International Journal of Behavioral Medicine

, Volume 21, Issue 2, pp 292–301 | Cite as

The Association Between Childhood Stress and Body Composition, and the Role of Stress-Related Lifestyle Factors—Cross-sectional Findings from the Baseline ChiBS Survey

  • Barbara VanaelstEmail author
  • Nathalie MichelsEmail author
  • Els Clays
  • Diana Herrmann
  • Inge Huybrechts
  • Isabelle Sioen
  • Krishna Vyncke
  • Stefaan De Henauw



Stress has been hypothesised to be involved in obesity development, also in children. More research is needed into the role of lifestyle factors in this association.


This study investigates the cross-sectional relationship between stress and body composition and, more importantly, the possible moderating or mediating role of lifestyle factors.


A total of 355 Belgian children (5–10 years old) participating in the baseline ‘Children’s Body composition and Stress’ survey were included in this study. The following variables were studied: psychosocial stress (i.e. stressful events, emotions and behavioural/emotional problems, salivary cortisol), stress-related lifestyle factors (high-caloric snack consumption frequency, screen exposure time and sleep duration) and body composition parameters [BMI z-score, waist to height ratio (WHtR)]. Using linear regression analyses (adjusted for sex, age and socio-economic status), the relation between stress and body composition and, more importantly, the possible moderating or mediating role of lifestyle factors was tested.


No association was observed between body composition and negative emotions, conduct and emotional problems and salivary cortisol. However, negative life events were positively and happiness was negatively associated with BMI z-score and WHtR. Peer problems and WHtR were positively associated in girls only. These associations were not significantly reduced after correction for lifestyle factors. Nevertheless, all lifestyle parameters moderated one or more stress–body composition associations, resulting in even more significant relations after subgroup analysis.


Childhood stress was positively related to both overall and central adiposity measures with lifestyle factors acting as moderators but not as mediators. Thus, lifestyle could be a vulnerability factor in stress-induced adiposity, creating a perspective for multi-factorial obesity prevention, targeting stress and lifestyle factors in parallel.


Stress Body composition Child High-caloric snack Sedentary lifestyle Sleep 



Area under the curve with respect to the ground


Body mass index


Children’s Body Composition and Stress


Children’s Eating Habits Questionnaire-Food Frequency Questionnaire


Coddington Life Events Scale


Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infants


International Standard Classification of Education


Waist to height ratio



The project was financed by the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD) and the research council of Ghent University (Bijzonder Onderzoeksfonds). This work was done as part of the IDEFICS Study ( Nathalie Michels is financially supported by the research council of Ghent University (Bijzonder Onderzoeksfonds). Barbara Vanaelst, Krishna Vyncke and Isabelle Sioen are financially supported by the Research Foundation-Flanders. The authors want to thank the participating children and their parents for their voluntary participation.


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Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Barbara Vanaelst
    • 1
    • 2
    Email author
  • Nathalie Michels
    • 1
    Email author
  • Els Clays
    • 1
  • Diana Herrmann
    • 3
  • Inge Huybrechts
    • 1
    • 4
  • Isabelle Sioen
    • 1
    • 2
  • Krishna Vyncke
    • 1
    • 2
  • Stefaan De Henauw
    • 1
    • 5
  1. 1.Department of Public Health, Faculty of Medicine and Health SciencesGhent University, University HospitalGhentBelgium
  2. 2.Research Foundation–FlandersBrusselsBelgium
  3. 3.BIPS-Institute for Epidemiology and Prevention ResearchBremenGermany
  4. 4.Dietary Exposure Assessment Group, International Agency for Research on Cancer (IARC)Lyon CEDEX 08France
  5. 5.Department of Health Sciences, Vesalius, Hogeschool GentGhentBelgium

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