Abstract
Eating in response to negative emotions (emotional eating, EE) may predispose an individual to obesity. Yet, it is not well known how EE in children is associated with body mass index (BMI) and health behaviours (i.e., diet, physical activity, sleep, and TV-viewing). In the present study, we examined these associations in a cross-sectional sample of 5426 (54% girls) 9–11-year-old children from 12 countries and five continents. EE, food consumption, and TV-viewing were measured using self-administered questionnaires, and physical activity and nocturnal sleep duration were measured with accelerometers. BMI was calculated using measured weights and heights. EE factor scores were computed using confirmatory factor analysis, and dietary patterns were identified using principal components analysis. The associations of EE with health behaviours and BMI z-scores were analyzed using multilevel models including age, gender, and household income as covariates. EE was positively and consistently (across 12 study sites) associated with an unhealthy dietary pattern (β = 0.29, SE = 0.02, p < 0.0001), suggesting that the association is not restricted to Western countries. Positive associations between EE and physical activity and TV viewing were not consistent across sites. Results tended to be similar in boys and girls. EE was unrelated to BMI in this sample, but prospective studies are needed to determine whether higher EE in children predicts the development of undesirable dietary patterns and obesity over time.
Highlights
Childhood obesity rates are high in both developed and developing countries [1]
We found that emotional eating (EE) was positively associated with both moderate to vigorous physical activity (MVPA) and TV viewing, yet these patterns were not consistent across all study sites
We found a significant positive association between EE and an unhealthy diet pattern, which was consistent across the 12 different study sites
Summary
Childhood obesity rates are high in both developed and developing countries [1]. It is likely that the most important contributors are the increased availability of energy-dense foods and a reducedNutrients 2019, 11, 351; doi:10.3390/nu11020351 www.mdpi.com/journal/nutrientsNutrients 2019, 11, 351 need for physical activity—the current obesogenic environment. According to the EE theory ( called the psychosomatic theory), individuals with EE use eating to reduce the intensity of negative emotions [2]. This is considered a poor coping strategy, and such difficulties in emotion regulation may be one possible mechanism underlying EE [4]. Foods consumed in response to negative emotions are usually high in sugar and/or fat [3]. Because an expected normal physiological reaction to negative emotions is a suppressed appetite [3,5], EE may interfere with physiological regulation It may represent a risk factor for becoming overweight and obese. Several studies have suggested this might be the case in adults, since EE has been found to correlate positively with body mass index (BMI) [6,7,8,9] and to predict weight gain [10,11]
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