Cortisol reactivity and distress-induced emotional eating
Introduction
Negative mood or distress is associated with both increased and decreased food intake (Greeno and Wing, 1994), with eating less being the typical and predominant response (Heatherton et al., 1991, Stone and Brownell, 1994, Gold and Chrousos, 2002). Distress is normally associated with activation of the hypothalamic pituitary adrenal (HPA) axis, with physiological reactions that are designed to prepare the individual for a fight or flight reaction. These adaptations include inhibition of gastric motility and the release of sugar into the bloodstream thereby suppressing hunger (Gold and Chrousos, 2002). However, so-called emotional eaters show an atypical response and eat the same amount or even more during distress (Oliver et al., 2000, Van Strien and Ouwens, 2003, Van Strien et al., 2012a). This opposite pattern may be the result of changes in the stress reactivity of the HPA-axis related to chronic stress as indicated by changes in responses of the stress hormone cortisol (e.g., Fries et al., 2005, Dallman, 2010). Revealing such a relationship in humans would be highly relevant as it may provide an explanatory mechanism for human emotional eating (Dallman et al., 2003a, Dallman et al., 2003b, Gibson, 2006, Van Strien et al., 2012a).
To our knowledge there are no previously published studies that have experimentally tested the relationship between stress-induced cortisol responses and actual acute stress-induced food intake in high and low emotional eaters. Animal studies have shown that chronically stressed rodents or rhesus monkeys who are allowed to eat calorie-dense food develop greater mesenteric fat, which in turn dampens the activity of the HPA-axis (Pecoraro et al., 2004, Arce et al., 2009, Dallman, 2010). Also in humans, it has been shown that chronically stressed people report higher scores on emotional eating, have a greater abdominal fat distribution and have dampened HPA-axis activity (Tomiyama et al., 2011). The latter authors hypothesized that highly stressed humans tend to cope with high levels of stress by engaging in stress eating, thereby developing a blunted HPA-axis responses. The evidence from this study is however largely cross-sectional and it remains to be tested whether low cortisol stress reactivity in those high emotional eaters is in turn associated with increased stress-induced food intake. Also, not all studies report reduced cortisol stress responses in emotional eating. Epel et al. (2004) and Raspopow et al. (2010) reported increased cortisol stress responses in emotional eaters in the context of an exam period and the Trier Social Stress Test (TSST, Kirschbaum et al., 1993), respectively. However, although blunted cortisol stress responsiveness is not necessarily a trait characteristic in emotional eaters it may still be the case that those high emotional eaters that do show blunted HPA-axis stress reactivity are the ones who show increased stress-induced food intake.
The aim of the present study was to test this animal based model of emotional eating (Dallman, 2010) in humans by assessing the relationship of the difference in food intake following a laboratory stress task or control task with cortisol reactivity in high vs low emotional eaters. Earlier, emotional eating was found to significantly moderate the participants’ relation between distress and food intake, with low emotional eaters eating less after the stress than after the control task and high emotional eaters eating more (Van Strien et al., 2012a). For the present study we hypothesized that relative to low emotional eaters, high emotional eaters would show a negative association between cortisol stress reactivity and food intake after stress. Specifically: high emotional eaters with a blunted cortisol stress response were expected to eat more after the stressor than those with the typical elevated cortisol stress response.
Section snippets
Sample
Participants were recruited from a pool of female students taking introductory psychology or pedagogy courses who had completed the emotional eating scale of the Dutch Eating Behaviour Questionnaire (DEBQ; Van Strien, 2010) and a questionnaire on exclusion criteria. Exclusion criteria included taking medications that could influence the cortisol response. Because most Dutch female students use hormonal contraceptives, it was not possible to exclude participants using hormonal contraceptives, so
Preliminary analyses
Of the total of 46 participants, 35 reported using hormonal contraceptives, 6 reported smoking, and 40 reported taking alcoholic drinks. On both testing occasions all participants reported waking up at least 2.5 h before arrival at the lab. HEE had significantly higher BMI's than LEE (mean (SD) = 22.10 (3.2) vs 20.25 (1.4); p = .02) and also their scores on external eating were significantly higher (mean (SD) = 3.76 (.47) vs 2.87 (.67); p < .001). There were no significant differences between the two
Discussion
In the present study on female students with extreme scores on emotional eating, we tested the hypothesis that high emotional eaters with a blunted cortisol stress response would eat more after the stressor than those with the typical elevated cortisol stress response. This hypothesis was indeed supported: in HEE there was a negative association of cortisol reactivity with delta kcal (food intake in the stress condition minus food intake in the control condition). In contrast, in LEE cortisol
Conclusion
Whereas HEE participants with a blunted cortisol stress response ate more food after distress than those with an elevated cortisol stress response, LEE participants showed no such relationship. These findings would suggest support for the relevance of an animal-based model on the relationship between blunted cortisol stress responses and increased stress-induced food intake for human high emotional eaters.
Role of funding source
This study was supported by the Radboud University Nijmegen. This organization had no role in the study design, in the collection, analysis and interpretation of data; in the preparation of the manuscript and in the decision to submit the manuscript for publication.
Conflict of interest
Tatjana van Strien has a copyright and royalty interest in the Dutch Eating Behaviour Questionnaire (DEBQ) and manual.
Acknowledgement
We thank our Bachelor and Master students for their help with data collection and data preparation. Karin Roelofs is supported by the Netherlands Organization of Scientific Research (NWO), VIDI grant #452-07-008.
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2022, AppetiteCitation Excerpt :Raspopow et al. (2010) found more pronounced cortisol level increases in emotional eaters compared to non-emotional eaters after an acute stressor, and Klatzkin and colleagues reported greater cortisol responsivity to mental stress among young healthy women who endorsed heightened perceived stress, in comparison to those with lower perceived stress (Klatzkin et al., 2019). On the other hand, van Strien, Roelofs, and de Weerth (2013) reported no significant differences in cortisol between emotional and non-emotional eaters, although emotional eating was a significant moderator of the relationship between cortisol reactivity and food consumption across the whole group. These results indicate a role of emotional eating in the relationship between HPA-axis reactivity and eating behaviors, but more studies are needed to understand this association.