Stress and Eating Behaviors Pre- and Post COVID-19 Pandemic Declaration in Two Independent Samples of College-Aged Adults Original Research
Main Article Content
Keywords
Emotional eating, Psychological distress, Gender differences
Abstract
Introduction: This study compared stress and eating behaviors of two independent samples of college students before and after declaration of the COVID-19 pandemic to understand pandemic-related changes in these health-related behaviors.
Methods: This was a non-experimental comparative study using a between-subjects design. Two independent groups were invited to the laboratory for a single visit to measure eating behaviors and stress indicators. Four validated instruments were used in this study: The Weight and Lifestyle Inventory questionnaire, Mindfulness Eating Questionnaire, Three-Factor Eating Questionnaire (TFEQ), and the Perceived Stress Scale (PSS). Independent t-tests and two-way ANOVA were used to compare participants who were tested prior to the COVID-19 pandemic declaration and after.
Results: N=151 (n=81 male, n=70 female) participants completed testing in the pre-COVID group, and a separate group, N=79, completed testing in the post-COVID group (n=40 male and n=26 female). There was a significant difference in TFEQ-uncontrolled eating between groups by sex (F(1,207)=4.73, p =.031, ƞ2=.022). There were differences between the pre-COVID and post-COVID groups (F(1,204)=5.64, p 019, ƞ2=.027) and between sexes (F(1,204)=16.84, p <0.001, ƞ2=.076) on the TFEQ-emotional eating. The post-COVID group reported higher levels of eating when stressed, depressed/upset, anxious, and when alone compared to the pre-COVID group (all p <.05). There were sex differences in eating when stressed, depressed/upset, anxious, and when alone (all p <.05). PSS scores were significantly higher in the post-COVID group (p =.003). Females (20.4±5.4) reported higher stress than males (17.8±6.3) (p =.003).
Conclusions: College students assessed after the pandemic declaration showed higher stress levels and emotional eating scores. Female college students reported higher stress and emotional eating levels than males.
References
2. McIntosh K, Hirsch MS, Bloom A. Coronavirus disease 2019 (COVID-19). UpToDate Hirsch MS Bloom. 2020;5:1
3. Saez M, Tobias A, Varga D, Barceló MA. Effectiveness of the measures to flatten the epidemic curve of COVID-19. The case of Spain. Sci Total Environ. 2020;727:138761. https://doi.org/10.1016/j.scitotenv.2020.138761.
4. Scarmozzino F, Visioli F. Covid-19 and the subsequent lockdown modified dietary habits of almost half the population in an Italian sample. Foods. 2020;9(5):675. https://doi.org/10.3390/foods9050675.
5. Abu Hatab A, Krautscheid L, Boqvist S. COVID-19, livestock systems and food security in developing countries: A systematic review of an emerging literature. Pathogens. 2021;10(5):586. https://doi.org/10.3390/pathogens10050586.
6. Zachary Z, Brianna F, Brianna L, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obesity research & clinical practice. 2020;14(3):210–216. https://doi.org/10.1016/j.orcp.2020.05.004.
7. Zeigler Z. COVID-19 self-quarantine and weight gain risk factors in adults. Current obesity reports. 2021;10:423–433.https://doi.org/10.1007/s13679-021-00449-7.
8. Yannakoulia M, Panagiotakos DB, Pitsavos C, et al. Eating habits in relations to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA Study. Appetite. 2008;51(3):519–525. https://doi.org/10.1016/j.appet.2008.04.002.
9. Razzoli M, Bartolomucci A. The dichotomous effect of chronic stress on obesity. Trends in Endocrinology & Metabolism. 2016;27(7):504–515
10. Sominsky L, Spencer SJ. Eating behavior and stress: a pathway to obesity. Frontiers in psychology. 2014;5:434. https://doi.org/10.3389/fpsyg.2014.00434.
11. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian journal of psychiatry. 2020;52:102066. https://doi.org/10.1016/j.ajp.2020.102066.
12. Frayn M, Knäuper B. Emotional eating and weight in adults: a review. Current Psychology. 2018;37:924–933. https://doi.org/10.1007/s12144-017-9577-9.
13. Sidor A, Rzymski P. Dietary choices and habits during COVID-19 lockdown: experience from Poland. Nutrients. 2020;12(6):1657. https://doi.org/10.3390/nu12061657.
14. Di Renzo L, Gualtieri P, Pivari F, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. Journal of translational medicine. 2020;18(1):1–15. https://doi.org/10.1186/s12967-020-02399-5.
15. Sparling PB, Snow TK. Physical activity patterns in recent college alumni. Res Q Exerc Sport. 2002;73(2):200–205. https://doi.org/10.1080/02701367.2002.10609009.
16. Fish C. Health promotion needs of students in a college environment. Public Health Nursing. 1996;13(2):104–111. https://doi.org/10.1111/j.1525-1446.1996.tb00227.x.
17. Machado BC, Moreira CS, Correia M, Veiga E, Gonçalves S. Coping as a mediator and moderator between psychological distress and disordered eating behaviors and weight changes during the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 2023;20(3):2504. https://doi.org/10.3390/ijerph20032504.
18. Güneşer R, Aydın H. Evaluation of Perceived Stress Level and Emotional Eating Behaviors of Sports College Students During COVID-19 Pandemic. Sakarya Tıp Dergisi. 2021;11(2):434–441. https://doi.org/10.31832/smj.871642.
19. Al-Musharaf S. Prevalence and predictors of emotional eating among healthy young Saudi women during the COVID-19 pandemic. Nutrients. 2020;12(10):2923. https://doi.org/10.3390/nu12102923.
20. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The lancet. 2020;395(10227):912–920. https://doi.org/10.1016/S0140-6736(20)30460-8.
21. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. 10.1001/jama.2013.281053.
22. Wadden TA, Foster GD. Weight and lifestyle inventory (WALI). Obesity. 2006;14(S3):99S–118S
23. Framson C, Kristal AR, Schenk JM, Littman AJ, Zeliadt S, Benitez D. Development and validation of the mindful eating questionnaire. J Am Diet Assoc. 2009;109(8):1439–1444. https://doi.org/10.1016/j.jada.2009.05.006.
24. Shearin EN, Russ MJ, Hull JW, Clarkin JF, Smith GP. Construct validity of the three‐factor eating questionnaire: Flexible and rigid control subscales. Int J Eat Disord. 1994;16(2):187–198. https://doi.org/10.1002/1098-108X(199409)16:2%3C187::AID-EAT2260160210%3E3.0.CO;2-U.
25. Lee E. Review of the psychometric evidence of the perceived stress scale. Asian nursing research. 2012;6(4):121–127. https://doi.org/10.1016/j.anr.2012.08.004.
26. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Human kinetics books; 1988
27. National Institutes of Health. Clinical guidelines for the identification, evaluation, and treatment of overweight and obesity in adults-the evidence report. Obes Res. 1998;6(2):51S–209S
28. Fields DA, Hunter GR, Goran MI. Validation of the BOD POD with hydrostatic weighing: Influence of body clothingin. Int J Obes. 2000;24(2):200–205. https://doi.org/10.1038/sj.ijo.0801113.
29. Glass GV, Peckham PD, Sanders JR. Consequences of failure to meet assumptions underlying the fixed effects analyses of variance and covariance. Review of educational research. 1972;42(3):237–288. https://doi.org/10.3102/00346543042003237.
30. Lubke GH, Muthén BO. Applying multigroup confirmatory factor models for continuous outcomes to Likert scale data complicates meaningful group comparisons. Structural equation modeling. 2004;11(4):514–534. https://doi.org/10.1207/s15328007sem1104_2.
31. Westenhoefer J. Dietary restraint and disinhibition: is restraint a homogeneous construct? Appetite. 1991;16(1):45–55. https://doi.org/10.1016/0195-6663(91)90110-E.
32. Macht M. How emotions affect eating: a five-way model. Appetite [Internet]. 2008 Jan [cited 2014 Jan 22]; 50 (1): 1–11.
33. Coulthard H, Sharps M, Cunliffe L, van den Tol A. Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety. Appetite. 2021;161:105082. https://doi.org/10.1016/j.appet.2020.105082.
34. Wang Y, Yang YY, Li S, Lei X, Yang YF. Investigation on the status of influencing factors for depression symptom of children and adolescents with home quarantine during the prevalence of novel coronavirus pneumonia. Chin J Child Health Care. 2020;28(03):277–280. https://doi.org/10.11852/zgetbjzz2020-0178.
35. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol , Health Med. 2021;26(1):13–22. https://doi.org/10.1080/13548506.2020.1746817.
36. Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord. 2020;277:55–64. https://doi.org/10.1016/j.jad.2020.08.001.
37. Burnatowska E, Surma S, Olszanecka-Glinianowicz M. Relationship between mental health and emotional eating during the COVID-19 pandemic: A systematic review. Nutrients. 2022;14(19):3989. https://doi.org/10.3390/nu14193989.
38. Umano GR, Rondinelli G, Rivetti G, et al. Effect of COVID-19 lockdown on children’s eating behaviours: A longitudinal study. Children. 2022;9(7):1078. https://doi.org/10.3390/children9071078.
39. Maier SU, Makwana AB, Hare TA. Acute stress impairs self-control in goal-directed choice by altering multiple functional connections within the brain’s decision circuits. Neuron. 2015;87(3):621–631. https://doi.org/10.1016/j.neuron.2015.07.005.
40. Tryon MS, Carter CS, DeCant R, Laugero KD. Chronic stress exposure may affect the brain's response to high calorie food cues and predispose to obesogenic eating habits. Physiol Behav. 2013;120:233–242. https://doi.org/10.1016/j.physbeh.2013.08.010.
41. Järvelä-Reijonen E, Karhunen L, Sairanen E, et al. High perceived stress is associated with unfavorable eating behavior in overweight and obese Finns of working age. Appetite. 2016;103:249–258. https://doi.org/10.1016/j.appet.2016.04.023.
42. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009-2010. NCHS Data Brief. 2012;(82)(82):1–8
43. American College Health Association. National college health assessment: Reference group executive summary. Hanover: American College Health Association. 2010
