title: Perceived stress and coping strategies in relation to body mass index: cross-sectional study of 12,045 Japanese men and women.
abstract: BACKGROUND
  Accumulated evidence suggests a weak positive relationship between psychosocial stress and body mass index (BMI), but little is known about stress coping strategies and BMI.
  
  
  OBJECTIVE
  We aimed to examine if perceived stress and coping strategies are related to BMI, with any of their mutual interactions on BMI.
  
  
  METHODS
  This cross-sectional study included 5,063 men and 6,982 women aged 40-69 years. A self-administered questionnaire ascertained perceived stress and 5 items of coping strategies (emotion expression, emotional support seeking, positive reappraisal, problem solving, and disengagement). Analyses were performed by gender with adjustment for age, socioeconomic status, and lifestyle factors.
  
  
  RESULTS
  No significant associations were detected between perceived stress and BMI in either men (P(trend) = 0.09) or women (P(trend) = 0.58). In men, however, 'disengagement' showed an inverse association with BMI (P(trend) < 0.001), and 'positive reappraisal' and 'problem solving' revealed a positive association with BMI (P(trend) = 0.04 and 0.007, respectively) even after controlling for perceived stress. A possible interaction between perceived stress and 'disengagement' on BMI was found in men (P(interaction) = 0.027); the inverse association between 'disengagement' and BMI was more evident in higher levels of stress (β = -0.13, P(trend) = 0.21 in low; β = -0.22, P(trend) = 0.01 in medium; and β = -0.24, P(trend) = 0.06 in high). In men, 'disengagement' was inversely associated with overweight/obesity (odds ratio 0.79, 95% confidential interval 0.67-0.95), and "positive reappraisal" was positively associated with it (1.25, 1.02-1.54).
  
  
  CONCLUSIONS
  Coping strategies may have an important role in developing overweight/obesity, particularly in men.
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Chisato
authors: C
authors: Shimanoe
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Megumi
authors: M
authors: Hara
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Yuichiro
authors: Y
authors: Nishida
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan; Department of Public Health, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
authors: Hinako
authors: H
authors: Nanri
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Yasuko
authors: Y
authors: Otsuka
authors: St. Mary's College Faculty of Nursing, Kurume, Japan.
authors: Kazuyo
authors: K
authors: Nakamura
authors: Laboratory of Exercise Physiology, Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan.
authors: Yasuki
authors: Y
authors: Higaki
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Takeshi
authors: T
authors: Imaizumi
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Naoto
authors: N
authors: Taguchi
authors: Chikushi Office for Health, Human Services and Environmental Issues, Fukuoka Prefectural Government, Onojo, Japan.
authors: Tatsuhiko
authors: T
authors: Sakamoto
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Mikako
authors: M
authors: Horita
authors: Division of International Health and Nursing, Faculty of Medicine, Saga University, Saga, Japan.
authors: Koichi
authors: K
authors: Shinchi
authors: Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Keitaro
authors: K
authors: Tanaka
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*