Purpose: 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.
Methods: 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.
Results: 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 η2: 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.
Conclusion: 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.
Keywords: Diet quality; Emotional eating; Moderation; Snack; Stress; Students.