Emotional eating, depressive symptoms and self-reported food consumption. A population-based study

Stress mindset predicts psychophysiological responses to stress and eating behaviors and moderates the stress-eating relationship in women

Individuals tend to shift their preferences towards comfort foods following acute stressors, but do not ubiquitously increase the amount of food consumed. Many individuals overeat in response to stressors, yet others decrease or do not change their food intake. Individual differences in factors related to stress and eating, such as stress mindset (i.e., perceptions regarding the nature of stress), may explain this variability in stress-eating. To investigate, we conducted the present pre-registered study, where we investigated whether stress mindset, 1) predicted psychophysiological stress responses, 2) predicted snack intake post-stress, and 3) moderated the stress-eating relationship. Participants were 86 women (34 % non-White) between 18 and 22 years old, with a mean body mass index of 24 kg/m2, who completed two visits. Participants completed an assessment of stress mindset during a preliminary screening and, on a subsequent laboratory visit, underwent a stress mindset manipulation followed by an acute social stress task (i.e., TSST) and a snack food taste test. Greater stress-is-enhancing mindsets during screening predicted more adaptive stress responses (greater ratio of sympathetic markers to cortisol levels) and healthier post-stress eating behaviors. Furthermore, the moderation model (PROCESS model 1) was significant: greater post-stress negative affect was associated with more M&M intake only for women with greater stress-is-debilitating mindsets at screening, and greater heart rate was associated with less chip and veggie straw intake only for women with greater stress-is-enhancing mindsets at screening. Thus, stronger stress-is-enhancing mindsets may reduce the impact of psychophysiological stress responses on snack food intake for women. Replications in larger and more diverse samples may elucidate the mechanisms underlying the moderation and inform eating- and obesity-related treatments targeting stress mindset.

Feeding the inner critic: Self-criticism and shame in the association of affiliative memories with emotional and disordered eating in women

Emotional eating, defined as overeating in response to intense negative emotions, is considered part of a disordered eating continuum, as a milder form of binge eating. It is linked to high emotional dysregulation and risk factors like negative traumatic childhood memories, which have been associated with several negative psychopathological outcomes. Recent research has started to also highlight the negative impact of the lack of early positive memories on psychopathological outcomes, including eating-related disorders. This study explores the role of early affiliative memories on emotional eating, specifically examining whether self-criticism, a strategy to mitigate feelings of shame, is linked to women's tendencies towards emotional and disordered eating attitudes. The study involved 427 female participants. Results show that fluctuations in self-criticism levels are linked to differences in emotional and disordered eating, with higher self-criticism corresponding to more severe emotional and disordered eating. The path analysis showed that a lack of early affiliative memories was associated to emotional and disordered eating, through the mediating roles of internal shame and self-criticism. The model explained 44 % of disordered eating variance, showing an excellent model fit. These findings suggest that internal shame and self-criticism are defensive mechanisms tied to the absence of early affiliative experiences. Self-criticism strategies seem to amplify self-monitoring and negative self-evaluations, leading to emotional eating as a coping mechanism. Clinically, our study incites the development of compassion-focused interventions to address shame and self-criticism, and promote adaptive emotional regulation strategies, preventing emotional eating attitudes and reducing the risk for further disordered eating behaviours.

Partial substitution of red or processed meat with plant-based foods and the risk of cardiovascular disease

A shift towards more plant-based diets may promote human and planetary health. This modelling study aimed to assess the impact of moderate partial substitution of red or processed meat with plant-based foods on cardiovascular disease (CVD) risk. We used pooled data from five Finnish cohorts (42,868 participants aged ≥ 25 years, 78% men). Median follow-up time was 12.7 years, with 11,031 incident CVD cases. Diet was assessed by a validated food frequency questionnaire. We modelled substitutions of red meat (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards multivariate models adjusted for relevant confounding factors and pooled together using a random effects model. There was a suggestive reduction in CVD risk in men when processed meat was substituted with vegetables or the combination of plant-based foods (HR 0.99, 95% CI 0.99-1.00, P < 0.05). In women, there was an increase in CVD risk when red meat was substituted with legumes (HR 1.10, 95% CI 1.01-1.20, P < 0.05). However, when all cohorts were followed for the same length of time (7.9 years), several plant-based foods reduced CVD risk and none of them increased the risk when partially replacing red or processed meat. Even a small, easily implemented change towards a more plant-based diet may contribute to cardiovascular health at the population level. These findings support global strategies towards healthy and environmentally sustainable diets.

Exploring exercise, emotional eating, and body dissatisfaction in depression risk: Using structural equation modeling

In order to fill the relevant research gap on the influence of body dissatisfaction on depression in Chinese college students, we used structural equation modeling to explore the relationships between physical activity, body dissatisfaction, eating behavior, and depression. Participants were 1,714 undergraduate students in Southern China. Exercise served as a significant mediator between body mass index and depression, as well as between body dissatisfaction and emotional eating, accounting for 30% and 19.8% of the total effects, respectively. Emotional eating behavior mediated the relationship between exercise and depression. This study underscores the influences of body dissatisfaction on both physical inactivity and emotional eating patterns among Chinese university students. It suggests that reducing body dissatisfaction and emotional eating holds significant potential for preventing depression.

Bidirectional associations between affect and food craving within and between individuals: A mega-analysis

The empirical robustness of emotional eating and stress eating - the tendency to eat in response to affective experience - is under ongoing debate. Is this a general phenomenon or is this seen only in certain groups? And, if so, can such interindividual differences be reliably assessed with self-report questionnaires? Here, we approach this question not through measuring overt eating - a behavior that is subject to several contextual conditions - but through food craving, an important precursor to food intake that can be triggered rapidly and involuntarily. We also study temporal ordering, i.e., whether affect cooccurs with, precedes, or follows craving. We pooled 8 ecological momentary assessment (EMA) studies comprising 764 participants answering 4-6 daily questionnaires for 7-20 days (mega-analysis). Trait-level eating style questionnaire scores were modeled as moderators for potential emotion/stress-craving relationships. Negatively toned affect (feeling bored, irritated, stressed) but also positive affect (cheerful, enthusiastic, relaxation with reverse direction) co-occurred with more craving. Feeling bored, stressed, or less relaxed, calm, and cheerful was also associated with later craving which, in turn, related to feeling more relaxed and less stressed at the next time point. Eating style questionnaires moderated concurrent but not prospective affect-craving or craving-affect relationships. Our results highlight the disparities between questionnaires and EMA measures, particularly for prospective relationships. Affect and craving seem to interact in close temporal proximity in this mostly healthy weight sample whereas the predictive validity of eating style questionnaires for naturalistic contexts is limited. We suggest a refined terminology to reflect these findings.

Exploring the multifaceted factors influencing overweight and obesity: a scoping review

Introduction

Obesity and overweight problems in public health have substantial impacts which affect the health status of individuals and community well-being and healthcare service provision worldwide. This scoping review aims to identify and classify factors from social, technological, environmental, economic and political domains which influence obesity and overweight conditions. The systematic analysis of determinants in this study generates usable information to guide public health intervention design and obesity epidemic management strategies.

Methods

The study utilized the ProQuest, ISI Web of Science, PubMed, and Scopus databases, and it also included grey literature in its analysis. The research objectives focused on identifying factors that contribute to overweight or obesity issues. The researchers used framework analysis to examine the qualitative data collected from these studies.

Results

The synthesis incorporated 121 research studies which satisfied the established criteria. This comprised 98 studies from 46 different countries, 17 studies conducted at the international level, and 6 studies involving multiple countries. Eighty-two factors influencing overweight and obesity were identified as determinants and categorized into five main categories: sociocultural, economic, technological, environmental, and political. Most of the identified determinants belong to the socio-cultural category, which demonstrates their substantial impact on lifestyle and health behaviors.

Conclusion

The implementation of public health prevention and intervention programs depends on complete knowledge of all factors that affect overweight and obesity rates. This issue needs a comprehensive approach which analyzes sociocultural aspects together with economic, technological, environmental, and political factors, as well as other policy goals within defined societal challenges. Effective solutions to resolve this situation depend on multi-sectoral collaboration to tackle obesity and promote health-enhancing factors for the entire community.

Bidirectional Relationship Between Nutrition and Mental Health and Its Impact on the Health of Canadian Immigrants: An Integrative Review

Background: Immigration is a key factor contributing to population growth in Canada, a trend that is expected to continue. Immigrants generally arrive with better health than the Canadian-born population, but this advantage often diminishes over time, partially due to dietary acculturation. Emerging evidence points to a bidirectional link between nutrition and mental health. Objective: To explore the bidirectional relationship between nutrition and mental health and its impact on the health of Canadian immigrants, with a specific focus on immigrants' mental health and the healthy immigrant effect. Methods: For this integrative review, two comprehensive literature searches were conducted in the databases MEDLINE, CINAHL, Embase, PsycINFO, Scopus, and Web of Science from inception to July 2024. The review adhered to Whittemore and Knafl's integrative methodology, with the Mixed Methods Assessment Tool used to assess the quality of the studies. Results: A total of 42 and 34 scientific articles were included from the first and second literature searches, respectively. Four main themes emerged from the literature: (1) food insecurity and mental health, (2) obesity and mental health, (3) diet quality and mental health, and (4) the gut microbiome and mental health. These themes were explored in the context of Canadian immigrants' health. Conclusions: The health of immigrants to Canada is likely shaped by complex, bidirectional interactions among various determinants of health, influencing both physical and mental well-being. As newcomers are expected to form an increasing proportion of the Canadian population, further research is needed to understand how the interaction between nutrition and mental health can help promote and safeguard the health of Canadian immigrants.

Pathways linking BMI trajectories and mental health in an adult population-based cohort: role of emotional eating and body dissatisfaction

BACKGROUND

Overweight and obesity are associated with poor mental health, and the association is bidirectional. Few studies have examined the association between weight change and mental health over time. We aimed to provide further insight into the association between weight gain and mental health, with a focus on emotional eating and body dissatisfaction as mediating factors.

METHODS

Height and weight were self-reported upon registration, and in Spring 2022, 2023, and 2024 in the Specchio cohort (Geneva, Switzerland). BMI trajectories were estimated by (1) mixed-effects models to calculate participants' personal slopes (increase in BMI score per year), and (2) testing the odds of an upward BMI category transition from baseline to last follow-up. The associations of behavioural and psychosocial factors with BMI trajectories (slopes and transitions), and BMI trajectories with mental health outcomes were estimated using regressions adjusted for age, sex, education, and physical health condition. Structural equation modelling was used to test mediating pathways.

RESULTS

Among 7388 participants (59% women, mean age 51 years), factors associated with increasing BMI over 4 years included financial hardship, short sleep duration, less physical activity, more leisure screen time, depressive and anxiety symptoms, and emotional eating (β range [95% CI] = 0.03 [0, 0.05]-0.12 [0.09, 0.15]). Increasing BMI was associated with body dissatisfaction (β = 0.36 [0.33, 0.38]) and poorer quality of life (β = -0.06 [-0.09, -0.03]) at 4-year follow-up after adjustment for anxiety and depressive symptoms at baseline. Emotional eating partly mediated the association between anxiety and depressive symptoms at baseline and increasing BMI, and between financial hardship and increasing BMI. Body dissatisfaction and poorer self-rated health partly mediated the association between increasing BMI and quality of life at follow-up.

CONCLUSIONS

Emotional eating and body dissatisfaction contribute to the association between BMI trajectories and mental health and should be considered in weight management and mental health promotion strategies.

Emotional Eating, Impulsivity, and Affective Temperaments in a Sample of Obese Candidates for Bariatric Surgery: Which Linkage?

Background/Objectives: Obesity is a major public health challenge of the 21st century, with prevalence rates steadily rising globally. Disordered eating behaviors, particularly emotional eating (EE), complicate the clinical management of obesity and hinder long-term outcomes, such as maintaining weight loss after bariatric surgery. Studies reveal that EE affects 65-75% of overweight or obese adults, and such behavior may stem from a disrupted brain reward system linked to emotional dysregulation and impulsivity. Impulsivity in obesity involves deficient cognitive inhibitory control, creating an imbalance between impulsive and reflective systems. While problematic eating behaviors and obesity are well studied, the role of affective temperaments-innate traits influencing mood, energy, and responses to stimuli-remains underexplored. This study aims to examine the interplay between emotional eating, impulsivity, and affective temperaments in obese patients preparing for bariatric surgery. Methods: A total sample of 304 obese outpatients was consecutively enrolled at the Psychiatry Clinic of the Department of Clinical and Experimental Medicine of the University of Pisa during the presurgical mental health evaluation routinely performed before the bariatric intervention. Sociodemographic and clinical data were collected by psychiatrists during a single consultation. Assessments also included the following psychometric tests: the Structured Clinical Interview (SCID-5), the Emotional Eating Scale (EES), the Barratt Impulsivity Scale-Version 11 (BIS-11), and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A). Results: A significant correlation was observed between the EES total score and the BIS total score (p = 0.003), as well as with the sub-dimensions of attentional impulsivity (p < 0.001) and motor impulsivity (p = 0.024). In addition, a significant correlation has been found between the total score of EES and the cyclothymic (p < 0.001), depressive (p < 0.001), irritable (p = 0.013), and anxious (0.020) temperaments. When comparing obese patients with EE and without EE (No-EE), higher rates of both current (p = 0.007) and lifetime (p = 0.024) psychiatric comorbidities were observed in the EE group, namely for anxiety disorders (p = 0.008) and eating disorders (p = 0.014). Conclusions: Our study highlights a significant association between EE in obese patients with the cyclothymic, irritable, anxious, and depressive temperaments, and impulsivity dimension. Thus, problematic eating behaviors and temperamental traits may have a bidirectional psychopathological influence in obese patients and need to be carefully evaluated in subjects seeking bariatric surgery.

Turkish version of the German Eating Behavior Scale (SEV-Tr): a study of reliability and construct validity

This two-phase study aims to develop the Turkish version of the German Eating Behavior Scale (SEV-Tr), and to investigate the potential associations of health-conscious and weight-controlling eating behaviors with nutritional and health status. In the first phase, the original scale was adapted to the Turkish language and its validity and reliability were assessed in 299 healthy individuals aged 19-64 years. In the second phase, the SEV-Tr was retested in a study population of 110 healthy individuals, aged 19-64 years, and the potential associations between the SEV-Tr score, anthropometrical and biochemical measurements, and other eating behaviors assessed by the Three-Factor Eating Questionnaire (TFEQ-Tr21) were examined. Statistical analyses were performed using AMOS 20.00 and SPSS 22.0 software packages. A two-dimensional structure was identified for the SEV-Tr, and named 'health-conscious eating behavior' and 'weight- controlling eating behavior'. In the second phase, participants were clustered based on their weight-controlling and health-conscious eating behaviors (F = 59.46, p = 0.01). Participants with lower health-conscious and weight-controlling eating behaviors had higher lean body mass (p = 0.03), serum triglyceride levels (p = 0.01), emotional eating behavior (p = 0.03), and lower cognitive restraint behavior (p = 0.01, p < 0.05). Furthermore, participants with high levels of health-conscious eating behavior had higher serum HDL cholesterol (r = 0.23, p = 0.02). Regression models suggested that lower levels of emotional eating and higher levels of cognitive restraint were associated with increased weight-controlling and health-conscious eating behaviors. This study provided a valid and reliable version of the SEV to assess the health-conscious and weight-controlling eating patterns in people from Turkish culture.

Taming "hanger" and falling prey to boredom-emotional and stress-eating in 801 healthy individuals using ecological momentary assessment

Emotional eating and Stress Eating concepts hold that affective experiences can instill the desire for palatable foods. The empirical evidence for such couplings between affective and appetitive systems, however, is mixed and it remains unclear which one precedes the other or whether interindividual differences in such relationships exist. To study the temporal relations between a range of negative and positive emotions and stress on the one hand and snacking behavior on the other, we analyzed over 40.000 questionnaire entries obtained through ecological momentary assessment from 801 participants across nine different studies. Several trait-level eating style questionnaire scores were modelled as moderators for the emotion/stress - snacking relationships. Results showed that stronger boredom was followed by more snacking. Only irritation showed the pattern of reduction following snacking that would be predicted by emotion regulation accounts of emotional eating. Restrained eaters showed larger increases in boredom after snacking (compared to not snacking) than unrestrained eaters. Eating style questionnaires did not significantly moderate any other emotion - snacking - emotion relationships. Together with other recent findings from this dataset (Aulbach et al., n.d.) the present results suggest that eating style questionnaires capture tendencies to experience food cravings, but not snacking, as the latter might be 'gated' by several internal and external conditions that our EMA data and the trait questionnaire do not capture well. Accordingly, we suggest a novel terminology for affect-eating relationships that increases precision on the temporal (affects before or after eating/craving) and the phenomenological (snacking, craving) level.

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

BACKGROUND/OBJECTIVES

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

Role of Planetary Health Diet in the association between genetic susceptibility to obesity and anthropometric measures in adults

BACKGROUND/OBJECTIVE

The roles of overall diet quality in linking genetic background with anthropometric measures are unclear, particularly regarding the recently developed Planetary Health Diet (PHD). This study aims to determine if the PHD mediates or moderates the relationship between genetic susceptibility to obesity and anthropometric measures.

SUBJECTS/METHODS

The study involved 2942 individuals from a Finnish population-based cohort (54% women, mean age 53 (SD ± 13) years). Habitual diet was assessed using a validated 130-item food frequency questionnaire, and the PHD Score (total score range 0-13 points) was adapted for Finnish food culture to evaluate diet quality. Genetic susceptibility to obesity was evaluated with a polygenic risk score (PRS) based on one million single nucleotide polymorphisms associated with body mass index (BMI). Baseline anthropometrics included weight, height, waist circumference (WC), and body fat percentage, with changes in these measures tracked over 7 years. A five-step multiple linear regression model and multivariable logistic regression with interaction terms were used to assess the mediating and moderating effects of the PHD. These analyses were also replicated in another Finnish cohort study (2 834 participants).

RESULTS

PRS for BMI was positively associated with baseline BMI and changes in anthropometric measures, except waist circumference (p = 0.12). Significant associations were observed for baseline BMI and WC (p < 0.001), changes in BMI and WC (p = 0.01), and body fat percentage change (p = 0.05). However, the PHD (average score 3.8 points) did not mediate or moderate these relationships. These findings were consistent in the replication cohort.

CONCLUSION

Diet quality assessed with the PHD did not mediate or moderate the associations between genetic susceptibility to obesity and anthropometric measures. This lack of effect may be partly due to low adherence to the PHD and the older age of participants ( > 50 years) at baseline.

Depressive symptoms, eating habits, and dietary quality among young adults in Chungcheong, Korea

BACKGROUND/OBJECTIVES

The prevalence of depression has increased globally, and depressive symptoms have been reported to lead to undesirable lifestyle choices, including poor eating behaviors. The aim of this study was to assess the severity of depressive symptoms in young adults and to investigate the differences in eating habits and dietary quality by the degree of these symptoms.

SUBJECTS/METHODS

This cross-sectional study included 497 young adults aged 19-39 yrs living in Chungcheong, Korea. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale, and eating habits and dietary quality were surveyed using questionnaires and nutrition quotient (NQ) for Korean adults.

RESULTS

The prevalence of depression in the participants was approximately 31.4%, based on a depressive symptom score of 16 on the CES-D scale, and the proportion of women was significantly higher than men. The depressed group considered food combinations and consumed snacks more frequently than the nondepressed group. No statistically significant differences were found in the total NQ score between the depressed and nondepressed groups; however, the moderation score was significantly lower in the depressed group for all participants and female participants.

CONCLUSION

We found that dietary quality, including snacking and moderation-related eating habits, varied with the degree of depressive symptoms in young adults. Further intervention studies are needed to clarify the association between dietary factors and depressive symptom.

Prevalence of Emotional and Binge Eating Among Patients With Obesity Attending a Specialist Weight Management Service for Bariatric Surgery in the United Kingdom

BACKGROUND

Emotional eating (EE) is a tendency to consume food in response to positive or negative emotions, leading to obesity and an increased Body Mass Index (BMI). Evidence supports the positive association between EE and binge eating disorder (BED), but little is known about its prevalence among patients referred for bariatric surgery and the psychological characteristics of this patient population. We aim to examine (i) the prevalence of binge eating and EE, (ii) its association with the prevalence of anxiety, depression, diabetes and hypertension and (iii) the correlation between anxiety and depression with emotional and binge eating behaviours among patients attending a regional bariatric service in the UK.

METHOD

A cross-sectional case file design involving 285 participants (mean age = 43.88 ± 11.5, female (80.7%) and male (19.3%)) was used. Outcome measures included body weight, BMI, the Weight Loss Readiness (WLR) Questionnaire, Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorders Identification Test- Consumption (AUDIT-C).

RESULTS

Within this patient group, the prevalence of binge eating and EE were 28.8% and 22.1% respectively. Among these, 19.3% had diabetes mellitus, 24.8% hypertension, 21% harmful alcohol use, 65% had high anxiety score and 77% high depression scores. Most correlations between body weight and variables like AUDIT-C, GAD-7, PHQ-9 scores and WLR scores for hunger, binge eating and EE were not significant. A positive association was observed between depression and anxiety with binge eating, and EE behaviours.

CONCLUSION

Patients awaiting bariatric surgery have a wide range of mental and physical health comorbidities, with evidence of positive associations between higher depression and anxiety levels with abnormal eating behaviours. These findings highlight the need for screening for comorbidities in this patient population to optimise patient outcomes postbariatric surgery.

Rearing in an envy-like environment increases anxiety-like behaviour in mice

Interest in the societal and psychological harm caused by widespread envy and social comparison is increasing. Envy is associated with anxiety and depression, though the mechanism by which envy affects neuropsychiatric disorders, such as depression, remains unclear. Clarifying the neurobiological basis of envy's effects on behaviour and emotion regulation in experimental mice is essential for developing disease-prevention and treatment strategies. As mice recognize other mice in neighbouring cages, this study investigated whether they recognize neighbouring cages housed in environmentally enriched cages and suffer psychological stress due to envy. After being raised in an envy-like environment for 3 weeks, we revealed changes in the behaviour of the mice through a series of behavioural experiments. Mice raised in an envious environment showed increased body weight and anxiety-like behaviour but decreased social behaviour and serum corticosterone levels compared to control mice. Thus, mice recognize their neighbouring cages and experience psychological stress due to envy. This study revealed a part of the scientific basis for why envy increased anxiety. Using this novel experimental breeding environment, it may be possible to create an experimental animal model of anxiety disorders.

Bicultural identity integration, depressive symptoms, and emotional eating among Asian and Latino undergraduate students in the U.S

College students increasingly identify as bicultural. Bicultural identity integration (BII), the extent to which an individual can effectively manage their various cultural identities, has been associated with mental health, including depressive symptoms. However, few studies have examined the association between BII and eating behaviors among racial/ethnic minority students, even though these students are at high risk for disordered eating behaviors. The primary goals of the present study were to examine the association between BII and emotional eating, and whether depressive symptoms represent an indirect pathway in the association. Asian and Latino undergraduate college students in the U.S. (N = 497; age range: 18-46 years, M = 20.81) completed online standardized questionnaires assessing demographics, BII, depressive symptoms, and emotional eating. Higher scores on BII harmony, not blendedness, were associated with fewer depressive symptoms (r = - 0.16, p < .001) and less emotional eating (r = - 0.13, p < .001). Moreover, depressive symptoms were the indirect pathway between BII harmony and emotional eating (b = - 0.15, p = .003, 95%CI boot [- 0.25, - 0.05]), but not between BII blendedness and emotional eating (b = - 0.04, p = .42, 95%CI boot [- 0.15, 0.06]). The results can help inform counseling services about the need to address cultural harmony to promote healthy eating behaviors, mental health, and well-being among bicultural undergraduate students.

The relationship between emotional eating, mindful eating, and depression in young adults

The aim of this study was to examine the relationship between eating behavior, eating awareness, and depression in young adults. Young adults aged between 18 and 25 years were included in the study. Questionnaires and body composition measurements were made face-to-face by the researcher in the interview room. The demographic characteristics were questioned through the questionnaire form. Three Factor Eating Questionnaire (TFEQ), Mindful Eating Questionnaire (MEQ), and Beck Depression Inventory (BDI) were used. It was determined that the Mindful Eating Questionnaire total score and Beck Depression Inventory total score affected emotional eating. A statistically significant positive correlation was found between the Beck Depression Inventory total score and the Three Factor Eating Questionnaire sub-scores. There was a statistically significant negative correlation Beck Depression Inventory total score and the Mindful Eating Questionnaire total score and sub-scores of mindless eating and emotional eating. In summary, depression seems to be a factor that triggers emotional eating, and emotional eating is a factor that negatively affects mindful eating.

Stress-induced eating and drinking and their associations with weight among women and men during 30-year follow-up

BACKGROUND

Stress is associated with obesity through several mechanisms, including coping methods used in stressful situations. However, long-term prospective studies investigating stress-induced eating and drinking in parallel and their relationships with weight are scarce.

PURPOSE

We examined the prevalence of stress-induced eating and drinking and their associations with body mass index (BMI) among women and men during a 30-year follow-up, as well as BMI trajectories from early adulthood to middle age.

METHODS

Participants of a Finnish cohort study were followed by questionnaires at the ages of 22 (N = 1656), 32 (N = 1471), 42 (N = 1334), and 52 (N = 1160). Their coping methods were evaluated by asking how common it was for them to act in certain ways when they encountered stressful situations. We used linear regression analysis to examine the associations between coping methods and BMI, and latent growth models to analyze the BMI trajectories.

RESULTS

The prevalence of stress-induced eating was higher among women than men throughout the follow-up, whereas stress-induced drinking was more common among men at 22 and 32 years of age. Stress-induced eating was associated with higher BMI at all ages among women, and from the age of 32 among men. Eating as a persistent coping method over the life course was associated with a higher and faster growth rate of BMI trajectories. Stress-induced drinking was associated with higher BMI in middle age, and with a faster growth of BMI among men.

CONCLUSIONS

Effective, appropriate stress management may be one essential factor in preventing weight gain in the adult population.

Heterogeneous appetite patterns in depression: computational modeling of nutritional interoception, reward processing, and decision-making

Accurate interoceptive processing in decision-making is essential to maintain homeostasis and overall health. Disruptions in this process have been associated with various psychiatric conditions, including depression. Recent studies have focused on nutrient homeostatic dysregulation in depression for effective subtype classification and treatment. Neurophysiological studies have associated changes in appetite in depression with altered activation of the mesolimbic dopamine system and interoceptive regions, such as the insular cortex, suggesting that disruptions in reward processing and interoception drive changes in nutrient homeostasis and appetite. This study aimed to explore the potential of computational psychiatry in addressing these issues. Using a homeostatic reinforcement learning model formalizing the link between internal states and behavioral control, we investigated the mechanisms by which altered interoception affects homeostatic behavior and reward system activity via simulation experiments. Simulations of altered interoception demonstrated behaviors similar to those of depression subtypes, such as appetite dysregulation. Specifically, reduced interoception led to decreased reward system activity and increased punishment, mirroring the neuroimaging study findings of decreased appetite in depression. Conversely, increased interoception was associated with heightened reward activity and impaired goal-directed behavior, reflecting an increased appetite. Furthermore, effects of interoception manipulation were compared with traditional reinforcement learning parameters (e.g., inverse temperature β and delay discount γ), which represent cognitive-behavioral features of depression. The results suggest that disruptions in these parameters contribute to depressive symptoms by affecting the underlying homeostatic regulation. Overall, this study findings emphasize the importance of integrating interoception and homeostasis into decision-making frameworks to enhance subtype classification and facilitate the development of effective therapeutic strategies.

Examination of Gender Differences: Causal Attributions of Treatment-Seeking Individuals With Overweight and Obesity

Background

Addressing patients' perceptions of the causes of their overweight and obesity may be a promising approach to enhance treatment motivation and success. Previous research suggests that there are gender differences in these aspects. The objective of this study was to investigate gender differences in causal attributions among individuals with overweight and obesity who participated in a cognitive-behavioral mobile health (mHealth) intervention.

Method

Causal attributions were assessed using the revised Illness Perceptions Questionnaire, which included a rated and open answering section. An ANCOVA was conducted for each causal factor (behavioral, psychological, risk, external) as a dependent variable to determine gender differences, which were analysed with chi-squared tests for open-ended responses.

Results

The most frequently mentioned and highly rated cause was behavior for both genders (59.8% of 639 responses). The results indicated that women rated psychological causes, particularly stress-related causes, significantly higher, F(1,211) = 14.88, p < .001, η2 = .07, and were more likely to cite emotional eating than men, χ2(1, N = 639) = 15.06, p < .001. Men rated alcohol stronger as cause than women, t(125.05) = 3.79, p < .001.

Conclusion

The findings of this study contribute to the understanding of the gender differences in causal attributions among individuals with overweight or obesity. Implementing stress management interventions with a focus on emotion regulation is pivotal, especially for females. Interventions should focus on sensitizing males to the association between emotions and eating behavior. The causal attributions should be assessed with different survey methods in order to match the patient's view of their condition.

Psychological Mediators of the Association between Obesity and Symptoms of Depression, Anxiety, and Stress

INTRODUCTION

There is still paucity of knowledge about which factors can mediate the link between obesity and mental health problems. This study aimed to investigate psychological mediators of the association between different weight profiles (healthy, overweight, and obesity) and symptoms of depression, anxiety, and stress.

METHODS

A sample of 407 adults (≥18 years old) with different weight profiles recruited from general population was assessed for symptoms of depression, anxiety, and stress, and dimensions of emotion regulation and body investment/body image. Robust regression and robust mediation analyses were employed to investigate predictors and mediators of mental health outcomes in relation to different weight profiles.

RESULTS

Body investment difficulties in relation to body image and body care, and emotion regulation difficulties related to a tendency towards negative secondary responses to negative emotions, and/or denial of distress, significantly mediated the association between obesity and symptoms of depression. The association between obesity and symptoms of anxiety and stress was significantly mediated by body investment difficulties related to body image concerns.

CONCLUSIONS

The current study brings evidence on specific dimensions of emotion regulation and body image that play a key role for the co-occurrence of mental health problems in individuals with obesity.

INTRODUCTION

There is still paucity of knowledge about which factors can mediate the link between obesity and mental health problems. This study aimed to investigate psychological mediators of the association between different weight profiles (healthy, overweight, and obesity) and symptoms of depression, anxiety, and stress.

METHODS

A sample of 407 adults (≥18 years old) with different weight profiles recruited from general population was assessed for symptoms of depression, anxiety, and stress, and dimensions of emotion regulation and body investment/body image. Robust regression and robust mediation analyses were employed to investigate predictors and mediators of mental health outcomes in relation to different weight profiles.

RESULTS

Body investment difficulties in relation to body image and body care, and emotion regulation difficulties related to a tendency towards negative secondary responses to negative emotions, and/or denial of distress, significantly mediated the association between obesity and symptoms of depression. The association between obesity and symptoms of anxiety and stress was significantly mediated by body investment difficulties related to body image concerns.

CONCLUSIONS

The current study brings evidence on specific dimensions of emotion regulation and body image that play a key role for the co-occurrence of mental health problems in individuals with obesity.

Is there a link between the inflammatory potential of a diet and mental health among patients with migraine? Findings from a cross-sectional survey

AIMS

In this study, we aimed to evaluate the relationship between the dietary inflammatory index (DII) and mental health outcomes among patients with migraine headaches.

METHODS

In this cross-sectional study, 262 subjects were included. The dietary intakes were collected using a validated 168-item semi-quantitative food frequency questionnaire. Items were scored according to their inflammatory potential, so a higher DII indicated a more pro-inflammatory diet. The association between DII and the mental health of participants was investigated using multinomial logistic regression and odds ratio (OR) with a corresponding 95% confidence interval (CI) was reported.

RESULTS

Overall, 224 women and 38 men, with a mean (standard error) DII of -2.96 (0.06), age of 36.1 (0.53) years, and BMI of 25.55 (0.21) kg/m2, comprised our study population. DII was positively associated with a higher risk of depression in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence (OR = 1.76; 95%CI: 1.04, 3.00; Ptrend = 0.035). Adjustments for age, sex, marital status, smoking status, migraine headache index score, number of family members, mean arterial pressure, medication, physical activity, and BMI intensified the association in a way that the risk of depression was 2.03 times higher in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence to a pro-inflammatory diet (OR = 2.03; 95%CI: 1.18, 3.49; Ptrend = 0.011).

CONCLUSION

Our findings suggest that depression was positively associated with adherence to a pro-inflammatory diet. However, no significant association was observed between anxiety and stress with DII.

Lifetime stressor exposure is associated with greater rewarding effects of stress-related eating

Acute stressors tend to shift preferences toward comfort foods, yet they do not ubiquitously increase the amount of food consumed. Moreover, although many individuals eat more under stress, others eat less or show no change. Although the precise mechanisms explaining this variability in stress-related eating are unknown, they may be driven by individual differences in the rewarding effects of comfort eating, which are enhanced by greater lifetime stressor exposure. To investigate this possibility, we examined whether differences in lifetime stressor exposure predicted reductions in negative affect following snacking (i.e., negative reinforcement) and if this effect was specific to stress-related snacking or snacking in general. Participants were 26 women (23 % non-White) between 20 and 45 years old (M = 31), with a mean body mass index of 26, who completed three laboratory visits. Participants completed an assessment of lifetime stressor exposure (i.e., STRAIN) on the first visit and, on two subsequent laboratory visits in counterbalanced order, were given snacks after an acute social stress task (i.e., TSST) or rest period. Greater lifetime stressor exposure was related to greater post-ingestive decreases in negative affect following the acute social stressor but not following the rest period. If stress-related eating is more comforting for women with greater lifetime stressors and contributes to a stronger stress-eating association, then this may inform obesity-related clinical treatments that target behaviors and cognitions related to reward-based learning.

Self-reported food liking and wanting: A factor analytic study of ratings across 49 consecutive days

Reward responses to food are thought to play an important role in highly palatable food overconsumption. In animal models, food reward responses can be decoupled into unique "liking" (in the moment enjoyment) and "wanting" (motivation/craving) components. However, research on liking and wanting has been hampered by uncertainty regarding whether liking and wanting can be reliably separated in humans. We used factor analysis to test whether ratings of liking and wanting could be empirically separated in women assessed across 49 consecutive days. Female participants (N = 688; ages 15-30) from the Michigan State University Twin Registry reported liking and wanting of foods consumed that day, and wanting of foods not consumed that day, separately for sweets (e.g., cookies), fast food (e.g., French fries), carbohydrates (e.g., bread), and whole foods (fruit, plain chicken) each evening for 49 consecutive days. We examined both average levels and daily levels of liking/wanting across the 49-day period that captured individual differences in liking/wanting over time. Across both types of analyses, liking and wanting for foods that were eaten formed a single factor rather than separate, dissociable factors, while wanting of foods not eaten formed an independent factor. At the daily level, a liking/wanting factor emerged for each individual food category (e.g., liking/wanting sweets), whereas in average analyses, a single factor emerged that collapsed across all food types (i.e., liking/wanting of all foods). Results suggest individuals have difficulty distinguishing between liking and wanting of foods they have eaten on that day but may be able to more reliably separate wanting of foods they have not consumed.

Emotional eating mediates the relationship between perceived stress and body appreciation in adult male and female: A cross-sectional study in Turkey

The aim of this study was to investigate the association between adults' perceived stress, emotional eating, and body appreciation. The Emotional Eater Questionnaire (EES), the Perceived Stress Scale (PSS), and the Body Appreciation Scale-2 (BAS-2) were completed by 710 adult participants. Emotional eating was found to be adversely related to body appreciation in both female (=-0.232, p: <.001) and male (β = -0.180, p < .05). The study's findings highlighted the harmful impacts of perceived stress and emotional eating on the range of body appreciation. This finding shows that stress and emotion management should be considered in the context of adult body appreciation practices.

Ethnic and sexual orientation inequalities in mental health-obesity comorbidity, self-harm, and attempted suicide among British adolescents

PURPOSE

Mental illness and obesity (MH-OB) may co-occur in adolescence and have a strong risk to track into adulthood. Using an intersectional framework, we explored associations between ethnic-sexual identities and MH-OB comorbidity in adolescents. We examined the risk of self-harm (SH) and attempted suicide (AS) by comorbidity status and ethnic-sexual identities.

METHODS

Participants included 9,789 adolescents (aged 17 years) from the UK-wide Millennium Cohort Study with data on self-identified ethnicity and sexuality. Participants were categorised as White-heterosexual, White-sexual minority (SM), Ethnic Minority (EM) heterosexual or EM-SM adolescents. We used multivariable logistic regression to examine associations between 1.dual ethnic-sexual identities and MH-OB comorbidity, 2.risk for self-harm (or attempted suicide) in relation to comorbidity and ethnic-sexual identities (including interactions between the comorbidity and ethnic-sexual identities variables to assess whether risk for self-harm differed by ethnic-sexual identities and comorbidity status).

RESULTS

Comorbidity was higher among White-SM (OR = 3.73, 95%CI 2.42-5.75) and EM-SM (OR = 1.96, 1.03-3.73) adolescents. SM identities (OR = 3.02, 2.41-3.78 for White-SM) and having comorbidity (OR = 2.83, 2.03-3.95) were independently associated with SH or AS. Risk of SH among White-heterosexual individuals was greater among comorbid individuals (40%) relative to non-comorbid individuals (19%). Risk of SH was higher in SM individuals (58% vs. 41% in White-SM and 50% vs. 29% in EM-SM individuals with and without comorbidity, respectively). Risk of AS was 5% and 19% in comorbid and non-comorbid White-heterosexual individuals, respectively; the corresponding figures for White-SM individuals were 14% and 17%.

CONCLUSION

Irrespective of ethnicity, SM adolescents have a significantly greater risk of SH and AS. Comorbidity further amplifies this risk.

Emotional Eating in Primary Care: Considerations for Assessment and Management

LEARNING OBJECTIVES

After participating in this CME activity, the psychiatrist should be better able to:• Describe how to identify and address emotional eating in the primary care setting.

ABSTRACT

Emotional eating (i.e., eating in response to negative emotional states and stress) is a highly prevalent concern within primary care settings. It is associated with myriad health issues such as the experience of overweight or obesity, increased difficulty losing weight and sustaining weight loss, various eating disorders, diabetes, and heart disease. Given the effects of emotional eating on patient health goals regarding weight loss or management, it is imperative to incorporate interventions that address emotional underpinnings alongside traditional, behaviorally based weight-loss treatment. Ensuring that primary care providers, who represent pivotal frontline touch points for patients interested in weight-related treatment, can identify emotional eating is an important first step in supporting these patients' goals. The primary purpose of this paper is to provide background information and practical guidance for addressing emotional eating in the primary care setting. We summarize theorized biological and psychological mechanisms that underlie emotional eating, and review traditional (i.e., psychological) interventions, with special consideration for adapting available treatments for use in primary care contexts.

Proof-of-concept testing of a brief virtual ACT workshop for emotional eating

BACKGROUND

Emotional eating, or eating in response to negative emotions, is a commonly reported short-term emotion regulation strategy but has been shown to be ineffective in the long term. Most emotional eating interventions based on Acceptance and Commitment Therapy (ACT) have been delivered in the context of weight loss trials, highlighting a need for ACT-based emotional eating interventions in weight-neutral contexts.

AIMS

This proof-of-concept study aimed to test the acceptability and efficacy potential of a brief virtual ACT workshop for emotional eating in a small sample of adults identifying as emotional eaters.

METHODS

Twenty-six adult emotional eaters completed an ACT workshop delivered in two 1.5-h sessions over two weeks. The workshop targeted awareness and acceptance of emotions and eating urges, and valued actions around eating.

RESULTS

The acceptability of the workshop was demonstrated by high participant satisfaction. Significant improvements on all outcome measures were found and maintained up to 3 months follow-up.

CONCLUSIONS

These proof-of-concept findings suggest that a brief virtual ACT workshop may improve emotional eating and associated ACT processes. Results from this study can inform a future randomized controlled trial to test the efficacy of the workshop and the role of theoretical processes of change.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04457804.

LEVEL OF EVIDENCE

Level IV, evidence obtained from multiple time series with the intervention.

The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.

Longitudinal associations between psychosomatic and emotional status and selected food portion sizes in European children and adolescents: IDEFICS/I.Family study

This study aims to investigate the influence of psychosomatic and emotional status on food portion sizes (PSs) consumption from high energy-dense food groups in European children and adolescents. We hypothesized that psychosomatic and emotional status would have a significant association with the PS selection of energy-dense food. The study included 7355 children aged between 2 and 9.9 years at baseline (T0) (48.8% females); 3869 after 2 years (T1) (48.2% females), and 2971 (51.8% females) after 6 years of follow-up (T3). Psychosomatic and emotional status were measured using emotional well-being during the last week score (KINDL) and Strengths and Difficulties Questionnaire. PS was calculated from daily food intake recorded in 24-hour dietary recalls. The associations between emotional status indicators and PS from selected energy-dense food groups were assessed by multilevel linear regression models. In the cross-sectional analysis, we observed that higher KINDL scores were linked to lower PS consumption from sweet bakery products and savory snacks in both genders. Moreover, we found that adolescent females with high emotional and peer problem scores tended to consume larger PS of carbohydrate-rich and sugar-fatty food items (P < .017). Longitudinally, higher peer problem scores were associated with increased PS from bread and rolls, margarine and lipids, and dairy products in all genders and age groups (P< .017). In adolescents, psychosomatic and emotional status could be a trigger for consuming large PS from carbohydrate-rich and sugar-fatty energy-dense foods. Thus, nutritional interventions should consider emotional status to decrease unhealthy dietary habits in children and adolescents.

Relation of preconception eating behaviours to dietary pattern trajectories and gestational weight gain from preconception to late pregnancy

Studies examining preconception eating behaviours with longitudinal dietary patterns from preconception to late pregnancy as well as gestational weight gain (GWG) are limited. We derived dietary pattern trajectories from preconception to late-pregnancy, and related preconception eating behaviours to these trajectories and GWG. Preconception eating behaviours were assessed using the Three-Factor Eating Questionnaire measuring cognitive restraint (CR) - conscious restriction of food intake, emotional eating (EE) - overeating in response to negative emotions, and uncontrolled eating (UE) - overeating with a feeling of lack of control. Dietary intakes were measured at preconception, 20-21 and 34-36 weeks' gestation with food frequency questionnaires. Dietary patterns were determined using factor analysis, and trajectories derived using group-based trajectory modelling. Inadequate and excessive GWG were defined according to Institute of Medicine guidelines based on weights at preconception and the last antenatal visit (median: 38 weeks' gestation). Two dietary patterns were derived: 'Fast Food, Fried Snacks and Desserts (FFD)' and 'Soup, Fish and Vegetables (SFV)'. Adherence trajectories from preconception to late-pregnancy were characterised as consistently high ("stable-high") and low ("stable-low"). Women with higher UE scores had higher odds of being in the "stable-high" trajectory (n = 34) of the FFD pattern [Odds Ratio (OR): 1.25, 95% Confidence Interval (CI): 1.03, 1.51], compared to "stable-low" (n = 260). Percentages of women with inadequate, adequate or excessive GWG were 21.7% (n = 70), 25.8% (n = 83), and 52.5% (n = 169), respectively; women with higher EE scores had a higher likelihood of excessive GWG [Relative Risk Ratio (RRR): 1.35, 95% CI: 1.02, 1.80], but this association was attenuated after adjusting for preconception body mass index. Eating behaviour interventions to improve dietary patterns among pregnant women may need to start as early as preconception, incorporating strategies to manage UE.

Psychometric evaluation of three-factor eating questionnaire -R18 in aging Finnish men with increased risk for type 2 diabetes

BACKGROUND

Deeper comprehension of eating-related behaviour (how and why people eat) can reveal new aspects to support health and prevent type 2 diabetes (T2D). However, such research is largely missing in aging men.

AIM

The aim was to investigate suitability of the Three-Factor Eating Questionnaire-R18 (TFEQ-R18) in Finnish aging men which is widely used to examine factors: cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE).

METHODS

Study population consisted of 420 men aged 50-75, who completed the TFEQ-R18 at the baseline of the T2D-GENE lifestyle intervention study. Inclusion criteria were impaired fasting glucose (IFG) and body mass index ≥25 kg/m2. Confirmatory factor analysis was used to study psychometrics (reliability, validity, and model fit) and factor structure of TFEQ-R18.

RESULTS

The items loaded to the three factors (CR, UE, EE) as in previous studies, except two items at CR factor and one at UE factor, which were therefore omitted. UE was also discovered split into two sub factors (named as 'craving' and 'loss-of-control'), UE being a higher-order (h) factor. The resultant revised version was named as Three-Factor Eating Questionnaire Revised to 15-items with higher-order factor (TFEQ-R15h).

CONCLUSION

The original 18-item version of the TFEQ was not optimal in the population consisting of Finnish aging men with elevated T2D risk. A modified 15-item version of the TFEQ could be used to describe EB in this population instead.

Behavioral and Psychosocial Mediators of the Effects of Increased Self-Regulation on Short- and Long-Term Weight Loss in Women Within Community-Based Obesity Treatments

The aim of this study was to evaluate behavioral mediators of relationships between increased self-regulation of eating and weight loss so that findings on psychosocial correlates of treatment-associated weight change could be extended. Participants were women enrolled in 6-month community-based obesity treatments using primarily self-regulatory (SR-treatment, n = 52) or education-focused (Didactic training, n = 54) methods. Changes from baseline in self-regulation of eating, self-efficacy for controlled eating, emotional eating propensity, exercise, and the diet were first calculated. There were significant overall improvements in each psychosocial and behavioral measure, and weight. Except for emotional eating change from baseline-Month 12, improvements were each significantly greater in the SR-treatment group. Mediation of the relationships of change in self-regulation with 6-, 12-, and 24-month weight changes, by changes in self-efficacy and emotional eating, were significant, R2s = .19-.26, ps < .001. Only changes in emotional eating over 6 and 12 months were significant mediators. Mediations of the same self-regulation-weight change relationships by changes in exercise and the diet were also significant, R2s = .19-.28, ps < .001, and only changes in exercise over 12 and 24 months were significant mediators. Although group membership did not moderate effects on weight, substitution of sweets for the (composite) diet demonstrated it to be a significant mediator over 6 and 12 months. In women with obesity, self-regulation improvement was associated with short- and longer-term weight loss through changes in emotional eating, exercise, and sweets consumption. Thus, behavioral treatments will benefit from targeting those variables.

Association of disaster-related damage with inflammatory diet among older survivors of the Great East Japan Earthquake and Tsunami

Traumatic experiences from disasters have enduring effects on health, both directly and indirectly by influencing health behaviours. Among potential pathways, the impact of disaster-related trauma on dietary patterns has been understudied. This study investigated the relationship between disaster-related trauma and dietary inflammatory index (DII®), and how these relationships differed by gender and whether they prepare meal by themselves or not among older survivors of the 2011 Great East Japan Earthquake and Tsunami (n 1375). Dietary data were collected in 2020 using a brief-type self-administered diet history questionnaire, from which we derived a dietary inflammatory index (DII®) based on twenty-six food/nutrient items, where higher scores indicate pro-inflammatory (i.e. unhealthy) diet. We found that the experience of housing damage due to the earthquake and tsunami was associated with slightly higher DII scores (coef. = 0·38, 95 % CI -0·05, 0·81). Specifically, women who cooked by themselves tended to have higher DII when they experienced housing damage (coef. = 1·33, 95 %CI -0·63, 3·28). On the other hand, loss of friends was associated with a lower DII score (coef. = -0·28, 95 % CI -0·54, -0·01). These findings highlight the importance of providing support to groups who are at increased risk of deterioration in dietary quality in the aftermath of disasters.

Obesity in Latinx and White U.S. military veterans: Mental health, psychosocial burden, non-suicidal self-injury and suicidal behavior

Obesity disproportionately affects Latinx communities and is linked to an increased risk of mental health problems. Military veterans are more likely to develop mental health problems, but the role of Latinx ethnicity in moderating the association between obesity and these problems is unclear. To address this gap, this study examined psychiatric and psychosocial correlates of obesity in a nationally representative sample of Latinx and White U.S. military veterans. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed 3524 Latinx and White veterans. Analyses revealed that Latinx ethnicity moderated associations between obesity and several measures. Specifically, among veterans with obesity, Latinx veterans had higher rates of major depression, generalized anxiety, post-traumatic stress disorders, drug use disorders, non-suicidal self-injury, and higher levels of childhood trauma, loneliness, and hostility relative to White veterans. These findings underscore the importance of culturally sensitive prevention and treatment efforts to help mitigate symptoms of internalizing disorders, drug use disorder, loneliness, and hostility, and to cultivate psychosocial resources such as resilience and coping self-efficacy among Latinx veterans with obesity.

Role of Eating Behavior and Stress in Maintenance of Dietary Changes During the PREVIEW Intervention

OBJECTIVE

To examine whether eating behavior and perceived stress predict the maintenance of self-reported dietary change and adherence to dietary instructions during an intervention.

DESIGN

A secondary analysis of the behavior maintenance stage (6-36 months) of the 3-year PREVIEW intervention (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World).

PARTICIPANTS

Adults (n = 1,311) with overweight and prediabetes at preintervention baseline.

VARIABLES MEASURED

Eating behavior (Three-Factor Eating Questionnaire), stress (Perceived Stress Scale), and dietary intake (4-day food records on 4 occasions) were reported.

ANALYSIS

Associations between predictors and dietary outcomes were examined with linear mixed-effects models for repeated measurements.

RESULTS

Eating behaviors and stress at 6 months did not predict the subsequent change in dietary outcomes, but higher cognitive restraint predicted lower energy intake, and both higher disinhibition and hunger predicted higher energy intake during the following behavior maintenance stage. In addition, higher disinhibition predicted higher saturated fat intake and lower fiber intake, and higher hunger predicted lower fiber intake. Stress was not associated with energy intake or dietary quality. Eating behaviors and stress were not consistently associated with adherence to dietary instructions.

CONCLUSIONS AND IMPLICATIONS

Higher cognitive restraint predicted lower energy intake (food quantity), but disinhibition and hunger were also associated with dietary quality.

Tryptophan metabolic pathway plays a key role in the stress-induced emotional eating

Chronic stress disrupts the emotional and energetic balance, which may lead to abnormal behaviors such as binge eating. This overeating behavior alleviating the negative emotions is called emotional eating, which may exacerbate emotional instability and lead to obesity. It is a complex and multifaceted process that has not yet been fully understood. In this study, we constructed an animal model of chronic mild stress (CMS)-induced emotional eating. The emotional eating mice were treated with tryptophan for 21 days to reveal the key role of tryptophan. Furthermore, serum-targeted metabolomics, immunohistochemical staining, qPCR and ELISA were performed. The results showed that CMS led to the binge eating behavior, accompanied by the disturbed intestinal tryptophan-derived serotonin (5-hydroxytryptamine; 5-HT) metabolic pathways. Then we found that tryptophan supplementation improved depression and anxiety-like behaviors as well as abnormal eating behaviors. Tryptophan supplementation improved the abnormal expression of appetite regulators (e.g., AgRP, OX1R, MC4R), and tryptophan supplementation also increased the tryptophan hydroxylase 2 (tph2) and 5-HT receptors in the hypothalamus of CMS mice, which indicates that the 5-HT metabolic pathway influences feeding behavior. In vitro experiments confirmed that 5-HT supplementation ameliorated corticosterone-induced aberrant expression of appetite regulators, such as AgRP and OX1R, in the hypothalamic cell line. In conclusion, our findings revealed that the tryptophan-derived 5-HT pathway plays an important role in emotional eating, especially in providing targeted therapy for stress-induced obesity.

Association of dietary overall antioxidant intake with all-cause and cause-specific mortality among adults with depression: evidence from NHANES 2005-2018

Higher intakes of individual antioxidants such as vitamins A, C, and E have been linked to mortality in the general population, but the association of overall antioxidant intake with mortality especially in depressed adults remains unclear. We aimed to investigate whether the dietary overall antioxidant intake is associated with all-cause and cause-specific mortality among depressed adults. This study included 3051 US adults with depression, who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Patient Health Questionnaire-9 (PHQ-9) was used to define depression and evaluate depression severity. The dietary antioxidant quality score (DAQS) and dietary antioxidant index (DAI) were calculated based on the intakes of vitamins A, C, and E, zinc, selenium, and magnesium. A higher DAQS and DAI were significantly associated with lower depression scores (PHQ-9) (all P-trend < 0.05). For individual antioxidants, significant negative associations of vitamins A and E with all-cause mortality were observed. For overall antioxidant intake, the DAQS and DAI were inversely associated with all-cause and cancer mortality. Compared with participants in the lowest categories of DAQS and DAI, the corresponding HRs (95% CIs) in the highest categories were 0.63 (0.42-0.93) and 0.70 (0.49-0.98) for all-cause mortality and 0.39 (0.17-0.87) and 0.43 (0.21-0.88) for cancer mortality, respectively. The overall dietary antioxidant intake was beneficially associated with all-cause and cancer mortality in depressed adults. These findings suggest that comprehensive dietary antioxidant intake may improve depressive symptoms and lower mortality risk among adults with depression.

A comprehensive investigation of the association between menopause symptoms and problematic eating behavior in peri- and post-menopause cisgender women

Midlife individuals assigned female at birth are at risk for problematic eating behavior, associated with negative health outcomes. Little is known about how menopausal symptoms may increase risk in this population. The current study aimed to understand how a comprehensive range of menopause symptoms were globally associated with problematic eating behaviors. A total of 281 cisgender women (176 post-menopause, 105 peri-menopause) from the United States aged 40 to 64 were recruited utilizing Prolific, an online survey platform. Participants answered questionnaires about menopause symptoms and problematic eating. Participants were selected using demographic and health information provided in a screener survey. Participants also completed the Eating Disorder Questionnaire (EDE-Q), Women's Health Questionnaire (WHQ), Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Using Structural Equation Modeling, menopause symptoms explained 16.7 percent of the variance in problematic eating. Higher frequency and severity of anxiety, depression, sleep concerns, cognitive complaints, pain, and vasomotor symptoms was associated with greater frequency and severity of problematic eating behaviors, β = .40, p < .001. Invariance testing showed no significant differences between peri- and postmenopausal women. These findings support the association between menopause symptoms and problematic eating in Midlife cisgender women and highlight the need for continued investigation.

Eating behavior during pregnancy mediates the association between depression and diet quality--a new strategy for intervention in pregnancy

Background

Depression can result in changes in eating behavior and decrease the quality of eating. It has been shown that maternal depression during pregnancy can result in malnutrition, which can have adverse effects on the pregnancy and the offspring. There is currently no clear association between depression and diet.

Methods

Five hundred and forty-nine pregnant women recruited from Danyang Maternal and Child Health Hospital in Jiangsu Province participated in this study and were administered the Intuitive Eating Scale-2 (IES-2), Edinburgh Post-natal Depression Scale (EPDS), Pregnancy Stress Scale (PPS), Self-rating Anxiety Scale (SAS), and Dietary Guidelines Adherence Index for Pregnant Women during Pregnancy (CDGCI-PW). The nutritional software collected dietary records for three consecutive days in mid-pregnancy to calculate dietary intake and nutrients that support energy production. The mediation analyses were conducted using SPSS 24.0 macro PROCESS.

Results

The relationship between depressive symptoms during pregnancy and diet quality was moderated primarily by two aspects of eating behavior, "Reliance on Hunger and Satiety Cues" (RHS) and "Body-Food Choice Congruence" (BFC). Depressive symptoms (EPDS scores) showed a negative correlation with RHS, BFC, and RHS, and BFC showed a positive correlation with diet quality, yielding a significant specific indirect effect. The multiple mediation model explained 14.7% of the variance in the diet quality.

Conclusion

This study highlights the important role of eating behaviors during pregnancy in the relationship between depressive symptoms (EPDS scores) and diet quality, and provides preliminary evidence for feasible ways pregnant women with depressive symptoms can improve diet quality, promote maternal and child health, and reduce depression.

Perceived Stress and Depressive Symptoms Are Associated With Emotional Eating but Not Nutritional Intake During Pregnancy: A Prospective Cohort Study

INTRODUCTION

Pregnancy is a major life event during which women may experience increased psychological distress and changes in eating behaviors. However, few studies have investigated the influence of psychological distress on pregnant women's eating behaviors. The primary objective of this prospective study was to examine the associations of changes in perceived stress and depressive symptoms with emotional eating and nutritional intake during pregnancy. In addition, we examined the direct and moderating effects of perceived social support.

METHODS

Participants were racially diverse pregnant women (14-42 years) from 4 clinical sites in Detroit, MI, and Nashville, TN (N = 678). We used multiple linear and logistic regression models to determine if changes in stress and depressive symptoms across pregnancy were associated with changes in emotional eating and nutritional intake. We examined residualized change in stress and depressive symptoms from second to third trimester of pregnancy; positive residualized change scores indicated increased stress and depressive symptoms.

RESULTS

Participants showed significant improvement in emotional eating and nutritional intake from second to third trimester of pregnancy (P < .001 for both). At second trimester, higher depressive symptoms were associated with a greater likelihood of emotional eating (P < .001) and worse nutritional intake (P = .044) at third trimester. Increased stress and depressive symptoms during pregnancy were both associated with increased risk, whereas increased perceived social support reduced risk of emotional eating at third trimester (stress: adjusted odds ratio [AOR], 1.17; 95% CI, 1.08-1.26; depressive symptoms: AOR, 1.05; 95% CI, 1.01-1.08; social support: AOR, 0.93; 95% CI, 0.88-0.99). None were associated with changes in nutritional intake. Perceived social support did not show any moderating effects.

DISCUSSION

Increased psychological distress during pregnancy may increase emotional eating. Efforts to promote healthy eating behaviors among pregnant women should consider and address mental health.

The role of emotion in eating behavior and decisions

The present paper aims to provide the latest perspectives and future directions on the association between emotions and eating behavior. We discussed individual differences in the impact of negative emotions on eating, emotional eating as disinhibited eating decisions with heightened reward values of and sensitivity to palatable foods in response to negative emotions and social isolation, in addition to emotional eating as maladaptive coping strategies under negative emotion and stress, hedonic (pleasure-oriented) eating decisions mediated by the brain reward system, and self-controlled (health-oriented) eating decisions mediated by the brain control system. Perspectives on future directions were addressed, including the development of early eating phenotypes in infancy, shared neural mechanisms mediated by the ventromedial prefrontal cortex and the dorsolateral prefrontal cortex in emotion and eating decision regulation, possible roles of interoception incorporating hunger and satiety signals, gut microbiome, the insula and the orbitofrontal cortex, and emotional processing capacities in hedonic eating and weight gain.

Associations of food motives with red meat and legume consumption in the population-based DILGOM study

PURPOSE

To improve human health and environmental sustainability, red meat consumption should decrease and legume consumption increase in diets. More information on food motives, however, is required when developing more tailored and effective interventions targeting legume and meat consumption. We aimed to examine the associations between food motives and red meat and legume consumption, and whether these associations differ between different subgroups (gender, age groups, marital status, education, BMI).

METHODS

Ten food motives (health, mood, convenience, sensory appeal, natural content, price-cheap, price-value, weight control, familiarity and ethical concern measured with Food Choice Questionnaire) were studied in 3079 Finnish adults in the population-based DILGOM study. Food consumption was assessed with Food Frequency Questionnaire. The adjusted estimates from multivariable regression models are reported.

RESULTS

Higher relative importance of natural content (β = - 0.275, 95% CI - 0.388; - 0.162) and ethical concern (β = - 0.462, 95% CI - 0.620; - 0.305) were associated with lower red meat consumption, and higher appreciation of sensory appeal (β = 0.482, 95% CI 0.347; 0.616) and price-cheap (β = 0.190, 95% CI 0.099; 0.281) with higher red meat consumption. Higher importance of health (β = 0.608, 95% CI 0.390; 0.825) was associated with higher legume consumption, and higher appreciation of convenience (β = - 0.401, 95% CI - 0.522; - 0.279), price-value (β = - 0.257, 95% CI - 0.380; - 0.133) and familiarity (β = - 0.278, 95% CI - 0.393; - 0.164) with lower legume consumption. The associations of particularly ethical concern, weight control, sensory appeal and mood varied according to gender, age, marital status or BMI.

CONCLUSION

The development and implementation of actions to decrease red meat and increase legume consumption should focus on several food motives across different subgroups.

Stress during the COVID-19 Pandemic and Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Results in Girls: Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress related to the outbreak of the COVID-19 pandemic may have caused substantial changes in eating behaviors, and may have been associated with emotional eating, especially in female individuals. The aim of the present study was to analyze the association between stress perceived during the COVID-19 pandemic and emotional eating in girls, within the third phase of the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. A nationwide sample of 818 Polish female adolescents, aged 15-20, was gathered. The adolescents were recruited to the study based on a random quota sampling procedure. Using a computer-assisted web interview (CAWI) survey, participants filled out the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) to assess the urge to cope with negative emotions by eating, and the Adolescent Stress Questionnaire (ASQ) to assess perceived stress. Additionally, the data concerning body mass, height, as well as body mass change during the COVID-19 pandemic were verified. The groups most susceptible to emotional eating were excessive body mass female adolescents, those who gained weight during the COVID-19 pandemic and those experiencing high stress levels while facing negative emotions. In order to plan effective therapeutic interventions dealing with the issue of emotional eating, both psychological therapy and dietary strategy tailored to the individual should be considered for the indicated susceptible groups.

Social Networking Site Use and Emotional Eating Behaviors among Chinese Adolescents: The Effects of Negative Social Comparisons and Perspective-Taking

Emotional eating has emerged as a significant disordered eating and public health concern among adolescents. Despite the widespread prevalence of social networking site (SNS) use among this population, research investigating the influence of SNS use on adolescent eating behaviors remains limited. This study is to examine the impact of SNS use on emotional eating among Chinese adolescents, with a specific focus on exploring the mediating role of negative social comparisons and the moderating effect of perspective-taking. Data were obtained through an online survey involving 778 middle school students in China. The findings indicate that SNS use exerts a positive influence on adolescents' engagement in emotional eating, with this association being mediated by the presence of negative social comparisons. Perspective-taking demonstrated a protective role in the context of adolescents' utilization of social media platforms. For individuals characterized by high levels of perspective-taking, the effects of SNS use on negative social comparisons are mitigated, subsequently reducing its impact on emotional eating.

Excessive gestational weight gain and emotional eating are positively associated with postpartum depressive symptoms among taiwanese women

BACKGROUND

Excessive gestational weight gain and emotional eating may be associated with postpartum depression symptoms. This study was designed to identify how gestational weight gain and eating behaviors are related to postpartum depression (PPD) symptoms among women in Taiwan.

METHODS

A cross-sectional study was conducted from March 2022 to October 2022 with 318 postpartum women recruited in Taipei, Taiwan. Gestational weight gain (GWG) for the total pregnancy period was recorded as inadequate, adequate, or excessive, based on the 2009 Institute of Medicine recommendations (IOM), accounting for pre-pregnancy body mass index category. Eating behavior at one month postpartum was measured on a 16-item 5-point Likert scale with three subscales: uncontrolled, restrained, and emotional. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale with a cutoff score of 13.

RESULTS

The prevalence of postpartum depression symptoms (Edinburgh Postnatal Depression Scale ≥ 13) was 23.9% at one month postpartum. Logistic regression analysis revealed that excessive gestational weight gain and emotional eating were positively associated with postpartum depression symptoms at that time.

CONCLUSION

Evidence presented here suggests that emotional eating and excessive GWG are associated with PPD symptoms in a Taiwanese population. In addition, it should be a public health priority to ensure a particular focus on mental health during the postpartum period. Healthcare providers should discourage pregnant women from unhealthy eating habits by targeting appropriate GWG and focusing on demand eating to reduce PPD in the postpartum period.

Depression symptoms and sweet foods consumption in Mexican college men: the role of emotional eating

Introduction

Objective: to evaluate the association between depression symptoms and frequency of unhealthy food consumption, and to explore the mediation effect of emotional eating in this relationship in college men. Method: a cross-sectional study was performed on 764 men at a public university in Mexico City. To assess emotional eating (EE), a validated Spanish-language version of the Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES) was applied. Depression symptoms were evaluated using the scale elaborated by the Center for Epidemiologic Studies (CES-D) and a Questionnaire of Frequency of Food Consumption was used to measure frequency of food consumption. Path and mediation analysis were applied. Results: one-fifth (20.42 %) of college men reported depression symptoms (CES-D ≥ 16). Students with depression symptoms had a higher mean EE score (p < 0.001), a higher frequency of fried food (p = 0.049), sweetened beverages (p = 0.050), and sweet foods consumption (p = 0.005) than students with low CES-D score. According to the mediation analysis, the effect of depression symptoms on the frequency of sweet foods consumption was partially mediated by EE (23.11 % of the total effect). Conclusion: the prevalence of depression symptoms was high. EE is an important mediator in the relationship between depression symptoms and the consumption of sweet foods. Understanding the manifestation of eating behaviors in men and their relationship with depression symptoms may help clinicians and health authorities develop treatment and prevention programs aimed to decrease the risk of obesity and eating disorders.

Influence of Food Type on Human Psychological-Behavioral Responses and Crime Reduction

The purpose of this narrative review is to emphasize the importance of food consumption and meal selection on mental health and brain function, including psychological and behavioral reactions such as mood, loving relationships, violence, and criminal activity. Additionally, by being aware of the link between food and mental health, the community can be encouraged to make informed food choices in order to avoid unfavorable outcomes like criminality. Food behaviors are shifting significantly over the world. There are also significant changes in mood, sadness, happiness, and violence, as well as the spread of the variety and severity of mental diseases that lead to violent acts. Food intake and meal selection have evolved over the last ten years as the variety and accessibility of food options have become easier and more diverse. These modifications might have both beneficial and bad consequences. This article examines the relationship between food intake and its impact on marital satisfaction. The goal of this review is to support or refute the claim that food influences mood, love, or criminal behavior, or vice versa. Various diets can have an impact on one's mental health and brain, influencing psychological reactions and behavioral responses such as mood, loving relationships, violence, and even criminal activity. Food insecurity has been demonstrated in various studies to have a negative impact on health and psychological well-being, leading to despair, loss of happiness, marital conflict, and violence. For example, herbal extracts and flavonoids have the potential to improve gut microbiota and treat mood disorders. Understanding how the gut-brain axis communicates might help guide interventions for mood and cognitive function. Since the root of most diseases and behaviors is significantly related to the type of food consumed, this research addresses this issue in order to reduce the cost of treatment and prevention of crime and delinquency at the community level by consciously choosing the food consumed by the society. In other words, prevention is always better than cure.

The effects of body dissatisfaction and depression levels on the dietary habits of university students in southern China during COVID-19

Introduction

The novel coronavirus disease of 2019 has impacted people's lives greatly. The spread of the pandemic has restricted many everyday social lives. Some studies have shown that strict risk control during the pandemic threatens people's mental health and eating habits. University students vulnerable to mental health problems may have more prominent mental health and eating disorders during the pandemic. This study aims to elucidate the relationship between body dissatisfaction, depression, body mass index, and emotional eating among university students in the context of the pandemic in southern China. It provides a theoretical basis for developing future approaches to improve depression and emotional eating among university students.

Methods

A total of 1,135 university students were recruited for the study. All participants completed anthropometric, body dissatisfaction, eating behavior, and depression level surveys.

Results

The study finds that female students have higher levels of body dissatisfaction, depression, and emotional eating than male students. University students in the high body dissatisfaction group had higher levels of depression. Depression level (β = 0.33, p < 0.01), body dissatisfaction (β = 0.22, p < 0.01), sex (β = 0.16, p < 0.01), and income (β = 0.06, p < 0.01) were significant predictors of emotional eating. Fundamentally, this study highlights the impact of body dissatisfaction on depression and emotional eating.

Discussion

The potential to improve depression and emotional eating among university students by improving their levels of body dissatisfaction was demonstrated.