Perceived stress and coping strategies in relation to body mass index: cross-sectional study of 12,045 Japanese men and women

Sunday, 17 August 2014
Exhibit hall (Dena'ina Center)
Chisato Shimanoe, PhD , Saga University, Saga, Japan
Megumi Hara, PhD , Saga University, Saga, Japan
Yuichiro Nishida, PhD , Saga University, Saga, Japan
Hinako Nanri, PhD , Showa University, Tokyo, Japan
Yasuko Otsuka, MD , Saga University, Saga, Japan
Kazuyo Nakamura, PhD , St. Mary's College, Fukuoka, Japan
Yasuki Higaki, PhD , Fukuoka University, Fukuoka, Japan
Takeshi Imaizumi, PhD , Saga University, Saga, Japan
Naoto Taguchi, PhD , Saga University, Saga, Japan
Tatsuhiko Sakamoto, PhD , Fukuoka Institute of Health and Environmental Sciences, Fukuoka, Japan
Mikako Horita, BS , Saga University, Saga, Japan
Koichi Shinchi, PhD , Saga University, Saga, Japan
Keitaro Tanaka, PhD , Saga University, Saga, Japan
INTRODUCTION: The relationship between psychosocial stress and body mass index (BMI) has been inconsistent, and little is known about stress coping strategies and BMI. We aimed to examine if perceived stress and coping strategies are related to BMI, with any of their mutual interactions on BMI.

METHODS: This cross-sectional study included 5,063 men and 6,982 women aged 40-69 years. A self-administered questionnaire ascertained perceived stress and 5 items of coping strategies (emotional expression, emotional support seeking, positive reappraisal, problem solving, and disengagement). Analyses were performed by gender with adjustment for age, socioeconomic status and lifestyle factors.

RESULTS: No significant associations were detected between perceived stress and BMI in either men (Ptrend = 0.09) or women (Ptrend = 0.58). In men, however, 'disengagement' showed an inverse association with BMI (Ptrend < 0.001), and 'positive reappraisal' and 'problem solving' revealed a positive association with BMI (Ptrend = 0.007 and 0.04, respectively) even after controlling for perceived stress. A possible interaction between perceived stress and 'disengagement' on BMI was found in men (Pinteraction = 0.027); the inverse association between 'disengagement' and BMI was more evident in higher levels of stress (β = −0.13, Ptrend = 0.21 in low; β = −0.22, Ptrend = 0.01 in medium; and β = −0.24, Ptrend= 0.06 in high). In men, 'disengagement' was inversely associated with overweight/obesity (odds ratio 0.79, 95% confidential interval 0.67-0.95), and "positive reappraisal" was positively associated with it (1.25, 1.02-1.54).

CONCLUSIONS: Coping strategies may have an important role in developing overweight/obesity, particularly in men, thereby complicating the association between psychosocial stress and BMI. Future studies should assess the risk of obesity related to psychosocial stress, taking into account the influence of coping strategies.