According to research presented at the European Congress on Obesity (ECO), held May 28 – 31 in Sofia, Bulgaria, there is a link between a child’s stress, hormones, diet and increasing body fat. The study, led by Nathalie Michels, MD, Department of Public Health, Ghent University, Belgium, suggests that targeting stress in addition to other lifestyle factors could be an effective means of controlling the rising tide of childhood obesity.

While body fat levels and stress have been linked in previous studies before, Michels and her colleagues targeted the underlying behavioral and hormonal reasons that are still not entirely clear. "The stress hormone cortisol might directly influence adiposity or might indirectly lead to less healthy dietary intake," says Michels. "This dietary change may be due to a higher appetite and desire for reward through resistance to the satiety hormone leptin."

With a cohort made up of 312 Belgian children (aged 5-12) from the Belgian Children’s Body Composition and Stress Study, the investigators found that children with a high stress score reported more sweet food consumption, emotional eating, external eating in response to food and restrained eating. "Importantly, stress increased adiposity only in children with high sweet food consumption or high cortisol," says Michels. "High levels of the stress hormone cortisol were associated with an unhealthy diet and in the girls also with higher leptin levels. The associations of cortisol with leptin and diet support the theory of cortisol–induced comfort food preference. Indeed, children’s stress makes their diet less healthy, which stimulates increases in body fat. This creates potential for a multi-part obesity prevention program, targeting stress – including coping skills – and lifestyle factors together."

In a separate study presented at the ECO, researchers found that children who consumed a Mediterranean diet were 15 percent less likely to be overweight or obese than children who did not. Drawing their results from eight countries – Sweden, Germany, Spain, Italy, Cyprus, Belgium, Estonia and Hungary – the authors of the investigation used data from the IDEFICS study, measuring weight, height, waist circumference, and percent body fat mass at a baseline (n = 16,220) and a two-year follow-up (n = 9,114).

"The promotion of a Mediterranean dietary pattern is no longer a feature of Mediterranean countries," write the authors. "Considering its potential beneficial effects on obesity prevention, this dietary pattern should be part of EU obesity prevention strategies and its promotion should be particularly intense in those countries where low levels of adherence are detected."

In yet another study presented at the ECO, researchers concluded that mandatory menu energy labelling in fast food outlets will not reduce socioeconomic differences in overweight and obesity. In high income countries, poorer people with a lower socioeconomic position have a higher prevalence of obesity and consume fast food more frequently than those with a higher socioeconomic position. While mandatory menu labelling is designed to enable healthier choices and reduce obesity, a disparity exists between its intent and its actual effect. Of 10 studies reporting on effectiveness of labelling in low socioeconomic populations, all but one reported no reduction in calories or foods purchased. According to the study’s authors, "Based on the limited evidence, it seems unlikely that mandatory menu energy labelling alone will have a direct benefit in low income populations. Whether it will in fact increase socioeconomic disparities in overweight and obesity is unclear and further evidence on different contexts and regions is needed."

Keywords: Life Style, Follow-Up Studies, Overweight, Pediatric Obesity, Body Weight, Diet, Mediterranean, Reward, Prevalence, Waist Circumference, Public Health, Fast Foods, Developed Countries, Adiposity, Leptin, Food Preferences, Obesity, Poverty, Hydrocortisone