Abstract Body: Background: Obesity remains a public health problem for Puerto Ricans in the mainland US and on the island, influenced by suboptimal diet quality and high stress exposure. The Theory of Planned Behavior (TPB) helps explain how healthy eating self-efficacy influences obesogenic behaviors, like stress eating. Yet, this relationship and its variation by sociocultural context remain understudied. This study examines associations between healthy eating self-efficacy, stress eating, and BMI among young Puerto Rican adults in the Bronx-NY, and San Juan-PR.
Methods: This cross-sectional analysis used data from the Boricua Youth Study-Health Assessment, a sample of Puerto Rican adults in San Juan, PR (n=410) and the South Bronx, NY (n=356; mean age=23y). Healthy eating self-efficacy was assessed with a 7-item scale on perceived control, attitudes, and confidence toward healthy eating (higher scores=greater efficacy). Stress eating was measured with two items on overeating or consuming sweets/fatty foods to cope (‘most of the time’, ‘some of the time’, ‘rarely’, ‘never’). BMI was derived from measured height and weight. Site-stratified multivariable models examined associations between (1) self-efficacy and stress eating and (2) stress eating and BMI.
Results: Mean (SE) healthy eating efficacy scores were 40.0(0.4) in NY and 38.6(0.3) in PR. The proportion of those reporting ‘never’ overeating was 48.3% in NY and 26.8% in PR; ‘never’ eating sweets/fatty foods was 39.2% in NY and 35.1% in PR. In adjusted models, in PR, each unit increase in healthy eating efficacy was linked to 8% (0.86-0.99) lower odds of overeating and 11% (0.85-0.94) lower odds of eating sweets/fatty foods most of the time (vs. never). This was not observed for those in NY. In NY, those reporting overeating ‘most of the time’ or ‘some of the time’ (vs. never) had BMIs that were 4 units higher on average (B=3.9; 95%CI=0.1-7.7; and B=3.8, 95%CI=1.6-6.1, respectively), while no associations were found for eating sweets/fatty foods. In PR, stress eating behaviors were not associated with BMI.
Conclusion: Healthy eating self-efficacy appeared protective against stress eating in PR but not NY, suggesting environmental or sociocultural influences. Stress eating was linked to higher BMI in NY only, indicating geographic variation. Findings underscore the need for context-specific, TPB-based interventions to promote healthy eating and reduce stress-related obesity among Puerto Ricans across contexts.