Eating speed and emotional eating, are associated with early vascular injury in individuals at cardiovascular risk

Abstract Ιntroduction Eating speed and emotional eating are linked to poor diet quality and obesity, which are major risk factors for atherosclerosis. Although these behaviors are common, their clinical importance in cardiovascular disease is not adequately investigated. Objective The purpose of this study was to investigate the association between eating speed and emotional eating with markers of early subclinical atherosclerosis. Materials & Methods This observational study enrolled 162 consecutive adults (59.26% male) with an average age of 58.15 ± 10.99 years, with one or more cardiovascular risk factors. Participants underwent clinical evaluations and anthropometric measurements as well as assessment of eating speed and emotional eating, using a specialized eating behavior questionnaire. Diet quality was assessed through adherence to the Mediterranean Diet using the Mediterranean Diet Adherence Score (MEDAS). Stress levels were assessed using the 14-item Perceived Stress Scale (PSS-14).The presence and extent of subclinical arterial disease were assessed via ultrasound, focusing on the presence of atherosclerotic plaques in the femoral or carotid arteries and the Intima-Media Thickness (IMT). Results Eating speed (19.3% slow, 45.3% moderate, 35.4% fast) was positively associated with IMT (Β=0,167, 95% CI: 0,005, 0,329) and the number of atherosclerotic plaques(Β=0,206, 95% CI: 0,023, 0,390), in the femoral arteries (for the total sample), As regards to emotional eating, food consumption due to loneliness was associated with increased common carotid IMT(Β=-0,042, 95% CI: -0,082 , -0,003) in the total sample. Ιn women, an even stronger association was observed between eating speed and femoral artery thickness (Β=0.206, 95% CI: 0.012, 0.401), total plaque count (Β=0.599, 95% CI: 0.100, 1.098), as well as femoral artery plaques (Β=0.340, 95% CI: 0.070, 0.610). Furthermore, women reported a higher frequency of stress-induced eating (48.5% vs. 17.9%, p<0.005) and eating triggered by intense emotions (33.3% vs. 10.5%, p=0.007). Overeating due to loneliness was significantly associated with increased IMT Β=-0,069, 95% CI: -0,121 , -0,017 for common carotids; Β=-0,052,95% CI: -0,099, -0,006 for the mean of all measurement sites. These associations remained statistically significant after adjusting for age, waist circumference, sex, physical activity, smoking, hypertension, dyslipidemia, diet quality, and overall stress levels. Conclusions In a cohort of outpatients visiting a cardiovascular prevention clinic, eating speed and emotional eating associates with subclinical atherosclerosis, regardless of diet quality. These effects were more pronounced in women. These hypothesis generating data suggest that the utility of behavioral screening and mindful eating interventions merit further research in cardiovascular prevention strategies.