Relationship Between Stress, Lifestyle, and Unhealthy Eating Behaviours: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aim to integrate 20 years of empirical studies (2004–2024) of the relationship between psychological stress and unhealthy eating behaviours. Upon review of the literature, 28 studies (N = 10,207) with correlation coefficients reporting the relationship between stress and unhealthy eating indicators were identified in PubMed, PsycINFO, Web of Science and Scopus databases. The results of the random effects meta-analysis showed a positive and significant association (r = .286, 95% CI [.258, .314], p < .001), suggesting that unhealthy eating is moderately related to increased stress. Heterogeneity was moderate (I2 = 58.9%, Q = 65.64, df = 27). Subgroup analyses showed greater effects in longitudinal studies (r = .350) than in cross-sectional (r = .261) and experimental design studies (r = .270). This association was slightly more positive with changes over the 20-year period. The detection of publication bias using Egger's regression test showed an intercept of −0.120 (p < .001), which indicated that the pooled effect could be slightly downwards. Trim-and-fill analysis showed no evidence of publication bias. The results highlight the strong association of stress and unhealthy diets and the relevance of public health strategies aiming to improve nutritional health promotion by including stress management.