Emotional eating and cardiovascular health


Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India    26 February 2023

Emotional eating is when people eat to alleviate difficult emotions such as anxiety, sadness rather than to satisfy hunger. It is associated with overeating. “The reward system may be particularly involved in emotional eating, where eating may reduce anxiety and eating comfort foods may blunt the response to acute stress,” note the authors of a study from France, which has for the first time demonstrated that eating behavior affects the health of the heart and emotional eating is associated with subclinical cardiovascular damage.1


To examine the association of emotional eating with cardiovascular damage, researchers enrolled 1109 French participants (916 adults and 193 adolescents) from the single-center familial STANISLAS (Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux) study comprising of parents and adolescents. The selected subjects were healthy at baseline and nearly half (49.7%) of them were women. The Dutch Eating Behaviour Questionnaire was used to assess emotional eating. Carotid-femoral pulse-wave velocity (cfPWV), left ventricular mass, carotid intima-media thickness and diastolic dysfunction were examined after 13 years to evaluate heart health.


Results published in the European Journal of Preventive Cardiology showed a positive association between emotional eating and higher cfPWV. In adults, the risk of diastolic dysfunction was also increased by 38% after follow-up at 13.4 years with odds ratio of 1.38. Mediation analysis showed that stress levels accounted for around 32% of the interrelationship between emotional eating and diastolic dysfunction.  External eating i.e., eating by external stimuli, such as the presence of the food or its smell, had a negative association with cfPWV, but no mediation effect could be found. No association between eating behavior and metabolic syndrome was observed.


These findings highlight that along with advising patients about eating a healthy diet (one that is rich in fruits, vegetables, whole grains, low-fat dairy products, poultry and fish and limiting red meat, foods high in salt and added sugars), eating behavior should also be incorporated in preventive cardiology. All emotional eaters, not just the obese, should be counselled about managing their emotions and reduce stress.


Mindful eating or eating with awareness can come to the aid. It means being aware of the hunger and satiety cues of the body. Mindful eating also means using all the five senses while eating: colors (eye), smells (nose), textures (touch), flavors (taste), and sound while chewing (ear) of the food. Distractions like using a phone or watching TV during meal times lead to impulsive eating.




  1. Puchkova-Sistac A, et al. Association between eating behaviour and 13-year cardiovascular damages in the initially healthy STANISLAS cohort. Eur J Prev Cardiol. 2023 Jan 11;zwac287. doi: 10.1093/eurjpc/zwac287.

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