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Stress, diet interventions may reduce childhood obesity
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Stress, hormones, diet and increased body fat in children are interrelated, suggesting stress and lifestyle interventions are logical methods to control childhood obesity, according to research presented at the European Congress on Obesity in Sofia, Bulgaria.
The associations found among cortisol and leptin in combination with children’s food choices and eating patterns support the notion that hormones influence the consumption of comfort foods and could deteriorate diet and create conditions for weight gain.
“Our data shows that stress deteriorates children’s diet and eating behavior, with cortisol emerging as an underlying factor and diet playing a role in a child’s vulnerability to stress-induced adiposity,” Nathalie Michels, PhD, of the department of public health, Ghent University, Belgium, told Endocrine Today.
Nathalie Michels
Michels and colleagues looked at the 2-year longitudinal stress-diet-adiposity relation in 312 Belgian children aged 5 to 12 years from the Children’s Body Composition and Stress Study, conducted at the institution.
The researchers evaluated stress data (negative events, problem behavior and negative emotions), food consumption, psychological eating behavior and adiposity (BMI, fat percentage and waist circumference). Salivary cortisol levels (four samples/day) and fasting serum leptin were determined at baseline. The researchers analyzed longitudinal stress-diet-adiposity relations and multi-level time modeling was used to determine the relation of cortisol with diet and leptin.
Children with high stress scores reported more sweet food consumption, emotional eating, external eating and restrained eating. Stress was found to increase adiposity only in children with high sweet food consumption and high cortisol.
Michels highlighted data from research under revision for publication that showed children who consumed low amounts of sweet food maintained low BMI with high stress compared with children who consumed high amounts of sweet food, whose BMI increased along with stress (P=.030).
High cortisol correlated with unhealthy diet, particularly with sweet foods, and was associated with higher leptin levels in girls.
Michels presented additional unpublished data showing that leptin was related to whole-day cortisol output in 254 girls. At awakening, cortisol peaked in the highest leptin quartile at 14.4 nmol/l and in the lowest leptin quartile at only 13.0 nmol/l. By evening, measures of cortisol in the highest quartile had dropped to 1.8 nmol/l and to 1.6 nmol/l in lowest.
“The stress hormone cortisol might directly influence adiposity or might indirectly lead to less healthy dietary intake,” Michels said in a press release. “This dietary change may be due to a higher appetite and desire for reward through resistance to the satiety hormone leptin.”
The study’s findings create the potential for a multi-pronged approach to prevent obesity, to target stress, including coping skills, and lifestyle factors, including diet, together.
“Physicians, along with parents and school teachers, should enhance patients’ resilience and mindfulness,” Michels said in an interview, “by enforcing good stress coping skills, creating a healthy food zone and making them aware of their emotional eating.” — by Allegra Tiver
For more information:
Michels N. Abstract T2:RS1.3. Presented at: 21st European Congress on Obesity; May 28-31, 2014; Sofia, Bulgaria.
Disclosure: The study was funded by the research council of Ghent University (Bijzonder Onderzoeksfonds).