This survey shows that more than half of the survey participants change often or very often their eating behaviour in response to stress. The two most favourite comfort foods were chocolate and coffee. The consideration of substitutes for chocolate, cookies, and coffee was heterogeneous with different substitutes per comfort food.
According to the literature, about 50% of stress-eaters eat more and about 50% of stress-eaters eat less than normal (e.g. [4]). In contrast, 68.9% of the self-reported stress-eaters in this survey population stated to be stress-overeaters.
Chocolate and coffee were by far the two most favoured comfort foods, followed by cookies. This finding confirms the result of a study conducted in the USA that identified chocolate as the most frequently mentioned sweet comfort food [22]. A previous survey completed by students in the USA has reported a significantly positive association of perceived stress with coffee consumption [16]. The fact that only two out of 13 comfort foods were stated to be consumed often or very often by our survey participants could indicate that stress-eating behaviour does not vary much from person to person. Furthermore, experiencing stress as well as eating behaviour per se is very subjective and it might be difficult for participants to figure out that dietary patterns and food consumption change in response to stress.
The offered substitutes per comfort food were diverse. Some substitutes were very similar to the respective comfort food (e.g. dark chocolate instead of chocolate). Other substitutes were very different from the comfort food (e.g. fresh fruits instead of cookies). The fact that all offered substitutes for the three most favourite comfort foods could be imagined more or less by the survey participants as healthier alternative might indicate that these substitutes may be suitable for practical terms in real life. However, this assumption needs to be examined in an intervention study. We further found that rather healthy substitutes were stated more often compared to others (e.g. fresh fruits instead of chocolate and cookies, tea without added sugar instead of coffee). This fact could be used to address the issue of “stress-eating” comprehensively with nudging, an approach to change food choices. A systematic review showed its ability to promote healthy food choices by changing the order of food products or their proximity [27]. However, it cannot be ruled out that our survey participants made these healthy substitute choices due to social desirability, as participants were only asked if they could imagine to eat the offered substitutes.
Regarding the role of sex for the reported consumption frequency of comfort foods, we found that chocolate was more frequently consumed by women in stressful situations than by men, which is in line with previous findings [5, 15, 18]. Looking at substitutes, women stated more often to consider chocolate fruits instead of chocolate than men.
Age was partially associated with comfort food consumption. For example older people stated more often to consume frequently coffee during stress. Furthermore, older people stated less often to accept selected substitutes for chocolate, but more often to consider self-named substitutes than younger people. This could be a hint that older people have different preferences regarding substitutes.
A higher BMI was associated with a frequent consumption of fried food, hamburgers, and sugar-sweetend beverages. This result is plausible since individuals with overweight or obesity often experience emotional stress like social exclusion and shame [28], which could promote emotional eating. Previous studies examing the relationship between perceived stress, eating behaviour, and obesity differ in their study design (e.g. cross-sectional, longitudinal), methods, and research question. In a cross-sectional study by Richardson et al. including 101 American women with children, perceived stress was positively associated with uncontrolled and emotional eating, and stress with severe obesity, but independently from eating behaviour and quality [29]. A longitudinal, population-based study with almost 6000 participants in Finland could show for women at the age of 31 years that stress-eaters had the highest BMI and that stress-eating was associated with obesity [30]. In general, more longitudinal studies are needed to be able to assess the causal relationship between stress-eating and obesity.
Because of these findings the issue of “stress-eating” should be tackled to protect people at risk. It has to be mentioned that the present survey has not collected data about the quantity of comfort food consumption and the causality for obesity is, therefore, speculative. The focus of this survey was on collecting data about comfort foods per se and on examing whether and what healthier substitutes the survey participants could imagine to choose.
The findings of this survey on stress-eating behaviour provide new insights into potential new strategies to address this frequent cause of high-caloric and unhealthy food intake. However, there is need to perform prospective and intervention studies to explore how stress-related consumption of popular comfort foods can be replaced by healthier food alternatives, and how approaches like nudging and personalised dietary recommendations can be best employed to achieve the consumption of healthy food during stress.
This online survey is the first examining the topic of “comfort foods” and “suitable healthy substitutes” among adults in Germany. The data has been collected with a standardised questionnaire developed by an interdisciplinary team. Although the sample size is rather large, the validity is limited by the non-representative study population consisting of a majority of females and students, and by the fact that all data are self-reported. In addition, a set of pre-selected comfort foods was presented to the participants and they could not specify any others. In addition, the consideration of specific foods as healthier substitutes was theoretical, which allows no conclusion whether these substitutes would work in real life. Therefore, the knowledge about comfort foods and substitutes should be explored in intervention studies to examine whether stress-eaters consume substitutes and whether eating behaviour in stressful situations can be improved. Lastly, it is noteworthy that the data collection was performed during the Covid-19 pandemic, which is associated with changed food consumption [31]. This survey did not focus on stress-eating during the pandemic period or collected detailed data on the reason of perceived stress but aimed to collect data about stress and stress-induced eating in general.