European adolescents' level of perceived stress and its relationship with body adiposity: the HELENA study

Background: Since stress is hypothesized to be involved in the aetiology of obesity, the present study examined the current perception of stress in European adolescents and the association between adolescent perceived stress and their adiposity. Methods: Observational data from 1121 adolescents aged 12.5-17.5 years from six European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study, was investigated. The adolescents completed the adolescent stress questionnaire, comprising 10 different stress dimensions. Anthropometric measurements (weight, height, skinfold thicknesses and circumferences) and bioelectrical impedance analysis were performed, and personal characteristics (age, pubertal stage and parental education) were collected. The measures of perceived stress were described for boys and girls separately and gender differences were investigated. Associations between the adolescents' perceived stress and indicators of general (body mass index z-score, sum of skinfold thicknesses and body fat%) and abdominal (waist and hip circumference, and waist/height ratio) adiposity were examined using hierarchical linear models. Results: While girls reported systematically higher levels of stress compared with boys, their stress profiles were similar, with highest levels for school-related stress followed by future uncertainty. Only in girls, perceived stress was significantly associated with increased measures of general and abdominal adiposity. In boys, no relationship between perceived stress and adiposity measures was observed. Conclusions: School is reported to be an important source of adolescent stress and should be the focus of stress management campaigns. Only in girls, the hypothesis that stress might be involved in the aetiology of obesity during adolescence was supported