Gender-Based Differences in Psychological, Nutritional, Physical Activity, and Oral Health Factors Associated with Stress in Teachers

Stress is a response primarily regulated by the autonomic nervous system and the hypothalamic–pituitary–adrenal axis [1]. This response evolves to adapt to the demands imposed by an individual’s stimulating and ever-changing environment. The goal of this complex reaction is to maintain organic homeostasis through cardiovascular, metabolic, and immunological processes [2]. However, continuous exposure to a stressor leads to alterations in the autonomic nervous system, resulting in the onset of psychopathologies such as depression and anxiety [3,4,5]. Particularly in the workplace, and more specifically in the educational context, there is regular exposure to stressors. A study by Biron et al. found that 40% of teachers reported experiencing severe psychological distress, double the percentage in the general population (20%) [6]. This ongoing exposure and the consequences of unmanaged stress [7] can lead to burnout syndrome, a common psychopathology among this group [8], characterized by three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment [9]. Therefore, it is possible to evaluate the emergence of this syndrome and the different personality traits that may predispose individuals to it through various questionnaires [10]. In academic settings, teachers often feel emotionally drained, exhibiting emotional and behavioral symptoms that can lead to disorders like depression due to personal, professional, and emotional demands [11,12,13], indicating these symptoms are linked to the inability to control work-related stress [7]. Burnout syndrome arises when there is a mismatch between job demands and uncontrolled stress, affecting performance in the short and long term. This can lead to the development of physical and mental illnesses, associated with about 50% of medical leaves [13,14,15,16] and a high rate of workplace absenteeism [13]. For common mental illnesses, a few days off may be granted, but according to 2018 statistics, they are the leading cause of work disability in Central Europe, thus posing a significant socioeconomic challenge in several European nations [17]. Consequently, due to the severe impact of work-related psychopathologies, various authors propose psychological and behavioral tools for effective stress management [18,19,20].

There is a multivariate component to enhancing individuals’ ability to modulate their stress response. Engaging in physical activity is identified as one of the most significant factors, as regular practice is associated with significantly lower levels of perceived stress [21,22]. This effect is due to the increase in neurotransmitters such as serotonin, dopamine, and endorphins during and after exercise, which are responsible for modulating the autonomic nervous system [23,24,25,26]. Additionally, mind–body activities like yoga are recommended for improved stress control [23]. Such modulations have been studied in other population groups, like the military, where a systematic review concluded that chronic autonomic and cardiovascular stress in soldiers appears to be managed through experience and prior training. However, the extent of this management may depend on the activity performed [27], thus explaining how controlled exercise modulates autonomic stress. Another important factor influencing the modulation of the stress response is nutrition; it is crucial in some studies since the consumption of carbohydrates, saturated fats, and refined sugars is linked with the onset of depressive states and stress [28,29,30,31]. This situation is exacerbated by a low intake of vegetables, dairy, and fruits [32,33]. Furthermore, studies demonstrate that nutrition is bidirectional, as increased calorie consumption is observed in individuals under stress [34,35,36]. However, recent research suggests that healthy eating is not linked with immediate stress modulation but may affect long-term well-being if there are physical consequences impacting the individual [37]. Finally, the oral health status of individuals is also associated with stress levels. It is observed that patients with high levels of perceived stress show alterations in their oral habits, leading to poorer dental hygiene and thus affecting periodontal tissues. Therefore, various studies indicate that the onset of periodontal diseases may be a consequence of patients experiencing conditions like stress [38,39]. On the other hand, dental problems are also linked to patients prone to mental illnesses, as studies have shown that people with functional oral or phonetic problems affect interpersonal relationships, leading to limited social activities and thus increasing feelings of isolation, loneliness, stress, and depression [40].

Due to the complex nature of psychopathologies manifested in the workplace, it is necessary to study the interactions between biological factors and social determinants, including gender stereotypes, as differences are expected in the establishment of socially described roles [41]. Meta-analysis studies have observed gender differences in the perception and communication of stress. These studies aim to resolve the role conflict assumed by each gender in their professional establishment, providing data where women score higher in emotional exhaustion and men show higher levels of depersonalization [42,43,44]. The above findings confirm theoretical claims that employees in gender-atypical occupations experience adverse health-related effects. Importantly, however, women employed in male-typed occupations experience negative outcomes for very different reasons than men employed in female-typed occupations. Women in male-typed occupations feel that they may be criticized for playing too feminine or not too feminine. Along with feelings of inferiority, the perceived and actual stressors associated with being a minority can create stress on women’s roles in male-type roles [45,46]. Though popular belief holds that women experience and are impacted by work–family conflict to a greater extent than men [47], the issue is more nuanced in reality: Byron’s meta-analysis demonstrated that women are more likely to experience family-to-work conflict, whereas men are more likely to experience work-to-family conflict [48]. Specifically, because women are still responsible for well over 50% of household chores and because they are still the primary child and elderly caregivers, they experience more family-related demands, such as role juggling and role conflict. Further, because men tend to be employed in white-collar jobs, they experience more job-related demands, such as time pressure and high expectations [49]. For this reason, we observe gender differences in stress management across various professions. In the hospital context, there is a significant increase in individuals with high levels of stress, burnout syndrome, and depression [50,51] due to the high psychosocial workload these individuals face [52]. We also found data in other research that female accountants scored highest on an anxiety measure and reported more work-related hassles compared to male accountants and male and female nurses. In contrast, male nurses had the highest rate of sickness absence compared to female nurses and male and female accountants and also perceived more work-related hassles than female nurses (vans and Steptoe, 2002). Furthermore, meta-analysis studies have found that women have a significantly higher risk of suicide compared to their male counterparts, with both genders exhibiting higher rates than those in the general population [50]. This gender difference can be explained by the additional tension imposed by social roles [53]. An additional aspect that deserves consideration is the complex and multifaceted relationship between creativity and personality. Research indicates the presence of certain personality traits in subjects with high creativity, and a more detailed understanding of these traits could be fundamental to understanding the differences in teaching behavior between genders within educational contexts in order to adequately address the needs of students. According to Plomin (2003), these characteristics include qualities such as a marked capacity for cooperation, remarkable persistence, and pronounced self-direction, which are representative of the teaching profile [54]. Effective management of these behaviors is essential for personality development and provides valuable insights into the various strategies for coping with situations in which personality plays a critical role in career success [55,56]. Gender influences the self-assessment of creativity, according to various studies, and the comparison between the two genders is vital to understanding the differences in creative thinking capacity. Kaufman found that men considered themselves more creative in scientific-analytical and athletic aspects, while women did so in aspects of social and visual–artistic communication [57]. Other studies showed significantly higher data for female college students on the originality subscales [58]. However, Henderson (2003) found no significant differences between the two genders in terms of creativity, suggesting that the relationship between creativity and personality is complex [59]. These discrepancies could be because self-assessments reflect internalized gender stereotypes rather than actual differences. Abra and Valentine-French (1991) propose that gender differences in creativity are explained by biological and environmental factors, such as specific cognitive abilities and educational opportunities [60]. Thus, creative achievement depends on both biological and environmental factors. So, we would argue that assuming any gender differences in creativity are most likely the product of differing environments would represent the best overall synthesis of what we currently know about gender differences in creativity [57]. Other gender differences were observed during the COVID-19 pandemic, which affected men and women differently. The authors have suggested that there is a gender difference in the psychological experience, somatization, and impact of the COVID-19 pandemic and the emotions it provokes, suggesting that women are more emotionally vulnerable to the effects of the COVID-19 context than men [61]. While men had higher fatality rates and a greater risk of mortality [62], women showed a higher prevalence and severity of symptoms of anxiety, depression, and acute stress [63]. This may be related to the greater levels of state-trait anxiety reached in this study, where females presented higher levels than males in line with previous literature [64]. Additionally, during the pandemic, significant psychological effects were observed in students and teachers due to academic and job uncertainties, leading to depressive symptoms affecting these groups [65]. In these studies, female students exhibited a higher prevalence of depression than their male counterparts [66]. In addition, psychometric analysis reveals that variations in personality traits between genders could be responsible for the influence of perceived risk and anxiety in the female gender. According to the data obtained, it is observed that male students exhibit higher levels of extraversion compared to their female counterparts. On the other hand, female students show higher rates of conscientiousness and neuroticism [67]. These findings are consistent with existing literature indicating greater openness to new experiences in women, which contrasts with the results obtained by Castañeiras et al. (2006), who found greater openness in men [68]. However, these discrepancies could be explained by differences in sociocultural contexts (Latin America–Europe) and the particularities of the samples studied.

Other Possible sex differences in work-related stress are due in part to the different types of work carried out by men and women. In the UK, women are concentrated in clerical, service, and sales work and in jobs such as teaching and nursing (Office for National Statistics, 1998) [69]. Women earn less than men and occupy less prestigious positions at work [70]. In 1993, men were twice as likely as women to be managers and administrators. Women experienced lower control and higher job strain than men [71] and had fewer learning opportunities at work [72]. Emslie et al. (1999) have argued that when men and women in the same occupation are compared, sex accounts for little of the variance in psychological distress or minor morbidity in comparison with working conditions. However, this pattern may depend on the culture of the workplace [70].

Regarding teachers, previous studies have noted gender differences in stress response, with female teachers exhibiting higher levels of emotional exhaustion [73] and perceived stress [74] and a greater prevalence of burnout syndrome compared to men [73,75]. However, other authors have found no statistically significant gender differences in perceived stress [75]. Given the multifactorial basis and the controversy found in the scientific literature, it is interesting to investigate consistent findings that clearly conclude the influence of gender on the onset of stress and exhaustion in teachers. Therefore, we present an in-depth analysis of behavioral differences in psychological, nutritional, physical activity, and oral health factors related to stress. Hence, we propose the following study with the objective of analyzing gender differences in psychological, nutritional, physical activity, and oral health factors that are associated with stress levels in teachers with the aim of developing specific and effective strategies to promote their overall well-being. The initial hypothesis was that there would be gender differences in both the stress-related factors experienced by teachers and the psychological, nutritional, physical activity, and oral health components.

Regarding psychological profile data, male teachers exhibited significantly higher levels of depersonalization (p = 0.000) and personal accomplishment (p = 0.043) compared to their female counterparts. Conversely, female teachers demonstrated significantly higher levels of perceived stress (p = 0.001) and conscientiousness (p = 0.014) than male teachers. No statistically significant gender differences were found in teacher satisfaction, teaching stress, emotional exhaustion, psychological inflexibility, loneliness, extraversion, agreeableness, neuroticism, and openness to experience (Table 1).

In terms of nutritional habits, male teachers exhibited significantly higher figures in the number of glasses of water consumed daily (p = 0.000), the tendency to snack between meals (p = 0.025), adherence to diets (p = 0.000), and weekly intake of legumes (p = 0.022), fried foods (p = 0.000), and distilled beverages (p = 0.000). On the other hand, female teachers showed significantly higher levels in the number of meals per day (p = 0.027), the practice of eating slowly (p = 0.000), daily dairy consumption (p = 0.032), and weekly fish consumption (p = 0.000). No statistically significant gender differences were observed in other nutritional values (Table 2).

According to the physical activity data, significantly higher values in unstructured sports participation/minutes of daily movement were found among female teachers (p = 0.009). However, the figures for participation in endurance sports (p = 0.000), team sports (p = 0.000), and resistance training (p = 0.000) were significantly higher in males. No gender differences were observed in the incidence of illness per year (Table 3).

Regarding oral health habits, female teachers showed significantly higher incidences of dry mouth (p = 0.000), gastritis (p = 0.000), smoking habits (p = 0.000), and frequency of daily tooth brushing (p = 0.011). In contrast, no significant data were observed for the male gender. No statistically significant differences were found in issues related to gum bleeding and halitosis (Table 3).

In the three dimensions that make up the Maslach Burnout Inventory, in our research, we found significant gender differences in depersonalization and self-fulfillment. The results indicate that males obtained higher levels of depersonalization, an alteration of the consciousness of the self, in such a way that the depersonalized individual feels himself as strange and distant, a mere observer of his mental processes and his bodily sphere [85]. These results are supported by other research, which also shows higher levels in males than in females [86,87]. These findings are in line with previous findings that reported an increase in these aspects among men [88]. Improving the quality of life for both male and female workers is imperative, as safe working conditions contribute greatly to overall well-being [89]. Burnout syndrome, characterized by professional exhaustion, depersonalization, and low personal accomplishment, is prevalent among professions involving intense human interaction, such as teaching [90]. While some studies [91,92,93] found higher depersonalization scores among female teachers compared to male teachers, others indicated higher levels of depersonalization and personal fulfillment among male teachers. This highlights the need for more research to investigate these contradictory gender differences in teacher burnout. In this research, countries from South America and the European Union (EU) were selected due to the similarity in social policies, particularly after the consolidation of the EU. A comparative analysis of employment policies reveals a divergence between the United States and the nations examined in this study, indicating that the former maintains a more conservative approach to labor legislation, while the EU and the mentioned South American countries tend towards a more socially progressive stance. Previous research has corroborated these results in relation to depersonalization, showing that gender disparity in this phenomenon is more pronounced in the U.S. compared to more progressive labor policies. Specifically, it is likely that males in the U.S. report experiences of depersonalization compared to the average woman in the same country. In contrast, in contexts where labor policies are more advanced—in EU member states and certain South American countries—gender differences in terms of depersonalization are smaller [94]. Even more relevant, these findings offer initial support to the hypothesis proposed by various entities and governmental organizations, which assert that labor policies with a socially responsible approach are essential for the well-being of workers, as suggested by the International Labour Office in its 2008 report [95]. Additionally, our study observed significantly higher levels of perceived stress among females. Teaching, a profession prone to high stress levels, often exceeds that of other high-risk professions [96], and this is consistent with previous studies showing higher stress levels in female teachers [97,98,99]. The dual burden of work and home responsibilities for women could be a contributing factor, leading to heightened stress levels compared to men, who generally face fewer domestic demands [100]. The interaction between work and family life is significantly correlated with occupational stress [101].

Looking at other collectives than teachers, we find similar results, as male workers in the health sector or in the banking sector also showed higher levels than females [102,103,104]. Regarding self-fulfillment, we found that females present lower levels than males. In line with this, a recent study shows comparable results among university professors [67]. Likewise, in the present study, females presented higher levels of perceived stress. Previous authors also found higher levels of perceived stress values in female than male Spanish college professors [105]. Not only in the Spanish population but also in Portuguese and American populations, as the previous bibliography points out [42,67,106]. Regarding personality traits that may influence perceived stress, in our study, we found higher levels of conscientiousness in females than in males and no significant differences in extroversion, agreeableness, neuroticism, or openness to experience. Reviewing the previous literature and analyzing other university groups, such as students, we found results where females also presented these levels [107].

As for nutritional habits, males in our study showed a higher adherence to diets. Prior research indicated a higher prevalence of overweight among Spanish adult males (43.9%) [108], an issue of growing concern in public health globally [109]. Higher consumption of fried foods was also noted among male teachers. A recent study found that high consumption of fried foods adversely affects anxiety and depression due to altered lipid metabolism and neuroinflammation [110]. Furthermore, our study observed a higher water intake among male teachers, aligning with the European Food Safety Authority (EFSA) guidelines suggesting greater hydration and nutritional needs in men compared to women [111]. Higher levels of distilled beverage consumption were also observed among male teachers. Limited research exists on teachers’ consumption habits and their consequences, as harmful alcohol use in educational settings is typically associated with students [112]. Alcohol consumption has been reported as a coping mechanism for personal problems and crises [113], indicating the need for future research to include teachers in health promotion and preventive campaigns in educational settings related to alcohol consumption. In contrast, female teachers showed a tendency to eat more slowly, a practice scientifically proven to reduce food and energy intake [114] and potentially protect against overeating and conditions like overweight or obesity [115]. Additionally, female teachers reported having more meals per day. Stress activates the hypothalamic–pituitary–adrenal axis, increasing glucose demand for bodily homeostasis and thus elevating appetite and food intake [116]. Numerous studies have examined the relationship between stress and eating behavior, leading to the concept of ‘emotional eating,’ which refers to the use of food as a dysfunctional coping mechanism for negative emotions [117,118].

Regarding physical activity, male teachers demonstrated higher levels of physical activity than their female counterparts. Higher physical activity levels are associated with better control in stressful situations [119]. In Spain, gender differences persist in sports participation, with higher rates among men (63.1% annually) compared to women (51.8%) and a growing preference for individual sports [120]. Male teachers engaged more in resistance training, directly influencing health, hence its inclusion in health improvement and quality of life programs [121]. Female teachers participated more in unregulated sports activities, highlighting the importance of promoting women’s sports for healthy lifestyle habits [122]. Individuals with sedentary lifestyles tend to smoke more, aligning with our findings, where less physically active women were more likely to smoke [123]. In terms of oral health habits, female teachers exhibited significantly higher levels of dry mouth, gastritis, and daily tooth brushing. Generally, being female is associated with better oral health habits [124]. Higher levels of dry mouth in female teachers, related to stress, anxiety, and smoking, were consistent with our study’s findings [125]. Higher instances of gastritis in female teachers align with other studies finding elevated gastritis levels in academic teachers regardless of gender [126].