health psychology report · volume 7(2), 9 Simran Dutt

original article A,B,C,D,E,F

Rebecca Keyte
E
Helen Egan
E
Misba Hussain
E,F
Michail Mantzios id
A,C,D,E,F

Healthy and unhealthy eating amongst stressed

students: considering the influence of mindfulness
on eating choices and consumption

background of healthy food, but assisted the decrease in consuming

Academic stress is associated with (a) increased food in- unhealthy food when compared to the control group. The
take and (b) choosing calorie-dense food choices in higher main analyses revealed that when mindfulness alleviated
education students. In this research, mindfulness was used stress (i.e., by using the anxiety measurements as a ma-
to alleviate academic stress and, in effect, promote healthi- nipulation check), students consumed more healthy food
er eating behaviours and decision-making. and less unhealthy food.

participants and procedure conclusions

Ninety students were randomly allocated to either a mind- Mindfulness appears to enable better decision making as re-
fulness or a control condition. Both conditions exposed gards healthy and unhealthy foods when mindfulness med-
students to a stress-inducing task and levels of anxiety itation actually works. While the results appear positive,
were recorded three times (i.e., prior to and after stress non-engagement with mindfulness meditation may necessi-
induction, and post-intervention) during the experiment. tate the availability of other practices to reduce anxiety and
Chocolate and grapes were available to participants after stress. Clinical implications and the integration of health
the experiment as a token of appreciation. and wellbeing initiatives into universities are discussed.

results key words

Intention-to-treat analyses revealed that mindfulness academic stress; anxiety; mindfulness; unhealthy eating;
had a non-significant effect on increasing consumption healthy eating

organization – Birmingham City University, Birmingham, United Kingdom

authors’ contributions – A: Study design · B: Data collection · C: Statistical analysis · D: Data interpretation ·
E: Manuscript preparation · F: Literature search · G: Funds collection
corresponding author – Michail Mantzios, Ph.D., Birmingham City University, The Curzon Building Room C307,
4 Cardigan Str., Birmingham B4 7BD, United Kingdom, e-mail: michael.mantzios@bcu.ac.uk
to cite this article – Dutt, S., Keyte, R., Egan, H., Hussain, M., & Mantzios, M. (2018). Healthy and unhealthy eating
amongst stressed students: Considering the influence of mindfulness on eating choices and consumption. Health
Psychology Report, 7(2), 113–120. https://doi.org/10.5114/hpr.2019.77913
received 26.03.2018 · reviewed 04.05.2018 · accepted 28.08.2018 · published 21.09.2018
 Background ering the barriers to healthy food choices amongst
students (Beerman, Jennings, & Crawford, 1990), the
Obesity remains an unsolved crisis, with approxi- need for interventions to increase students’ aware-
mately 25% of adults in England being obese (Health ness of eating has been highlighted (El Ansari, Suom-
and Social Care Information Centre, 2015). Obesity inen, & Samara, 2015). Students who are stressed and
is associated with long-term distress and disabili- non-resilient display more problematic eating be-
ties, increasing disease burdens and healthcare costs haviours, where stress management tools could not
globally (Lean, 2018). Consequently overweight and only be used to relieve stress, but also decrease stu-
obesity prevention is a worldwide concern (World dents’ consumption of unhealthy foods (O’Connor,
Health Organization [WHO], 2004), with much re- Armitage, & Ferguson, 2015). Research suggests that
Simran Dutt, search focusing on eating behaviours and weight mindfulness alleviates stress and increases students’
Rebecca Keyte, regulation to inform current interventions. A special awareness of hunger and satiety cues (Tsenkova,
Helen Egan, focus is currently placed on childhood obesity, which Boylan, & Ryff, 2013).
Misba Hussain, is an urgent public health challenge. Public Health Mindfulness-Based Stress Reduction (MBSR –
Michail Mantzios England has recently implemented sugar reduction Kabat-Zinn, 1982) is practised in the form of medi-
(i.e., in 2016), and are now implementing a reduc- tation where individuals learn to be aware of the
tion of calories (Selbie, 2018) in an attempt to reduce present moment in a non-judgemental way, reduc-
childhood obesity within the UK. ing stress and negative emotions such as impatience
Whilst much attention is placed on childhood and frustration (e.g., Kabat-Zinn, 1982; Khoury,
obesity, there has been a lack of research conduct- Sharma, Rush, & Fournier, 2015). Mindfulness has
ed amongst students within higher education. The been used to reduce academic stress amongst stu-
first year of university is identified as an ‘at risk’ dents, where academic benefits and a positive im-
period for body weight gain (Brown, 2008; Sprake pact on psychological wellbeing were observed
et al., 2017), with students commonly develop- (Hjeltnes, Binder, Moltu, & Dundas, 2015; Iranzo-
ing less healthy eating behaviours (Tanton, Dodd, Bennett, Egan, Cook, & Mantzios, 2018). Therefore,
Woodfield, & Mabhala, 2015). Transition to uni- stressors and stress are positively influenced though
versity creates a change in support networks and mindfulness practices.
social norms (Tanton et al., 2015), with it often be- In addition to tackling stress, mindfulness has
ing the first time an individual has lived away from also been used to increase awareness of eating and
home, and has had the responsibility of preparing food, with such practices being referred to as mind-
all their own meals. Barriers to healthy eating are ful eating (Brunt, Berdal, & Stastny, 2013; Moor,
access to unhealthy foods, the time taken to pre- Scott, & McIntosh, 2013). Mindful eating assists in
pare healthy foods and a lack of motivation to cook the gradual change of external to internal eating,
healthy foods (Ashton, Hutchesson, Rollo, Morgan, promoting healthier eating behaviours (Mantzios
& Collins, 2016; Escoto, Laska, Larson, Neumark- & Wilson, 2014, 2015a,b; Mantzios & Giannou,
Sztainer, & Hannan, 2012; McMorrow, Ludbrook, 2014), such as an increased intake of fruit and veg-
Macdiarmid, & Olajide, 2017), with weight gain etables (Gilbert & Waltz, 2010), as well as a reduc-
being particularly evident in students who live on tion in the consumption of high sugar and energy-
campus (Tanton et al., 2015). dense foods (Mason et al., 2016). Research has found
With transition to university creating a number of a negative association between mindful eating and
changes within an individual’s life, it can be a stressful fat and sugar consumption (Mantzios, Egan, Husse-
period, having the potential to have a negative impact in, Keyte, & Bahia, 2018b), grazing (Mantzios, Egan,
on health-related behaviours (Quick & Byrd-Bred- Bahia, Hussein, & Keyte, 2018a), motivations to eat
benner, 2013). Stressed individuals within the general palatable foods (Mantzios & Egan, 2018), as well
population often consume more food (Mouchacca, as weight gain (Mantzios, Wilson, Linnell, & Mor-
Abbott, & Ball, 2013; Tomiyama, Dallman, & Epel, ris, 2014). Allirot et al. (2018) recently reported that
2011; Torres & Nowson, 2007). Research indicates that brief exposure to mindfulness meditation through
acute and chronic stress are associated with a high- a video format increased attention and resulted
er calorific intake of sweet and high fat foods (Bly- in better decisions regarding the consumption of
derveen et al., 2016; Tomiyama et al., 2012; Dallman, healthier foods.
2010; Tryon, Carter, Decant, & Laugero, 2013), as well Despite previous literature stating that mindful-
as a higher intake of saturated fats (Roberts, Camp- ness may require regular practice to be effective
bell, & Troop, 2014), with such eating behaviours con- (Mantzios & Giannou, 2018), this research focused
tributing to weight dysregulation. on the immediate effect of mindfulness practice
With stress having the potential to make students through experimental design with short interven-
vulnerable to becoming external eaters (i.e., respond- tions observed in other eating and/or mindfulness
ing to external cues rather than internal cues such research (Jenkins & Tapper, 2014; Zeidan, Gordon,
as hunger – Nolan & Geliebter, 2012), and by consid- Merchant, & Goolkasian, 2010). The current study

114 health psychology report

aimed to investigate the impact mindfulness has in ing You will be taking part in a task that requires you
the decision-making and consumption of healthy to solve these anagrams. Most participants completed
foods among higher education students. The prima- all the anagrams correctly, and very rarely one or two
ry aim was to investigate whether brief exposure to mistakes were spotted.
mindfulness meditation offers a solution in reduc- State Trait Anxiety Inventory (STAI) Short Form.
ing unhealthy eating and increasing healthy eating The STAI Short Form was given to participants on
in response to stress amongst university students, three separate occasions (1: before the stress-induc-
when healthy and unhealthy choices are available. ing task; 2: after the stress-inducing task; 3: after
We hypothesised that participants in the mindful- listening to the audio file) in the control and experi-
ness condition would chose healthy (over unhealthy) mental conditions to measure how the individual felt
snacks, and consume less food when compared to at the present moment, recording their anxiety lev- Healthy vs.
a control group. els (Marteau & Bekker, 1992). The STAI Short Form unhealthy
includes six items with a four-point scale ranging eating through
from 6 to 24 points. The questionnaire contains three mindfulness
Participants and procedure items which are reverse-scored (“I feel calm”, “I am practice
relaxed” and “I feel content”) and three items which
Design are not reverse-scored (“I am tense”, “I feel upset”
and “I am worried”). The original scale has shown
A between-subjects design was used to investigate a Cronbach’s α of .95, with the current study dis-
the impact mindfulness had on students’ eating playing a Cronbach’s α of .78 before the stress task,
choices and consumption levels in response to stress. .85 after the stress task and .83 after the audio file
Participants were randomly allocated to one of two was employed.
groups consisting of a control condition and an ex- Audio files. Participants from the control condi-
perimental condition. tion listened to a nature audiobook file which lasted
for 12 minutes and 14 seconds as a control interven-
tion as used in previous research (Zeidan, Johnson,
Participants Diamond, David, & Goolkasian, 2010; White, 1908).
The experimental condition subjected listened to
Ninety students were recruited (M = 20.70 years, a guided-mindfulness meditation audio file, which
SD = 2.17) through opportunity sampling at a West lasted for 12 minutes and 16 seconds (Mantzios,
Midlands University in the United Kingdom. Forty- 2016), allowing participants to practise mindfulness
five participants were randomly allocated to the breathing meditation. This involved participants fol-
control condition where they were provided with lowing through a series of breathing practices, with
a nature audiobook file, whilst the remaining 45 par- no information about food being recited.
ticipants joined the experimental condition where Food types. Grapes and chocolates were pre-
mindfulness meditation was used. Participants were sented on a plate. Twenty pieces of each food were
excluded if they had a previous or current diagnosis provided. Portion sizes were kept consistent as in-
of eating disorders. No prior exposure to mindfulness consistency can influence the amount of food in-
practice was required, with this not been controlled take within individuals who are or not under the
for within the analysis. influence of mindfulness (Cavanagh, Vartanian,
Sixteen participants (7 participants from the mind- Herman, & Polivy, 2013). Grapes were selected as
fulness condition, 9 participants from the control the healthy option, with research indicating that
condition) were eliminated due to the stress-induc- students consume less healthy foods when stressed
ing task having no effect on their anxiety levels. Af- (Unusan, 2006). Chocolate pieces of Galaxy Min-
ter elimination, a total of 74 participants were used strels were chosen as the unhealthy option as re-
(M = 20.72, SD = 2.32). search indicates that individuals snack on chocolate
more when compared to crisps and biscuits (Wallis
& Hetherington, 2009). Whilst grapes do contain
Materials high levels of natural sugars, compared to choco-
lates grapes contain less fat and more protein and
Stress-Inducing Task. Ten unsolvable and ten solvable are consequently considered to be more “healthy”
anagrams were used from the Aspinwall and Richter than chocolates (Langlet, Fagerberg, Glossner, & Io-
(1999) study as a stress-inducing task (Zellner et al., akimidis, 2017; Zellner et al., 2006). Both grapes and
2006). The anagrams were presented in the form of chocolates were chosen due to them being “sweet”
a PowerPoint presentation on a computer, with each foods, with research indicating that students con-
slide presented at a 10-second interval. Participants sume more sweet foods when stressed, in compari-
recorded their answers on a response sheet. The re- son to other food types (Emond et al., 2016; Kim,
searcher gave participants verbal instructions, recit- Yang, Kim, & Lim, 2013).

volume 7(2), 9 115

 Table 1
Means, standard deviations and 95% confidence intervals of STAI scores for each condition

Condition STAI scores M SD Confidence interval

Lower bound Upper bound
Before stress 9.84 3.16 8.90 10.79
Mindfulness After stress 15.00 4.59 13.62 16.38
After Condition 9.47 3.81 8.32 10.61
Before stress 10.09 3.27 9.11 11.07
Simran Dutt, Control After stress 14.71 4.66 13.31 16.11
Rebecca Keyte, After condition 10.24 3.59 9.17 11.32
Helen Egan,
Misba Hussain,
Michail Mantzios
Table 2 Analysis
Means and standard deviations of food consumption
within each condition SPSS V23 was used to perform statistical analysis.
Descriptive statistics (including the mean and stan-
Condition Food M SD dard deviation), Cronbach’s α, and two-way be-
Grapes 3.13 4.78 tween-groups ANOVA were conducted.
Mindfulness
Chocolate 1.93 3.44

Control
Grapes 5.53 6.88 Results
Chocolate 5.07 6.37
Parametric assumptions were met. Table 1 shows the
means, standard deviations and the 95% confidence
intervals for the STAI scores before the stress task,
Procedure after the stress task and after the application of audio
files for the mindfulness and control condition.
The experiment was conducted within a laboratory
setting lasting 35 minutes. Participant information
was given verbally and in a hard copy. On receiving Intervention-to-treat-analysis
informed consent, the STAI was administered through
an online Google Forms application. Once completed, A two-way between-groups ANOVA was conducted
participants were required to complete the anagram to explore the impact of mindfulness on grape con-
stress task. Instructions were given to participants sumption between mindfulness and control condi-
verbally and on the computer screen. The participants tions. There was a non-significant main effect for
were provided with a response sheet to record their mindfulness [F(1, 88) = 3.69, p = .058].
answers from the stress task. On completion of the A two-way between-groups ANOVA was con-
stress task, participants were asked again to complete ducted to explore the impact of mindfulness on choc-
the STAI. Participants were then allocated to either olate consumption between mindfulness and control
the control or experimental condition to listen to the conditions. There was a statistically significant main
relevant audio file. Once participants had listened to effect for mindfulness [F(1, 88) = 8.43, p = .005] with
either the mindfulness meditation or the nature au- a large effect size (partial eta squared = .09). Table 2
diobook file, they once again completed the STAI. displays the means and standard deviations of par-
On completion, participants were given grapes and ticipants’ food consumption. Participants within the
chocolates for ten minutes without the presence of mindfulness condition consumed fewer chocolates.
the researcher as a token of appreciation for their par- Overall, participants consumed more food (grapes
ticipation. The researcher then re-entered the room and chocolates) in the control condition.
and debriefed the participant verbally and in writing.
Since participants were blind to the aim of the study,
a second consent form was provided to participants Main analysis
to approve their data being used regarding their food
consumption and choice. All participation was volun- Further analyses were conducted when excluding
tary and participants could withdraw from the study participants who were not influenced by the mind-
at any time during and after their participation. Ethi- fulness practice. We used anxiety reduction as a ma-
cal approval was obtained by the Ethics Committee in nipulation check and excluded participants who did
the Department of Psychology of the host institution. not display a decline as observed in mindfulness

116 health psychology report

practices. A two-way between-groups ANOVA was Table 3
conducted to explore the impact of mindfulness on Means and standard deviations of food consumption
grape consumption between mindfulness and control within each condition after elimination of participants
conditions. There was a statistically significant main
effect for mindfulness [F(1, 72) = 4.56, p = .036] with Condition Food M SD
a medium effect size (partial eta squared = .06). Grapes 3.08 5.09
A two-way between-groups ANOVA was con- Mindfulness
Chocolate 2.21 3.67
ducted to explore the impact of mindfulness on choc-
olate consumption between mindfulness and con- Grapes 6.14 7.12
Control
trol conditions. There was a statistically significant Chocolate 5.33 6.82
main effect for mindfulness [F(1, 72) = 6.11, p = .016] Healthy vs.
and the effect size was medium-large (partial eta unhealthy
squared = .09). eating through
Table 3 displays the means and standard devia- propose practices. It is suggested for future research mindfulness
tions of participants’ food consumption after the that differences in exposure to mindfulness, longitu- practice
elimination of participants. The results demonstrate dinal interventions and individual differences be ex-
that grapes were consumed more in the control con- plored to ensure the effectiveness of different groups,
dition than the mindfulness condition. as it is plausible that those who score higher in trait
mindfulness may have responded more positively to
the mindfulness audio file.
Discussion Additionally, participants were required to com-
plete the STAI on three occasions. This repeated
The current study aimed to investigate the impact exposure had the potential to result in participants
mindfulness has in the decision-making and con- rehearsing the items on the STAI, creating carry-
sumption of healthy food choices within a stressful over effects; which, in turn, could have led to fatigue
environment amongst students in higher education. and boredom (Bergh & Vrana, 1998). Furthermore,
The findings suggest that mindfulness meditation the current study only used sweet foods (grapes and
presented as an audio file has the potential to pro- chocolate), whereas students are exposed to a wide
mote healthy eating behaviours amongst students, range of foods such as savoury snacks. As previous
with participants consuming more grapes than choc- research has established that there is an increase in
olates within the mindfulness condition when stress students’ consumption of sweet food during academ-
reduction was successful. ic stress (Emond et al., 2016), future research should
These findings are consistent with the findings of expose students to a variety of healthy and un-
Hjeltnes et al. (2015), who explored mindfulness as healthy sweet and salty foods, to provide a more real-
a method to alleviate the academic stress experienced istic view on students’ consumption of foods within
by students. However, unlike Hjeltnes et al.’s (2015) a stressful setting (Mikolajczyk, Ansari, & Maxwell,
research, the current study also investigated the im- 2009). Lastly, the portion of food exposed within the
pact that mindfulness has on the stress response (i.e., current study was kept equal; however, students are
eating), with participants within the mindfulness exposed to snacks with different portion sizes, which
condition consuming more healthy foods. The results influences their food intake. Future research should
of the current study were also consistent with previ- take into consideration the amount of food exposed
ous research, which found that increasing an individ- to, as keeping a record of portion sizes may result in
ual’s awareness of how they eat (Ouwens, Schiffer, participants being prone to engage in external eating.
Visser, Raeijmaekers, & Nyklicek, 2015) increases Overall, the current study supported the notion
their likelihood of consuming healthier foods (Tsen- that eating in response to stress can be influenced
kova et al., 2013). Evidently, mindfulness has the po- by mindfulness (Hussein, Egan, & Mantzios, 2017;
tential to promote healthy snacking, as demonstrated Jordan, Wang, Donatoni, & Meier, 2014; Marchiori
in previous research (Mantzios & Egan, 2018; Man- & Papies, 2014). The findings suggest that universi-
tzios et al., 2018a,b; Tanton et al., 2015). ties should provide awareness on healthy eating by
Overall, this research provides insight into inter- promoting mindfulness and mindful eating (Blot-
ventions that could be implemented into higher edu- nicky, Mann, & Joy, 2015; El Ansari et al., 2015; Man-
cation to promote both physical and psychological tzios & Giannou, 2014; Pool, Delplanque, Coppin,
wellbeing. Nonetheless, limitations of this research & Sander, 2015). However, when mindfulness medi-
do need to be acknowledged. Firstly, no prior expo- tation is not working for an individual in the capacity
sure to mindfulness practice was required to partici- of an audio file, the ability to explore and enhance
pate within this research, and exposure to mindful- other practices, such as mindfulness colouring books,
ness over longer durations and/or controlling for is vital in assisting the enhancement of physiological
trait mindfulness would give more information to and psychological health (Mantzios & Giannou, 2018;

volume 7(2), 9 117

 Krusche, Cyhlarova, King, & Williams, 2012). This Brunt, A., Berdal, L., & Stastny, S. (2013). The rela-
research provides practical insight into the need for tionships of eating mindfulness and demographic
mindfulness-based interventions or attentive eating characteristics, physical activity, and focus of aca-
protocols to be integrated into universities to help demic major among college students. Journal of
students lead healthier lives during periods of stress the Academy of Nutrition and Dietetics, 113, A23.
during and after higher education. https://doi.10.1016/j.jand.2013.06.068
Cavanagh, K., Vartanian, L. R., Herman, C. P., & Po-
The study was approved by the Ethical Review Board livy, J. (2013). The effect of portion size on food
of the university, and was in accordance with the ethical intake is robust to brief education and mindful-
standards of the institutional and/or national research ness exercises. Journal of Health Psychology, 19,
Simran Dutt, committee, and with the 1964 Helsinki Declaration and 730–739. https://doi.10.1177/1359105313478645
Rebecca Keyte, its later amendments. Informed written consent was ob- Dallman, M. F. (2010). Stress-induced obesity and
Helen Egan, tained prior to the experiment. This article does not con- emotional nervous system. Trends in Endocrinol-
Misba Hussain, cern any studies with animals. ogy and Metabolism, 21, 159–165. https://doi.
Michail Mantzios 10.1016/j.tem.2009.10.004
El Ansari, W., Suominen, S., & Samara, A. (2015). Eating
References habits and dietary intake: is adherence to dietary
guidelines associated with importance of healthy
Allirot, X., Miragall, M., Perdices, I., Baños, R. M., Ur- eating among undergraduate university students in
daneta, E., & Cebolla, A. (2018). Effects of a brief Finland? Central European Journal of Public Health,
mindful eating induction on food choices and en- 23, 306–313. https://doi.10.21101/cejph.a4195
ergy intake: external eating and mindfulness state Emond, M., Eycke, K. T., Kosmerly, S., Robinson, A. L.,
as moderators. Mindfulness, 9, 750–760. https:// Stillar, A., & Van Blyderveen, S. (2016). The ef-
doi.10.1007/s12671-017-0812-0 fect of academic stress and attachment stress on
Ashton, L. M., Hutchesson, M. J., Rollo, M. E., Mor- stress-eaters and stress-undereaters. Appetite, 100,
gan, P. J., & Collins, C. E. (2016). Motivators and 210–215. https://doi.10.1016/j.appet.2016.01.035
barriers to engaging in healthy eating and physi- Escoto, K. H., Laska, M. N., Larson, N., Neumark-
cal activity a cross sections survey in young adult Sztainer, D., & Hannan, P. J. (2012). Work hours and
men. American Journal of Men’s Health, 11, 330– perceived time barriers to healthful eating among
343. https://doi.10.1177/1557988316680936 young adults. American Journal of Health Behav-
Aspinwall, L. G., & Richter, L. (1999). Optimism and iours, 36, 786–796. https://doi.10.5993/AJHB.36.6.6
self-mastery predict more rapid disengagement Gilbert, D., & Waltz, J. (2010). Mindfulness and health
from unsolvable tasks in the presence of alterna- behaviours. Mindfulness, 1, 227–234. Retrieved
tives. Motivation and Emotion, 23, 221–245. https:// from https://link-springer-com.ezproxy.bcu.ac.uk/
doi.10.1023/A:1021367331817 article/10.1007%2Fs12671-010-0032-3
Beerman, K. A., Jennings, G., & Crawford, S. (1990). Health and Social Care Information Centre. (2015).
The effect of student residence on food choice. Retrieved from https://www.gov.uk/government/
Journal of American College Health, 38, 215–220. organisations/health-and-social-care-informa-
https://doi.10.1080/07448481.1990.9936190 tion-centre
Bergh, O. V., & Vrana, S. R. (1998). Repetition and bore- Hjeltnes, A., Binder, P. E., Moltu, C., & Dundas, I. (2015).
dom in a perceptual fluency/attributional model Facing the fear of failure: An exploration qualitative
of affective judgements. Cognition and Emotions, study of client experiences in a mindfulness-based
12, 533–553. https://doi.10.1080/026999398379556 stress reduction program for university students
Blotnicky, K. A., Mann, L. L., & Joy, P. R. (2015). An with academic evaluation anxiety. International
assessment of university students’ healthy eating Journal of Qualitative Studies on Health and Well-
behaviours with the expectancy theory. ASBBS Being, 10, 1–14. https://doi.10.3402/qhw.v10.27990
eJournal, 11, 31–44. Retrieved from http://www. Hussein, M., Egan, H., & Mantzios, M. (2017). Mindful
asbbs.org/files/2015/eJournal_2015.pdf#page=31 construal diaries: a less anxious, more mindful, and
Blyderveen, S. V., Lafrance, A., Emond, M., Kosmer- more self-compassionate method of eating. SAGE
ly, S., O’Connor, M., & Chang, F. (2016). Person- Open, 7, 1–8. https://doi.10.1177/2158244017704685
ality differences in the susceptibility to stress- Iranzo-Bennett, R., Egan, H. H., Cook, A., & Mantzios, M.
eating: The influence of emotional control and (2018). Mindfulness as an intervention for recall-
impulsivity. Eating Behaviors, 23, 76–81. https:// ing information from a lecture as a measure of
doi.10.1016/j.eatbeh.2016.07.009 academic performance in higher education: a ran-
Brown, C. (2008). The information trail of the ‘Fresh- domized experiment. Higher Education for the Fu-
man 15’ – a systematic review of a health myth ture, 5, 75–88.
within the research and popular literature. Health Jenkins, K. T., & Tapper, K. (2014). Resisting chocolate
Information and Libraries Journal, 25, 1–12. temptation using a brief mindfulness strategy.

118 health psychology report

 British Journal of Health Psychology, 19, 509–522. pulsivity, and weight management in two separate
https://doi.10.1111/bjhp.12050 mindfulness meditation settings. Applied Psychol-
Jordan, C. H., Wang, W., Donatoni, L., & Meier, B. P. ogy: Health and Well-Being, 6, 173–191. https://
(2014). Mindful eating: Trait and state mindful- doi.10.1111/aphw.12023
ness predict healthier eating behaviour. Personal- Mantzios, M., & Giannou, K. (2018). When did colour-
ity and Individual Differences, 68, 107–111. https:// ing books become mindful? Exploring the effec-
doi.10.1016/j.paid.2014.04.013 tiveness of a novel method of mindfulness-guided
Kabat-Zinn, J. (1982). An outpatient program in instructions for colouring books to increase mind-
behavioural medicine for chronic pain patients fulness and decrease anxiety. Frontiers in Psychol-
based on the practice of mindfulness meditation: ogy, 9, 56.
Theoretical considerations and preliminary re- Mantzios, M., & Wilson, J. C. (2014). Making con- Healthy vs.
sults. General Hospital Psychiatry, 4, 33–47. https:// crete construals mindful: a novel approach for de- unhealthy
doi.10.1016/0163-8343(82)90026-3 veloping mindfulness and self-compassion to as- eating through
Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. sist weight loss. Psychology & Health, 29, 422–441. mindfulness
(2015). Mindfulness-based stress reduction for https://doi.10.1080/08870446.2013.863883 practice
healthy individuals: A meta-analysis. Journal Mantzios, M., & Wilson, J. C. (2015a). Exploring mind-
of Psychosomatic Research, 78, 519–528. https:// fulness and mindfulness with self-compassion-
doi.10.1016/j.psychores.2015.03.009 centered interventions to assist weight loss: theo-
Kim, Y., Yang, H. Y., Kim, A., & Lim, Y. (2013). Aca- retical considerations and preliminary results of
demic stress levels were positively associated with a randomized pilot study. Mindfulness, 6, 824–835.
sweet food consumption among Korean high- https://doi.10.1007/s12671-014-0325-z
school students. Nutrition (Burbank, Los Angeles Mantzios, M., & Wilson, J. C. (2015b). Mindfulness,
County, Calif.), 29, 213–218. https://doi.10.1016/ eating behaviours, and obesity: A review and re-
j.nut.2012.08.005 flection on current findings. Current Obesity Re-
Krusche, A., Cyhlarova, E., King, S., & Williams, J. M. G. ports, 4, 141–146. https://doi.10.1007/s13679-014-
(2012). Mindfulness online: A preliminary evalua- 0131-x
tion of the feasibility of a web-based mindfulness Mantzios, M., Wilson, J. C., Linnell, M., & Morris, P.
course and the impact on stress. BMJ Open, 2, 1–6. (2014). The role of negative cognitions, intolerance
https://doi.10.1136/bmjopen-2011-000803 of uncertainty, mindfulness, and self-compassion
Langlet, B., Fagerberg, P., Glossner, A., & Ioakimidis, I. in weight regulation among male army recruits.
(2017). Objective quantification of the food prox- Mindfulness, 6, 545–552. https://doi.10.1007/s12671-
imity effect on grapes, chocolate and cracker con- 014-0286-2
sumption in a Swedish high school. A temporal Marchiori, D., & Papies, E. K. (2014). A brief mindful-
analysis. PLoS One, 12, 1–16. https://doi.10.1371/ ness intervention reduces unhealthy eating when
journal.pone.0182172 hungry, but not the portion size effect. Appetite,
Lean, M. E. J. (2018). Making progress on the global 75, 40–45. https://doi.10.1016/j.appet.2013.12.009
crisis of obesity and weight management. The Marteau, T. M., & Bekker, H. (1992). The development
BMJ, 361, 2538–2544. https://doi.10.1136/bmj.k2538 of a six-item short form of the state scale of the
Mantzios, M. (2016). Mindfulness breathing medita- Spielberger State-Trait Anxiety Inventory (STAI).
tion [Audio file]. Available through personal com- British Journal of Clinical Psychology, 31, 301–306.
munication. https://doi.10.1111/j.2044-8260.1992.tb00997.x
Mantzios, M., & Egan, H. H. (2018). An exploratory Mason, A. E., Epel, E. S., Kristeller, J., Moran, P. J.,
examination of mindfulness, self-compassion, Dallman, M., Lustig, R. H., Acree, M., Bacchetti, P.,
and mindful eating in relation to motivations to Laraia, B. A., Hecht, F. M., & Daubenmier, J. (2016).
eat palatable foods and BMI. Health Psychology Effects of a mindfulness-based intervention on
Report, 6, 207–215. mindful eating, sweet consumption, and fast-
Mantzios, M., Egan, H., Bahia, H., Hussain, M., ing glucose levels in obese adults: data from the
& Keyte, R. (2018a). How does grazing relate to body SHINE randomized controlled trial. Journal of Be-
mass index, self-compasssion, mind­fulness and mind- havioral Medicine, 39, 201–213. https://doi.10.1007/
ful eating in a student pop­ulation? Health Psychol- s10865-015-9692-8
ogy Open, 1-7. https://doi.10.1177/2055102918762701 McMorrow, L., Ludbrook, A., Macdiarmid, J. I., & Ola-
Mantzios, M., Egan, H. H., Hussein, M., Keyte, R., jide, D. (2017). Perceived barriers towards healthy
& Bahia, H. (2018b). Mindfulness, self-compas- eating and their association with fruit and veg-
sion, and mindful eating in relation to fat and etable consumption. Journal of Public Health, 39,
sugar consumption: An exploratory investigation. 330–338. https://doi.10.1093/pubmed/fdw038
Eating and Weight Disorders, 23, 833–840. Mikolajczyk, R. T., Ansari, W. E., & Maxwell, A. E.
Mantzios, M., & Giannou, K. (2014). Group vs. single (2009). Food consumption frequency and per-
mindfulness meditation: exploring avoidance, im- ceived stress and depressive symptoms among

volume 7(2), 9 119

 students in three European countries. Nutrition stressed: evidence of the chronic stress response
Journal, 8, 1–8. https://doi.10.1186/1475-2891-8-31 network in high stress women. Psychoneuroen-
Moor, K. R., Scott, A. J., & McIntosh, W. D. (2013). docrinology, 36, 1513–1519. https://doi.10.1016/
Mindful eating and its relationship to body mass j.psyneuen.2011.04.005
index and physical activity among university stu- Tomiyama, A. J., Schamarek, I., Lustig, R. H., Kirsch-
dents. Mindfulness, 4, 269–274. https://doi.10.1007/ baum, C., Puterman, E., Havel, P. J., & Epel, E. S.
s12671-012-0124-3 (2012). Leptin concentrations in response to acute
Mouchacca, J., Abbott, G. R., & Ball, K. (2013). Associa- stress predict subsequent intake of comfort foods.
tions between psychological stress, eating, physi- Physiology and Behaviour, 107, 34–39. https://
cal activity, sedentary behaviours and body weight doi.10.1016/j.physbeh.2012.04.021
Simran Dutt, among women: a longitudinal study. BMC Public Torres, S. J., & Nowson, C. A. (2007). Relationship be-
Rebecca Keyte, Health, 13, 828. https://doi.10.1186/1471-2458-13-828 tween stress, eating behaviour, and obesity. Nutrition,
Helen Egan, Nolan, L. J., & Geliebter, A. (2012). Night eating is 23, 887–894. https://doi.10.1016/j.nut.2007.08.008
Misba Hussain, associated with emotional and external eating in Tryon, M. S., Carter, C. S., Decant, R., & Laugero, K. D.
Michail Mantzios college students. Eating Behaviors, 13, 202–206. (2013). Chronic stress exposure may affect the
https://doi.10.1016/j.eatbeh.2012.02.002 brain’s response to high calorie food cues and
O’Connor, D. B., Armitage, C. J., & Ferguson, E. predispose to obesogenic eating habits. Physiol-
(2015). Randomized test of an implementation ogy & Behaviour, 120, 233–242. https://doi.10.1016/
intention-based tool to reduce stress-induced eat- j.physbeh.2013.08.010
ing. Annals of Behavioral Medicine, 49, 331–343. Tsenkova, V., Boylan, J. M., & Ryff, C. (2013). Stress
https://doi.10.1007/s12160-014-9668-x eating and health. Findings from MIDUS, a na-
Ouwens, M. A., Schiffer, A. A. J., Visser, L. I., Raeij- tional study of US adults. Appetite, 69, 151–155.
maekers, N. J. C., & Nyklicek, I. (2015). Mindful- https://doi.10.1016/j.appet.2013.05.020
ness and eating behaviour styles in morbidly obese Unusan, N. (2006). Linkage between stress and fruit
males and females. Appetite, 87, 62–67. https:// and vegetable intake among university students:
doi.10.1016/j.appet.2014.11.030 an empirical analysis on Turkish students. Nutri-
Pool, E., Delplanque, S., Coppin, G., & Sander, tion Research, 26, 385–390. https://doi.10.1016/j.
D. (2015). Is comfort food really comforting? nutres.2006.06.002
Mechanisms underlying stress-induced eating. Wallis, D. J., & Hetherington, M. M. (2009). Emo-
Food Research International, 76, 207–215. https:// tions and eating. Self-reported and experimen-
doi.10.1016/j.foodres.2014.12.034 tally induced changes in food intake under stress.
Quick, V. M., & Byrd-Bredbenner, C. (2013). Dis- Appetite, 52, 355–362. https://doi.10.1016/j.appet.
turbed eating behaviours and associated psycho- 2008.11.007
graphic characteristics of college students. Journal White, G. (1908). Natural history and antiquities of
of Human Nutrition and Dietetics, 1, 53–63. https:// selbourne [Audio book]. London: Cassell and
doi.10.1111/jhn.12060 Company.
Roberts, C. J., Campbell, I. C., & Troop, N. (2014). World Health Organization (WHO). (2004). Obesity:
Increases in weight during chronic stress are Preventing and managing the global epidemic. Ge-
partially associated with a switch in food choice neva: World Health Organization.
towards increased carbohydrate and saturated Zeidan, F., Gordon, N. S., Merchant, J., & Goolka-
fat intake. European Eating Disorders Review, 22, sian, P. (2010). The effects of brief mindfulness
77–82. https://doi.10.1002/erv.2264 meditation training on experimentally induced
Selbie, D. (2018). Reducing childhood obesity in the pain. The Journal of Pain, 11, 199–209. https://
UK. The Lancet, 391, 26. https://doi.10.1016/S0140- doi.10.1016/j.pain.2009.07.015
6736(17)33314-7 Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z.,
Sprake, E., Lavin, J., Grabowski, P., Russell, J., Feath- & Goolkasian, P. (2010). Mindfulness medita-
erstone, M., & Barker, M. (2017). Eating habits tion improves cognition: Evidence of brief mental
associated with body weight gain in female uni- training. Consciousness and Cognition, 19, 597–
versity students: a UK-based study of slimming 605. https://doi.10.1016/j.concog.2010.03.014
world members. British Food Journal, 119, 2571– Zellner, D. A., Loaiza, S., Gonzalez, Z., Pita, J., Morales,
2582. https://doi.10.1108/BFJ-10-2016-0495 J., Pecora, D., & Wolf, A. (2006). Food selection
Tanton, J., Dodd, L. J., Woodfield, L., & Mabhala, M. changes under stress. Physiology & Behaviour, 87,
(2015). Eating behaviours of British university 789–793. https://doi.10.1016/j.physbeh.2006.01.014
students: A cluster analysis on a neglected issue.
Advances in Preventive Medicine, 2015, 1–8. https://
doi.10.1155/2015/639239
Tomiyama, A. J., Dallman, M. F., & Epel, E. S. (2011).
Comfort food is comforting to those most

120 health psychology report