Emotional eating in relation to anthropometric indices and dietary energy intake based on gender

Abstract

BACKGROUND:

Emotional eating is one of the important factors in etiology of obesity and eating disorders.

OBJECTIVE:

This study aimed to compare gender differences in response to emotional eating and to identify the anthropometric indices and dietary intake factors correlation with emotional eating.

METHODS:

A sample of 247 subjects from three schools in Tabriz University of Medical Sciences in Iran was participated in the study. Each participant filled out a general ten-item and an emotional eating fourteen-item questionnaire. Statistical analyses of the study were conducted by an independent t-test, a chi-square, Pearson correlations and logistic regression using the SPSS version 19.

RESULTS:

The findings of this investigation indicated that body mass index (BMI) (r = – 0.759, p < 0.0001 and r = – 0.818, p < 0.0001), waist circumference (WC) (r = – 0.217, p = 0.014 and r = – 0.182, p = 0.048) and dietary energy intake (r = – 0.221, p = 0.012 and r = – 0.186, p = 0.024) correlated significantly with emotional eating in female and male groups, respectively. The female had higher emotional eating score versus the male (6.56±1.56 and 6.47±1.21, respectively). Marital status, smoking, recent weight loss, and weight gain, were the strong predictors of the emotional eating.

CONCLUSIONS:

Knowing predicting factors of emotional eating and understanding the fact that gender differences could affect chances of being emotional eater can help us provide appropriate nutritional and psychological educational programs in the community. This can in turn control the emotional eating status and consequently lead to beneficial outcomes on the level of individuals’ health in the society.

Keywords

Emotional eating dietary intake gender anthropometric indices obesity

1 Introduction

Obesity and overweight are important predisposing factors for most non-communicable diseases [1]. Increasing incidence of weight gain is considered as an important health problem at national level in most countries [2]. Weight gain is often attributed to a variety of interactions among genetic, economic, social, cultural, and psychological factors [3]. Among these factors, physical inactivity and inappropriate eating behavior may affect body weight and the incidence of many chronic disorders [4].

Every person suffers from specific moods and emotions such as anger, fear, stress, and sadness at different stages of his or her life. If these emotional states continue to be chronic, they may expose them to abnormal conditions. These chronic life emotions seem to be associated with a greater preference for energy and nutrient-dense foods, which may be causally linked to weight gain [5]. Stress-induced eating which is called emotional eating occurs when people attempt to make themselves feel better by eating or drinking in stressful situations. In these conditions, internal factor including neuropeptide Y hormone and palatability of foods as an external factor can influence food intake [6, 7].

Several studies have suggested that emotional eating is related to body weight status. Although there were inconsistent outcomes that observed in these studies, but most of the results indicated relative overeating in negative emotional states in overweight and obese individuals [8 –11]. The inconsistency in recent findings is possibly attributable to the differences in population features and different available methods for evaluating emotional eating. Furthermore, several studies have found that a woman in stress conditions tends to eat more sweet foods while a man prefers to eat comfort foods such as steak casseroles, and soup [12, 13]. Nonetheless, to the best of our knowledge, there are relatively few researches regarding assessing the effects of anthropometric and dietary factors on emotional eating based on gender.

This study aimed firstly to compare the gender differences in response to emotional eating and to identify the correlation between anthropometric and dietary factors with regard to emotional eating. The contributing factors to emotional eating were also assessed. These data may help resolve some of the controversies regarding the relation between various moods of individuals and their diets.

2 Materials and methods

This cross-sectional study was designed to understand the factors that can influence the emotional eating of healthy people. A sample consisting of 247 apparently healthy students were recruited from the school of management and medical informatics, school of health sciences and the school of advanced medical sciences of Tabriz University of Medical Sciences in Iran from January to March 2017. Inclusion criteria for the participants were as follows: 1) aged between 20–30 years, 2) consented to participate in the study. Participants with any mental illnesses, eating disorders, cancer, and pregnancy were excluded from the study. The mothers during two years of lactation were not also included in the present research.

2.1 Collection of basic characteristics and anthropometric indices

Body weight was measured to the nearest 0.1 kg on an electronic digital scale while the subjects were wearing light clothing, and height was measured to the nearest 0.1 cm using a wall-mounted stadiometer. Body mass index (BMI) defined as the weight in kilograms of the individual divided by the square of the height in meters was then calculated. Waist circumference (WC) was measured as the minimum circumference between the iliac crest and the rib cage.

2.2 Questionnaires

First, we gave a general 10– item questionnaire for each participant. This questionnaire included age, gender, marital status, health conditions, smoking habits, history of illness, and other socio-demographic variables.

2.3 Dietary intake

Dietary intake was assessed by means of two 24– hour dietary recalls.

2.4 Emotional eating

The emotional eater questionnaire (EEQ) was given to the participants in order to assess their emotional eating scores which contained 14 items [14]. Response categories for each item include a 10– point Likert scale ranging from 0 (strongly disagree) to 10 (strongly agree). The questions were about food choices, body shape, the type and amount of foods, favorite foods, and eating sweet foods like chocolate in emotional conditions like stress, anger, boredom, exhaustion at night. The questionnaire was scored from 0–20 which higher scores indicating healthier emotional eating behavior [15].

The questions were carefully explained by the nutritionist to ensure complete understanding and to avoid any vague questions. The participants who were eligible to be included in the study were asked to sign an informed consent and all ethical principles were considered in all phases of the research.

2.5 Data analysis

The initial characteristics of the participants were summarized by descriptive statistics. We conducted a baseline univariate analysis of the data on the aforementioned variables between the gender groups. For continuous variables, comparisons between gender groups were assessed using Student’s t test. Categorical variables were compared using the chi-square test, and relationships of emotional eating score with dietary intake and anthropometric indices were investigated using Pearson correlation analysis. The variables that were significant at the 0.25 level [16] in the univariate analyses were selected as candidates for a multivariable logistic regression model. All statistical analyses were performed using SPSS 19 software (SPSS Inc. IL, Chicago, USA) with a 2– sided P value of less than 0.05 considered significant.

3 Results

Characteristics of the study participants by gender are shown in Table 1. The mean±SD of age in female and male groups were 25.75±2.77 and 25.95±3.30, respectively which were not different between the two groups (P > 0.05). Most of the male participants were married whereas the females were mostly single (P < 0.001). There were not any differences between BMI of two groups but WC was higher in male group compared with female group (P < 0.05). Most of the smokers were in the male group (P < 0.001). The female group had higher body weight change in the last 6 months and the family size was bigger in this group compared with male group (P < 0.05).

Table 1
Initial characteristics of the study participants

Women (n = 128) Men (n = 119) P.value

Age (Years)^* 25.75 (2.77) 25.95 (3.30) 0.124^¶

Body mass index^* 27.42 (4.60) 28.85 (4.44) 0.173^¶

Waist circumference (cm)^* 89.14 (8.70) 102.01 (12.32) 0.020^¶

Family size^* 3.42 (1.07) 3.37 (1.27) 0.004^¶

Marital status^

Single 109 (85.2) 49 (41.2) <0.0001^¥

Married 19 (14.8) 70 (58.8)

Smoking^

Smoker 2 (1.6) 35 (29.4) <0.0001^¥

Non-smoker 126 (98.4) 84 (70.6)

Body weight change in recent 6 month^

No 65 (50.8) 75 (63) 0.010^¥

Increase 24 (18.8) 28 (23.5)

Decrease 39 (30.5) 16 (13.4)

Weight loss diet^

Yes 41 (32) 45 (37.8) 0.341^¥

No 87 (68) 74 (62.2)

Weight gain diet^

Yes 23 (18) 15 (12.6) 0.244^¥

No 105 (82) 104 (87.4)

Resident in student dormitory^

Yes 54 (42.2) 59 (49.6) 0.245^¥

No 74 (57.8) 60 (50.4)

History of obesity in first-degree relatives^

Yes 48 (37.5) 53 (44.5) 0.262^¥

No 80 (62.5) 66 (55.5)

Nutritional supplements intake^

Yes 53 (41.4) 50 (42) 0.923^¥

No 75 (58.6) 69 (58)

Education status^**

Bachelor of Science 60 (46.9) 59 (49.6) 0.673^¥

Master of Science 56 (43.8) 37 (31.1)

Doctor of Philosophy 12 (9.4) 23 (19.3)

	Women (n = 128)	Men (n = 119)	P.value
Age (Years)^*	25.75 (2.77)	25.95 (3.30)	0.124^¶
Body mass index^*	27.42 (4.60)	28.85 (4.44)	0.173^¶
Waist circumference (cm)^*	89.14 (8.70)	102.01 (12.32)	0.020^¶
Family size^*	3.42 (1.07)	3.37 (1.27)	0.004^¶
Marital status^**
Single	109 (85.2)	49 (41.2)	<0.0001^¥
Married	19 (14.8)	70 (58.8)
Smoking^**
Smoker	2 (1.6)	35 (29.4)	<0.0001^¥
Non-smoker	126 (98.4)	84 (70.6)
Body weight change in recent 6 month^**
No	65 (50.8)	75 (63)	0.010^¥
Increase	24 (18.8)	28 (23.5)
Decrease	39 (30.5)	16 (13.4)
Weight loss diet^**
Yes	41 (32)	45 (37.8)	0.341^¥
No	87 (68)	74 (62.2)
Weight gain diet^**
Yes	23 (18)	15 (12.6)	0.244^¥
No	105 (82)	104 (87.4)
Resident in student dormitory^**
Yes	54 (42.2)	59 (49.6)	0.245^¥
No	74 (57.8)	60 (50.4)
History of obesity in first-degree relatives^**
Yes	48 (37.5)	53 (44.5)	0.262^¥
No	80 (62.5)	66 (55.5)
Nutritional supplements intake^**
Yes	53 (41.4)	50 (42)	0.923^¥
No	75 (58.6)	69 (58)
Education status^**
Bachelor of Science	60 (46.9)	59 (49.6)	0.673^¥
Master of Science	56 (43.8)	37 (31.1)
Doctor of Philosophy	12 (9.4)	23 (19.3)

^*Data are reported as mean (SD). ^**Data are presented as frequency (percent). ^¶Independent T-test analysis. ^¥chi-square analysis.

Dietary intakes of the study participants separated by gender are provided in Table 2. Dietary intake of energy, carbohydrates, protein and fats were higher in the male group; moreover, significant differences were found in dietary intakes of the energy (p < 0.002), the protein (p < 0.031) and the fat (p < 0.014) between the male and female groups.

Table 2

Dietary intake of the study participants

	Women	Men	P.value^*
Energy (Kcal/day)	1836.12±347.20	2049.09±448.27	0.002
Carbohydrate (g/day)	255.81±76.21	272.72±64.99	0.075
Protein (g/day)	57.06±19.53	60.15±22.35	0.031
Fat (g/day)	70.62±22.31	71.21±17.12	0.014

^*Based on Independent T-test.

Figure 1 shows emotional eating scores in both groups. As indicated, the females had higher scores versus the males (6.56±1.56 and 6.47±1.21, respectively). These results indicate that the total participants of this study had low emotional eating scores.

Fig.1

Emotional eating scores in two groups, by independent T-test.

Correlation among emotional eating scores, dietary intakes, and anthropometric indices are shown in Table 3. Results of the Pearson correlation showed that BMI (r = – 0.759, p < 0.0001 and r = – 0.818, p < 0.0001), WC (r = – 0.217, p = 0.014 and r = – 0.182, p = 0.048), and dietary energy intake (r = – 0.221, p = 0.012 and r = – 0.186, p = 0.024) correlated significantly with emotional eating in male and female groups, respectively.

Table 3

Correlations of emotional eating score with dietary intake and anthropometry indices according to gender

Variables	Women (n = 128)		Men (n = 119)		Total (n = 247)
	r^*	p^*	r^*	p^*	r^*	p^*
Age	– 0.030	0.737	0.025	0.791	– 0.006	0.929
Body mass index	– 0.759	<0.0001	– 0.818	<0.0001	– 0.774	<0.0001
Waist circumference	– 0.217	0.014	– 0.182	0.048	– 0.136	0.033
Energy	– 0.221	0.012	– 0.186	0.024	– 0.255	0.014
Protein	0.106	0.234	– 0.030	0.747	0.052	0.413
Carbohydrate	– 0.139	0.118	0.102	0.268	– 0.093	0.144
Fat	– 0.075	0.401	– 0.085	0.360	– 0.079	0.217

^*Based on Pearson test.

The results of logistic regression for adjusted Odds Ratios (ORs) with related variables of emotional eating are shown in Table 4. Logistic regression analysis with 9 factors showed some significantly associated predictors for emotional eating including marital status, smoking, weight loss, and weight gain diets. Participants with married status were approximately 78% more likely to be emotional eaters than those individuals with single status (OR = 1.87, 95% CI = 1.29 to 2.93; P < 0.002). Smoker participants were 7.60 times higher odds to be emotional eater than non-smoker participants (OR = 7.60, 95% CI = 4.49 to 12.58; P < 0.001). The participants with weight loss diet were 2.67 times higher odds to be emotional eaters than the participants with no weight loss diet (OR = 2.67, 95% CI = 1.233 to 3.620; P < 0.033). The participants who had weight gain diet were 2.06 times higher odds to be emotional eaters than the participants with no weight gain diet (OR 2.06, 95% CI 1.277 to 2.870; P < 0.027).

Table 4

Results of logistic regression for adjusted Odds Ratios (ORs) for emotional eating related variables

Variables	OR	Lower	Upper	P-Value
Marital status
Married	1.78	1.29	2.93	0.002
Single	Referent	– – – –	– – – –
Smoking
Yes	7.60	4.49	12.58	<0.001
No	Referent	– – – –	– – – –
Body weight change in recent 6 month
Increase	1.67	0.688	4.086	0.255
Decrease	1.14	0.384	3.408	0.810
No	Referent	– – – –	– – – –	– – – –
Weight loss diet
Yes	2.67	1.233	3.620	0.033
No	Referent	– – – –	– – – –	– – – –
Weight gain diet
Yes	2.06	1.277	2.870	0.027
No	Referent	– – – –	– – – –	– – – –
Resident in student dormitory
Yes	0.801	0.416	1.543	0.507
No	Referent	– – – –	– – – –	– – – –
History of obesity in first-degree relatives
Yes	1.065	0.538	2.112	0.856
No	Referent	– – – –	– – – –	– – – –
Nutritional supplements intake
Yes	0.930	0.455	1.899	0.842
No	Referent	– – – –	– – – –	– – – –
Education status
Bachelor of Science	1.599	0.488	5.237	0.438
Master of Science	2.141	0.648	7.070	0.212
Doctor of Philosophy	Referent	– – – –	– – – –	– – – –

OR: Odds ratio. Lower: Lower Bound for 95% C.I. for OR. Upper: Upper Bound for 95% C.I. for OR. Hosmer and Lemeshow Test showed an acceptable of model fit (Chi-square (8)) = 9.445, P-Value = 0.306). A total of 81.6% of subjects were correctly classified.

4 Discussion

This study determined the relationships between emotional eating score, dietary intake and anthropometric parameters regarding the male and female students. There were significant correlations among BMI, WC, and energy intake with emotional eating in two gender groups. According to the results of this study, the participants whose BMI and WC were within normal ranges had a better control over their emotions. In other words, it was shown that BMI, WC and energy intake were inversely related to the emotional eating score (Table 3). Canetti et al. showed that the individuals with higher BMI and a tendency to eat more high-calorie food, reduce their levels of anxiety, discomfort, and psychological problems. This finding is due to several psychological mechanisms including mistaken dietary habits about hunger, satiety, and food intake [17].

In a review study conducted by Gibson et al, it was shown that in the studies which were conducted in different countries such as England, France, Sweden, the Netherlands, the United States, Canada, and Finland, the average score of emotional eating in women was higher than men [18]. In addition, this score was found to be associated with BMI in most of the above-mentioned studies, except for six of them [19 –24]. Results of logistic regression for adjusted ORs for variables related to emotional eating revealed that the emotional eating can be affected by several factors including marital status (single or married), smoking, weight loss and weight gain diets. The odds of emotional eating respondents in married participants were 1.78 times higher than in the single participants. This finding can be due to an increase in negative and positive emotions in marital life. Single people and in general those who live alone and have less willingness to prepare and eat food have more control over their emotions [25, 26].

Odds ratios of food emotion respondents in smokers were 7.60 times higher than non-smokers. This could be due to the impact of smoking on the individuals’ mood, and consequently the increasing frequency of joy and sadness. The odds of emotional eating respondents in the participants with weight loss and weight gain diets were 2.67 and 2.06 times higher than in the participants with no weight loss or weight gain diets, respectively. This result showed that weight gain and weight loss diets are able to change nutritional behaviors due to the changes in morale and mood which can in turn affect emotional eating. Due to the cross-sectional nature of this study, it is suggested that in future studies, emotional eating and related factors would be investigated over the time.

5 Limitations

Several limitations of this study should be noted. First, since this was a cross-sectional study our ability to draw temporal or causal inferences about the relationship between measures of current study was limited. Second, our findings are not generalizable to minority populations due to the diversity in sociodemographic variables. Future researches should include diverse populations to further understand the relationships of emotional eating with anthropometric indices and dietary intake in young adults.

6 Conclusion

According to the results of this study, the emotional eating score was higher in women compared with men which correlated significantly with high BMI, WC and energy intakes. As our study showed, several factors including marital status, smoking, recent weight loss and weight gain diets can predict emotional eating scores. Knowing these factors could help health and nutrition policy makers to provide appropriate nutritional and psychological education programs in the community, which may control the emotional eating status, food choices and consequently, give positive health benefits to everyone in the society.

Funding

The authors reports no funding.

Conflict of interest

All authors declare no conflict of interest.

Footnotes

Acknowledgments

We thank all of the students in this study for their active participation.

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