title: Longitudinal association between child stress and lifestyle.
abstract: OBJECTIVE
  Psychosocial stress has been linked with an unhealthy lifestyle but the relation's direction remains unclear. Does stress induce sleeping problems, comfort food consumption, and lower physical activity, or do these unhealthy lifestyle factors enhance stress? This study examined the bidirectional stress-lifestyle relation in children.
  
  
  METHODS
  The relation between stress and lifestyle was examined over 2 years in 312 Belgian children 5-12 years old as part of the Children's Body Composition and Stress study. Stress-related aspects were measured by questionnaires concerning negative events, negative emotions, and behavioral problems. The following lifestyle factors were assessed: physical activity (by accelerometers), sleep duration, food consumption (sweet food, fatty food, snacks, fruits and vegetables), and eating behavior (emotional, external, restrained). Bidirectional relations were examined with cross-lagged analyses.
  
  
  RESULTS
  Certain stress aspects increased physical activity, sweet food consumption, emotional eating, restrained eating, and external eating (βs = .140-.319). All relations were moderated by sex and age: Dietary effects were mainly in the oldest children and girls; stress increased physical activity in the youngest, whereas it tended to decrease physical activity in the oldest. One reversed direction effect was found: Maladaptive eating behaviors increased anxiety feelings.
  
  
  CONCLUSIONS
  Relations were mainly unidirectional: Stress influenced children's lifestyle. Stress stimulated eating in the absence of hunger, which could facilitate overweight. Consequently, families should realize that stress may influence children's diet, and problem-solving coping skills should be acquired. In contrast to recent findings, stress might also stimulate physical activity in the youngest as positive stress coping style.
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Michels
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sioen
authors.affiliation: Department of Developmental, Personality, and Social Psychology, Ghent University.
authors.forename: Liesbet
authors.initials: L
authors.lastname: Boone
authors.affiliation: Department of Developmental, Personality, and Social Psychology, Ghent University.
authors.forename: Caroline
authors.initials: C
authors.lastname: Braet
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
authors.forename: Barbara
authors.initials: B
authors.lastname: Vanaelst
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
authors.forename: Inge
authors.initials: I
authors.lastname: Huybrechts
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D001530:Belgium; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D004032:Diet / Q000523:psychology* / Q000706:statistics & numerical data; D004435:Eating / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D012737:Sex Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors