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Abstract

Statement of the Problem: Worldwide global surveys had demonstrated increasing trend of mental health among adolescents which is concurrent with high prevalence of obesity among this population. This study aim to explore the effects of change in stress level and coping strategies adapted when dealing with examination stress on eating behavior of the adolescents. Methodology: A total of 797 multi-ethnic Malaysian adolescents participated in this cohort. This is a sub-study of a cohort. The changes of stress level and eating behavior between two time points and coping strategies adapted were explored using validated questionnaires; the Cohen Perceived Stress Scale (CPSS) questionnaire, self-reported Child Eating Behavior Questionnaire (CEBQ) and brief COPE questionnaire. All participants and parents consented for the study. Baseline data were collected within two weeks prior to final year school examination. Follow up data were collected six months later during normal school days. Findings: The results revealed positive correlation between change in perceived stress level and emotional overeating (r=0.18, p<0.01) and between change in perceived stress level and food responsiveness behavior (r=0.14, p<0.01). Students who experienced an increase in stress level (OR=1.9, 95%CI: 1.3, 2.9), doing a little bit of planning (OR=2.0, 95%CI: 1.1, 3.5) and use a lot of emotional support to cope with stress (OR=1.7, 95%CI: 0.9, 3.1) were more likely to emotional overeat. Students who experienced an increase in stress level (OR=1.4, 95%CI: 1.0, 2.1), use humor (OR=1.4, 95%CI: 0.9, 2.0) and self-blame (OR=1.6, 95%CI: 0.9, 2.7) a little when coping with stress were more likely to be responsive to food. Conclusion: The findings suggested for a comprehensive intervention focusing on managing the changes in stress level by adapting an appropriate stress coping strategy. This will promote positive healthy eating behavior thus assist in the prevention of obesity among the adolescents.

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