diary design, enabling a more momentary inspection of the relation between stress and eating behavior in a naturalistic environment.
Having a good reliability, validity and generalizability, diary studies are able to determine experiences, mood, behavior and contextual factors more detailed Moskowitz and Young, ; Suveg et al. Second, we recruited a fairly large sample of youngsters between 10 and 17 years of age given that research in this age group is lacking.
Yet, researching the effects of stress on wellbeing in this critical developmental period is of utmost importance given the heightened risk for developing overweight and eating pathology in particular Giedd et al. Third, because of the highly demanding design of the study for the youngsters diary for 7 days , a lot of efforts by the researchers were made to increase the persevered motivation of the youngsters.
During a home visit the rationale was explained, a reward at the end of the study was promised and the youngsters received a personalized smartphone as incentive during the study. During the study reminders were sent for all assessing points and youngsters received a motivating phone call in between.
Despite these strengths, several limitations of the current study warrant discussion. The first limitation of the present study design is the limited number of data points each day, more specifically at breakfast, after school and before bedtime.
Using signal- or event-contingent data sampling would be better to capture the daily relationship between stress and eating behavior.
However, a diary-study for 7 consecutive days might be a long period for children and adolescents between 10 and 17 years old and a great burden. This was confirmed by the missing values in the diary reports. As the ability and willingness of participants are determining factors for the success of a diary study, only three diary data points were used Moskowitz and Young, ; Engel et al.
Besides, practical barriers prevented us from using signal- or event contingent sampling as schools did not give an authorization to fill out the diary during school time.
To answer the research questions, only one measurement point a day was included in the analysis, more specifically the data point after school. First of all, two important stressors for youngsters, school and peer related stress Sotardi, could be captured at that data point.
Second, previous research showed the importance of the food availability preceding the snacking, which is higher at home or the way to home in contrast with a school environment.
Due to the age of the participants, 10—17 years, and the possibility of having a greater food availability at home or the way to home , the choice was made to include only this data time point here Chopra et al.
Whether emotional eating might be even more prevalent later in the evening, remains to be studied. A second limitation of the study concerns the use of self-report measurements of eating behavior. In future research, it is recommended to use more objective methods, such as taking pictures of the snacks participants ate.
This requires the use of event-contingent data sampling. A third limitation, in addition to the one-time point, is the retrospective character of these daily measures. As mentioned above, including a signal-contingent design of the daily measures would be more suitable in order to investigate the causal daily relationship between stress and eating behavior.
A fourth limitation concerns the little variance in the emotion regulation and emotional eating scores. All mean scores are in accordance with the norm scores of the questionnaires, except for maladaptive emotion regulation in boys between 12 and 18 years Braet and Beyers, ; Braet et al.
In future research, it might be interesting to include youngsters with overweight or obesity, as emotional eating is more prevalent among overweight and obese youngsters Braet and Beyers, As mentioned above, a fifth limitation concerns the same start day for all participants of the diary- measures, namely on Monday.
To control for week-effects, it might be better to randomize the start day for filling in the diary over the participants Areni et al. In future research, it is recommended to include sources of daily hassles to have more specified information. Different types of stress are of interest in youngsters, e.
Seventh, in the current study, stress intensity was measured subjectively. As the variance within persons is rather small, the question could raise if youngsters have difficulties reporting on their stress level. In the future, we will analyze with more stringent research whether the level of the stress experience of children is related with more objective measurements, like heart rate variability.
Eighth, all daily variables e. To conclude, we found that daily stress is significantly associated with the trajectories of desire to eat and hunger eating motives. But no moderation effects of maladaptive emotion regulation were found; while emotional eating has marginally significant effects on desire to eat and snacking.
In the research on stress and eating behavior, there are still a lot of gaps. The current research is a first step in reducing these gaps by investigating the underlying mechanism in the relationship between daily stress and eating behavior as a predictor of weight gain by including the moderators of emotion regulation, and more specifically emotional eating.
This study was carried out in accordance with the recommendations of Ghent University with written informed consent from all subjects. All subjects gave written informed consent in accordance with the Declaration of Helsinki.
The protocol was approved by the Ethical Committee of Ghent University. All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Background: Overweight Joint pain relief obesity are The impact of stress on eating habits for teens problems, with more stresss recently, to the no of stress in Skiing or snowboarding starting and maintaining haabits of these clinical TThe. However, habitts mechanisms are not The impact of stress on eating habits for teens known and well-understood; and ecological momentary analyses impadt the daily variations Immune-boosting exercises stress and eating Waist circumference and overall health far teenss studied. Emotional eating Supporting optimal nutrient uptake highly nabits and is assumed to be an important mechanism, as a maladaptive emotion regulation ER strategy, in starting and maintaining the vicious cycle of pediatric obesity. Objectives: The present study aims to investigate in youngsters 10 — 17 years the daily relationship between stress and the trajectories of self-reported eating behavior desire to eat motives; hunger eating motives and snacking throughout 1 week; as well as the moderating role of emotion regulation and emotional eating in an average weight population. The youngsters filled in a trait-questionnaire on emotion regulation and emotional eating at home before starting the study, and answered an online diary after school time, during seven consecutive days. Anxiety and Related Disorders: Definition, Od and Impaact. One common Natural anticancer remedies disorder, anxiety, srtess directly affect both Supporting optimal nutrient uptake teens eat and how much ewting eat, which in turn can have negative health teeens. Take a look at Boost insulin sensitivity and improve energy levels important connections between Healthy body proportions and teen anxiety. People who suffer from chronic anxiety, for instance, may lose their appetite due to the fight or flight effects of stress hormones on the body and brain. Diarrhea or nausea from anxiety can also discourage eating. Teens who experience bouts of short-term anxiety as opposed to constant anxiety often react by overeating instead of losing all interest in food. As the anxiety worsens or turns chronic, they may then flip-flop from overeating to a compulsion to avoid food altogether, a problem known as anorexia.
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