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      Stress-related eating, obesity and associated behavioural traits in adolescents: a prospective population-based cohort study

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          Abstract

          Background

          Stress-related eating is associated with unhealthy eating and drinking habits and an increased risk of obesity among adults, but less is known about factors related to stress-driven eating behaviour among children and adolescents. We studied the prevalence of stress-related eating and its association with overweight, obesity, abdominal obesity, dietary and other health behaviours at the age of 16. Furthermore, we examined whether stress-related eating is predicted by early-life factors including birth size and maternal gestational health.

          Methods

          The study population comprised 3598 girls and 3347 boys from the Northern Finland Birth Cohort 1986 (NFBC1986). Followed up since their antenatal period, adolescents underwent a clinical examination, and their stress-related eating behaviour, dietary habits and other health behaviours were assessed using a postal questionnaire. We examined associations using cross-tabulations followed by latent class analysis and logistic regression to profile the adolescents and explain the risk of obesity with behavioural traits.

          Results

          Stress-related eating behaviour was more common among girls (43%) than among boys (15%). Compared with non-stress-driven eaters, stress-driven eaters had a higher prevalence of overweight, obesity and abdominal obesity. We found no significant associations between stress-eating and early-life factors. Among girls, tobacco use, shorter sleep, infrequent family meals and frequent consumption of chocolate, sweets, light sodas and alcohol were more prevalent among stress-driven eaters. Among boys, the proportions of those with frequent consumption of sausages, chocolate, sweets, hamburgers and pizza were greater among stress-driven eaters. For both genders, the proportions of those bingeing and using heavy exercise and strict diet for weight control were higher among stress-eaters. Besides a ‘healthy lifestyle’ cluster, latent class analysis revealed two other patterns (‘adverse habits’, ‘unbalanced weight control’) that significantly explained the risk of overweight among boys and girls.

          Conclusions

          Stress-related eating is highly prevalent among 16-year-old girls and is associated with obesity as well as adverse dietary and other health behaviours among both genders, but intrauterine conditions are seemingly uninvolved. In terms of obesity prevention and future health, adolescents who use eating as a passive way of coping could benefit from learning healthier strategies for stress and weight management.

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          Most cited references41

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          Parental influence on eating behavior: conception to adolescence.

          The first years of life mark a time of rapid development and dietary change, as children transition from an exclusive milk diet to a modified adult diet. During these early years, children's learning about food and eating plays a central role in shaping subsequent food choices, diet quality, and weight status. Parents play a powerful role in children's eating behavior, providing both genes and environment for children. For example, they influence children's developing preferences and eating behaviors by making some foods available rather than others, and by acting as models of eating behavior. In addition, parents use feeding practices, which have evolved over thousands of years, to promote patterns of food intake necessary for children's growth and health. However in current eating environments, characterized by too much inexpensive palatable, energy dense food, these traditional feeding practices can promote overeating and weight gain. To meet the challenge of promoting healthy weight in children in the current eating environment, parents need guidance regarding alternatives to traditional feeding practices.
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            If it changes it must be a process: study of emotion and coping during three stages of a college examination.

            This natural experiment provides substantial evidence for the following major themes, which are based on a cognitively oriented, process-centered theory of stress and coping: First, a stressful encounter should be viewed as a dynamic, unfolding process, not as a static, unitary event. Emotion and coping (including the use of social support) were assessed at three stages of a midterm examination: the anticipation stage before the exam, the waiting stage after the exam and before grades were announced, and after grades were posted. For the group as a whole there were significant changes in emotions and coping (including the use of social support) across the three stages. Second, people experience seemingly contradictory emotions and states of mind during every stage of an encounter. In this study, for example, subjects experienced both threat emotions and challege emotions. The complexity of emotions and their cognitive appraisals reflects ambiguity regarding the multifaceted nature of the exam and its meanings, especially during the anticipation stage. Third, coping is a complex process. On the average, subjects used combinations of most of the available forms of problem-focused coping and emotion-focused coping at every stage of the exam. Different forms of coping were salient during the anticipation and waiting stages. Problem-focused coping and emphasizing the positive were more prominent during the former, and distancing more prominent during the latter. Finally, despite normatively shared emotional reactions at each stage, substantial individual differences remained. Using selected appraisal and coping variables, and taking grade point averages (GPA) into account, approximately 48% of the variances in threat and challenge emotions at the anticipation stage was explained. Controlling for variance due to the grade received, appraisal, and coping variables accounted for 28% of the variance in positive and negative emotions at the outcome stage. Including grade, 57% of the variance in positive emotions at outcome and 61% of the negative emotions at outcome were explained.
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              Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review.

              To review associations between the family environment and young people's fruit and vegetable consumption. A systematic review. Published English-language (n 60) papers were identified using electronic databases and manual searches of personal files and reference lists. Observational research reporting a measure of fruit/vegetable intake for children (aged 6-11 years) and/or adolescents (aged 12-18 years) and at least one potential family correlate of dietary intake was included. Parental modelling and parental intake were consistently and positively associated with children's fruit and fruit, juice and vegetable (FJV) consumption. There were also positive associations between home availability, family rules and parental encouragement and children's fruit and vegetable consumption. Parental intake was positively associated with adolescents' fruit and vegetable consumption. There were also positive associations between parental occupational status and adolescent fruit consumption and between parental education and adolescents' FJV consumption. Our findings highlight the importance of targeting the family environment for the promotion of healthy eating behaviours among children and adolescents. Future interventions should encourage parents to be positive role models by targeting parental intake and to create a supportive home environment through increased encouragement and availability of fruits and vegetables and employing rules to govern eating behaviours. For adolescents, indicators of family circumstances (e.g. parental education) should be used to identify target groups for interventions aimed at promoting healthy eating.
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                Author and article information

                Contributors
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2014
                7 April 2014
                : 14
                : 321
                Affiliations
                [1 ]Finnish Institute of Occupational Health, P.O. Box 310, FI-70101 Kuopio, Finland
                [2 ]Finnish Institute of Occupational Health, Oulu, Finland
                [3 ]Biocenter Oulu, University of Oulu, Oulu, Finland
                [4 ]Institute of Health Sciences, University of Oulu, Oulu, Finland
                [5 ]National Institute for Health and Welfare, Oulu, Finland
                [6 ]Department of Epidemiology and Biostatistics, MRC Health Protection Agency Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
                [7 ]Unit of Primary Care, Oulu University Hospital, Oulu, Finland
                Article
                1471-2458-14-321
                10.1186/1471-2458-14-321
                3995503
                24708823
                d01f53fa-d5a5-4985-8f24-3a11b841b203
                Copyright © 2014 Jääskeläinen et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 28 May 2013
                : 6 March 2014
                Categories
                Research Article

                Public health
                adolescent,body mass index,cohort studies,diet,drinking behaviour,health behaviour,latent class analysis,obesity,psychological stress

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