Momentary Associations between Dietary Restriction, Stress, and Eating Behaviors in Adolescents

Background: Adolescence is a critical period for the development of eating behaviors that can influence health outcomes later in life. During this stage, youth gain more autonomy over food choices, eating behaviors including binge eating and the consumption of unhealthy food like sugar-added foods. Stress has been shown to impact eating behavior, but most research focuses on trait-level stress, leaving the effects of momentary stress unclear. Dietary restriction may influence this relationship by reducing self-control under stress, leading to overeating and poor food choices.

Methods: This secondary analysis used data from the Brain Influences on Teens’ Eating (BITE) Study, which examined contextual influences on adolescent eating. Participants (N = 75, ages 14–17) completed a 10-day ecological momentary assessment (EMA), responding to random and event-contingent prompts via smartphone. Binge eating (loss of control eating, overeating) and food choices (sugar-added foods, fruits/vegetables) were the primary outcomes. Perceived stress and dietary restriction were measured through EMA scales. Time-lagged analyses examined associations between stress, dietary restriction, and eating behavior using generalized linear mixed models (GLMMs).

Results: Dietary restriction was associated with increased loss of control eating and a higher likelihood of consuming sugar-added foods at the subsequent timepoint. Specifically, participants who reported more dietary restriction exhibited greater loss of control eating compared to those with less restriction, and greater restriction than their personal average was linked to increased loss of control eating. Additionally, dietary restriction was positively associated with higher frequency of sugar-added food consumption, with adolescents reporting more restriction being more likely to consume sugar-added foods than those with less restriction. In contrast, perceived stress was negatively correlated with loss of control eating on the between-individual level, but this association did not hold within individuals. Neither stress nor dietary restriction predicted fruit and vegetable consumption, and no significant interactions between stress and dietary restriction were observed.

Implications: The findings underscore the importance of dietary restriction as a significant predictor of binge eating behaviors in adolescents. This highlights the need for early screening of dietary restriction and its potential role in the development of disordered eating. Pediatricians and caregivers should be vigilant in monitoring adolescents for signs of restrictive eating patterns and provide interventions aimed at preventing loss of control eating. Additionally, food access programs are crucial to prevent food insecurity from exacerbating binge-eating behaviors. Furthermore, future research should explore more innovative methods to assess stress, as current measures may not fully capture the relationship between stress and eating behaviors.