Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3 De Pintelaan 185, 9000, Ghent, Belgium.
Eur J Nutr. 2020 Feb;59(1):273-286. doi: 10.1007/s00394-019-01906-9. Epub 2019 Jan 25.
Stress is thought to stimulate unhealthy dietary choices towards fat and sweet foods. Nevertheless, individual vulnerabilities might exist depending on psychological factors. We wanted to check dietary change during examination stress via a longitudinal study, while identifying risk groups via moderation by eating behavior (emotional/external/restrained), food choice motive, taste preference, reward/punishment sensitivity, impulsivity, coping strategies, sedentary behavior, social support, living in a student home and being a first-year student.
Before and after the examination period January 2017, 232 Flemish students completed online questionnaires on diet (food frequency questionnaire with diet quality index), the above mentioned psychological factors, perceived exam stress and some demographics.
During the examination period, diet quality decreased: lower general diet quality index, lower fruit and vegetables intake, higher fast food intake and more difficulties to eat healthy. Based on significant time moderation, emotional eaters, external eaters, sweet/fat lovers, those with health as food choice motive, sensitive to reward or punishment, highly sedentary, non-first-year students and those with high stress reports were at higher risk for exam-induced diet deteriorations (partial η: 017-0.071; highest effects for health as food choice motive and external eating). Most tested variables were also related to baseline dietary intake which was of rather low quality.
The overall stress-diet hypothesis was confirmed as students were vulnerable to diet deterioration during examination periods and high-risk groups were identified. Prevention strategies should integrate psychological and lifestyle aspects: stress management, nutritional education with techniques for self-effectiveness, awareness of eating-without-hunger and a health stimulating environment.
压力被认为会刺激人们选择不健康的高脂肪和高糖食物。然而，个体的脆弱性可能因心理因素而异。我们希望通过一项纵向研究来检查考试压力期间的饮食变化，同时通过饮食行为（情绪/外部/克制）、食物选择动机、口味偏好、奖励/惩罚敏感性、冲动性、应对策略、久坐行为、社会支持、居住在学生宿舍和作为一年级学生等因素的调节来确定风险群体。
在 2017 年 1 月的考试前后，232 名佛兰芒学生完成了在线饮食问卷（食物频率问卷和饮食质量指数）、上述心理因素、感知的考试压力和一些人口统计学数据。
在考试期间，饮食质量下降：一般饮食质量指数较低，水果和蔬菜摄入量较低，快餐摄入量较高，更难健康饮食。基于显著的时间调节，情绪进食者、外部进食者、甜食/高脂肪爱好者、以健康为食物选择动机的人、对奖励或惩罚敏感的人、久坐不动的人、非一年级学生和报告压力较高的人更容易因考试而导致饮食恶化（偏 η：0.071；以健康为食物选择动机和外部进食的影响最大）。大多数测试的变量也与基线饮食摄入有关，而基线饮食摄入的质量相当低。
总体而言，压力-饮食假说得到了证实，因为学生在考试期间容易出现饮食恶化，而且确定了高风险群体。预防策略应综合考虑心理和生活方式因素：压力管理、营养教育与自我效能技术、对无饥饿进食的认识以及健康促进环境。
