title: Perceived stress, behavior, and body mass index among adults participating in a worksite obesity prevention program, Seattle, 2005-2007.
abstract: BACKGROUND
  Stress in numerous contexts may affect the risk for obesity through biobehavioral processes. Acute stress has been associated with diet and physical activity in some studies; the relationship between everyday stress and such behavior is not clear. The objective of this study was to examine associations between perceived stress, dietary behavior, physical activity, eating awareness, self-efficacy, and body mass index (BMI) among healthy working adults. Secondary objectives were to explore whether eating awareness modified the relationship between perceived stress and dietary behavior and perceived stress and BMI.
  
  
  METHODS
  Promoting Activity and Changes in Eating (PACE) was a group-randomized worksite intervention to prevent weight gain in the Seattle metropolitan area from 2005 through 2007. A subset of 621 participants at 33 worksites provided complete information on perceived stress at baseline. Linear mixed models evaluated cross-sectional associations.
  
  
  RESULTS
  The mean (standard deviation [SD]) Perceived Stress Scale-10 score among all participants was 12.7 (6.4), and the mean (SD) BMI was 29.2 kg/m2 (6.3 kg/m2). Higher levels of perceived stress were associated with lower levels of eating awareness, physical activity, and walking. Among participants who had low levels of eating awareness, higher levels of perceived stress were associated with fewer servings of fruit and vegetables and greater consumption of fast food meals.
  
  
  CONCLUSIONS
  Dietary and physical activity behaviors of workers may be associated with average levels of perceived stress. Longitudinal studies are needed, however, to support inclusion of stress management or mindfulness techniques in workplace obesity prevention efforts.
authors.affiliation: Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195-7236, USA. wendybar@uw.edu
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Barrington
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Ceballos
authors.forename: Sonia K
authors.initials: SK
authors.lastname: Bishop
authors.forename: Bonnie A
authors.initials: BA
authors.lastname: McGregor
authors.forename: Shirley A A
authors.initials: SA
authors.lastname: Beresford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004034:Diet Surveys; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior / Q000208:ethnology / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D009786:Occupational Health Services / Q000379:methods*; D015397:Program Evaluation; D057185:Sedentary Behavior / Q000208:ethnology; D020377:Self Efficacy; D012923:Social Class; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014861:Washington; D016526:Workload / Q000523:psychology