Abstract: Background: Restrained, emotional, and external eating are related to obesity and eating disorders. A salutogenic model has confirmed sense of coherence (SOC) as a health resource that moderates stress and helps limit the occurrence of overweightness and eating disorders. This study aimed to examine the relationship between SOC, social support, stress, body image satisfaction (BIS) and eating behaviors in different cultural environments. Methods: A total of 371 Austrian (161 men, 210 women) and 398 Japanese (226 men, 172 women) university students participated. The SOC-13 scale, Multidimensional Scale of Perceived Social Support, Dutch Eating Behavior Questionnaire, BMI-Based Silhouette Matching Test and an analogue single-stress item were used as measurements. Results: SOC negatively affected all three types of eating in Austrian students (men: β = −0.227 to −0.215; women: β = −0.262 to −0.214). In Japanese students, SOC negatively affected external eating in both sexes (men: β = −0.150; women: β = −0.198) and emotional eating (β = −0.187) in men. BIS indicated that the desire to become slim predicted restrained eating, women’s emotional eating, and men’s and Austrian women’s external eating. Stress was only predictive of emotional eating in Japanese men. Conclusions: This study found that SOC, BIS and stress might be valuable factors regulating eating behavior in a cultural context. However, the relationship between SOC, BIS, stress and eating behavior differs between cultures.
Keywords: sense of coherence; restrained eating; emotional eating; external eating; body image satisfaction; cross-culture
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emotional eating (EME), external eating (EXE), restrained eating (RE)
4. Discussion
The
main findings of this study indicate that SOC and BIS pertain
negatively to RE, EME, and EXE with the appearance of culture and gender
differences. In particular, SOC negatively predicts RE, EME, and EXE,
particularly in Austrian students. For Japanese students, the
relationship between SOC and eating behaviors seems to be less
pronounced.
Japanese students had higher scores
for RE and EXE but did not differ in EME. Not all eating behaviors
reflect disordered eating, per se, but some eating behaviors seem to be
associated with occasional overeating and moderate overweightness, such
as restrained and emotional eating [31]. High RE values do not differentiate between successful and unsuccessful restrained eaters [7,32].
Considering the higher percentage of underweight Japanese students, RE
seems to be a highly and successfully practiced eating behavior in
Japan, independent of SOC and social support. Only BIS predicts RE in
Japanese students, whereas SOC seems to be a source of eating
regulation, in addition to BIS, in Austrian students. However,
considering the higher rate of overweight students in Austria, this
regulation is less successful for Austrian students than for Japanese
students. SOC predicted EME in both male and female Austrian students
and in Japanese male students, but not in Japanese female students. In
the Japanese student sample, BIS was a significant predictor in women
but not men, and stress was another predictor of EME. EXE was related to
SOC in both countries, and BIS helped predict EXE in Austrian men and
women and Japanese men but not in Japanese women. Stress correlated
negatively and SOC correlated positively with social support among
Japanese women; however, both variables disappeared as predictors of
eating behavior in Japanese women, and seemed to be coping resources.
A
previous study with Dutch subjects found that being female and having a
strong SOC, a flexible RE, and self-efficacy promoted healthy eating
practices [33].
The work of Speirs et al. suggested that a higher SOC is expected to
prevent unhealthy eating practices and foster healthy eating behaviors
in children [14]. This study found that SOC tended to prevent unhealthy eating behaviors.
In
this investigation of two cultures, we examined the association between
SOC and eating behaviors, based on a salutogenic model. SOC indicates
the extent to which an individual has a pervasive and enduring, yet
dynamic, feeling of confidence that the environment is predictable and
that things will work out as well as can reasonably be expected. SOC
contains aspects of optimism and control and represents the ability to
cope with stressful events and find them meaningful [15]. A previous study reported that a strong SOC may confer some resilience against chronic diseases [34].
The results of the present study suggest that a high SOC might prevent
RE, EME, and EXE in Austrian subjects. In contrast, SOC affected EXE in
Japanese men and women and EME in Japanese men. SOC and stress were
strongly associated in Japanese students and had a more indirect
association with eating behaviors. In Austrian students, SOC, stress and
social support were weakly correlated, while SOC was more strongly
correlated with eating behaviors.
A higher SOC has been reported to relate to less perceived stress and a lower stress response [35]. Some studies have reported that obesity and eating disorders are caused by stressful situations [36].
Controlling stress is therefore necessary to maintain healthy eating
behaviors. Because the degree of stress affected EME in Japanese men in
the present study, we suggest that improving SOC might be effective in
reducing EME via stress reduction. Social support, as an external health
factor resource, was not directly related to the three eating behaviors
but was correlated with SOC in this study. Social support seems to be
associated with eating behaviors via SOC-mediated effects. This finding
is in line with the results of our previous study, which showed that
eating behavior was associated with interpersonal relationships [37].
Overall,
as expected, the results supported the hypothesis that SOC affects
eating behaviors and overweight-related eating behaviors more directly
in Austrian students, whereas SOC relates to stress reduction in
Japanese students and indirectly relates to eating habits.
It
is important to note that cultural and gender-based differences were
observed between variables in this study. The obesity rate was lower in
women than in men, and the desire to become slim and RE were more
prevalent in women than in men. Ideal body images are affected by
cultural expectations, which often lead women to want to become thinner.
Such a cultural context fosters restrained eating behaviors in women,
and the degree to which women desire to become slimmer predicts RE.
Conversely, the structure of the relationship between the desire to get
slimmer and EME or EXE may differ by country and gender. In women, the
desire to be slim was positively related to EME, while in Austrian and
Japanese men, the desire to be slim was related to EXE. This result is
in line with theories related to the DEBQ. Both EXE and EME are regarded
as consequences of intense RE. Small positive differences between ideal
and real body images were found among Japanese men, because young men
are mainly concerned with gaining muscle rather than becoming slim [38].
Our results show that the highest rate of thinness was in Japanese
women, and the desire to become slimmer might control EXE. These results
support our previous findings [22].
A
strength of this study is that it investigated a homogeneous group; all
participants were university students. Additionally, all variables were
investigated in their respective cultural groups using the same
methodology in both Western and Asian countries [39].
However,
this study had some limitations. First, we used one analogue scale to
measure the degree of stress, to avoid a severe burden on the
participants. A more sophisticated measure of stress should be used in
future studies. A negative relationship was found between stress and
resilience in Japanese students. In Austrian students, this negative
relationship was weak and not significant. In Austria, the validity of
the stress scale is insufficient. In the future, it is necessary to use a
more validated stress scale and examine the relationship with eating
behavior. Second, the national higher educational systems differ in
these two cultures. For example, in Japan, approximately 50% of high
school students enter a university after graduating high school, whereas
Austria has a more flexible higher education system. This difference is
reflected in the significant difference between the participants’ mean
ages, but these small age differences did not influence our results.
Third, some limitations might be a result of different effects and the
importance of social support. The work of Kim et al. reported that
Asians and Asian-Americans are more reluctant to ask for support from
others, but are more likely to use and benefit from forms of support
that do not involve explicit disclosure [40].
Japanese female students’ social support from family, friends and
significant others was highly negatively correlated with stress, as with
SOC, while in Austrians, this relationship was missing, although they
endorsed receiving more social support. Another aspect contributing to
the cultural differences might be response style differences between
Japanese and Austrian students. The work of Harzing et al. showed that
Asians preferred middle rather than extreme categories on rating scales,
in comparison with Western respondents [41]. Using a coherent sample and harmonized measurements in both German and Japanese may have reduced this bias.
Despite
these limitations, we conclude that SOC, BIS and stress are essential
factors that regulate eating behavior in Japan and Austria, with a
relationship to body weight. However, the relationships showed specific
patterns. The relationships between SOC and eating practices in Austrian
and Japanese populations must be further examined. Exploring these
mechanisms will be relevant to fostering the development of programs to
change eating behaviors, because culture is an important external
resource for health promotion.
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