Association Between Perceived Levels of Stress and Self-Reported Food Preferences Among Males and Females: A Stated Preference Approach Based on the China Health and Nutrition Survey

OBJECTIVE: Stress is a major public health challenge and is associated with undesirable eating behavior. This cross-sectional study aimed to explore whether there is an association between perceived level of stress and food preference among Chinese adults. STUDY DESIGN: Perceived level of stress was measured using the Chinese version of the 14-item Perceived Stress Scale, whereas self-reported food preferences were investigated by means of five food classification questions, including questions regarding the consumption of fast food, salty snacks, fruit, vegetables, and soft/sugary drinks. METHODS: The data were collected from the 2015 China Health and Nutrition Survey. Information of 8,216 adults (≥18 years) on perceived level of stress, self-reported food preferences, and other important covariates was available and analyzed. RESULTS: Perceived level of stress was negatively associated with a preference for fruit (β = −0.58, 95% CI: −0.81 to −0.34, p < 0.0001) and vegetables (β = −1.13, 95% CI: −1.41 to −0.85, p < 0.0001), while it was positively associated with a preference for fast food (β = 0.36, 95% CI: 0.08–0.64, p = 0.011) and soft/sugary drinks (β = 0.48, 95% CI: 0.30–0.66, p < 0.0001) after adjusting for potential confounders. No association between a preference for salty snacks and perceived level of stress was found in either men or women. CONCLUSIONS: The present population-based study reported strong associations between perceived level of stress and self-reported food preferences among Chinese adults. Sex differences related to this association were also worthy of attention.