Stress and Food Choice

Stress and Food Choice: A Laboratory Study
GEORGINA OLIVER, PHD, JANE WARDLE, PHD,
AND
E. LEIGH GIBSON, PHD
Objective: This study investigated experimentally whether acute stress alters food choice during a meal. The study
was designed to test claims of selective effects of stress on appetite for specific sensory and nutritional categories
of food and interactions with eating attitudes. Methods: Sixty-eight healthy men and women volunteered for a study
on the effects of hunger on physiology, performance, and mood. Eating attitudes and food preferences were
measured on entry to the study. The stressed group prepared a 4-minute speech, expecting it to be filmed and
assessed after a midday meal, although in fact speeches were not performed. The ad libitum meal included sweet,
salty, or bland high- and low-fat foods. The control group listened to a passage of neutral text before eating the meal.
Blood pressure, heart rate, mood, and hunger were measured at baseline and after the 10-minute preparatory period,
when appetite for 34 foods and food intake were recorded. Results: Increases in blood pressure and changes in mood
confirmed the effectiveness of the stressor. Stress did not alter overall intake, nor intake of, or appetite for the six
food categories. However, stressed emotional eaters ate more sweet high-fat foods and a more energy-dense meal
than unstressed and nonemotional eaters. Dietary restraint did not significantly affect appetitive responses to stress.
Conclusions: Increased eating of sweet fatty foods by emotional eaters during stress, found here in a laboratory
setting, may underlie the previously reported finding that dietary restraint or female gender predicts stress-induced
eating. Stress may compromise the health of susceptible individuals through deleterious stress-related changes in
food choice. Key words: stress, food choice, emotional eating, dietary restraint, appetite, nutrition.
ANOVA analysis of variance; DBP diastolic blood

pressure; DEBQ Dutch Eating Behavior Questionnaire; PANAS Positive and Negative Affect Schedule; SBP systolic blood pressure; STAI State-Trait
Anxiety Inventory.
INTRODUCTION
There is increasing evidence that stress may affect
health not only through its direct biological effects but
also through changes in health behaviors that themselves influence health (1, 2). Clearly, one such health
behavior is food choice: that is, stress may lead to ill
health through unhealthy changes in diet as well as
more general effects on appetite (3).
Stress and diet associations are particularly complex. Stress is associated with biological changes that
might be expected to reduce food intake, at least in the
short-term, such as adrenaline-induced glycogenolysis, slowed gastric emptying, autonomic shunting of
blood from gut to musculature, and activation of the
hypothalamic-pituitary-adrenal axis (4, 5). Yet the experimental results have been inconsistent. Animal
studies have produced evidence of both hyperphagia
and hypophagia in response to stress (57). Research
on everyday food intake in human subjects under lowFrom the Imperial Cancer Research Fund (ICRF) Health Behaviour
Unit, Department of Epidemiology and Public Health, University
College London, London, United Kingdom.
Address reprint requests to: Professor Jane Wardle, ICRF Health
Behaviour Unit, Department of Epidemiology and Public Health,
University College London, 2-16 Torrington Place, London WC1E
6BT, United Kingdom. Email: j.wardle@ucl.ac.uk
Received October 18, 1999; revision received May 3, 2000.
Psychosomatic Medicine 62:853 865 (2000)

0033-3174/00/6206-0853
Copyright 2000 by the American Psychosomatic Society
and high-stress conditions has also produced inconsistent results. Stress in the workplace has been associated with higher energy intake in two studies (8, 9),
examination stress has produced mixed results (10,
11), and surgical stress, probably the most extreme
stressor examined, has been found to have no consistent effect (12). These varying results may be related to
the nature of the stressor; for example, mild stressors
could induce hyperphagia, and more severe stressors,
hypophagia (7, 13).
Alternatively, there could be significant individual
differences in responses to stress, with the study samples varying in the proportions of the different response types. Pollard et al. (11) found that students
who were high on anxiety and low on social support
were more likely to show a hyperphagic response, and
Wardle et al. (9) found that dietary restraint levels
moderated the response to work stress. An individual
difference model is supported by data from both prospective (14) and retrospective (15, 16) self-report
studies, showing either increased, decreased, or no
change in eating during stress but with consistent effects within individuals.
The importance of individual differences in the eating response to stress has also been borne out by a
number of laboratory studies (13). Such studies typically induce stress through one of a number of standard procedures while assessing food intake, ostensibly as incidental to some other task, such as making
taste ratings. A consistent pattern is that participants
scoring highly on a measure of dietary restraint eat
more under stress, whereas intake is the same or lower
in unrestrained eaters (1722).
This rather complex pattern of results suggests that
more attention needs to be directed toward specifying
the nature and intensity of the stress response, and the
853
G. OLIVER et al.
characteristics and motivational state of the participants (eg, hunger, restraint, and emotional eating tendency). Furthermore, in these studies, usually only a
single food type is available, typically high in fat
and/or sugar, such as ice cream. Thus, food intake has
been conflated with food choice. Understanding
which foods are selected or avoided under stress is a
crucial issue, both because it is necessary for theoretical interpretation of the mechanisms involved and for
prediction of harmful effects of stress on health.
In contrast to the laboratory studies, self-reported
retrospective (15, 23) and prospective data (8, 9, 11)
suggest that food choice does change under stress,
with a tendency toward a relative increase in sugary,
fatty (often snack-type) foods. Therefore, experimental
tests of effects of stress on eating should take into
account the sensory properties of foods.
Grunberg and Straub (24) extended the usual laboratory paradigm by providing participants with a range
of foods differing in taste qualities (sweet, salty, and
bland), although these were still snack foods presented
incidentally to the main task of viewing a film (used
for stress induction). They found that men in the
stressed group ate less than men in the control group.
In women there were no significant differences, although stressed women did show a trend toward a
modest increase in consumption of sweet and bland
foods with no change in intake of salty foods. These
gender differences may have reflected differences in
dietary restraint, which is known to be higher in
women (16, 25, 26), but unfortunately, as the authors
noted, they did not include a measure of restraint. The
ecological validity of Grunberg and Straubs (24) findings may also be limited by the fact that the amount of
food eaten by their participants was very small (20 g
per person on average), whereas the variation was
relatively high, suggesting that not all subjects were
choosing to eat.
The present study was designed to extend the work
of Grunberg and Straub (24), including foods from the
sweet, salty, and bland taste categories and high- and
low-fat examples within those sensory groups. Aside
from replicating the work of Grunberg and Straub (24),
analyzing effects by taste category may be important
because stress has been shown to affect taste perception (27). A wider range of foods was provided to
represent the kinds of foods that might be eaten in both
meals and snacks. Participants were tested when they
were moderately deprived of food and given a test
meal around midday to increase the likelihood of eating beyond brief tasting.
Dietary restraint and emotional eating tendencies
were assessed as possible explanatory variables. Previous studies that incorporated restraint used the Re-
854
straint Scale (28, 29) to measure such tendencies.

However, that instrument does not clearly distinguish
between cognitive restraint, which might be disrupted
by stress; the tendency to overeat in the face of facilitating cues; and the tendency to find relief from emotional stress through eating. Thus, the DEBQ was used
because it measures separate factors for dietary restraint and emotionally and externally influenced eating tendencies (30).
The literature suggests that women and restrained
eaters consume more calories and fat under stress (8, 9)
and shift their food choices away from meal-type
foods, such as meat and vegetables, toward snack-type
foods (15). In contrast, men and unrestrained eaters
show either little difference or a reduction in food
intake under stress (12, 24). Therefore, we hypothesized that stress would elicit greater preference for,
and consumption of, highly palatable, snack-type
foods, most especially in women and restrained and
emotional eaters. In contrast, unrestrained, low emotional eaters (most likely to be men) were expected to
show no change or even a decrease in consumption in
response to stress.
Finally, hunger state and appetite for specific foods
were assessed for potential mediation of effects of
stress on food intake. In particular, hunger was expected to be lower in the stressed group and to be
negatively correlated with biological signs of arousal,
by means of which the impact of the stressor could be
gauged.
METHODS
Participants
Sixty-eight healthy, nonobese, nonsmoking volunteers (27 men
and 41 women, students and staff of the University of London)
agreed to participate in a study advertised as an investigation of the
effects of hunger on physiology, performance, and mood. Volunteers were recruited through advertisements placed around the campus and were paid UK5 ($7) on completion of the study. Participants were allocated to either a stress or control condition, during
which they were provided with a buffet lunch in the laboratory. The
study design was approved by the Research Committee on Ethics of
University College London.
Stress Manipulation
Anticipation of a speech performance was used as a stressor.
Participants were told that they would be making a 4-minute speech
that would be recorded by video equipment set up prominently in
the laboratory and subsequently assessed. Written instructions for
the speech task, based on those used by Kapczinski et al. (31), were
given. Participants were invited to select 1 of 10 controversial topics
for their speech and to prepare notes for a period of 10 minutes
before receiving a meal. The speech was scheduled to take place
immediately after the meal, and participants were led to believe that
the study was about hunger and its effect on performance and that
STRESS AND FOOD CHOICE

they had been placed in a low-hunger condition that necessitated
them eating a meal before making their speech. This ensured that the
anticipatory stress created by the threat of public speaking was
sustained while subjects were exposed to food but that there was no
active competing task to eating. Unknown to subjects at this stage
was that they were not required actually to perform the speech. No
mention of the speech task was made to participants in the control
condition. Instead they were given a nonstressful task of comparable
duration (10 minutes), which was to listen to a passage of emotionally neutral text (an excerpt from Under Milk Wood, Ref. 32). They
were instructed to sit and relax while listening to the text, after
which, they were told, they would receive a meal. They were led to
believe that the study was concerned with changes in physiological
measurements before and after a meal.
Assessment of Impact of Stress Manipulation

Both physiological and psychological indices of arousal were
included, because desynchrony between self-reported anxious
mood and physiological measures of arousal has been well documented (33). Blood pressure and heart rate were measured using a
Copal digital sphygmomanometer UA-251 (baseline was an average
of two readings taken over a 3- to 5-minute period). A self-reported
measure of mood, the PANAS (34), was completed on arrival in the
laboratory (baseline) and after the 10-minute stress induction. At the
end of the study, as part of the debriefing, participants were asked to
rate the perceived stressfulness of the study on a seven-point Likert
scale (where 1 not at all stressful and 7 extremely stressful).
Assessment of Eating Behavior

Participants had been asked to refrain from eating for 4 hours
before the study to ensure a reasonably standardized level of deprivation, resulting in a substantial intake from the meal. Ratings of
current hunger (on a seven-point Likert scale, where 1 not at all
and 7 extremely) were taken on arrival in the laboratory (baseline) and after the stress or control manipulation.
Two measures were used to assess the effect of the stress manipulation on eating behavior and food choice: 1) appetite for a range of
foods immediately before eating the meal and 2) food intake during
the meal. Foods had been selected on the basis of their nutrient
content to represent three taste categories, sweet, salty, and bland,
following the method of Grunberg and Straub (24). Within these
taste categories, foods were additionally divided into low- and highfat groups. A total of 34 foods were selected for the food preference
tasks (Table 1). Fifteen similarly categorized foods were provided for
the buffet meal (Table 2): 9 of these were represented by similar
foods among the 34 foods, but in addition, 3 bland high-fat spreads
and 3 sweet low-fat foods were chosen for appropriate use as small
portions and practicality for meal construction. To test the assumption that taste was related to nutrient content, 34 adults (not those
who took part in the main study) were asked to rate the taste of each
of the 34 foods for sweetness, saltiness, and fattiness (where 1 not
at all and 7 extremely). Perceptions of taste were found to
correlate highly with actual nutrient content (sugar content and
sweetness: r 0.84, p .001; salt content and saltiness: r 0.76, p
.001; fat content and fatty taste: r 0.77, p .001), thus validating
the use of nutritional composition data to generate categories based
on taste.
Food Appetite Ratings. Photographs of each of the 34 foods were
presented one at a time. For each food, participants were asked,
How much do you fancy eating some of this food at the moment?,
and indicated their response on a scale from 1 (I definitely dont
want to eat this food at all at the moment) to 7 (Right now I really
want to eat this food). The appetite ratings had previously been
found to show adequate test-retest reliability when administered to
12 different adults on two occasions 30 minutes apart (mean r
0.83, p .01). The ratings were completed after the stress (or
control) manipulations, immediately before the meal was served.
The photographs were presented in random order to each subject to
control for possible order effects between sequentially presented
foods.
Food Intake. Participants were allowed to eat freely for 15 minutes from a buffet lunch consisting of, as far as was practicable, foods
from each of the taste categories described above (Table 2). The
foods were weighed to the nearest 0.1 g before and after the meal to
determine the amount consumed.
Individual Difference Variables

A number of trait measures were completed before participation.
Trait anxiety was assessed with the Trait scale of the STAI (35).
Dietary restraint and the tendency to eat more when cognitive restraint on eating is disrupted by psychological, sensory, or emotional challenges (sometimes labeled disinhibition) were assessed
with the Restraint, Emotional, and External Eating scales from the
DEBQ (30). In addition, for each of the 34 foods listed in the appetite
ratings, participants were asked to indicate how much they liked the
food in general. Responses were recorded on a Likert scale (where
4 I really dislike this food and 4 I really like this food).
Procedures and Scheduling

The study was performed between 11:30 AM and 1:30 PM, that
is, at a time when a meal would usually be eaten. This is in
contrast to the usual laboratory eating paradigms in which snack
consumption is measured without regard to meal times. On arrival at the laboratory, participants confirmed that they had eaten
nothing in the previous 4 hours, and baseline measures of blood
pressure, heart rate, mood (PANAS), and hunger were completed.
Participants then received instructions for either the stress or control
task, according to their random allocation, and were left alone for the
10-minute duration of the tasks. At the end of the 10-minute period,
blood pressure, heart rate, and mood were reassessed in all subjects. A
second hunger rating and the food appetite ratings were also completed. Participants then received a meal with the foods presented on
separate plates on two trays, the position of the plates on the trays being
varied for each participant. They were instructed that they could eat
whatever they wished from the selection and in whatever quantities
they desired, just as long as they ate something and were less hungry at
the end of the meal. The experimenter explained that they would be left
alone to eat for 15 minutes. At the end of the meal, the experimenter
returned, and the true nature of the study was explained. The debriefing included a rating of the perceived stressfulness of the study. Finally, age, height, and weight were recorded.
Data Analysis
The main hypotheses were tested by ANOVAs; the interactions
between stress condition (group) and individual difference variables, such as gender, restraint, and emotional eating, were of primary interest. In most cases, there was an a priori prediction for the
direction of the interaction effect, and so an level of 0.05 was taken
as significant, despite quite large numbers of statistical tests. Unexpected results that achieved this level of significance were interpreted cautiously. Multiple comparison tests on the same dependent
855
G. OLIVER et al.
TABLE 1.
Foods Included in the Food Desirability Rating With Relevant Nutritional Compositiona
Food
Category
Bland
Low fat
High fat
Salty
Low fat
High fat
Sweet
Low fat
High fat
Energy
(kcal)
Sugars
(g)
Fat
(g)
Energy as
Fat (%)
Sodium
(mg)
Steamed rice
Boiled potatoes
Bread (white)
Raw carrot
Raw tomato
Steamed fish
Avocado
Fried cod in batter
Unsalted peanuts
Boiled egg
Clotted cream
Greek yogurt
138
72
217
35
17
83
190
247
564
147
586
115
Trace
0.7
3
7.4
3.1
0.0
0.5
Trace
6.2
Trace
2.3
2
1.3
0.1
1.3
0.4
0.3
0.9
19.5
15.4
46.1
10.8
63.5
9.1
8.5
1.3
5.4
10.3
15.9
9.8
92.4
56.1
73.6
66.1
97.5
71.2
1
7
530
25
9
65
6
160
2
140
18
71
Prawns
Smoked salmon
Marmite (autolysed yeast extract)
Pretzels
Noodles and soy sauce
Cheddar cheese
Crisps (potato chips, salted)
Dry-roasted peanuts
Salami
Frankfurters (hot dogs)
Bacon
107
142
172
381
70
412
546
589
491
274
422
0
0
0
0
1.7
0.1
0.7
3.8
Trace
Trace
0.0
1.8
4.5
0.7
3.5
0.5
34.4
37.6
49.8
45.2
45.2
36.0
15.1
28.5
3.7
8.3
6.4
75.1
62.0
76.1
82.9
82.9
76.8
1590
1880
4500
1720
1424
670
1070
790
980
980
1990
Honey
Boiled sweets (candies)
Lemon sorbet
Banana
Meringue
Milk chocolate
Vanilla ice cream
Jam doughnut
Fudge
Chocolate-coated biscuit
Sponge cake
288
327
131
95
379
529
194
336
441
524
459
76.4
86.9
34.2
20.9
95.4
56.5
22.1
18.8
81.1
43.4
30.9
0.0
Trace
Trace
0.3
Trace
30.3
9.8
14.5
13.7
27.6
26.3
0.0
Trace
Trace
2.8
Trace
51.6
45.5
38.8
28.0
47.4
51.6
11
25
69
1
110
120
69
180
160
160
350
Food
Nutrients per 100 g. Data from Holland et al. (51).
variable were not required by this design. In addition, some relationships between physiological and psychological variables were
assessed by using Pearsons product-moment correlation.
RESULTS
Participant Characteristics
The background characteristics of the group are
summarized in Table 3. Participants were between
18 and 46 years old. The men were predictably
heavier (F(1,64) 117.17, p .001) and taller (F(1,64)
46.04, p .001) than the women, but body mass index
did not differ between the sexes. There were no differences between groups randomized to the stress or control
856
condition on any of these measures. There were no significant group or gender differences in trait anxiety.
As expected, dietary restraint scores were significantly higher in women (F(1,64) 13.50, p .001), and
women scored higher than men on the emotional eating
scale (F(1,64) 4.99, p .05), but there were no gender
differences in external eating. There were no differences
between stress and control groups in dietary restraint,
emotional eating, or external eating.
Ratings for liking of the foods to be used in the
study showed that fatty sweet foods were most liked
by the sample as a whole (see Table 3) and that salty
low-fat foods were the least liked. Men reported

TABLE 2.
Energy
(kcal)
Carbohydrate
(g)
Sugars
(g)
Protein
(g)
Total
Fat
(g)
White bread
Raw carrot
Raw tomato
Peanut butter
Flora (soft margarine)
Butter
252
35
17
592
739
737
48.5
7.9
3.1
12.5
1.0
Trace
1.6
7.4
3.1
6.5
1.0
Trace
9.6
0.3
0.3
23.6
0.2
0.5
2.2
0.6
0.7
49.7
81.6
81.7
500
25
9
400
800
750
5 rolls (200 g)
100 g
1 ( 80 g)
70 g (2 35-g jars)
50 g (5 10-g packets)
Marmite (autolysed yeast

extract)
Cheddar cheese
Salted crisps (potato chips)
Salted peanuts
172
1.8
0.0
39.7
0.7
4500
412
557
600
0.1
49.9
8.6
0.1
0.4
3.8
25.5
4.5
29.0
34.4
37.7
50.0
700
600
500
Mandarin
Grapes
Strawberry jam
Cake (cherry, slices)
Chocolate biscuits
35
60
265
407
493
8.0
15.4
66.0
50.9
66.5
8.0
15.4
66.0
34.2
28.5
0.1
0.4
0.4
3.9
6.8
0.9
0.1
0.1
20.8
24.1
2
2
Trace
80
450
Food
Category
Bland
Low fat
High fat
Salty
Low fat
High fat
Sweet
Low fat
High fat
Compositiona of Test Meal Given to Participants
Food
Quantity Provided
100 g (grated)
30 g
200 g
2 medium (300 g)
100 g
70 g (2 35-g jars)
100 g (3 slices)
70 g (4 biscuits)
Nutrients per 100 g. Data from Holland et al. (51).

TABLE 3.
Characteristics of Participantsa
Stress Group
N
Age (y)
Body weight (kg)
Height (m)
Body mass index
Psychological indices
Trait anxiety (STAI)
Self-esteem (Rosenberg)
Measures of eating behavior (DEBQ)
Dietary restraint
Emotional eating
External eating
General food-liking scores
Bland
Low fat
High fat
Salty
Low fat
High fat
Sweet
Low fat
High fat
a
Sodium
(mg)
Control Group
Men
Women
Men
Women
14
25.6 4.8
70.9 8.8
1.80 0.07
21.7 2.2
20
26.5 7.0
58.5 8.7
1.63 0.7
22.0 2.5
13
26.9 6.7
76.3 9.4
1.82 0.06
23.1 2.6
21
25.3 4.2
59.7 7.8
1.66 0.05
21.7 2.3
40.9 10.7
21.3 4.8
44.2 8.7
22.2 3.9
42.1 11.2
22.5 4.6
42.3 10.8
23.0 5.7
2.15 0.89
2.18 0.71
3.09 0.62
2.49 0.81
2.59 0.86
3.21 0.49
1.66 0.60
2.50 1.08
3.33 0.51
2.79 0.85
3.07 0.91
3.37 0.53
1.57 0.81
1.78 0.60
1.82 0.96
0.96 1.10
2.01 0.52
1.32 1.03
1.84 1.15
0.81 1.20
0.96 1.64
1.92 0.89
1.82 1.14
0.73 1.58
1.37 1.23
1.88 0.90
0.47 1.54
0.56 1.43
1.37 0.96
1.99 1.25
1.27 1.29
2.08 1.27
1.62 1.24
2.50 0.87
1.36 1.31
1.61 1.79
Data are mean SD.
liking fatty bland and fatty salty foods significantly

more than women (F(1,64) 6.65, p .02 for fatty
bland foods; F(1,64) 15.12, p .001 for fatty salty
foods). There were no significant differences in general food preferences between stress and control
groups.
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G. OLIVER et al.
Effectiveness of the Stress Manipulation
At baseline, there were no differences between the
stress and control groups in heart rate, SBP, or DBP
(see Table 4). Men in both groups had significantly
higher SBP (F(1,64) 25.98, p .001) and DBP
(F(1,64) 4.28, p .05) than women. The change in
heart rate after the stress manipulation did not reach
significance (group-by-time interaction: F(1,64)
2.82, p .10; Table 4). SBP increased over time (from
baseline to after stress) in the stressed group and decreased in the control group (group-by-time interaction: F(1,64) 14.41, p .001; Table 4). The pattern
was the same for men and women. DBP decreased in
the control but not in the stress group (group-by-time
interaction: F(1,64) 4.42, p .05).
There were no significant differences between stress
and control subjects in positive or negative affect
scores at baseline. Negative affect scores were logtransformed to produce a normal distribution. As predicted, subjects in the stress group showed a significant increase in negative affect from baseline, whereas
those in the control group showed a reduction in negative affect relative to baseline (group-by-time interaction: F(1,64) 11.77, p .001). For positive affect, the
control group showed a decrease, whereas in the
stressed group positive affect remained constant
TABLE 4.
(group-by-time interaction: F(1,64) 10.00, p .01).

Gender had no effect on affect scores.
Overall, the manipulation achieved significant if
modest differences between groups in both physiological and psychological indices of stress (Table 4). This
was borne out by the post hoc subjective ratings of
perceived stress. Participants in the stressed group
rated their experience as significantly more stressful
(mean rating 4.26, SD 1.4) than the control group
(mean rating 1.62, SD 1.0) (F(1,64) 69.12, p
.01). This between-group difference applied to both
men and women.
Food Intake: Effects of Gender and Stress

Gender Differences. Men ate significantly more
weight of food (F(1,64) 6.03, p .02) and had a
higher total energy intake (F(1,64) 11.07, p .001)
than women (Table 5), as would be expected from their
significantly higher body weights and consequently
greater daily energy requirements. Controlling for energy requirements (covariate F(1,63) 5.77, p .02)
removed this gender effect (for grams: F(1,63) 1.16;
for kilocalories: F(1,63) 1; both NS), and so estimated energy requirement was included as a covariate
in subsequent analyses involving total amounts of food
Effectiveness of the Stress Manipulation: Physiological and Psychological Indices

Stress Group
Men
Physiological indices
Heart rate (beats/min)
Baseline
T1
Change
SBP (mm Hg)
Baseline
T1
Change
DBP (mm Hg)
Baseline
T1
Change
Psychological indices
Positive affect
Baseline
T1
Change
Negative affect
Baseline
T1
Change
Perceived stressfulness of manipulation
858
Control Group
Women
Men
Women
Mean
SD
Mean
SD
Mean
SD
Mean
SD
65.6
66.0
0.4
9.4
11.2
10.0
68.2
71.4
3.3
12.4
11.6
8.2
63.9
62.9
1.0
8.7
9.4
8.5
71.6
69.1
2.5
13.7
12.8
7.8
129.1
130.4
1.3
15.5
14.5
10.2
113.1
114.2
1.1
13.0
13.7
9.2
132.2
124.5
7.7
14.6
10.1
6.9
114.8
108.4
6.4
10.8
8.7
8.2
82.6
81.6
1.0
10.9
11.4
4.9
75.1
80.9
5.8
9.5
13.8
7.4
81.5
81.2
0.3
10.1
10.7
6.3
79.2
76.9
2.3
8.5
6.8
8.4
28.6
27.6
0.9
6.5
6.5
2.9
28.6
29.3
0.7
5.3
5.3
5.5
33.4
29.9
3.5
5.6
6.6
2.9
30.2
26.9
3.3
5.9
5.6
3.9
14.2
15.7
1.5
4.1
4.3
5.1
3.5
1.5
14.5
16.6
2.1
4.4
5.0
6.4
6.1
1.4
12.9
12.4
0.5
1.7
2.4
2.5
1.9
0.9
12.3
10.7
1.6
1.6
2.8
1.1
2.6
1.0

Effect of Stress, Gender, and Sensory Category on Food Intakea
TABLE 5.
Stress Group
Intake Category
Total food intake

Total energy intake (kcal)
Energy density of intake (kcal/g)
Bland foods
All
Low fat
High fat
Salty foods
All
Low fat
High fat
Sweet foods
All
Low fat
High fat
a
Men
Control Group
Women
Men
Women
Mean
SD
Mean
SD
Mean
SD
Mean
SD
378.9
884.4
2.31
135.6
402.2
0.51
310.7
686.9
2.26
110.6
282.3
0.64
391.8
922.5
2.45
140.6
293.1
0.74
316.6
637.3
2.09
94.4
203.6
0.63
204.2
189.1
15.0
74.6
70.3
11.7
155.3
142.3
13.0
60.2
51.2
13.9
217.8
200.8
17.0
72.0
75.9
13.0
154.6
142.5
12.1
63.7
64.5
10.8
57.1
2.4
54.7
44.3
6.4
45.1
44.3
0.5
43.8
32.2
1.7
32.2
60.4
1.5
58.8
28.8
2.5
28.8
39.5
0.8
38.7
25.0
1.4
25.4
117.7
72.4
45.3
96.2
67.5
49.6
111.1
76.1
35.0
95.4
76.9
41.3
113.6
75.1
38.5
84.6
72.2
34.3
122.5
92.2
30.2
73.1
68.4
29.5
Units are grams except where indicated.
eaten. However, analyses involving measures of selection of different food sensory categories were not adjusted for energy requirements. Daily energy requirements were estimated on the basis of published
figures.1 This resulted in mean (SD) daily energy requirements of 3031.0 (236.9) kcal/d for the men and
2172.6 (185.1) kcal/d for the women (sex difference:
F(1,64) 284.6, p .001). Both men and women
consumed about one-third of their daily caloric requirements from the food presented, suggesting that
this eating episode could realistically be considered a
meal rather than merely a snack.
Stress Effects. There were no significant main effects of stress group on weight of food consumed, total
energy intake, or energy density of the meal (kcal/g),
nor were there any interactions between group and
gender (Table 5). Total intake was also analyzed in
terms of the main macronutrients (carbohydrate, fat,
and protein) and for starch and sugar separately, but
no significant effects were found (data not shown).
To examine intake in relation to choice from the
food sensory categories (sweet, salty, and bland), the
amount of food eaten from each category, including
high- and low-fat levels, was calculated (Table 5).
Four-factor repeated-measures ANOVA of intake (g)
1
Estimated daily energy requirements were calculated, using published equations, from basal metabolic rate, which is dependent on
age, sex, and weight, multiplied by physical activity level (PAL)
(36). Because no data were available for activity levels, moderate
levels were assumed for both occupational and nonoccupational
activity in both men (PAL 1.7) and women (PAL 1.6).
with food category and fat level as within-subjects

factors, and group and gender as between-subjects factors, revealed a number of significant effects (with
-corrected F values adjusted for sphericity where necessary). There was no significant main effect or any
interactions involving stress group (Table 5). However,
intake differed by food category (F(2,128) 67.47, p
.001), fat level (F(1,64) 116.76, p .001), and gender
(F(1,64) 6.03, p .02). Furthermore, food category
interacted with gender (F(2,128) 3.28, p .05) and
fat level (F(2,128) 194.55, p .001), and all of these
factors interacted (F(2,128) 6.94, p .001). Therefore, effects of fat level and gender were analyzed
within each food category by two-factor ANOVA. Results for energy intake were essentially similar and so
are not presented here.
Bland Foods. Men ate significantly more bland food
than women (F(1,66) 11.69, p .001), although this
difference was more apparent for low-fat than high-fat
bland foods (F(1,66) 9.57, p .01) (Table 5). This
may not be surprising given that the high-fat bland
foods were spreads, which were consumed in much
smaller amounts than the low-fat bland foods (bread,
carrots, and tomatoes) (F(1,66) 381.17, p .0001).
Salty Foods. Men ate significantly more salty foods
than women (F(1,66) 4.48, p .05). This effect was
independent of fat level, although the one low-fat salty
food available, yeast extract (Marmite spread), was
eaten in far smaller amounts than the high-fat salty
foods (F(1,66) 135.12, p .0001).
Sweet Foods. Unlike bland and salty foods, men did
not eat any more sweet foods than women (F(1,66) 1;
859
G. OLIVER et al.
Table 5). Both men and women ate significantly more
weight of low-fat than high-fat sweet foods (F(1,66)
20.44, p .001, no interaction).
Effects of Dietary Restraint on Intake
A median split of restraint scores was used to distinguish restrained and unrestrained eaters. Gender
was included as a covariate because there were significantly more female than male subjects in the highrestraint group (2 4.98, p .05).
There were no significant differences in intake (as
either weight or energy) between restrained and unrestrained eaters and no interaction between restraint
level and stress condition (F values 1, except the
gender covariate, which had values of F(1,63) 5.23,
p .05 for grams and F(1,63) 9.82, p .01 for kcal;
results were not qualitatively different without gender
as a covariate; see Table 6). Analyses grouping food
intake in terms of energy density of overall intake
(Table 6), sensory categories, and percentage of energy
from carbohydrate, protein, and fat (data not shown)
all failed to reveal any significant effects of restraint or
stress or any interactions involving these factors.
Effects of Emotional Eating on Intake
Restrained eaters scored significantly higher on the
emotional eating subscale of the DEBQ (t(66) 3.23, p
.01), and women were also more emotional eaters
than were men (t(66) 2.26, p .05) (Table 3). Thus,
although gender might mediate the interaction between restraint and emotional eating, effects of the
latter could give a clearer indication of individual differences in eating responses to stress. Again, gender
was included as a covariate in these analyses.
Subjects were divided, on the basis of a median
split, into high and low emotional eaters (ie, emotional eaters and nonemotional eaters). No significant effects of stress condition or any interaction with
emotional eating status were seen when total intake
was analyzed in terms of either weight or energy eaten
(group effect and group-by-emotional eating interacTABLE 6.
tion, all F values 1; see Table 7). Gender was a

significant covariate here for both grams of food eaten
(F(1,63) 7.18, p .01) and energy intake (F(1,63)
12.33, p .005).
Unlike total intake, the energy densities of the meals
eaten varied by stress condition and emotional eating
status (stress-by-emotional eating interaction: F(1,63)
6.17, p .02; Table 7). In the stress group, the
energy density of high emotional eaters intake was
significantly greater than that of low emotional eaters
(t(32) 2.22, p .05), whereas among control subjects
the high emotional eaters ate less energy-dense meals
on average (t(32) 1.45, NS). Gender was not a significant covariate for energy density (F(1,63) 1.56, NS;
Table 7), possibly reflecting the fact that variation in
energy density results from different choices rather
than differences in overall intake.
Effects of stress and emotional eating, and any interactions with fat level, were investigated separately
for intake of each food sensory category by using threefactor repeated-measures ANOVA. Intakes of bland
and salty foods were unaffected by these factors.
Sweet Foods. Gender was not a significant covariate
for intake of sweet foods, and so subsequent analyses
did not include gender. Overall, weight of intake of
sweet low-fat foods (fruit and jam) was higher than
intake of high-fat foods (cake and chocolate biscuits)
(F(1,64) 18.66, p .001), although the reverse was
true for energy intake (F(1,64) 35.12, p .001),
reflecting the far greater energy density of the sweet
high-fat foods (Table 7). There were no main effects for
stress group or emotional eating, but there were threeway interactions between fat level, group, and emotional eating (grams: (F(1,64) 3.53, p .07; kcal:
(F(1,64) 5.05, p .05), which were examined further
by separate analyses for low- and high-fat sweet foods.
High emotional eaters were found to eat almost
twice the weight of sweet fatty foods on average than
did low emotional eaters in the stress group (t(32)
1.78, p .05, one-tailed test; Table 7); in contrast,
among controls, high and low emotional eaters did not
differ significantly in their intake of sweet fatty foods
(t(32) 0.78). Although this interaction just failed to
Effect of Dietary Restraint and Stress on Overall Food Intake

Stress Group
Intake Category
Total food intake (g)

Energy density of meal eaten (kcal/g)
860
Low Restraint
Control Group
High Restraint
Low Restraint
High Restraint
Mean
SD
Mean
SD
Mean
SD
Mean
SD
312.7
730.3
2.33
123.9
357.2
0.59
365.0
806.2
2.24
122.6
339.8
0.60
364.0
799.9
2.24
142.6
327.5
0.68
326.7
692.9
2.22
87.9
209.1
0.72

TABLE 7.
Effect of Emotional Eating Status, Stress, and Sensory Category on Food Intakea
Stress Group
Low Emotional
Eating
Intake Category
Total food intake

Energy density of meal (kcal/g)
Bland foods
All
Low fat
High fat
Salty foods
All
Low fat
High fat
Sweet foods
All
Low fat
High fat
a
Control Group
High Emotional
Eating
Low Emotional
Eating
High Emotional
Eating
Mean
SD
Mean
SD
Mean
SD
Mean
SD
327.1
687.4
2.11
119.0
330.2
0.60
357.7
898.8
2.55
134.9
341.3
0.46
307.1
735.9
2.44
75.9
224.4
0.55
369.0
752.9
2.10
134.4
308.7
0.74
172.6
160.0
12.6
69.8
64.0
11.8
180.0
164.1
15.9
72.4
64.6
14.8
151.6
136.1
15.4
46.1
42.6
13.2
195.6
182.5
13.1
82.0
83.9
11.0
45.5
1.4
44.1
41.1
5.3
41.2
56.1
1.1
55.0
31.5
2.3
31.8
42.9
0.7
42.2
27.0
1.4
27.5
50.3
1.3
49.0
29.0
2.1
28.9
109.0
80.0
28.9
86.3
71.4
33.8
121.6
65.7
55.9
109.4
75.2
55.2
112.6
73.9
38.7
68.0
68.7
33.4
123.0
93.0
30.0
82.8
70.4
30.1
Units are grams except where indicated.
reach significance for grams eaten (stress-by-emotional

eating interaction: F(1,64) 3.60, p .06), the effect
on energy intake was significant (F(1,64) 4.26, p
.05) for the group-by-emotional eating interaction,
again with high emotional eaters eating nearly twice
the energy intake of low emotional eaters among
stressed subjects (Figure 1). In comparison, no effects
of emotional eating or stress were seen for intake of
sweet low-fat foods (Table 7).
Analyses of separate macronutrient intake did not
reveal any significant effects of stress or emotional
eating or any interactions for amount or percentage of
energy eaten.
Effects on Hunger
Men and women did not differ in their hunger rating
recorded at baseline, nor were there significant differences between participants allocated to the stress and
control groups. For the sample as a whole, initial hunger ratings were reasonably high (mean rating 4.87,
SD 1.23, of a maximum 7), so a substantial intake
could be expected during the meal.
Hunger showed no significant change from baseline
to after stress, nor was there any differential effect in
the two groups; thus, there was no support for the
prediction that stress affected hunger at the group level
(data not shown). Data from the stress group alone
were examined for evidence that greater physiological
arousal was linked with lower hunger. A significant
(negative) correlation emerged with heart rate in a
partial correlation controlling for gender (r 0.21, p

.05), with a higher heart rate being associated with
lower hunger. There were no significant associations
for hunger with blood pressure.
The association between rated hunger and desire to
eat specified foods was examined using mean appetite
ratings across all the 34 foods. This showed that hunger was positively correlated with appetite for the
foods (r 0.42, p .001).
Desire to Eat Bland, Salty, and Sweet Foods
In the analyses of rated appetites for the three food
sensory categories, general preference for foods in that
category (based on the liking ratings made at the start
of the study) was included as a covariate to assess
appetite independently of variation due to differences
in general liking. General preference ratings were consistently significant covariates for the rated desires to
eat bland, salty, and sweet food (bland: F(1,65)
12.57, p .001; salty: F(1,65) 10.22, p .01; sweet:
F(1,65) 12.82, p .001). When analyzing for effects
of restraint and emotional eating on desire for foods,
gender was not a significant covariate (largest F
1.63), and so it was excluded from those analyses.
Gender. No significant main effects were found, but
a group-by-gender interaction was seen for sweet foods
(F(1,63) 4.28, p .05), and in an unexpected direction, with appetite for sweet foods being increased by
stress in men but not in women (stressed vs. control
men: mean (SD) 3.57 (1.09) vs. 2.76 (1.10), F(1,24)
861
G. OLIVER et al.
(SD) desire to eat for high vs. low emotional eaters:
stressed group, 4.58 (0.90) vs. 3.62 (0.91), respectively;
control group, 3.73 (0.93) vs. 3.71 (0.90), respectively).
DISCUSSION
Fig. 1.
Effect of emotional eating status and stress manipulation on

intake (kcal) of sweet fatty foods. Data are mean SE. *t(32)
1.85, p .05, one-tailed test, for greater intake by high
emotional eaters in the stressed group vs. the control group
(independent t test; see text for details of significant
ANOVA interaction). Intakes among low emotional eaters
did not differ between groups.
4.64, p .05; stressed vs. control women: mean (SD)

3.32 (1.09) vs. 3.63 (1.10), F 1; all means were
adjusted for the effect of the general liking covariate).
In contrast, among unstressed control subjects, women
desired to eat sweet foods more than men (F(1,31)
4.58, p .05). This effect was independent of fat level
(group-by-gender-by-fat level interaction, F 1). No
effects of gender or group, nor any interactions, were
seen on appetite for either bland or salty foods (data
not shown).
Restraint. No significant effects of restraint, or any
interactions with stress, on desire to eat foods were
found (data not shown). This was the case for all food
sensory categories.
Emotional Eating. The only notable effect was that,
for salty foods only, stressed high emotional eaters
expressed greater appetite than low emotional eaters,
whereas control subjects did not differ (stress-by-emotional eating interaction: F(1,63) 4.22, p .05; mean
862
There was no evidence here of a general hypophagic

effect of stress on men nor any stress-induced hyperphagia specifically in women, contrary to the findings of Grunberg and Straub (24). Previous studies of
stress and eating typically gave snack-type foods to
nonfood-deprived subjects, with eating being presented as an incidental activity while performing a
more central task. The present study is unusual in
explicitly providing mildly food-deprived participants
with a meal to overcome the problem of low intake that
encumbered earlier studies and in incorporating a
wider range of foods to allow more valid assessment of
food choice.
However, stress did increase intake of sweet fatty
foods in emotional eaters. In addition, women scored
more highly on emotional eating than men, as is typically found (30). Thus, Grunberg and Straubs (24) sex
difference in the appetitive response to stress may in
fact have been mediated by a difference in emotional
eating.
The cake and chocolate biscuits preferred here by
stressed emotional eaters are typically eaten as snacks.
There is evidence that snack consumption may be
more susceptible to stress than meals (15, 37). Such
foods may be preferred during stress through learning
that small energy-dense snacks are more easily ingested and digested when gut activity is suppressed by
sympathetic arousal. In comparison, a naturalistic
study of the impact of surgical stress on food intake
found no effect of stress on meal intake or composition
(12).
Unlike a number of previous studies (18 20, 38,
39), the present study did not reveal a significant influence of dietary restraint on eating behavior under
stress, although there was a trend toward greater consumption of sweet foods by highly restrained stressed
subjects. In this study, restraint was measured using
the restraint scale of the DEBQ, which contains items
pertaining only to dietary restraint and thus is not a
measure of vulnerability to dietary disinhibition,
whether through emotional relief or other reasons. In
contrast, the Restraint Scale (28, 29), which has been
found to discriminate eating responses to stress (20,
38), paradoxically contains only 1 item (of 10) that
explicitly refers to dietary restraint; the remaining
items addressing weight fluctuation, preoccupation
with food, tendency to binge when eating alone, and
feeling guilty after overeating. The psychometric rele-

vance of labeling such a questionnaire as measuring
restraint has been discussed in detail elsewhere (30,
40, 41), but such a multifaceted instrument does not
allow clear interpretation of the psychological mechanisms by which stress could be influencing food consumption and choice. In any event, it cannot be concluded from that measure that a critical factor in
responding to stress is the tendency to restrain intake,
and we find no support for such a conclusion. Furthermore, the Disinhibition scale of the Three-Factor
Eating Questionnaire (41) (overeating elicited by social, sensory, and emotional cues) discriminates between women who report eating more during stress
and those who do not (16), whereas the restraint-specific scale of that instrument did not predict stressinduced eating.
In comparison, the emotional eating scale of the
DEBQ used here specifically defines individuals who
have a tendency to eat more during negative emotional
states (ie, emotion-induced disinhibition) (42). Just
such an emotional eating effect was observed here:
High emotional eaters ate more sweet, fatty, and thus
energy-dense foods under stress. Thus, this study provides some evidence that a stress-induced change in
food choice is a measurable behavioral phenomenon,
at least in this laboratory environment, not just a subjective phenomenon confined to self-report measures.
These results are particularly important because the
increased eating is confined to certain foods, especially those that current health recommendations suggest should be limited. In contrast to intake, rated
desire to eat the various categories of foods was less
affected by stress, although desire to eat salty foods
was specifically greatest in stressed emotional eaters.
Even so, the increased desire to eat sweet foods when
stressed seen here in men but not in women (irrespective of emotional eating status) is contrary to the (intake) results of Grunberg and Straub (24). These effects
on desire for food sensory categories require replication and should be interpreted cautiously.
Why might some individuals be more susceptible to
unhealthy shifts in food choice when under stress?
The effect is not dependent on gender per se, but the
emotional eaters were more likely to be female. From
an intervention perspective, it will be important to
understand how emotional eating tendencies develop.
This characteristic has been discussed extensively
elsewhere (13, 30), but its origin remains poorly understood. One consideration is that an initial experience of eating highly palatable energy-dense foods
when upset may become habitual by reinforcement
through sensory, nutritional, and neurohormonal
routes (43, 44).
A recent study provides some support for this mod-
el: Markus et al. (45) found that neurotic (stressprone) subjects were protected from depressed mood
and raised cortisol induced by a psychological stressor
task after eating a carbohydrate-rich/protein-poor
breakfast and lunch but not after a carbohydrate-poor/
protein-rich diet. In stable subjects, mood was depressed and cortisol increased equally after either diet.
This result was interpreted as improved coping after a
diet-induced increase in the supply of precursor
amino acids to serotonin synthesis. That is, the carbohydrate-rich/protein-poor diet specifically allows
greater uptake of the precursor amino acid tryptophan
into the brain. The implication is that neurotic or
stress-prone individuals may be particularly sensitive
to dietary effects on brain pathways influencing mood
and stress coping. Furthermore, to learn to self-medicate through eating in this manner would most likely
require ingestion of unusually low-protein foods in
isolation (46), as might be achieved by snacking on
sweet and fatty foods when hungry. Also, within this
theoretical framework, dietary restraint, found to be
positively correlated with emotional eating or disinhibition here and elsewhere (16, 30, 41), may predispose
an individual to learning such a dietary-induced relief
of dysphoria; that is, dieting has been shown to lower
plasma tryptophan levels in women and to sensitize
serotoninergic function (47).
An alternative neurohormonal mechanism for
stress-induced preferential selection of sweet fatty
foods is suggested by evidence that such highly palatable foods can themselves relieve stress through release of endogenous opioids (44, 48).
The effects of stress on hedonic reactions to, and
perception of, taste also need consideration. For instance, Dess and Edelheit (27) found that stress
changed peoples perception of saccharins bitterness
and sweetness, as it does in rats (6), but the direction of
change depended on aspects of temperament such as
trait arousability, pleasure (net affective valence), and
dominance. Despite no suggestion of gender differences (27), it could be fruitful to determine the relationship of these traits to emotional eating tendencies.
As with any laboratory study carried out in this
area, the impact of the stressor on the participants is
likely to be less severe than is the case for real events
occurring in a nonexperimental setting without ethical
constraints. Caution is required in generalizing from
these results to less controlled situations in daily life.
Even so, anticipation of public speaking is known to be
a fearful stimulus to students (49); actual performance
might have led to subjects eating while in a relieved
rather than stressed state. Here, certainly, subjects in
the stress group rated their experience as significantly
more stressful than did subjects in the control group,
863
G. OLIVER et al.
but this was in response to the question asked during
the debriefing session, and so answers may have been
influenced by demand effects. Nevertheless, on the
premise that stress-induced changes in food choice
might actually help to alleviate stress, group differences in the perceived stress level reported after the
meal may have been less than would be the case without a meal. It should be noted that the (presumably
adaptational) decrease from baseline in physiological
arousal among control subjects is a well-recognized
phenomenon in psychophysiological research (50):
Far from vitiating the use of stress and control
group labels, it illustrates the justification for such a
control group. The combination of this difference between groups in changes in physiological measures
and the evidence of greater physiological and psychological arousal in the stressed group justifies the
stressed vs. control group comparisons.
Despite the limitations described, this study is
unique in its assessment of the effect of stress on food
choice in the laboratory by presenting, in the form of
an explicit meal, a range of foods varying in nutritional
composition, taste and textural qualities, and dietary
roles (ie, snack foods and meal foods). Susceptible
individuals were found to select less healthy foods
under stress, supporting the proposition that stress
may damage health in part through unhealthy food
choice. However, the variety of foods was limited, and
so caution is needed in interpreting which properties
of the foods are critical to the effect. The findings
deserve replication and extension, for instance, under
different stress conditions and eating contexts, together with further characterization of vulnerable
traits (51).
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Stress and Food Choice

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Stress and Food Choice: A Laboratory Study

GEORGINA OLIVER, PHD, JANE WARDLE, PHD,

E. LEIGH GIBSON, PHD

ANOVA analysis of variance; DBP diastolic blood

Psychosomatic Medicine 62:853 865 (2000)

straint Scale (28, 29) to measure such tendencies.

Psychosomatic Medicine 62:853 865 (2000)