Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis
Abstract Background Poor diet quality is associated with obesity-related morbidity and mortality. Psychological stress can increase unhealthy dietary choices, but evidence pertinent to women of reproductive age remains unclear. This paper systematically reviewed the literature to determine the assoc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Nutrition Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12937-020-00609-w |
| _version_ | 1818883189256486912 |
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| author | Karim Khaled Fotini Tsofliou Vanora Hundley Rebecca Helmreich Orouba Almilaji |
| author_facet | Karim Khaled Fotini Tsofliou Vanora Hundley Rebecca Helmreich Orouba Almilaji |
| author_sort | Karim Khaled |
| collection | DOAJ |
| description | Abstract Background Poor diet quality is associated with obesity-related morbidity and mortality. Psychological stress can increase unhealthy dietary choices, but evidence pertinent to women of reproductive age remains unclear. This paper systematically reviewed the literature to determine the association between psychological stress and diet quality in women of reproductive age. Methods Medline, CINAHL, Scopus, Cochrane Library, Web of Science, and Sciencedirect were searched. Data extraction was determined by the PEO. Inclusion criteria consisted of: English language, stress (exposure) measured in combination with diet quality (outcome), healthy women of reproductive age (18–49 years old (population)). Observational studies, due to the nature of the PEO, were included. Quality assessment used the Risk of Bias in Non-randomised Studies from the Cochrane Handbook of Systematic Reviews of Interventions. Meta-analysis was conducted using random-effect model to estimate the Fisher’s z transformed correlation between stress and diet quality with 95% confidence interval (CI). Results From 139,552 hits, 471 papers were screened; 24 studies met the inclusion criteria and were conducted in different countries: 8 studies on diet quality and 16 on food intake and frequency of consumption. Studies of diet quality consisted of six cross-sectional and two longitudinal designs with a total of 3982 participants. Diet quality was measured with diverse indices; Alternate Healthy Eating Index (n = 2), Healthy Eating Index (n = 2), Dietary Approach to Stop Hypertension (DASH) Diet Index (n = 2), Dietary Quality Index- Pregnancy (n = 2), and Dietary Guideline Adherence Index (n = 1). Most studies used Cohen’s perceived stress scale and no study measured biological stress response. After sensitivity analysis, only 5 studies (3471 participants) were included in the meta-analysis. Meta-analysis revealed a significant negative association between stress and diet quality with substantial heterogeneity between studies (r = − 0.35, 95% CI [− 0.56; − 0.15], p value < 0.001, Cochran Q test P < 0.0001, I2 = 93%). The 16 studies of food intake and frequency of consumption were very heterogeneous in the outcome measure and were not included in the meta-analysis. These studies showed that stress was significantly associated with unhealthy dietary patterns (high in fat, sweets, salt, and fast food and low in fruits, vegetables, fish, and unsaturated fats). Conclusion Future studies that explore diet quality/patterns should include both diet indices and factor analysis and measure biological markers of stress and dietary patterns simultaneously. |
| first_indexed | 2024-12-19T15:29:42Z |
| format | Article |
| id | doaj.art-1056d4172f3f416c972f72221887fe59 |
| institution | Directory Open Access Journal |
| issn | 1475-2891 |
| language | English |
| last_indexed | 2024-12-19T15:29:42Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition Journal |
| spelling | doaj.art-1056d4172f3f416c972f72221887fe592022-12-21T20:15:47ZengBMCNutrition Journal1475-28912020-08-0119111510.1186/s12937-020-00609-wPerceived stress and diet quality in women of reproductive age: a systematic review and meta-analysisKarim Khaled0Fotini Tsofliou1Vanora Hundley2Rebecca Helmreich3Orouba Almilaji4Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth UniversityDepartment of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth UniversityCentre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth UniversityDepartment of Graduate Studies, Cizik School of Nursing, University of Texas Health Science Center at HoustonDepartment of Medical Science and Public Health, Faculty of Health & Social Sciences, Bournemouth UniversityAbstract Background Poor diet quality is associated with obesity-related morbidity and mortality. Psychological stress can increase unhealthy dietary choices, but evidence pertinent to women of reproductive age remains unclear. This paper systematically reviewed the literature to determine the association between psychological stress and diet quality in women of reproductive age. Methods Medline, CINAHL, Scopus, Cochrane Library, Web of Science, and Sciencedirect were searched. Data extraction was determined by the PEO. Inclusion criteria consisted of: English language, stress (exposure) measured in combination with diet quality (outcome), healthy women of reproductive age (18–49 years old (population)). Observational studies, due to the nature of the PEO, were included. Quality assessment used the Risk of Bias in Non-randomised Studies from the Cochrane Handbook of Systematic Reviews of Interventions. Meta-analysis was conducted using random-effect model to estimate the Fisher’s z transformed correlation between stress and diet quality with 95% confidence interval (CI). Results From 139,552 hits, 471 papers were screened; 24 studies met the inclusion criteria and were conducted in different countries: 8 studies on diet quality and 16 on food intake and frequency of consumption. Studies of diet quality consisted of six cross-sectional and two longitudinal designs with a total of 3982 participants. Diet quality was measured with diverse indices; Alternate Healthy Eating Index (n = 2), Healthy Eating Index (n = 2), Dietary Approach to Stop Hypertension (DASH) Diet Index (n = 2), Dietary Quality Index- Pregnancy (n = 2), and Dietary Guideline Adherence Index (n = 1). Most studies used Cohen’s perceived stress scale and no study measured biological stress response. After sensitivity analysis, only 5 studies (3471 participants) were included in the meta-analysis. Meta-analysis revealed a significant negative association between stress and diet quality with substantial heterogeneity between studies (r = − 0.35, 95% CI [− 0.56; − 0.15], p value < 0.001, Cochran Q test P < 0.0001, I2 = 93%). The 16 studies of food intake and frequency of consumption were very heterogeneous in the outcome measure and were not included in the meta-analysis. These studies showed that stress was significantly associated with unhealthy dietary patterns (high in fat, sweets, salt, and fast food and low in fruits, vegetables, fish, and unsaturated fats). Conclusion Future studies that explore diet quality/patterns should include both diet indices and factor analysis and measure biological markers of stress and dietary patterns simultaneously.http://link.springer.com/article/10.1186/s12937-020-00609-wDiet qualityDietStressWomenReproductive ageSystematic review |
| spellingShingle | Karim Khaled Fotini Tsofliou Vanora Hundley Rebecca Helmreich Orouba Almilaji Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis Nutrition Journal Diet quality Diet Stress Women Reproductive age Systematic review |
| title | Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis |
| title_full | Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis |
| title_fullStr | Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis |
| title_full_unstemmed | Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis |
| title_short | Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis |
| title_sort | perceived stress and diet quality in women of reproductive age a systematic review and meta analysis |
| topic | Diet quality Diet Stress Women Reproductive age Systematic review |
| url | http://link.springer.com/article/10.1186/s12937-020-00609-w |
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