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Stress and Food Choice: A Laboratory Study

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This study investigated experimentally whether acute stress alters food choice during a meal. The study was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories of food and interactions with eating attitudes. Sixty-eight healthy men and women volunteered for a study on "the effects of hunger on physiology, performance, and mood." Eating attitudes and food preferences were measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet, salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal. Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period, when appetite for 34 foods and food intake were recorded. Increases in blood pressure and changes in mood confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress. Increased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in food choice.
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Stress and Food Choice: A Laboratory Study
GEORGINA OLIVER,PHD, JANE WARDLE,PHD, AND E. LEIGH GIBSON,PHD
Objective: This study investigated experimentally whether acute stress alters food choice during a meal. The study
was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories
of food and interactions with eating attitudes. Methods: Sixty-eight healthy men and women volunteered for a study
on “the effects of hunger on physiology, performance, and mood.” Eating attitudes and food preferences were
measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and
assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet,
salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal.
Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period,
when appetite for 34 foods and food intake were recorded. Results: Increases in blood pressure and changes in mood
confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six
food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal
than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress.
Conclusions: Increased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory
setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced
eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in
food choice. Key words: stress, food choice, emotional eating, dietary restraint, appetite, nutrition.
ANOVA analysis of variance; DBP diastolic blood
pressure; DEBQ Dutch Eating Behavior Question-
naire; PANAS Positive and Negative Affect Sched-
ule; SBP systolic blood pressure; STAI State-Trait
Anxiety Inventory.
INTRODUCTION
There is increasing evidence that stress may affect
health not only through its direct biological effects but
also through changes in health behaviors that them-
selves influence health (1, 2). Clearly, one such health
behavior is food choice: that is, stress may lead to ill
health through unhealthy changes in diet as well as
more general effects on appetite (3).
Stress and diet associations are particularly com-
plex. Stress is associated with biological changes that
might be expected to reduce food intake, at least in the
short-term, such as adrenaline-induced glycogenoly-
sis, slowed gastric emptying, autonomic shunting of
blood from gut to musculature, and activation of the
hypothalamic-pituitary-adrenal axis (4, 5). Yet the ex-
perimental results have been inconsistent. Animal
studies have produced evidence of both hyperphagia
and hypophagia in response to stress (5–7). Research
on everyday food intake in human subjects under low-
and high-stress conditions has also produced inconsis-
tent results. Stress in the workplace has been associ-
ated with higher energy intake in two studies (8, 9),
examination stress has produced mixed results (10,
11), and surgical stress, probably the most extreme
stressor examined, has been found to have no consis-
tent effect (12). These varying results may be related to
the nature of the stressor; for example, mild stressors
could induce hyperphagia, and more severe stressors,
hypophagia (7, 13).
Alternatively, there could be significant individual
differences in responses to stress, with the study sam-
ples varying in the proportions of the different re-
sponse types. Pollard et al. (11) found that students
who were high on anxiety and low on social support
were more likely to show a hyperphagic response, and
Wardle et al. (9) found that dietary restraint levels
moderated the response to work stress. An individual
difference model is supported by data from both pro-
spective (14) and retrospective (15, 16) self-report
studies, showing either increased, decreased, or no
change in eating during stress but with consistent ef-
fects within individuals.
The importance of individual differences in the eat-
ing response to stress has also been borne out by a
number of laboratory studies (13). Such studies typi-
cally induce stress through one of a number of stan-
dard procedures while assessing food intake, ostensi-
bly as incidental to some other task, such as making
taste ratings. A consistent pattern is that participants
scoring highly on a measure of dietary restraint eat
more under stress, whereas intake is the same or lower
in unrestrained eaters (17–22).
This rather complex pattern of results suggests that
more attention needs to be directed toward specifying
the nature and intensity of the stress response, and the
From the Imperial Cancer Research Fund (ICRF) Health Behaviour
Unit, Department of Epidemiology and Public Health, University
College London, London, United Kingdom.
Address reprint requests to: Professor Jane Wardle, ICRF Health
Behaviour Unit, Department of Epidemiology and Public Health,
University College London, 2-16 Torrington Place, London WC1E
6BT, United Kingdom. Email: j.wardle@ucl.ac.uk
Received October 18, 1999; revision received May 3, 2000.
853Psychosomatic Medicine 62:853–865 (2000)
0033-3174/00/6206-0853
Copyright © 2000 by the American Psychosomatic Society
characteristics and motivational state of the partici-
pants (eg, hunger, restraint, and emotional eating ten-
dency). Furthermore, in these studies, usually only a
single food type is available, typically high in fat
and/or sugar, such as ice cream. Thus, food intake has
been conflated with food choice. Understanding
which foods are selected or avoided under stress is a
crucial issue, both because it is necessary for theoret-
ical interpretation of the mechanisms involved and for
prediction of harmful effects of stress on health.
In contrast to the laboratory studies, self-reported
retrospective (15, 23) and prospective data (8, 9, 11)
suggest that food choice does change under stress,
with a tendency toward a relative increase in sugary,
fatty (often snack-type) foods. Therefore, experimental
tests of effects of stress on eating should take into
account the sensory properties of foods.
Grunberg and Straub (24) extended the usual labo-
ratory paradigm by providing participants with a range
of foods differing in taste qualities (sweet, salty, and
bland), although these were still snack foods presented
incidentally to the main task of viewing a film (used
for stress induction). They found that men in the
stressed group ate less than men in the control group.
In women there were no significant differences, al-
though stressed women did show a trend toward a
modest increase in consumption of sweet and bland
foods with no change in intake of salty foods. These
gender differences may have reflected differences in
dietary restraint, which is known to be higher in
women (16, 25, 26), but unfortunately, as the authors
noted, they did not include a measure of restraint. The
ecological validity of Grunberg and Straub’s (24) find-
ings may also be limited by the fact that the amount of
food eaten by their participants was very small (20 g
per person on average), whereas the variation was
relatively high, suggesting that not all subjects were
choosing to eat.
The present study was designed to extend the work
of Grunberg and Straub (24), including foods from the
sweet, salty, and bland taste categories and high- and
low-fat examples within those sensory groups. Aside
from replicating the work of Grunberg and Straub (24),
analyzing effects by taste category may be important
because stress has been shown to affect taste percep-
tion (27). A wider range of foods was provided to
represent the kinds of foods that might be eaten in both
meals and snacks. Participants were tested when they
were moderately deprived of food and given a test
meal around midday to increase the likelihood of eat-
ing beyond brief tasting.
Dietary restraint and emotional eating tendencies
were assessed as possible explanatory variables. Pre-
vious studies that incorporated restraint used the Re-
straint Scale (28, 29) to measure such tendencies.
However, that instrument does not clearly distinguish
between cognitive restraint, which might be disrupted
by stress; the tendency to overeat in the face of facili-
tating cues; and the tendency to find relief from emo-
tional stress through eating. Thus, the DEBQ was used
because it measures separate factors for dietary re-
straint and emotionally and externally influenced eat-
ing tendencies (30).
The literature suggests that women and restrained
eaters consume more calories and fat under stress (8, 9)
and shift their food choices away from meal-type
foods, such as meat and vegetables, toward snack-type
foods (15). In contrast, men and unrestrained eaters
show either little difference or a reduction in food
intake under stress (12, 24). Therefore, we hypothe-
sized that stress would elicit greater preference for,
and consumption of, highly palatable, snack-type
foods, most especially in women and restrained and
emotional eaters. In contrast, unrestrained, low emo-
tional eaters (most likely to be men) were expected to
show no change or even a decrease in consumption in
response to stress.
Finally, hunger state and appetite for specific foods
were assessed for potential mediation of effects of
stress on food intake. In particular, hunger was ex-
pected to be lower in the stressed group and to be
negatively correlated with biological signs of arousal,
by means of which the impact of the stressor could be
gauged.
METHODS
Participants
Sixty-eight healthy, nonobese, nonsmoking volunteers (27 men
and 41 women, students and staff of the University of London)
agreed to participate in a study advertised as an investigation of “the
effects of hunger on physiology, performance, and mood.” Volun-
teers were recruited through advertisements placed around the cam-
pus and were paid UK£5 ($7) on completion of the study. Partici-
pants were allocated to either a stress or control condition, during
which they were provided with a buffet lunch in the laboratory. The
study design was approved by the Research Committee on Ethics of
University College London.
Stress Manipulation
Anticipation of a speech performance was used as a stressor.
Participants were told that they would be making a 4-minute speech
that would be recorded by video equipment set up prominently in
the laboratory and subsequently assessed. Written instructions for
the speech task, based on those used by Kapczinski et al. (31), were
given. Participants were invited to select 1 of 10 controversial topics
for their speech and to prepare notes for a period of 10 minutes
before receiving a meal. The speech was scheduled to take place
immediately after the meal, and participants were led to believe that
the study was about hunger and its effect on performance and that
G. OLIVER et al.
854 Psychosomatic Medicine 62:853–865 (2000)
they had been placed in a “low-hunger” condition that necessitated
them eating a meal before making their speech. This ensured that the
anticipatory stress created by the threat of public speaking was
sustained while subjects were exposed to food but that there was no
active competing task to eating. Unknown to subjects at this stage
was that they were not required actually to perform the speech. No
mention of the speech task was made to participants in the control
condition. Instead they were given a nonstressful task of comparable
duration (10 minutes), which was to listen to a passage of emotion-
ally neutral text (an excerpt from Under Milk Wood, Ref. 32). They
were instructed to sit and relax while listening to the text, after
which, they were told, they would receive a meal. They were led to
believe that the study was concerned with changes in physiological
measurements before and after a meal.
Assessment of Impact of Stress Manipulation
Both physiological and psychological indices of arousal were
included, because desynchrony between self-reported anxious
mood and physiological measures of arousal has been well docu-
mented (33). Blood pressure and heart rate were measured using a
Copal digital sphygmomanometer UA-251 (baseline was an average
of two readings taken over a 3- to 5-minute period). A self-reported
measure of mood, the PANAS (34), was completed on arrival in the
laboratory (baseline) and after the 10-minute stress induction. At the
end of the study, as part of the debriefing, participants were asked to
rate the perceived stressfulness of the study on a seven-point Likert
scale (where 1 “not at all stressful” and 7 “extremely stressful”).
Assessment of Eating Behavior
Participants had been asked to refrain from eating for 4 hours
before the study to ensure a reasonably standardized level of depri-
vation, resulting in a substantial intake from the meal. Ratings of
current hunger (on a seven-point Likert scale, where 1 “not at all”
and 7 “extremely”) were taken on arrival in the laboratory (base-
line) and after the stress or control manipulation.
Two measures were used to assess the effect of the stress manip-
ulation on eating behavior and food choice: 1) appetite for a range of
foods immediately before eating the meal and 2) food intake during
the meal. Foods had been selected on the basis of their nutrient
content to represent three taste categories, sweet, salty, and bland,
following the method of Grunberg and Straub (24). Within these
taste categories, foods were additionally divided into low- and high-
fat groups. A total of 34 foods were selected for the food preference
tasks (Table 1). Fifteen similarly categorized foods were provided for
the buffet meal (Table 2): 9 of these were represented by similar
foods among the 34 foods, but in addition, 3 bland high-fat spreads
and 3 sweet low-fat foods were chosen for appropriate use as small
portions and practicality for meal construction. To test the assump-
tion that taste was related to nutrient content, 34 adults (not those
who took part in the main study) were asked to rate the taste of each
of the 34 foods for sweetness, saltiness, and fattiness (where 1 “not
at all” and 7 “extremely”). Perceptions of taste were found to
correlate highly with actual nutrient content (sugar content and
sweetness: r0.84, p.001; salt content and saltiness: r0.76, p
.001; fat content and fatty taste: r0.77, p.001), thus validating
the use of nutritional composition data to generate categories based
on taste.
Food Appetite Ratings. Photographs of each of the 34 foods were
presented one at a time. For each food, participants were asked,
“How much do you fancy eating some of this food at the moment?,”
and indicated their response on a scale from 1 (“I definitely don’t
want to eat this food at all at the moment”) to 7 (“Right now I really
want to eat this food”). The appetite ratings had previously been
found to show adequate test-retest reliability when administered to
12 different adults on two occasions 30 minutes apart (mean r
0.83, p.01). The ratings were completed after the stress (or
control) manipulations, immediately before the meal was served.
The photographs were presented in random order to each subject to
control for possible order effects between sequentially presented
foods.
Food Intake. Participants were allowed to eat freely for 15 min-
utes from a buffet lunch consisting of, as far as was practicable, foods
from each of the taste categories described above (Table 2). The
foods were weighed to the nearest 0.1 g before and after the meal to
determine the amount consumed.
Individual Difference Variables
A number of trait measures were completed before participation.
Trait anxiety was assessed with the Trait scale of the STAI (35).
Dietary restraint and the tendency to eat more when cognitive re-
straint on eating is disrupted by psychological, sensory, or emo-
tional challenges (sometimes labeled “disinhibition”) were assessed
with the Restraint, Emotional, and External Eating scales from the
DEBQ (30). In addition, for each of the 34 foods listed in the appetite
ratings, participants were asked to indicate how much they liked the
food “in general.” Responses were recorded on a Likert scale (where
4“I really dislike this food” and 4“I really like this food”).
Procedures and Scheduling
The study was performed between 11:30 AM and 1:30 PM, that
is, at a time when a meal would usually be eaten. This is in
contrast to the usual laboratory eating paradigms in which snack
consumption is measured without regard to meal times. On ar-
rival at the laboratory, participants confirmed that they had eaten
nothing in the previous 4 hours, and baseline measures of blood
pressure, heart rate, mood (PANAS), and hunger were completed.
Participants then received instructions for either the stress or control
task, according to their random allocation, and were left alone for the
10-minute duration of the tasks. At the end of the 10-minute period,
blood pressure, heart rate, and mood were reassessed in all subjects. A
second hunger rating and the food appetite ratings were also com-
pleted. Participants then received a meal with the foods presented on
separate plates on two trays, the position of the plates on the trays being
varied for each participant. They were instructed that they could eat
whatever they wished from the selection and in whatever quantities
they desired, just as long as they ate something and were less hungry at
the end of the meal. The experimenter explained that they would be left
alone to eat for 15 minutes. At the end of the meal, the experimenter
returned, and the true nature of the study was explained. The debrief-
ing included a rating of the perceived stressfulness of the study. Fi-
nally, age, height, and weight were recorded.
Data Analysis
The main hypotheses were tested by ANOVAs; the interactions
between stress condition (group) and individual difference vari-
ables, such as gender, restraint, and emotional eating, were of pri-
mary interest. In most cases, there was an a priori prediction for the
direction of the interaction effect, and so an
level of 0.05 was taken
as significant, despite quite large numbers of statistical tests. Unex-
pected results that achieved this level of significance were inter-
preted cautiously. Multiple comparison tests on the same dependent
STRESS AND FOOD CHOICE
855Psychosomatic Medicine 62:853–865 (2000)
variable were not required by this design. In addition, some rela-
tionships between physiological and psychological variables were
assessed by using Pearson’s product-moment correlation.
RESULTS
Participant Characteristics
The background characteristics of the group are
summarized in Table 3. Participants were between
18 and 46 years old. The men were predictably
heavier (F(1,64) 117.17, p.001) and taller (F(1,64)
46.04, p.001) than the women, but body mass index
did not differ between the sexes. There were no differ-
ences between groups randomized to the stress or control
condition on any of these measures. There were no sig-
nificant group or gender differences in trait anxiety.
As expected, dietary restraint scores were signifi-
cantly higher in women (F(1,64) 13.50, p.001), and
women scored higher than men on the emotional eating
scale (F(1,64) 4.99, p.05), but there were no gender
differences in external eating. There were no differences
between stress and control groups in dietary restraint,
emotional eating, or external eating.
Ratings for liking of the foods to be used in the
study showed that fatty sweet foods were most liked
by the sample as a whole (see Table 3) and that salty
low-fat foods were the least liked. Men reported
TABLE 1. Foods Included in the Food Desirability Rating With Relevant Nutritional Composition
a
Food
Category Food Energy
(kcal)
Sugars
(g)
Fat
(g)
Energy as
Fat (%)
Sodium
(mg)
Bland
Low fat Steamed rice 138 Trace 1.3 8.5 1
Boiled potatoes 72 0.7 0.1 1.3 7
Bread (white) 217 3 1.3 5.4 530
Raw carrot 35 7.4 0.4 10.3 25
Raw tomato 17 3.1 0.3 15.9 9
Steamed fish 83 0.0 0.9 9.8 65
High fat Avocado 190 0.5 19.5 92.4 6
Fried cod in batter 247 Trace 15.4 56.1 160
Unsalted peanuts 564 6.2 46.1 73.6 2
Boiled egg 147 Trace 10.8 66.1 140
Clotted cream 586 2.3 63.5 97.5 18
Greek yogurt 115 2 9.1 71.2 71
Salty
Low fat Prawns 107 0 1.8 15.1 1590
Smoked salmon 142 0 4.5 28.5 1880
Marmite (autolysed yeast extract) 172 0 0.7 3.7 4500
Pretzels 381 0 3.5 8.3 1720
Noodles and soy sauce 70 1.7 0.5 6.4 1424
High fat Cheddar cheese 412 0.1 34.4 75.1 670
Crisps (potato chips, salted) 546 0.7 37.6 62.0 1070
Dry-roasted peanuts 589 3.8 49.8 76.1 790
Salami 491 Trace 45.2 82.9 980
Frankfurters (hot dogs) 274 Trace 45.2 82.9 980
Bacon 422 0.0 36.0 76.8 1990
Sweet
Low fat Honey 288 76.4 0.0 0.0 11
Boiled sweets (candies) 327 86.9 Trace Trace 25
Lemon sorbet 131 34.2 Trace Trace 69
Banana 95 20.9 0.3 2.8 1
Meringue 379 95.4 Trace Trace 110
High fat Milk chocolate 529 56.5 30.3 51.6 120
Vanilla ice cream 194 22.1 9.8 45.5 69
Jam doughnut 336 18.8 14.5 38.8 180
Fudge 441 81.1 13.7 28.0 160
Chocolate-coated biscuit 524 43.4 27.6 47.4 160
Sponge cake 459 30.9 26.3 51.6 350
a
Nutrients per 100 g. Data from Holland et al. (51).
G. OLIVER et al.
856 Psychosomatic Medicine 62:853–865 (2000)
liking fatty bland and fatty salty foods significantly
more than women (F(1,64) 6.65, p.02 for fatty
bland foods; F(1,64) 15.12, p.001 for fatty salty
foods). There were no significant differences in gen-
eral food preferences between stress and control
groups.
TABLE 3. Characteristics of Participants
a
Stress Group Control Group
Men Women Men Women
N
14 20 13 21
Age (y) 25.6 4.8 26.5 7.0 26.9 6.7 25.3 4.2
Body weight (kg) 70.9 8.8 58.5 8.7 76.3 9.4 59.7 7.8
Height (m) 1.80 0.07 1.63 0.7 1.82 0.06 1.66 0.05
Body mass index 21.7 2.2 22.0 2.5 23.1 2.6 21.7 2.3
Psychological indices
Trait anxiety (STAI) 40.9 10.7 44.2 8.7 42.1 11.2 42.3 10.8
Self-esteem (Rosenberg) 21.3 4.8 22.2 3.9 22.5 4.6 23.0 5.7
Measures of eating behavior (DEBQ)
Dietary restraint 2.15 0.89 2.49 0.81 1.66 0.60 2.79 0.85
Emotional eating 2.18 0.71 2.59 0.86 2.50 1.08 3.07 0.91
External eating 3.09 0.62 3.21 0.49 3.33 0.51 3.37 0.53
General food-liking scores
Bland
Low fat 1.57 0.81 1.82 0.96 2.01 0.52 1.84 1.15
High fat 1.78 0.60 0.96 1.10 1.32 1.03 0.81 1.20
Salty
Low fat 0.96 1.64 1.82 1.14 1.37 1.23 0.47 1.54
High fat 1.92 0.89 0.73 1.58 1.88 0.90 0.56 1.43
Sweet
Low fat 1.37 0.96 1.27 1.29 1.62 1.24 1.36 1.31
High fat 1.99 1.25 2.08 1.27 2.50 0.87 1.61 1.79
a
Data are mean SD.
TABLE 2. Composition
a
of Test Meal Given to Participants
Food
Category Food Energy
(kcal)
Carbohydrate
(g)
Sugars
(g)
Protein
(g)
Total
Fat
(g)
Sodium
(mg) Quantity Provided
Bland
Low fat White bread 252 48.5 1.6 9.6 2.2 500 5 rolls (200 g)
Raw carrot 35 7.9 7.4 0.3 0.6 25 100 g
Raw tomato 17 3.1 3.1 0.3 0.7 9 1 (80 g)
High fat Peanut butter 592 12.5 6.5 23.6 49.7 400 70 g (2 35-g jars)
Flora (soft margarine) 739 1.0 1.0 0.2 81.6 800 50 g (5 10-g packets)
Butter 737 Trace Trace 0.5 81.7 750 35 g (5 7-g packets)
Salty
Low fat Marmite (autolysed yeast
extract)
172 1.8 0.0 39.7 0.7 4500 24 g (3 8-g packets)
High fat Cheddar cheese 412 0.1 0.1 25.5 34.4 700 100 g (grated)
Salted crisps (potato chips) 557 49.9 0.4 4.5 37.7 600 30 g
Salted peanuts 600 8.6 3.8 29.0 50.0 500 200 g
Sweet
Low fat Mandarin 35 8.0 8.0 0.1 0.9 2 2 medium (300 g)
Grapes 60 15.4 15.4 0.4 0.1 2 100 g
Strawberry jam 265 66.0 66.0 0.4 0.1 Trace 70 g (2 35-g jars)
High fat Cake (cherry, slices) 407 50.9 34.2 3.9 20.8 80 100 g (3 slices)
Chocolate biscuits 493 66.5 28.5 6.8 24.1 450 70 g (4 biscuits)
a
Nutrients per 100 g. Data from Holland et al. (51).
STRESS AND FOOD CHOICE
857Psychosomatic Medicine 62:853–865 (2000)
Effectiveness of the Stress Manipulation
At baseline, there were no differences between the
stress and control groups in heart rate, SBP, or DBP
(see Table 4). Men in both groups had significantly
higher SBP (F(1,64) 25.98, p.001) and DBP
(F(1,64) 4.28, p.05) than women. The change in
heart rate after the stress manipulation did not reach
significance (group-by-time interaction: F(1,64)
2.82, p.10; Table 4). SBP increased over time (from
baseline to after stress) in the stressed group and de-
creased in the control group (group-by-time interac-
tion: F(1,64) 14.41, p.001; Table 4). The pattern
was the same for men and women. DBP decreased in
the control but not in the stress group (group-by-time
interaction: F(1,64) 4.42, p.05).
There were no significant differences between stress
and control subjects in positive or negative affect
scores at baseline. Negative affect scores were log-
transformed to produce a normal distribution. As pre-
dicted, subjects in the stress group showed a signifi-
cant increase in negative affect from baseline, whereas
those in the control group showed a reduction in neg-
ative affect relative to baseline (group-by-time interac-
tion: F(1,64) 11.77, p.001). For positive affect, the
control group showed a decrease, whereas in the
stressed group positive affect remained constant
(group-by-time interaction: F(1,64) 10.00, p.01).
Gender had no effect on affect scores.
Overall, the manipulation achieved significant if
modest differences between groups in both physiolog-
ical and psychological indices of stress (Table 4). This
was borne out by the post hoc subjective ratings of
perceived stress. Participants in the stressed group
rated their experience as significantly more stressful
(mean rating 4.26, SD 1.4) than the control group
(mean rating 1.62, SD 1.0) (F(1,64) 69.12, p
.01). This between-group difference applied to both
men and women.
Food Intake: Effects of Gender and Stress
Gender Differences. Men ate significantly more
weight of food (F(1,64) 6.03, p.02) and had a
higher total energy intake (F(1,64) 11.07, p.001)
than women (Table 5), as would be expected from their
significantly higher body weights and consequently
greater daily energy requirements. Controlling for en-
ergy requirements (covariate F(1,63) 5.77, p.02)
removed this gender effect (for grams: F(1,63) 1.16;
for kilocalories: F(1,63) 1; both NS), and so esti-
mated energy requirement was included as a covariate
in subsequent analyses involving total amounts of food
TABLE 4. Effectiveness of the Stress Manipulation: Physiological and Psychological Indices
Stress Group Control Group
Men Women Men Women
Mean SD Mean SD Mean SD Mean SD
Physiological indices
Heart rate (beats/min)
Baseline 65.6 9.4 68.2 12.4 63.9 8.7 71.6 13.7
T1 66.0 11.2 71.4 11.6 62.9 9.4 69.1 12.8
Change 0.4 10.0 3.3 8.2 1.0 8.5 2.5 7.8
SBP (mm Hg)
Baseline 129.1 15.5 113.1 13.0 132.2 14.6 114.8 10.8
T1 130.4 14.5 114.2 13.7 124.5 10.1 108.4 8.7
Change 1.3 10.2 1.1 9.2 7.7 6.9 6.4 8.2
DBP (mm Hg)
Baseline 82.6 10.9 75.1 9.5 81.5 10.1 79.2 8.5
T1 81.6 11.4 80.9 13.8 81.2 10.7 76.9 6.8
Change 1.0 4.9 5.8 7.4 0.3 6.3 2.3 8.4
Psychological indices
Positive affect
Baseline 28.6 6.5 28.6 5.3 33.4 5.6 30.2 5.9
T1 27.6 6.5 29.3 5.3 29.9 6.6 26.9 5.6
Change 0.9 2.9 0.7 5.5 3.5 2.9 3.3 3.9
Negative affect
Baseline 14.2 4.3 14.5 5.0 12.9 2.4 12.3 2.8
T1 15.7 5.1 16.6 6.4 12.4 2.5 10.7 1.1
Change 1.5 3.5 2.1 6.1 0.5 1.9 1.6 2.6
Perceived stressfulness of manipulation 4.1 1.5 4.4 1.4 1.7 0.9 1.6 1.0
G. OLIVER et al.
858 Psychosomatic Medicine 62:853–865 (2000)
eaten. However, analyses involving measures of selec-
tion of different food sensory categories were not ad-
justed for energy requirements. Daily energy require-
ments were estimated on the basis of published
figures.
1
This resulted in mean (SD) daily energy re-
quirements of 3031.0 (236.9) kcal/d for the men and
2172.6 (185.1) kcal/d for the women (sex difference:
F(1,64) 284.6, p.001). Both men and women
consumed about one-third of their daily caloric re-
quirements from the food presented, suggesting that
this eating episode could realistically be considered a
meal rather than merely a snack.
Stress Effects. There were no significant main ef-
fects of stress group on weight of food consumed, total
energy intake, or energy density of the meal (kcal/g),
nor were there any interactions between group and
gender (Table 5). Total intake was also analyzed in
terms of the main macronutrients (carbohydrate, fat,
and protein) and for starch and sugar separately, but
no significant effects were found (data not shown).
To examine intake in relation to choice from the
food sensory categories (sweet, salty, and bland), the
amount of food eaten from each category, including
high- and low-fat levels, was calculated (Table 5).
Four-factor repeated-measures ANOVA of intake (g)
with food category and fat level as within-subjects
factors, and group and gender as between-subjects fac-
tors, revealed a number of significant effects (with
-corrected Fvalues adjusted for sphericity where nec-
essary). There was no significant main effect or any
interactions involving stress group (Table 5). However,
intake differed by food category (F(2,128) 67.47, p
.001), fat level (F(1,64) 116.76, p.001), and gender
(F(1,64) 6.03, p.02). Furthermore, food category
interacted with gender (F(2,128) 3.28, p.05) and
fat level (F(2,128) 194.55, p.001), and all of these
factors interacted (F(2,128) 6.94, p.001). There-
fore, effects of fat level and gender were analyzed
within each food category by two-factor ANOVA. Re-
sults for energy intake were essentially similar and so
are not presented here.
Bland Foods. Men ate significantly more bland food
than women (F(1,66) 11.69, p.001), although this
difference was more apparent for low-fat than high-fat
bland foods (F(1,66) 9.57, p.01) (Table 5). This
may not be surprising given that the high-fat bland
foods were spreads, which were consumed in much
smaller amounts than the low-fat bland foods (bread,
carrots, and tomatoes) (F(1,66) 381.17, p.0001).
Salty Foods. Men ate significantly more salty foods
than women (F(1,66) 4.48, p.05). This effect was
independent of fat level, although the one low-fat salty
food available, yeast extract (Marmite spread), was
eaten in far smaller amounts than the high-fat salty
foods (F(1,66) 135.12, p.0001).
Sweet Foods. Unlike bland and salty foods, men did
not eat any more sweet foods than women (F(1,66) 1;
1
Estimated daily energy requirements were calculated, using pub-
lished equations, from basal metabolic rate, which is dependent on
age, sex, and weight, multiplied by physical activity level (PAL)
(36). Because no data were available for activity levels, moderate
levels were assumed for both occupational and nonoccupational
activity in both men (PAL 1.7) and women (PAL 1.6).
TABLE 5. Effect of Stress, Gender, and Sensory Category on Food Intake
a
Intake Category
Stress Group Control Group
Men Women Men Women
Mean SD Mean SD Mean SD Mean SD
Total food intake 378.9 135.6 310.7 110.6 391.8 140.6 316.6 94.4
Total energy intake (kcal) 884.4 402.2 686.9 282.3 922.5 293.1 637.3 203.6
Energy density of intake (kcal/g) 2.31 0.51 2.26 0.64 2.45 0.74 2.09 0.63
Bland foods
All 204.2 74.6 155.3 60.2 217.8 72.0 154.6 63.7
Low fat 189.1 70.3 142.3 51.2 200.8 75.9 142.5 64.5
High fat 15.0 11.7 13.0 13.9 17.0 13.0 12.1 10.8
Salty foods
All 57.1 44.3 44.3 32.2 60.4 28.8 39.5 25.0
Low fat 2.4 6.4 0.5 1.7 1.5 2.5 0.8 1.4
High fat 54.7 45.1 43.8 32.2 58.8 28.8 38.7 25.4
Sweet foods
All 117.7 96.2 111.1 95.4 113.6 84.6 122.5 73.1
Low fat 72.4 67.5 76.1 76.9 75.1 72.2 92.2 68.4
High fat 45.3 49.6 35.0 41.3 38.5 34.3 30.2 29.5
a
Units are grams except where indicated.
STRESS AND FOOD CHOICE
859Psychosomatic Medicine 62:853–865 (2000)
Table 5). Both men and women ate significantly more
weight of low-fat than high-fat sweet foods (F(1,66)
20.44, p.001, no interaction).
Effects of Dietary Restraint on Intake
A median split of restraint scores was used to dis-
tinguish restrained and unrestrained eaters. Gender
was included as a covariate because there were signif-
icantly more female than male subjects in the high-
restraint group (
2
4.98, p.05).
There were no significant differences in intake (as
either weight or energy) between restrained and unre-
strained eaters and no interaction between restraint
level and stress condition (Fvalues 1, except the
gender covariate, which had values of F(1,63) 5.23,
p.05 for grams and F(1,63) 9.82, p.01 for kcal;
results were not qualitatively different without gender
as a covariate; see Table 6). Analyses grouping food
intake in terms of energy density of overall intake
(Table 6), sensory categories, and percentage of energy
from carbohydrate, protein, and fat (data not shown)
all failed to reveal any significant effects of restraint or
stress or any interactions involving these factors.
Effects of Emotional Eating on Intake
Restrained eaters scored significantly higher on the
emotional eating subscale of the DEBQ (t(66) 3.23, p
.01), and women were also more emotional eaters
than were men (t(66) 2.26, p.05) (Table 3). Thus,
although gender might mediate the interaction be-
tween restraint and emotional eating, effects of the
latter could give a clearer indication of individual dif-
ferences in eating responses to stress. Again, gender
was included as a covariate in these analyses.
Subjects were divided, on the basis of a median
split, into high and low emotional eaters (ie, “emo-
tional eaters” and “nonemotional eaters”). No signifi-
cant effects of stress condition or any interaction with
emotional eating status were seen when total intake
was analyzed in terms of either weight or energy eaten
(group effect and group-by-emotional eating interac-
tion, all Fvalues 1; see Table 7). Gender was a
significant covariate here for both grams of food eaten
(F(1,63) 7.18, p.01) and energy intake (F(1,63)
12.33, p.005).
Unlike total intake, the energy densities of the meals
eaten varied by stress condition and emotional eating
status (stress-by-emotional eating interaction: F(1,63)
6.17, p.02; Table 7). In the stress group, the
energy density of high emotional eaters’ intake was
significantly greater than that of low emotional eaters
(t(32) 2.22, p.05), whereas among control subjects
the high emotional eaters ate less energy-dense meals
on average (t(32) 1.45, NS). Gender was not a signif-
icant covariate for energy density (F(1,63) 1.56, NS;
Table 7), possibly reflecting the fact that variation in
energy density results from different choices rather
than differences in overall intake.
Effects of stress and emotional eating, and any in-
teractions with fat level, were investigated separately
for intake of each food sensory category by using three-
factor repeated-measures ANOVA. Intakes of bland
and salty foods were unaffected by these factors.
Sweet Foods. Gender was not a significant covariate
for intake of sweet foods, and so subsequent analyses
did not include gender. Overall, weight of intake of
sweet low-fat foods (fruit and jam) was higher than
intake of high-fat foods (cake and chocolate biscuits)
(F(1,64) 18.66, p.001), although the reverse was
true for energy intake (F(1,64) 35.12, p.001),
reflecting the far greater energy density of the sweet
high-fat foods (Table 7). There were no main effects for
stress group or emotional eating, but there were three-
way interactions between fat level, group, and emo-
tional eating (grams: (F(1,64) 3.53, p.07; kcal:
(F(1,64) 5.05, p.05), which were examined further
by separate analyses for low- and high-fat sweet foods.
High emotional eaters were found to eat almost
twice the weight of sweet fatty foods on average than
did low emotional eaters in the stress group (t(32)
1.78, p.05, one-tailed test; Table 7); in contrast,
among controls, high and low emotional eaters did not
differ significantly in their intake of sweet fatty foods
(t(32) 0.78). Although this interaction just failed to
TABLE 6. Effect of Dietary Restraint and Stress on Overall Food Intake
Intake Category
Stress Group Control Group
Low Restraint High Restraint Low Restraint High Restraint
Mean SD Mean SD Mean SD Mean SD
Total food intake (g) 312.7 123.9 365.0 122.6 364.0 142.6 326.7 87.9
Total energy intake (kcal) 730.3 357.2 806.2 339.8 799.9 327.5 692.9 209.1
Energy density of meal eaten (kcal/g) 2.33 0.59 2.24 0.60 2.24 0.68 2.22 0.72
G. OLIVER et al.
860 Psychosomatic Medicine 62:853–865 (2000)
reach significance for grams eaten (stress-by-emotional
eating interaction: F(1,64) 3.60, p.06), the effect
on energy intake was significant (F(1,64) 4.26, p
.05) for the group-by-emotional eating interaction,
again with high emotional eaters eating nearly twice
the energy intake of low emotional eaters among
stressed subjects (Figure 1). In comparison, no effects
of emotional eating or stress were seen for intake of
sweet low-fat foods (Table 7).
Analyses of separate macronutrient intake did not
reveal any significant effects of stress or emotional
eating or any interactions for amount or percentage of
energy eaten.
Effects on Hunger
Men and women did not differ in their hunger rating
recorded at baseline, nor were there significant differ-
ences between participants allocated to the stress and
control groups. For the sample as a whole, initial hun-
ger ratings were reasonably high (mean rating 4.87,
SD 1.23, of a maximum 7), so a substantial intake
could be expected during the meal.
Hunger showed no significant change from baseline
to after stress, nor was there any differential effect in
the two groups; thus, there was no support for the
prediction that stress affected hunger at the group level
(data not shown). Data from the stress group alone
were examined for evidence that greater physiological
arousal was linked with lower hunger. A significant
(negative) correlation emerged with heart rate in a
partial correlation controlling for gender (r⫽⫺0.21, p
.05), with a higher heart rate being associated with
lower hunger. There were no significant associations
for hunger with blood pressure.
The association between rated hunger and desire to
eat specified foods was examined using mean appetite
ratings across all the 34 foods. This showed that hun-
ger was positively correlated with appetite for the
foods (r0.42, p.001).
Desire to Eat Bland, Salty, and Sweet Foods
In the analyses of rated appetites for the three food
sensory categories, general preference for foods in that
category (based on the liking ratings made at the start
of the study) was included as a covariate to assess
appetite independently of variation due to differences
in general liking. General preference ratings were con-
sistently significant covariates for the rated desires to
eat bland, salty, and sweet food (bland: F(1,65)
12.57, p.001; salty: F(1,65) 10.22, p.01; sweet:
F(1,65) 12.82, p.001). When analyzing for effects
of restraint and emotional eating on desire for foods,
gender was not a significant covariate (largest F
1.63), and so it was excluded from those analyses.
Gender. No significant main effects were found, but
a group-by-gender interaction was seen for sweet foods
(F(1,63) 4.28, p.05), and in an unexpected direc-
tion, with appetite for sweet foods being increased by
stress in men but not in women (stressed vs. control
men: mean (SD) 3.57 (1.09) vs. 2.76 (1.10), F(1,24)
TABLE 7. Effect of Emotional Eating Status, Stress, and Sensory Category on Food Intake
a
Intake Category
Stress Group Control Group
Low Emotional
Eating
High Emotional
Eating
Low Emotional
Eating
High Emotional
Eating
Mean SD Mean SD Mean SD Mean SD
Total food intake 327.1 119.0 357.7 134.9 307.1 75.9 369.0 134.4
Total energy intake (kcal) 687.4 330.2 898.8 341.3 735.9 224.4 752.9 308.7
Energy density of meal (kcal/g) 2.11 0.60 2.55 0.46 2.44 0.55 2.10 0.74
Bland foods
All 172.6 69.8 180.0 72.4 151.6 46.1 195.6 82.0
Low fat 160.0 64.0 164.1 64.6 136.1 42.6 182.5 83.9
High fat 12.6 11.8 15.9 14.8 15.4 13.2 13.1 11.0
Salty foods
All 45.5 41.1 56.1 31.5 42.9 27.0 50.3 29.0
Low fat 1.4 5.3 1.1 2.3 0.7 1.4 1.3 2.1
High fat 44.1 41.2 55.0 31.8 42.2 27.5 49.0 28.9
Sweet foods
All 109.0 86.3 121.6 109.4 112.6 68.0 123.0 82.8
Low fat 80.0 71.4 65.7 75.2 73.9 68.7 93.0 70.4
High fat 28.9 33.8 55.9 55.2 38.7 33.4 30.0 30.1
a
Units are grams except where indicated.
STRESS AND FOOD CHOICE
861Psychosomatic Medicine 62:853–865 (2000)
4.64, p.05; stressed vs. control women: mean (SD)
3.32 (1.09) vs. 3.63 (1.10), F1; all means were
adjusted for the effect of the general liking covariate).
In contrast, among unstressed control subjects, women
desired to eat sweet foods more than men (F(1,31)
4.58, p.05). This effect was independent of fat level
(group-by-gender-by-fat level interaction, F1). No
effects of gender or group, nor any interactions, were
seen on appetite for either bland or salty foods (data
not shown).
Restraint. No significant effects of restraint, or any
interactions with stress, on desire to eat foods were
found (data not shown). This was the case for all food
sensory categories.
Emotional Eating. The only notable effect was that,
for salty foods only, stressed high emotional eaters
expressed greater appetite than low emotional eaters,
whereas control subjects did not differ (stress-by-emo-
tional eating interaction: F(1,63) 4.22, p.05; mean
(SD) desire to eat for high vs. low emotional eaters:
stressed group, 4.58 (0.90) vs. 3.62 (0.91), respectively;
control group, 3.73 (0.93) vs. 3.71 (0.90), respectively).
DISCUSSION
There was no evidence here of a general hypophagic
effect of stress on men nor any stress-induced hy-
perphagia specifically in women, contrary to the find-
ings of Grunberg and Straub (24). Previous studies of
stress and eating typically gave snack-type foods to
nonfood-deprived subjects, with eating being pre-
sented as an incidental activity while performing a
more central task. The present study is unusual in
explicitly providing mildly food-deprived participants
with a meal to overcome the problem of low intake that
encumbered earlier studies and in incorporating a
wider range of foods to allow more valid assessment of
food choice.
However, stress did increase intake of sweet fatty
foods in emotional eaters. In addition, women scored
more highly on emotional eating than men, as is typi-
cally found (30). Thus, Grunberg and Straub’s (24) sex
difference in the appetitive response to stress may in
fact have been mediated by a difference in emotional
eating.
The cake and chocolate biscuits preferred here by
stressed emotional eaters are typically eaten as snacks.
There is evidence that snack consumption may be
more susceptible to stress than meals (15, 37). Such
foods may be preferred during stress through learning
that small energy-dense snacks are more easily in-
gested and digested when gut activity is suppressed by
sympathetic arousal. In comparison, a naturalistic
study of the impact of surgical stress on food intake
found no effect of stress on meal intake or composition
(12).
Unlike a number of previous studies (18–20, 38,
39), the present study did not reveal a significant in-
fluence of dietary restraint on eating behavior under
stress, although there was a trend toward greater con-
sumption of sweet foods by highly restrained stressed
subjects. In this study, restraint was measured using
the restraint scale of the DEBQ, which contains items
pertaining only to dietary restraint and thus is not a
measure of vulnerability to dietary disinhibition,
whether through emotional relief or other reasons. In
contrast, the Restraint Scale (28, 29), which has been
found to discriminate eating responses to stress (20,
38), paradoxically contains only 1 item (of 10) that
explicitly refers to dietary restraint; the remaining
items addressing weight fluctuation, preoccupation
with food, tendency to binge when eating alone, and
feeling guilty after overeating. The psychometric rele-
Fig. 1. Effect of emotional eating status and stress manipulation on
intake (kcal) of sweet fatty foods. Data are mean SE. *t(32)
1.85, p.05, one-tailed test, for greater intake by high
emotional eaters in the stressed group vs. the control group
(independent ttest; see text for details of significant
ANOVA interaction). Intakes among low emotional eaters
did not differ between groups.
G. OLIVER et al.
862 Psychosomatic Medicine 62:853–865 (2000)
vance of labeling such a questionnaire as measuring
“restraint” has been discussed in detail elsewhere (30,
40, 41), but such a multifaceted instrument does not
allow clear interpretation of the psychological mecha-
nisms by which stress could be influencing food con-
sumption and choice. In any event, it cannot be con-
cluded from that measure that a critical factor in
responding to stress is the tendency to restrain intake,
and we find no support for such a conclusion. Further-
more, the “Disinhibition” scale of the Three-Factor
Eating Questionnaire (41) (overeating elicited by so-
cial, sensory, and emotional cues) discriminates be-
tween women who report eating more during stress
and those who do not (16), whereas the restraint-spe-
cific scale of that instrument did not predict stress-
induced eating.
In comparison, the emotional eating scale of the
DEBQ used here specifically defines individuals who
have a tendency to eat more during negative emotional
states (ie, emotion-induced disinhibition) (42). Just
such an emotional eating effect was observed here:
High emotional eaters ate more sweet, fatty, and thus
energy-dense foods under stress. Thus, this study pro-
vides some evidence that a stress-induced change in
food choice is a measurable behavioral phenomenon,
at least in this laboratory environment, not just a sub-
jective phenomenon confined to self-report measures.
These results are particularly important because the
increased eating is confined to certain foods, espe-
cially those that current health recommendations sug-
gest should be limited. In contrast to intake, rated
desire to eat the various categories of foods was less
affected by stress, although desire to eat salty foods
was specifically greatest in stressed emotional eaters.
Even so, the increased desire to eat sweet foods when
stressed seen here in men but not in women (irrespec-
tive of emotional eating status) is contrary to the (in-
take) results of Grunberg and Straub (24). These effects
on desire for food sensory categories require replica-
tion and should be interpreted cautiously.
Why might some individuals be more susceptible to
unhealthy shifts in food choice when under stress?
The effect is not dependent on gender per se, but the
emotional eaters were more likely to be female. From
an intervention perspective, it will be important to
understand how emotional eating tendencies develop.
This characteristic has been discussed extensively
elsewhere (13, 30), but its origin remains poorly un-
derstood. One consideration is that an initial experi-
ence of eating highly palatable energy-dense foods
when upset may become habitual by reinforcement
through sensory, nutritional, and neurohormonal
routes (43, 44).
A recent study provides some support for this mod-
el: Markus et al. (45) found that neurotic (“stress-
prone”) subjects were protected from depressed mood
and raised cortisol induced by a psychological stressor
task after eating a carbohydrate-rich/protein-poor
breakfast and lunch but not after a carbohydrate-poor/
protein-rich diet. In stable subjects, mood was de-
pressed and cortisol increased equally after either diet.
This result was interpreted as improved coping after a
diet-induced increase in the supply of precursor
amino acids to serotonin synthesis. That is, the carbo-
hydrate-rich/protein-poor diet specifically allows
greater uptake of the precursor amino acid tryptophan
into the brain. The implication is that neurotic or
stress-prone individuals may be particularly sensitive
to dietary effects on brain pathways influencing mood
and stress coping. Furthermore, to learn to “self-med-
icate” through eating in this manner would most likely
require ingestion of unusually low-protein foods in
isolation (46), as might be achieved by snacking on
sweet and fatty foods when hungry. Also, within this
theoretical framework, dietary restraint, found to be
positively correlated with emotional eating or disinhi-
bition here and elsewhere (16, 30, 41), may predispose
an individual to learning such a dietary-induced relief
of dysphoria; that is, dieting has been shown to lower
plasma tryptophan levels in women and to sensitize
serotoninergic function (47).
An alternative neurohormonal mechanism for
stress-induced preferential selection of sweet fatty
foods is suggested by evidence that such highly palat-
able foods can themselves relieve stress through re-
lease of endogenous opioids (44, 48).
The effects of stress on hedonic reactions to, and
perception of, taste also need consideration. For in-
stance, Dess and Edelheit (27) found that stress
changed people’s perception of saccharin’s bitterness
and sweetness, as it does in rats (6), but the direction of
change depended on aspects of temperament such as
trait arousability, pleasure (net affective valence), and
dominance. Despite no suggestion of gender differ-
ences (27), it could be fruitful to determine the rela-
tionship of these traits to emotional eating tendencies.
As with any laboratory study carried out in this
area, the impact of the stressor on the participants is
likely to be less severe than is the case for real events
occurring in a nonexperimental setting without ethical
constraints. Caution is required in generalizing from
these results to less controlled situations in daily life.
Even so, anticipation of public speaking is known to be
a fearful stimulus to students (49); actual performance
might have led to subjects eating while in a relieved
rather than stressed state. Here, certainly, subjects in
the stress group rated their experience as significantly
more stressful than did subjects in the control group,
STRESS AND FOOD CHOICE
863Psychosomatic Medicine 62:853–865 (2000)
but this was in response to the question asked during
the debriefing session, and so answers may have been
influenced by demand effects. Nevertheless, on the
premise that stress-induced changes in food choice
might actually help to alleviate stress, group differ-
ences in the perceived stress level reported after the
meal may have been less than would be the case with-
out a meal. It should be noted that the (presumably
adaptational) decrease from baseline in physiological
arousal among control subjects is a well-recognized
phenomenon in psychophysiological research (50):
Far from vitiating the use of “stress” and “control”
group labels, it illustrates the justification for such a
control group. The combination of this difference be-
tween groups in changes in physiological measures
and the evidence of greater physiological and psycho-
logical arousal in the stressed group justifies the
“stressed” vs. “control” group comparisons.
Despite the limitations described, this study is
unique in its assessment of the effect of stress on food
choice in the laboratory by presenting, in the form of
an explicit meal, a range of foods varying in nutritional
composition, taste and textural qualities, and dietary
roles (ie, “snack” foods and “meal” foods). Susceptible
individuals were found to select less healthy foods
under stress, supporting the proposition that stress
may damage health in part through unhealthy food
choice. However, the variety of foods was limited, and
so caution is needed in interpreting which properties
of the foods are critical to the effect. The findings
deserve replication and extension, for instance, under
different stress conditions and eating contexts, to-
gether with further characterization of vulnerable
traits (51).
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STRESS AND FOOD CHOICE
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... Correlational evidence, in a non-clinical sample, also supports the prediction that, when stressed, food craving is significantly correlated with emotional eating, susceptibility to hunger, and only weakly correlated with dietary restraint (Hill, Weaver & Blundell, 1991 Experimental research has also found support of the relationship between stress and eating in emotional eaters. Oliver, Wardle & Gibson (2000) conducted an experimental study comparing healthy, non-obese men and women volunteers. They were randomly assigned into either a stress (anticipation of public speaking) or control condition. ...
... Their results suggested that negative affect enhanced the reward value of food, which in turn increased food craving. Laboratory studies on healthy volunteers also support the finding that stressed emotional eaters eat more sweet high fat foods than unstressed and non-emotional eaters (Oliver, Wardle & Gibson, 2000). Further studies have also found an association between emotional eaters and greater food intake (consumption of chocolate) after an ego-threat task (Wallis & Hetherington, 2003). ...
... Future research should take into account other characteristics of food (e.g. calorific value) which may be important determinants of motivation to eat as research has suggested a relationship between attentional bias to high calorie words in hungry participants (Placanica, Faunce & Soames, 2002) and a relationship between craving and high fat foods in stressed emotional eaters (Oliver, Wardle & Gibson, 2000). ...
Thesis
p>It is well recognised that emotions impact on eating behaviour and that negative affect in particular can lead to overeating (i.e. stress-induced overeating), which in turn, has been implicated in the onset of obesity. Different psychological views have attempted to understand this relationship and these are reviewed in this paper, with particular emphasis placed on understanding the role of negative affect in the maintenance of overeating. There is a growing body of research suggesting that trait individual differences such as weight category, eating style (emotional, external or restrained eating) and 'sensitivity to reward' are important in moderating this stress-eating relationship. This review therefore proposes to look at the empirical evidence in order to answer several key questions: Is there a general effect of mood on eating in obese and non-obese individuals? Do trait individual differences in eating style and reward sensitivity moderate the relationship between mood and eating? Do other variables (e.g. type of food or stressor) moderate the relationship between mood and eating? The evidence suggests that the findings are mixed with regards to the importance of weight category; i.e., obesity alone does not predict vulnerability to stress-induced eating, as there is a general effect of mood on eating in non-obese individuals. Research findings are discussed which suggest that eating style, sensitivity to reward, type of stressor and type of food consumed, have importance in moderating the stress-eating relationship. However, there is ambiguity surrounding the causal nature of these relationships and there is a lack of theory- driven research, which explores the underlying mechanisms, which might moderate and maintain these relationships. Future research and clinical implications are considered in light of these findings.</p
... In Latin America the pandemic has been characterized by a large number of infections, high mortality and long periods of confinement [3,4], which have affected food supply chain, food environments, as well as purchasing, selection, preparation and consumption of food [5]. Moreover, anxiety, frustration, fear and stress that occur quite often during emergency situations have induced unhealthy food choices and consumption, and conditioned eating behaviors such as binge eating and bulk buying episodes, among others [6]. Although Latin American countries are large producers of grains and fresh foods, consumption of unhealthy food including sugary drinks occurs quite often, clearly affecting quality of diet [7,8]. ...
... In addition, there is a low consumption of fruits and dairy products in all countries and a high consumption of fast-food juices and alcohol. The results obtained in our survey, could be influenced by eating under a state of anxiety or boredom derived from long periods of confinement, by a decrease in motivation to maintain a healthy diet or by an increase in diet driven by mood [6]. ...
Article
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Background and objectives The confinement by COVID-19 has affected the food chain and environments, which added to factors such as anxiety, frustration, fear and stress have modified the quality of the diet in the population around the world. The purpose of this study was to explore diet quality during the COVID-19 pandemic in 11 Latin American countries. Methodology Multicentric, cross-sectional study. An online survey was applied to residents of 11 Latin-American countries, during April and May 2020, when confinement was mandatory. Diet quality was evaluated using a validated questionnaire. Result 10,573 people participated in the study. The quality of the food by country shows that Colombia presented the best quality, while Chile and Paraguay presented the lowest. When comparing the overall results of diet quality by gender, schooling and age, women, people with more schooling and people under 30 years of age, presented better diet quality. The regression model showed that the variables associated with diet quality were: age ( df = 3, F = 4. 57, p < 0.001), sex ( df = 1, F = 131.01, p < 0.001), level of education ( df = 1, F = 38.29, p < 0.001), perception of weight change ( df = 2, F = 135.31, p < 0.001), basis services ( df = 1, F = 8.63, p = 0.003), and quarantine ( df = 1, F = 12.14, p = 0.001). Conclusion It is necessary for governments to intervene to reverse these indicators, considering that inadequate feeding favors the appearance of no communicable diseases, which favor a higher risk of infection and worse prognosis with COVID-19.
... Stress could lead to changes in weight induced by behavioral factors, such as dietary intake, physical activity, smoking, and alcohol use [8]. In those who gain weight, stress decreases energy expenditure [12] and leads to an increased energy intake, especially in the form of energy-dense foods high in sugar and fat [3,[13][14][15][16][17]. In contrast, about 20% of the people experiencing stress reduce their food intake as a result of suppressed appetite and increased physical activity such as fidgeting [11,18,19]. ...
Article
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Background We aimed to study the mediating role of diet quality, physical activity, smoking, and alcohol intake in the association of stressful life events with visceral obesity over a seven-year period and assessed effect modification by sex and SES. Methods: In total, 2416 participants with a mean age of 56.1 (±7.3) years, of which 51.4% were women, and 12.5% had a lower educational level from the Hoorn studies were followed for seven years. Stress was measured with a ‘Serious Life Events’ questionnaire, which was summed into a total score (range zero to ten events) and stratified to account for nonlinearity. Changes in visceral obesity were assessed by changes in BMI (kg/m²) and waist circumference (cm) in seven years. We used the product of coefficient approach to assess mediation of the following lifestyle factors: diet, physical activity, smoking, and alcohol intake. We analyzed associations between stressful life events and change in BMI and waist circumference with linear regression models. Results Within the low education group, we observed a significant association between ≥3 stressful life events and a change in BMI (0.60 kg/m² (CI: 0.05, 1.14)) and waist circumference (2.23 cm (CI: 0.19, 4.48)), compared to experiencing no events. For both BMI and waist circumference, no significant associations were observed when experiencing 1 or 2 events. In the moderate to high education group, we observed only statistically significant associations for waist circumference when experiencing ≥3 stressful life events (0.86 cm (CI: 0.05, 1.41)) and not for the other event groups. Our mediation analyses showed that the proportion mediated by smoking was 13.2%, while the other lifestyle factors showed no mediating effect. Conclusions Multiple stressful life events are associated with an increase in waist circumference and BMI in those with lower education. Smoking might play a mediating role in this association.
... As such, emotional eating (another form of dysregulated eating behaviour), is commonly associated with symptoms of mood disorders (Lazarevich et al., 2016). Emotional eating also a useful predictor of weight gain (Hays & Roberts, 2008) and has been associated with the habitual consumption of high calorie foods (Litwin et al., 2017;Lowe & Maycock, 1988;Oliver, Wardle & Gibson, 2000). For example, in Oliver, Wardle and Gibson's (2000) study, they examined participants food choices in response to acute stress. ...
Thesis
Full-text available
People who have serious mental illness experience greater levels of early mortality compared to their mentally healthy counterparts (Chesney, Goodwin & Fazel, 2014). This early death is largely attributed to physical illnesses that are associated with obesity. Individuals who have serious mental illness and who are treated in secure psychiatric hospitals experience significant increases in their weight upon admission. Several factors predispose people with serious mental illness to weight gain and obesity. This thesis explored the factors that mediate weight gain and obesity maintenance in secure psychiatric inpatients. Study 1 used routine patient data to explore changes in body weight following admission into secure services. This established that patient's body weight on admission was a significant predictor of weight gain over the first twelve weeks of secure inpatient treatment. Study 2 explored the influence of cognitive factors known to influence eating behaviour, the data demonstrated that although the patient group displayed attentional bias to food cues this was not predictive of weight gain. Levels of emotional and disinhibited eating were associated with weight gain over 3 months. Study 3 explored psychological predictors of weight gain; it was found that anxious-preoccupied attachment style was associated with weight gain over 6 months. Study 4 explored staff member's views on how the secure psychiatric environment impacts on patient weight gain and obesity. A thematic analysis highlighted 5 themes: secure service culture, food culture, poor diet versus lack of physical activity, poor mental health, and weight management initiatives. The results of this thesis are discussed in terms of theoretical perspectives of psychological factors and the wider implications for understanding secure psychiatric inpatient obesity.
... When stressed, humans tend to choose caloric dense food such as sweet, high-carbohydrate and high-fat snacks (Oliver et al., 2000;Zellner et al., 2006;Adam and Epel, 2007), often leading to stress-associated weight gain. The increase in consumption of such foods also leads to reprogramming of stress pathways and behavioral changes, as detailed by Hardaway et al. (2015). ...
Article
Full-text available
Animal models are essential for the discovery of mechanisms and treatments for neuropsychiatric disorders. However, complex mental health disorders such as depression and anxiety are difficult to fully recapitulate in these models. Borrowing from the field of psychiatric genetics, we reiterate the framework of ‘endophenotypes’ – biological or behavioral markers with cellular, molecular or genetic underpinnings – to reduce complex disorders into measurable behaviors that can be compared across organisms. Zebrafish are popular disease models due to the conserved genetic, physiological and anatomical pathways between zebrafish and humans. Adult zebrafish, which display more sophisticated behaviors and cognition, have long been used to model psychiatric disorders. However, larvae (up to 1 month old) are more numerous and also optically transparent, and hence are particularly suited for high-throughput screening and brain-wide neural circuit imaging. A number of behavioral assays have been developed to quantify neuropsychiatric phenomena in larval zebrafish. Here, we will review these assays and the current knowledge regarding the underlying mechanisms of their behavioral readouts. We will also discuss the existing evidence linking larval zebrafish behavior to specific human behavioral traits and how the endophenotype framework can be applied. Importantly, many of the endophenotypes we review do not solely define a diseased state but could manifest as a spectrum across the general population. As such, we make the case for larval zebrafish as a promising model for extending our understanding of population mental health, and for identifying novel therapeutics and interventions with broad impact.
... Eating habits changed for most of the participants (63.4%), but the results of the survey suggest that those who ate the same amount of food as before the pandemic reported less psychological distress and more perceived well-being. Food is also known as a mechanism to cope with stress, which can alter both the quantity and quality of eating habits 24,25 ; very recent research about this topic reached similar conclusions to our study 26 . ...
Article
Objective: The year 2020 was characterized by the outbreak of a new pandemic caused by a novel coronavirus named SARS-CoV-2. To face the pandemic, many countries worldwide imposed general lockdowns, closing all non-essential businesses. As primary care services, pharmacies had to remain open, thus putting pharmacy staff at significant risk of viral infection and overwork. This study aimed to assess the mental health of Italian Pharmacists, considering demographic and occupational characteristics, lifestyle, and habits, during the SARS-CoV-2 outbreak and the subsequent lockdown period (March-May 2020). Materials and methods: A web-based survey was created using Google® Forms to collect data from March 30, 2020, to June 1, 2020. The questionnaire consisted of three sections investigating: (1) demographic and occupational variables, (2) lifestyle and habits variables, (3) psychological distress and perceived well-being. Results: A total of 401 participants completed the questionnaire. Older workers and those with more work experience reported more psychological stress. Older and female workers, who felt lonely at home and reported psychological stress, perceived poor well-being. Conclusions: Our findings demonstrate that the Sars-CoV-2 outbreak and subsequent lockdown rules affected pharmacists' mental health and that it is important to put in place preventive measures against the occurrence of mental disorders among them.
... In HD patients, phosphorus is absorbed in the small intestine, which is more pronounced with the consumption of raw food that is rich in proteins and phosphates and is a factor that affects the progression of mineral and bone disorders in CKD since it induces PTH excretion in addition to hypocalcemia [40]. Since phosphatemia values immediately prior to hemodialysis in HD patients depend on the regular taking of medications such as phosphate binders, it is possible that alexithymia is linked to phosphatemia in HD patients in this manner [41]. Even though it was hypothesized that alexithymia would have a positive correlation with high phosphorus levels due to its effect on a lower degree of diet control, it is obvious that the relationship between alexithymia and the confounding factors is different [42]. ...
Article
Full-text available
Alexithymia, or the inability to distinguish between bodily feelings and emotions, has been linked to poor sleep quality in some studies. Rare studies examined the associations between electrolyte phosphorus in patients on hemodialysis and their sleep quality, daytime sleepiness, and alexithymia with inflammatory factors. Hemodialysis is a treatment method for terminal renal patients that involves the diffusion of unwanted metabolic products through the dialyzer membrane. Our study aimed to examine whether there was a difference in phosphorus levels, inflammatory factors, and daytime sleepiness according to the hemodialysis patients’ levels of alexithymia. The study involved 170 HD patients that had been treated with chronic dialysis for more than three months. Prior to the hemodialysis procedure, laboratory findings were sampled. Respondents completed the Pittsburgh Sleep Quality Index, the Toronto Alexithymia Scale 26, and the Epworth Sleepiness Scale, and were questioned about depression. The results showed that alexithymic HD patients exhibited significantly higher leukocyte counts, lower predialysis phosphorus values, and more pronounced daily sleepiness than the alexithymia-free group (Mann–Whitney U test, p = 0.02, p = 0.005, and p < 0.001, respectively). We concluded that alexithymia was an independent predictor of high daytime sleepiness in HD patients (OR = 1.05, 95% CI 1.02 to 1.09).
... In particular, it is known that anxiety and stress impact hunger, desire to eat, and food choices (Reichenberger et al., 2018;Zysberg, 2018). Studies that showed increases in food consumption demonstrated increases in motivation to eat during periods of negative emotions, along with more intense bodily symptoms of hunger (Oliver, Wardle, & Gibson, 2000;Tan & Chow, 2014). Such stress-induced increased drive to eat palatable food has been demonstrated in people with varied BMI (Groesz et al., 2012). ...
Article
Background The COVID-19 Pandemic resulted in high levels of fear, anxiety, and stress. People with pre-existing physical and mental health conditions may have been more affected by the sudden changes in daily habits during the initial months of global quarantine imposed during the COVID-19 pandemic. Methods We designed the Quarantine, Anxiety, and Diet (QUAD) Survey to investigate the effect of pre-existing health conditions on the relationship of COVID-19 stress and food behavior. The anonymous survey was distributed online and only adults were eligible to participate. Results The results showed that responders with pre-existing health conditions differed from healthy participants in eating behavior during this time of stress. Compared to those classified as healthy, fewer people with pre-existing physical illness showed an increase in appetite with stress during the COVID-19 pandemic. Responders with pre-existing psychiatric illness were more likely to show increases or decreases in appetite with stress compared to healthy responders. Furthermore, higher BMI was associated with higher rate of increased appetite, whereas low BMI showed a higher rate of decreased appetite, both compared to normal BMI. Conclusion The QUAD Survey demonstrated that individuals with pre-COVID-19 psychiatric conditions are at a higher risk of maladaptive food behavior under stress. Since pre-existing psychiatric illnesses and acute stressors are known risk factors for eating disorders, special attention should be placed on those at risk to mediate the psychological and physical effects of stress and anxiety.
Article
Eating behavior is a condition that occurs as a result of the combination of many factors such as physiological, sensory and sociocultural characteristics. In the study, it was tried to determine how the eating behaviors of adult women affect their meal habits and food preferences. The sample of the cross-sectional descriptive study consisted of 205 adult women who applied a Healthy Living Center. Data were collected with a questionnaire including food preferences and eating habits and the Dutch Eating Behaviors Questionnaire. It was determined that the external eating scores of the women participating in the study who had more than 4 meals per day were significantly higher than the individuals who consumed 2 or 3 meals. Emotional and external eating mean scores of women who consume unhealthy foods such as sugary packaged products, soft drinks and pastries are higher than those who do not; restrictive eating mean scores were found to be lower (p
Thesis
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RESUMEN: el presente trabajo analiza la influencia de la noción de empatía en los procesos de enseñanza y aprendizaje en contextos educativos a partir de algunos aspectos de la antropología evolutiva en términos de comprender el significado de la variación biológica, nutricional y comportamental entre estudiantes y docentes del grado undécimo de la Institución Educativa Enrique Vélez Escobar de Itagüí. Los aspectos adaptativos en el presente estudio se relacionan con: la nutrición como indicador de ventajas en la supervivencia, los comportamientos asociados al autocuidado o cuidado de otros y la comunicación eficiente entre los seres humanos. Se obtuvo una muestra no probabilística de 32 estudiantes entre los 15 y 20 años y 7 docentes entre los 32 y 60 años, a quienes se caracterizó a través de un formulario Google. Se analizó el estado nutricional de los estudiantes según talla para la edad e Índice de Masa Corporal (IMC), el cual se complementó con un patrón alimentario. Para medir la empatía, estudiantes y docentes aplicaron el Test de Empatía Cognitiva y Afectiva (TECA), pero únicamente los docentes a la prueba Reading the Mind in the Eyes; para el desempeño académico se estudiaron las calificaciones de los estudiantes en 8 asignaturas del primer período académico de 2021, y se entrevistaron 4 estudiantes y 3 docentes. Los datos fueron analizados mediante los softwares WHO Anthro versión 3.1.0 y el sistema de análisis estadístico SPSS, los cuales arrojaron estadísticos descriptivos y analíticos a través de la prueba χ² de Pearson, análisis bivariado con coeficiente de correlación Pearson y Análisis de Componentes Principales (ACP). Se encontró que estudiantes con mayor edad eran mejores en Alegría Empática, pero el resto de las variables no se asociaron; no obstante, como tendencia sin significación estadística, las mujeres fueron más empáticas, un mejor estado nutricional pudo influir en mejores desempeños de la empatía, y esta estuvo más cerca de influir en Inglés y Física. Finalmente, estudiantes y docentes concluyeron que la empatía interviene en los procesos educativos, en tanto al trabajo en equipo y a las actividades docente. Así, en esta investigación, la empatía puede relacionarse con comportamientos prosociales asociados a ventajas en el aprendizaje, donde las ventajas adaptativas se mostraron muy asociadas a la edad, y podrían encontrarse en una relación, aunque débil, con el estado nutricional de los jóvenes y con la mejor comunicación con otros (aprendizaje de idiomas). ABSTRACT: this paper analyzes the influence of empathy on teaching and learning process in educative contexts understanding some issues of evolutive anthropology like biologic, nutritional and behavior variation among students and teachers from Institución Educativa Enrique Vélez of Itagüí, Colombia. The evolutive aspects in this research are related with: the nutrition like survivel advantage indicator, the behaviors related to self-care or caring for others and the efficient communication among human beings. First, it obtained a non-probabilistic sample of 32 students between 15 and 20 years old and 7 teachers between 32 and 60 years old, who were characterized through a Google form. Later, the nutritional state of student was analyzed from size for age and Body Mass Index (BMI), which was supplemented with eating pattern study. Students and teachers applied a Test de Empatía Cognitiva y Afectiva (TECA) but only teachers did the Reading de Mind in the Eyes Test. Finally, the academic average was measured from notes in 8 subjects of first academic period, and 4 students and 3 professors were interviewed. The information was analyzed with WHO Anthro 3.1.0 software and statistical system analysis SPSS, it got analytic and descriptive analysis with Pearson's chi-squared test, bivariate Pearson's analysis coefficient and Principal Component Analysis (PCA). The results found the elder students was better in empathic joy, while the other variables didn’t show correlations; even so, women seemed to be more empathetic than men, and probably a better nutritional state —maybe for balanced diet—influenced the empathy, and the empathy was closer of subjects like English and Physis. Thereby, in this research, empathy can be related with prosocial behaviors related with advantages in learning, where the adaptive advantages showed to be very correlated with age, where it could find a relation, but weak, with nutritional state of teens and with the better communication between groups (like learning languages).
Article
The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
Article
The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
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The commonly-held view that stress can elicit eating, and that this eating is an attempt by the organism to reduce anxiety, is critically examined. It is shown that a variety of factors, other than food-deprivation and palatability, can elicit eating in animals and man. Many of these elicitors do not have obvious aversive correlates. It is argued, by analogy with avoidance learning, that the eating cannot produce a reduction in the aversiveness of the eliciting stimulus, since the eating behaviour would not be strengthened and maintained. It is suggested that the eliciting stimuli simply activate the organism, making it more responsive to external, food-related stimuli, which direct behaviour towards eating. These stimuli elicit metabolic responses associated with eating, which serve to increase activation, and strengthen the eating response further.
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Synopsis Dieting is a widespread behaviour in developed countries, which in predisposed individuals can lead to the development of clinical eating disorders such as bulimia nervosa and anorexia nervosa. We studied the effect of moderate dieting in healthy women on the prolactin response to the serotonin (5-HT) receptor agonist, m-chlorophenylpiperazine (mCPP), a measure of the sensitivity of post-synaptic 5-HT 2C receptors. Dieting significantly increased the prolactin response to mCPP and lowered plasma concentrations of the 5-HT precursor, tryptophan. We propose that dieting in women is associated with the development of functional supersensitivity of 5-HT 2C receptors, probably in response to lowered levels of brain 5-HT. Alterations in brain 5-HT neurotransmission could play a part in dieting-induced dysregulation of eating and the development of clinical eating disorders in predisposed individuals.
Article
The stress-eating relationship was examined in a prospective study of 158 subjects who completed daily records of stress and eating for 84 days, yielding 16.188 person days of observation. Using both within-subjects and between-subjects analyses, individuals were much more likely to eat less than usual than to eat more than usual in response to stressful daily problems. The likelihood of eating more did not change as severity of stress increased, but the likelihood of eating less increased substantially. There were also clear gender differences. Males had a slight tendency to eat less than to eat more across all levels of stress, except at the highest level, where eating less occurred much more frequently. In females, the tendency to eat less as opposed to eating more emerged at middle levels of stress; at the highest level of stress, females were more than three times more likely to eat less than to eat more. Individual subjects were highly consistent over levels of stress in the direction of eating; 82% of the subjects were consistent in eating more or less over the majority of their stressful periods. These results show a clear effect of stress on eating, with eating less being the predominant response.
Article
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)