Eating behaviors mediate the relationship between perceived stress and anthropometric measurements related to obesity in young adults

Yılmaz, Hacı Ömer; Meriç, Çağdaş Salih; Öztürk, Meryem Elif; Doğan, Gökcen; Er, Nida Tokaç; Ayhan, Nurcan Yabanci

doi:10.1590/1678-9865202437e230050

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Original - Collective Health • Rev. Nutr. 37 • 2024 • https://doi.org/10.1590/1678-9865202437e230050 copy

Eating behaviors mediate the relationship between perceived stress and anthropometric measurements related to obesity in young adults

Comportamentos alimentares medeiam a relação entre estresse percebido e medidas antropométricas relacionadas à obesidade em adultos jovens

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The aim of the present study was to investigate the association of perceived stress, eating behaviors and anthropometric measurements related to obesity in the university students.

Methods

A cross-sectional study was carried out with 658 university students (128 males, 530 females). A questionnaire comprising socio-demographic characteristics, eating habits, perceived stress using the Perceived Stress Scale-14, eating behaviors assessed with the Dutch Eating Behavior Questionnaire and measured anthropometric parameters was administered by researchers.

Results

Perceived stress was higher in pre-obesity/obese participants compared to those were underweight and had normal weight (p<0.001). Emotional and external eating behaviors were higher in pre-obesity/obese participants compared to others (p<0.001). The total score of the Perceived Stress Scale-14 showed significant correlations with body mass index (r=0.245, p<0.001), hip circumference (r=0.223, p<0.001), mid-upper arm circumference (r=0.248, p<0.001) and triceps skinfold thickness (r=0.178, p<0.001). In addition, after adjusting for mediators, a positive association was detected between the perceived stress score and body mass index (β=0.358, 95% CI [0.185, 0.531], p<0.001). Increased Dutch Eating Behavior Questionnaire score showed a mediating effect in this relationship (β=0.073, 95% CI [0.056, 0.091], p<0.001).

Conclusion

The findings of this study suggest a notable correlation between perceived stress, eating behaviors, and anthropometric measurements associated with obesity in university students. Enhancing stress coping strategies for individuals could potentially lead to improvements in eating behaviors and reduce risk of obesity.

Keywords:
Anthropometric measurements; Eating behavior; Obesity; Perceived stress; University students

Sociodemographic characteristics	Male (n=128)		Female (n=530)		Total (n=658)		Statistical test
Sociodemographic characteristics	n	%	n	%	n	%	Statistical test
Grade
1	26	20.3	96	18.1	122	18.5	χ²=15.836 p=0.01*
2	32	25.0	258	48.7	290	44.1
3	46	35.9	138	26.0	184	28.0
4	24	18.8	38	7.2	62	9.4
Mother's educational status
Iliterate	12	9.4	32	6.0	44	6.7	χ²=4.810 p=0.43
Literate	10	7.8	20	3.8	30	4.6
Primary	60	46.9	250	47.2	310	47.1
Secondary	26	20.3	96	18.1	122	18.5
High school	16	12.5	110	20.8	126	19.1
University/college	4	3.1	22	4.2	26	4.0
Father's educational status
Iliterate	2	1.6	8	1.5	10	1.5	χ²=4.359 p=0.36
Primary	48	37.5	148	27.9	196	29.8
Secondary	36	28.1	160	30.2	196	29.8
High school	22	17.2	148	27.9	170	25.8
University/college	20	15.6	66	12.5	86	13.1
Mother's profession
No profession	108	84.4	434	81.9	542	82.4	χ²=6.912 p=0.14
Self-employment	2	1.6	42	7.9	44	6.7
Officer	-	-	12	2.3	12	1.8
Employee	14	10.9	30	5.7	44	6.7
Retired	4	3.1	12	2.3	16	2.4
Father's profession
No profession	8	6.3	16	3.0	24	3.7	χ² =6.698 p=0.24
Self-employment	56	43.8	184	35.0	240	36.7
Officer	16	12.5	48	9.1	64	9.8
Employee	24	18.8	108	20.5	132	20.2
Retired	24	18.8	170	32.3	194	29.6
Accommodation
With family	20	15.6	168	31.7	188	28.6	χ²=19.804 p=0.00*
In dormitory	62	48.4	286	54.0	348	52.9
At home with friends	46	35.9	76	14.3	122	18.5
Family history of obesity
Yes	74	57.8	254	48.1	328	50.0	χ²=1.941 p=0.10
No	54	42.2	274	51.9	328	50.0	χ²=1.941 p=0.10
Smoking
No	86	67.2	424	80.0	510	77.5	χ²=4.869 p=0.08
Quit smoking	18	14.1	44	8.3	62	9.4
Yes	24	18.8	62	11.7	86	13.1

Nutritional habits	Male (n=128)		Female (n=530)		Total (n=658)		Statistical test
Nutritional habits	n	%	n	%	n	%	Statistical test
Main meals/day
1	24	18.8	70	13.2	94	14.3	χ²=7.005 p=0.03*
2	94	73.4	344	64.9	438	66.6
3	10	7.8	116	21.9	126	19.1
Snacks/day
No	22	17.2	44	8.3	66	10.0	χ²=22.816 p=0.00*
1	78	60.9	196	37.0	274	41.6
2	22	17.2	244	46.0	266	40.4
3	6	4.7	46	8.7	52	7.9
Skipping meal
Yes	72	56.3	252	47.5	324	49.2	χ²=1.607 p=0.44
Sometimes	50	39.1	252	47.5	302	45.9
No	6	4.7	26	5.0	32	4.9
Regular breakfast
Yes	78	60.9	358	67.5	436	66.3	χ²=1.007 p=0.19
No	50	39.1	172	32.5	222	33.7	χ²=1.007 p=0.19
Snacks before sleeping
Yes	98	76.6	260	49.1	358	54.4	χ²=15.723 p=0.00*
No	30	23.4	270	50.9	300	45.6	χ²=15.723 p=0.00*
Eating outside
Yes	86	67.2	326	61.5	412	62.6	χ²=0.710 p=0.24
No	42	32.8	204	38.5	246	37.4	χ²=0.710 p=0.24
Consumption of at least 5 servings of vegetables and fruits/day^¥
Yes	4	3.1	42	7.9	46	7.0	χ²=1.826 p=0.13
No	124	92.6	488	92.1	612	93.0	χ²=1.826 p=0.13
Consumption of at least 3 glasses of milk and yogurt/day^¥
Yes	34	26.6	142	26.8	176	26.7	χ²=0.001 p=0.54
No	94	73.4	388	73.2	482	73.3	χ²=0.001 p=0.54
Adding salt to meal
Yes	54	42.2	158	29.8	212	32.2	χ²=3.616 p=0.04*
No	74	57.8	372	70.2	446	67.8	χ²=3.616 p=0.04*
Doing regular physical activity^§
Yes	54	42.2	202	38.1	256	38.9	χ²=0.360 p=0.32
No	74	57.8	328	61.9	402	61.1	χ²=0.360 p=0.32
Thoughts on adequate and balanced nutrition
Yes	36	28.1	160	30.2	196	29.8	χ²=0.105 p=0.43
No	92	71.9	370	69.8	462	70.2	χ²=0.105 p=0.43

Variables	BMI group				F	p	Difference*
	Underweight (n=58)¹	Normal weight (n=454)²	Pre-obesity/Obesity³ (n=146)	Total (n=658)
	𝐗 ±SD	𝐗 ±SD	𝐗 ±SD	𝐗 ±SD
Anthropometric measurements
WC (cm)	68.10±4.32	76.93±7.47	88.60±8.04	78.74±9.39	101.73	<0.001	1-2, 1-3, 2-3
HC cm)	87.58±3.43	95.51±4.56	107.37±5.21	97.44±7.38	252.96	<0.001	1-2, 1-3, 2-3
MUAC cm)	21.37±1.57	24.81±2.50	28.91±2.54	25.42±3.21	121.15	<0.001	1-2, 1-3, 2-3
NC (cm)	30.37±1.89	32.24±2.49	34.53±2.84	32.58±2.77	34.77	<0.001	1-2, 1-3, 2-3
TSF (mm)	10.98±3.26	14.93±5.07	19.04±5.84	15.49±5.56	30.02	<0.001	1-2, 1-3, 2-3
DEBQ total score	71.24±17.27	87.47±18.67	98.17±15.39	88.41±19.12	24.57	<0.001	1-2, 1-3, 2-3
Restrained eating	22.51±6.29	25.94±8.24	27.97±6.96	26.09±7.92	5.17	<0.001	1-3
Emotional eating	25.96±10.58	33.49±12.91	39.31±10.94	34.12±12.76	13.13	<0.001	1-2, 1-3, 2-3
External eating	22.75±4.61	28.03±5.30	30.89±4.94	28.20±5.55	26.05	<0.001	1-2, 1-3, 2-3
PSS-14 total score	25.09±3.36	27.37±7.24	29.85±5.28	27.72±6.72	6.38	<0.001	1-3

Variables	PSS-14 total score		DEBQ total score
Variables	r^a	p	r^a	p
BMI (kg/m²)	0.245	<0.001	0.431	<0.001
WC (cm)	0.105	0.052	0.284	<0.001
HC (cm)	0.223	<0.001	0.389	<0.001
MUAC (cm)	0.248	<0.001	0.309	<0.001
NC (cm)	0.076	0.176	0.122	<0.05
TSF (mm)	0.178	<0.001	0.271	<0.001

Variables	B	SD	95% CI	p-value
Model a
PSS → BMI	0.438	0.096	(0,249, 0.627)	<0.001
Model b
Effect of predictor on outcome
PSS → BMI	0.358	0.087	(0.185, 0.531)	<0.001
Effect of predictor on mediators
PSS → DEBQ	1.081	0.057	(0.005, 2.158)	0.048
Effect of mediators on outcome
DEBQ → BMI	0.073	0.008	(0.056, 0.091)	<0.001
Indirect effects
BMI	0.079	0.044	(-0.040, 0.174)	>0.05

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[1] Correspondence to:
HÖ YILMAZ. E-mail: <hcmrylmz@hotmail.com>.