Perceived Stress and Eating Behaviors by Sex, Obesity Status, and Stress Vulnerability: Findings from the Vitamins and Lifestyle (VITAL) Study

Stress has been associated with eating patterns in human studies with differences due to the type and duration of stressor, type of food, and individual susceptibility factors. Laboratory and smaller epidemiological studies have reported stress-associated preferences for foods high in sugar and fat; associations have been found more consistently among women and people who are obese. Larger studies are needed to sufficiently test these relationships. The aim of this study was to evaluate associations between self-reported amount of stress and dietary nutrient intakes (percentage energy from fat, carbohydrates, added sugar) and dietary behaviors (number of eating occasions and servings of fruits and vegetables, high-fat snacks, fast-food items, and sweetened drinks) by sex, obesity status, and stress vulnerability. Linear regression was used to estimate associations of perceived stress with eating patterns among 65,235 older adults while adjusting for demographic factors, body mass index, physical activity, alcohol intake, number of comorbidities, and other relevant covariates. Higher perceived stress was associated with greater intake of energy from fat, high-fat snacks, and fast-food items as well as lower intake of energy from carbohydrates (all P for trend <= 0.002). Among those with high perceived stress vulnerability, perceived stress was associated with fewer eating occasions (P for interaction <0.0001). Although associations were small, significant relationships were found for perceived stress arising from everyday experiences among an older, mostly white population. These findings have public health implications and suggest that stress may be important to consider in programs promoting healthy eating.