1
|
Yeh KL, Meng Y, Fernandez ID, Groth SW. Validation of the Weight-Related Eating Questionnaire in pregnancy. Eat Behav 2024; 55:101887. [PMID: 38823372 DOI: 10.1016/j.eatbeh.2024.101887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Abstract
The Weight-Related Eating Questionnaire (WREQ), designed for assessing distinct constructs of dietary restraint and disinhibition-related eating behaviors, has not been validated in pregnancy. This secondary data analysis aimed to evaluate the WREQ's psychometrics in a diverse sample of pregnant women from the eMoms randomized controlled trial (N = 1399), randomly split for exploratory (EFA, n = 691) and confirmatory factor analysis (CFA, n = 708). Cronbach's alpha and corrected item-total correlation was used to examine internal consistency reliability. Sequential multiple regression analyses were used to assess criterion validity. EFA revealed three factors - dietary restraint, susceptibility to external cues, and emotional eating - accounting for 65.6 % of total variances. Parallel analysis confirmed a combination of two restraint subtypes (routine restraint and compensatory restraint). CFA showed that item 3 for assessing routine restraint had the lowest squared multiple correlation (0.22). The overall Cronbach's alpha of 0.87 demonstrated good internal consistency. Dietary restraint was negatively associated with the intake of energy (p = .03) and carbohydrates (p = .02), whereas susceptibility to external cues was positively associated with the intake of energy (p < .001), carbohydrates (p < .001), and total fat (p = .003). Additionally, emotional eating was positively associated with early-pregnancy body mass index (BMI) after adjustment for covariates (p < .001). These findings confirmed the reliability of the WREQ, the construct validity for susceptibility to external cues and emotional eating, and demonstrated its criterion validity regarding nutritional intake in pregnant women.
Collapse
Affiliation(s)
- Kuan-Lin Yeh
- School of Nursing, University of Rochester, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| | - Ying Meng
- School of Nursing, University of Rochester, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| | - I Diana Fernandez
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., Rochester, NY 14642, USA.
| | - Susan W Groth
- School of Nursing, University of Rochester, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| |
Collapse
|
2
|
Kloub SM, Banihani SA. Exploring associations between pregnancy cravings and sociodemographic, lifestyle and health factors: insights from a cross-sectional population study in Jordan. BMJ Open 2024; 14:e078082. [PMID: 38448075 PMCID: PMC10916096 DOI: 10.1136/bmjopen-2023-078082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE To explore the potential associations between pregnancy cravings and various sociodemographic, lifestyle and health factors. DESIGN Cross-sectional study. SETTING Population-based study in Jordan. PARTICIPANTS A total of 500 women who had children and experienced pregnancy cravings were included. PRIMARY AND SECONDARY OUTCOME MEASURES Pregnancy cravings are prevalent among Jordanian women and associated with some sociodemographic, lifestyle and health factors. RESULTS The results showed that 75.40% (377/500) of women experienced food cravings, with 40.6% and 29.1% of them having iron deficiency and vitamin D deficiency, respectively. The most commonly craved food items were sweets (17.2%, 86/500) and salts (22.2%, 115/500), while less than 1.0% of women craved non-food items. No significant correlation (p>0.05) was found between food cravings and the gender of the babies. Significant associations were found between food cravings and the mother's educational level (p=0.023), weight loss (p<0.001) and diseases such as anaemia (p=0.01). CONCLUSION Pregnancy cravings, particularly for food items, with sweets and salts being the most commonly craved, are prevalent among Jordanian women and are associated with the mother's educational level, changes in weight and the presence of anaemia. Additionally, the study found that iron and vitamin D deficiencies are prevalent health issues among women experiencing these cravings in Jordan. This research has important implications, emphasising the pressing need for targeted nutritional interventions and healthcare strategies to address identified deficiencies and improve maternal health outcomes in the region.
Collapse
Affiliation(s)
- Suad M Kloub
- Department of Allied Medical Sciences, Faculty of Karak, Al-Balqa Applied University, Salt, Jordan
| | - Saleem A Banihani
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
3
|
Ebinghaus M, Agricola CJ, Schmittinger J, Makarova N, Zyriax BC. Assessment of women's needs, wishes and preferences regarding interprofessional guidance on nutrition in pregnancy - a qualitative study. BMC Pregnancy Childbirth 2024; 24:154. [PMID: 38383376 PMCID: PMC10880225 DOI: 10.1186/s12884-024-06351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/14/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND A healthy nutrition in pregnancy supports maternal health and fetal development, decreasing the risk for adverse pregnancy outcomes. Guidance by prenatal care professionals can increase women's awareness regarding the importance of nutrition in pregnancy and thereby contribute to a reduced risk for adverse pregnancy outcomes. The aim of this study was to assess the needs, wishes and preferences of pregnant women regarding the interprofessional guidance on nutrition in pregnancy. METHODS Using a qualitative approach and a purposive maximum variation sampling strategy, 25 pregnant women were recruited to participate in six semi-structured, guideline-oriented online focus groups. In addition, two semi-structured, guideline-oriented interviews, with a midwife and an obstetrician, were conducted. The focus groups and interviews were audio-recorded and transcribed. Transcripts were analysed using a systematic deductive-inductive approach to qualitative content analysis according to Kuckartz. RESULTS Focus group participants covered diverse perspectives in terms of their age, different models of prenatal care as well as dietary forms from omnivorous to vegan. The majority of women perceived the guidance on nutrition during pregnancy as insufficient. Involved healthcare professionals, namely midwives and obstetricians, should provide more consistent information, especially to avoid uncertainties exacerbated by the internet and social media. There is a need for individual nutrition information regarding dietary supplements and the specifics of different dietary forms during pregnancy, such as a vegan diet. The majority of participants supported the integration of a free-of-charge professional nutrition counselling in prenatal care. Interviews with experts identified time pressure and the complexity of nutrition as a topic as the main obstacles in consultation settings. Both midwife and obstetrician emphasised the need for improved professional education on nutrition in pregnancy in their respective studies. CONCLUSION Professional guidance for pregnant women on nutrition and uncertainties going along with certain forms of diet during pregnancy could alleviate the burden and overwhelming amount of web-based information. Additionally, information adapted to the needs, wishes and preferences of pregnant women would improve prenatal care through a more personalised approach. The quality of nutrition guidance in pregnancy should be improved by the implementation of this topic in the education of involved healthcare professionals.
Collapse
Affiliation(s)
- Merle Ebinghaus
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
| | - Caroline Johanna Agricola
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Janne Schmittinger
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Nataliya Makarova
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| |
Collapse
|
4
|
Sun Y, Ferguson M, Reeves MM, Kelly JT. Maternal Dietary Patterns and Risk of Postpartum Depression: A Systematic Review. Matern Child Health J 2023; 27:2077-2090. [PMID: 37814068 PMCID: PMC10618401 DOI: 10.1007/s10995-023-03781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Postpartum depression (PPD) has deleterious effects on both maternal and child outcomes. Poor maternal nutrition during pregnancy has been implicated in the development of PPD. This review aimed to explore the association between the overall dietary intake patterns during pregnancy and the development of PPD. METHODS A literature search was performed in PubMed, Embase, Scopus, CINAHL, and PsycINFO databases for relevant randomized controlled trials, cohort and cross-sectional studies published up to 17th September 2020. Included studies assessed at least one dietary pattern during pregnancy and reported on PPD. The Newcastle Ottawa Scale and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of methodology. A narrative analysis was conducted. RESULTS Ten studies (eight cohort and two cross-sectional) were included with substantial heterogeneity in measurements of dietary intake exposures and PPD. The studies identified several types of healthy dietary patterns, including a 'healthy', 'health conscious', 'Japanese', 'high-glycemic index/glycemic load', 'Vegetable', 'Nut-Fruit', 'Seafood', and 'compliance with the Australian Dietary Guidelines'. The 'Western', 'unhealthy', 'Beverage', 'Cereal-Meat', and 'Egg' were labelled as unhealthy dietary patterns. Four of the eight studies showed an inverse association between adherence to healthy diets and risk of PPD, whereas only one of the seven studies showed that adherence to unhealthy diets was associated with increased risk of PPD. Methodological quality of the studies varied across the sample. CONCLUSIONS Our findings indicate that adherence to a healthy diet may be beneficial for PPD. However, the relationship between unhealthy diets and PPD needs to be corroborated by more high-quality studies.
Collapse
Affiliation(s)
- Yuyue Sun
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Marina M Reeves
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| |
Collapse
|
5
|
Flores-Quijano ME, Mota-González C, Rozada G, León-Rico JC, Gómez-López ME, Vega-Sánchez R. The Intuitive Eating Scale-2 Adapted for Mexican Pregnant Women: Psychometric Properties and Influence of Sociodemographic Variables. Nutrients 2023; 15:4837. [PMID: 38004230 PMCID: PMC10675059 DOI: 10.3390/nu15224837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
A weight-inclusive approach to health involves the promotion of intuitive eating, i.e., the individual's ability to be aware of their physiological hunger and satiety cues to determine when and how much to eat, while paying attention to how certain foods affect their body. The second version of the Intuitive Eating Scale (IES-2) evaluates four interrelated traits of intuitive eating: Unconditional Permission to Eat (UPE), Eating for Physical rather than emotional Reasons (EPR), Reliance on internal Hunger/Satiety Cues (RHSC), and Body-Food Choice Congruence (BFCC). In this study, our aim was to evaluate the psychometric properties of a Mexican Spanish adaptation of the IES-2 for pregnant women and examine the relationship between intuitive eating traits and maternal sociodemographic characteristics. A sample of 514 pregnant women answered our IES-2 adaptation and a sociodemographic questionnaire. We determined the quality, validity, and reliability of our adaptation through descriptive measures, frequency distributions, intra-class correlations, and extreme answer group comparison for each item, eliminating those with weak technical properties. We then performed an exploratory principal component analysis and a confirmatory factor analysis. Last, we analyzed the association between intuitive eating and maternal sociodemographic and reproductive variables through correlation tests and multivariable linear regressions. Psychometric tests confirmed the validity and reliability of our IES-2 adaptation, which comprised 18 out of the 23 original items. Notably, both the exploratory and confirmatory factor analyses yielded not four but five factors, due to the EPR subscale splitting in two (the "emotional" and "physical" components of EPR). We attribute this novel finding to the emotional manifestations that naturally accompany pregnancy, which may incline pregnant women to base their eating behaviors more on the emotional than the physical component that would otherwise dominate their EPR trait. Further research is also needed about the UPE subscale during pregnancy, due to item removal and subtle changes in meaning. Finally, the influence of sociodemographic variables on the IES-2 score was extremely low, suggesting that other variables, possibly of a psychological nature, may have greater influence on a pregnant woman's intuitive eating.
Collapse
Affiliation(s)
- María Eugenia Flores-Quijano
- Department of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.E.F.-Q.); (J.C.L.-R.)
| | - Cecilia Mota-González
- Department of Psychology, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (C.M.-G.); (M.E.G.-L.)
| | - Guadalupe Rozada
- Private Consultant, Alimentación Plena, Mexico City 06760, Mexico;
| | - Jacqueline Citlalli León-Rico
- Department of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.E.F.-Q.); (J.C.L.-R.)
| | - María Eugenia Gómez-López
- Department of Psychology, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (C.M.-G.); (M.E.G.-L.)
| | - Rodrigo Vega-Sánchez
- Department of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.E.F.-Q.); (J.C.L.-R.)
| |
Collapse
|
6
|
Haddad-Tóvolli R, Claret M. Metabolic and feeding adjustments during pregnancy. Nat Rev Endocrinol 2023; 19:564-580. [PMID: 37525006 DOI: 10.1038/s41574-023-00871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
Eating behaviours are determined by the integration of interoceptive and environmental inputs. During pregnancy, numerous physiological adaptations take place in the maternal organism to provide an adequate environment for embryonic growth. Among them, whole-body physiological remodelling directly influences eating patterns, commonly causing notable taste perception alterations, food aversions and cravings. Recurrent food cravings for and compulsive eating of highly palatable food can contribute to the development and maintenance of gestational overweight and obesity with potential adverse health consequences for the offspring. Although much is known about how maternal eating habits influence offspring health, the mechanisms that underlie changes in taste perception and food preference during pregnancy (which guide and promote feeding) are only just starting to be elucidated. Given the limited and diffuse understanding of the neurobiology of gestational eating patterns, the aim of this Review is to compile, integrate and discuss the research conducted on this topic in both experimental models and humans. This article sheds light on the mechanisms that drive changes in female feeding behaviours during distinct physiological states. Understanding these processes is crucial to improve gestational parent health and decrease the burden of metabolic and food-related diseases in future generations.
Collapse
Affiliation(s)
- Roberta Haddad-Tóvolli
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Marc Claret
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
- School of Medicine, Universitat de Barcelona, Barcelona, Spain.
| |
Collapse
|
7
|
Stein SF, Rios JM, Gearhardt AN, Nuttall AK, Riley HO, Kaciroti N, Rosenblum KL, Lumeng JC, Miller AL. Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression. Appetite 2023; 187:106589. [PMID: 37146651 PMCID: PMC11079996 DOI: 10.1016/j.appet.2023.106589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.
Collapse
Affiliation(s)
- Sara F Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI, 48109, USA.
| | - Julia M Rios
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, 552 West Circle Drive, East Lansing, MI, 48824, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, 4250 Plymouth Rd., Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Pediatrics, Michigan Medicine, 1522 Simpson Rd. East., Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| |
Collapse
|
8
|
Sámano R, Martínez-Rojano H, Ortiz-Hernández L, Nájera-Medina O, Chico-Barba G, Gamboa R, Mendoza-Flores ME. Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review. Nutrients 2023; 15:nu15061530. [PMID: 36986260 PMCID: PMC10058126 DOI: 10.3390/nu15061530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.
Collapse
Affiliation(s)
- Reyna Sámano
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación de la Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Luis Ortiz-Hernández
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Oralia Nájera-Medina
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Gabriela Chico-Barba
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Ricardo Gamboa
- Departamento de Fisiología, Instituto Nacional de Cardiología, Mexico City 14080, Mexico
| | - María Eugenia Mendoza-Flores
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
| |
Collapse
|
9
|
Waclawek T, Park SQ. Potential mechanisms and modulators of food intake during pregnancy. Front Nutr 2023; 10:1032430. [PMID: 36742431 PMCID: PMC9895105 DOI: 10.3389/fnut.2023.1032430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
Dietary choice during pregnancy is crucial not only for fetal development, but also for long-term health outcomes of both mother and child. During pregnancy, dramatic changes in endocrine, cognitive, and reward systems have been shown to take place. Interestingly, in different contexts, many of these mechanisms play a key role in guiding food intake. Here, we review how food intake may be impacted as a function of pregnancy-induced changes across species. We first summarize changes in endocrine and metabolic signaling in the course of pregnancy. Then, we show how these may be related to cognitive function and reward processing in humans. Finally, we link these to potential drivers of change in eating behavior throughout the course of pregnancy.
Collapse
Affiliation(s)
- Theresa Waclawek
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany,Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam, Germany
| | - Soyoung Q. Park
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany,Department of Decision Neuroscience and Nutrition, German Institute of Human Nutrition (DIfE), Potsdam, Germany,Charité–Universitätsmedizin Berlin, Neuroscience Research Center, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany,Deutsches Zentrum für Diabetesforschung, Neuherberg, Germany,*Correspondence: Soyoung Q. Park,
| |
Collapse
|
10
|
Camacho-Morales A, Montalvo-Martínez L, Cruz-Carrillo G, Maldonado-Ruiz R, Trujillo-Villarreal L, Garza-Villarreal E. Prenatal programing of motivated behaviors: can innate immunity prime behavior? Neural Regen Res 2023; 18:280-283. [PMID: 35900403 PMCID: PMC9396490 DOI: 10.4103/1673-5374.346475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Prenatal programming during pregnancy sets physiological outcomes in the offspring by integrating external or internal stimuli. Accordingly, pregnancy is an important stage of physiological adaptations to the environment where the fetus becomes exposed and adapted to the maternal milieu. Maternal exposure to high-energy dense diets can affect motivated behavior in the offspring leading to addiction and impaired sociability. A high-energy dense exposure also increases the pro-inflammatory cytokines profile in plasma and brain and favors microglia activation in the offspring. While still under investigation, prenatal exposure to high-energy dense diets promotes structural abnormalities in selective brain regions regulating motivation and social behavior in the offspring. The current review addresses the role of energy-dense foods programming central and peripheral inflammatory profiles during embryonic development and its effect on motivated behavior in the offspring. We provide preclinical and clinical evidence that supports the contribution of prenatal programming in shaping immune profiles that favor structural and brain circuit disruption leading to aberrant motivated behaviors after birth. We hope this minireview encourages future research on novel insights into the mechanisms underlying maternal programming of motivated behavior by central immune networks.
Collapse
|
11
|
Vaghef-Mehrabani E, Wang Y, Zinman J, Beharaj G, van de Wouw M, Lebel C, Tomfohr-Madsen L, Giesbrecht GF. Dietary changes among pregnant individuals compared to pre-pandemic: A cross-sectional analysis of the Pregnancy during the COVID-19 Pandemic (PdP) study. Front Nutr 2022; 9:997236. [DOI: 10.3389/fnut.2022.997236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
IntroductionDietary changes are common in pregnancy and may affect pregnancy outcomes, yet these changes and the associated contributory factors during the COVID-19 pandemic have been understudied. We aimed to investigate the association between dietary change and socioeconomic variables, pre-pregnancy BMI, and mental health symptoms; the change in intake of seven food categories and their reasons; and the association between intake of these food categories and mental health symptoms.Materials and methodsIn this cross-sectional analysis, we used data from the Pregnancy during the COVID-19 Pandemic (PdP) cohort study that collected data from pregnant Canadian individuals (n = 9,870, gestational age ≤ 35 weeks) on socioeconomic factors, pandemic-related hardships, pre-pregnancy body mass index (BMI), dietary changes compared to pre-pandemic and the reasons for these changes. We assessed depressive and anxiety symptoms using the Edinburgh Postpartum Depression Scale (EPDS) and Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety, respectively.Results54.3% of the participants reported a change in their diet. Non-white ethnicity (OR = 1.33), job loss (OR = 1.29), clinically elevated depressive and anxiety symptoms (OR = 1.26 and 1.14, respectively), self-isolation (OR = 1.20), pre-pregnancy BMI (OR = 1.19), fear of COVID-19 (OR = 1.15), and pandemic phase at enrolment (OR = 0.90) significantly predicted dietary change. Most participants ate about the same amounts of dairy, meats and canned foods/dried goods as pre-pandemic (61.5, 61.7, and 60.2%, respectively), increased their intake of fresh vegetables/fruits and sweets/snacks (43.2 and 54.5%, respectively), and decreased fast-food and take-out/home delivery (53.2 and 43.1%, respectively). Changes in consumption of the food categories had a curvilinear association with mental health symptoms (except resilience) indicating greater symptoms with either decreased or increased intakes. Changes in craving, having more time for cooking/preparing foods, and being unable to go grocery shopping frequently (but not reduced affordability) were the main reasons driving these dietary changes.ConclusionSome factors increase the odds of dietary change among pregnant individuals during the pandemic, with some changes toward a healthy and others toward an unhealthy diet. Given the importance of a healthy diet during gestation, identifying the risk and protective factors might be the first essential step in reducing the detrimental effects of unfavorable dietary changes during the pandemic on this vulnerable population.
Collapse
|
12
|
Lefebvre M, Hengartner MP, Tronci E, Mancini T, Ille F, Röblitz S, Krüger T, Leeners B. Food preferences throughout the menstrual cycle - A computer-assisted neuro-endocrino-psychological investigation. Physiol Behav 2022; 255:113943. [PMID: 35970225 DOI: 10.1016/j.physbeh.2022.113943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND As eating behavior changes in relation to the menstrual cycle and weight changes with menopausal transition, ovarian hormones appear to be involved in regulating eating behavior. However, observations are contradictory and are difficult to compare, due to methodological problems related to nutritional epidemiology. To better understand the relationship between ovarian steroid hormones and eating behavior, our study evaluates women's responses to visual food cues at different points in the menstrual cycle with their specific serum estrogen/progesterone levels and women's responses in the case of strong estrogen changes in the context of fertility treatments. METHODS We collected data from 129 women, 44 of whom received in vitro fertilization (IVF) at the Department of Reproductive Endocrinology, University Hospital Zurich. A total of 85 women with natural cycles were recruited at the University Hospital Zurich (n = 37) and at the Hannover Medical School (n = 48). Our observational study used 4 different measurement time points across the natural cycle and 2 measurement time points in women with supraphysiological estradiol levels during fertility treatments. Using a second cycle, we then tested our results for replication. At these predefined time points, women were shown pictures of 11 categories of food, with 4 items for each category and blood samples for measurement of hormone levels were taken. Food preferences registered at the time of the investigation were indicated on a visual analogue scale (0-100). RESULTS We did not find any statistically significant association between women's serum hormone levels and the rating of visually presented food, either during the menstrual cycle or during fertility treatments after controlling for multiple testing (all p > 0.005). Ratings for fruits, vegetables, and carbohydrates showed a significant linear decline throughout the first menstrual cycle (p < 0.01), which did not replicate in the second cycle (p > 0.05). In contrast, the ratings for sweets showed a significant linear decline in both cycles (both p < 0.01), with a mean rating of 54.2 and 48.8 in the menstrual phase of the first and second cycle, respectively, to a mean rating of 47.7 and 43.4 in the premenstrual phase of the first and second cycle, respectively. During fertility treatments, no food rating showed a significant change (all p > 0.05). Mood such as negative and positive affects did not influence ratings for visual food cues neither throughout the menstrual cycles nor during fertility treatment. CONCLUSIONS Serum levels of estradiol and progesterone do not correlate with food ratings in women, even when estradiol levels are above the physiological level of a natural menstrual cycle. Since, except for sweets, significant changes in food ratings in a first cycle did not replicate in a second menstrual cycle, significant findings from the literature based on animal or human studies focusing on a single-cycle have to be interpreted with caution.
Collapse
Affiliation(s)
- Marie Lefebvre
- Department of Reproductive Endocrinology, University hospital Zürich, 8910 Zurich, Frauenklinikstr. 10, Switzerland
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University for Applied Sciences (ZHAW), Zürich, Switzerland
| | - Enrico Tronci
- Department of Computer Science, University of Roma "La Sapienza", Roma, Italy
| | - Toni Mancini
- Department of Computer Science, University of Roma "La Sapienza", Roma, Italy
| | - Fabian Ille
- Center of Competence in Aerospace Biomedical Science & Technology, Lucerne University of Applied Sciences and Arts, Hergiswil, Switzerland
| | - Susanna Röblitz
- Computational Biology Unit, Department of Informatics, University of Bergen, Bergen, Norway
| | - Tillmann Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University hospital Zürich, 8910 Zurich, Frauenklinikstr. 10, Switzerland.
| |
Collapse
|
13
|
Fikrie A, Yalew A, Anato A, Teklesilasie W. Magnitude and effects of food cravings on nutritional status of pregnant women in Southern Ethiopia: A community-based cross sectional study. PLoS One 2022; 17:e0276079. [PMID: 36227946 PMCID: PMC9560518 DOI: 10.1371/journal.pone.0276079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Food cravings is a strong and intense urge to consume a specific food and reported as being associated with overweight and overall caloric intake in pregnant women. However, the nutritional and anthropometric consequences are not well recognized. Therefore, this study aimed to assess magnitude and effects of food cravings on nutritional status of pregnant women in Southern Ethiopia. METHODS A community-based cross-sectional study conducted among 586 randomly selected pregnant mothers at Sidama Regional State from June 1-20, 2019. Pre-tested and semistructured face-to-face interview questionnaires used to collect the data. The data were cleaned, coded, and entered into Epi Data version 3.1 and analysed using SPSS IBM version 20. The bi-variable and multivariable logistic regression used to identify the possible factors of food cravings. Principal component analysis used to determine the wealth status of the study participants. Adjusted Odds Ratio (AOR) together with 95% Confidence Intervals (CIs) used to declare statistical significance. RESULTS The study found that nearly three in five, 309 (58.3%) [95%, CI: 54.2%-62.8%] of the study participants reported food cravings. Meat (71.5%) and Fruits (41.7%) were the most frequently craved. About one-third, 194 (36.6%) of the study participants were undernourished (MUAC < 23 cm). Age of women (20-34 years), government employed, Antenatal Care (ANC), Pica practice, lowest wealth quintile, and skipping meals were statistically associated with food cravings. Whereas, wealth quintile and ability to consume craved food were factors associated with the nutritional status of pregnant women. Moreover, our study result found that maternal undernutrition and food cravings were statistically associated (p<0.001). CONCLUSION The prevalence of food cravings in this study is comparable to the global level. However, the magnitude of undernutrition found to be higher. Thus, health care providers need to take every opportunity to encourage women to adopt healthful dietary practices during pregnancy.
Collapse
Affiliation(s)
- Anteneh Fikrie
- School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
- * E-mail:
| | - Abel Yalew
- Medical Director, Abel Medium Clinic, Gondar Town, Northern Ethiopia
| | - Anchamo Anato
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Wondwosen Teklesilasie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Southern Ethiopia
| |
Collapse
|
14
|
Haddad-Tóvolli R, Ramírez S, Muñoz-Moreno E, Milà-Guasch M, Miquel-Rio L, Pozo M, Chivite I, Altirriba J, Obri A, Gómez-Valadés AG, Toledo M, Eyre E, Bortolozzi A, Valjent E, Soria G, Claret M. Food craving-like episodes during pregnancy are mediated by accumbal dopaminergic circuits. Nat Metab 2022; 4:424-434. [PMID: 35379970 DOI: 10.1038/s42255-022-00557-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Preparation for motherhood requires a myriad of physiological and behavioural adjustments throughout gestation to provide an adequate environment for proper embryonic development1. Cravings for highly palatable foods are highly prevalent during pregnancy2 and contribute to the maintenance and development of gestational overweight or obesity3. However, the neurobiology underlying the distinct ingestive behaviours that result from craving specific foods remain unknown. Here we show that mice, similarly to humans, experience gestational food craving-like episodes. These episodes are associated with a brain connectivity reorganization that affects key components of the dopaminergic mesolimbic circuitry, which drives motivated appetitive behaviours and facilitates the perception of rewarding stimuli. Pregnancy engages a dynamic modulation of dopaminergic signalling through neurons expressing dopamine D2 receptors in the nucleus accumbens, which directly modulate food craving-like events. Importantly, persistent maternal food craving-like behaviour has long-lasting effects on the offspring, particularly in males, leading to glucose intolerance, increased body weight and increased susceptibility to develop eating disorders and anxiety-like behaviours during adulthood. Our results reveal the cognitively motivated nature of pregnancy food cravings and advocates for moderating emotional eating during gestation to prevent deterioration of the offspring's neuropsychological and metabolic health.
Collapse
Affiliation(s)
- Roberta Haddad-Tóvolli
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Sara Ramírez
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Emma Muñoz-Moreno
- Experimental 7T MRI Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria Milà-Guasch
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Lluis Miquel-Rio
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Macarena Pozo
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Iñigo Chivite
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordi Altirriba
- Laboratory of Metabolism, Department of Internal Medicine Specialties, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Arnaud Obri
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alicia G Gómez-Valadés
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miriam Toledo
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Eyre
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Analia Bortolozzi
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Guadalupe Soria
- Experimental 7T MRI Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Laboratory of Surgical Neuroanatomy, Faculty of Medicine and Health Sciences, Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
- CIBER de Bioingeniera, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Marc Claret
- Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
- School of Medicine, Universitat de Barcelona, Barcelona, Spain.
| |
Collapse
|
15
|
Mehrabi F, Ahmaripour N, Jalali-Farahani S, Amiri P. Barriers to weight management in pregnant mothers with obesity: a qualitative study on mothers with low socioeconomic background. BMC Pregnancy Childbirth 2021; 21:779. [PMID: 34789171 PMCID: PMC8597093 DOI: 10.1186/s12884-021-04243-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal obesity is a public health issue that could affect both women's and children's health. This qualitative study aimed to identify barriers to weight management of pregnant women with obesity and low socioeconomic backgrounds. METHODS The current qualitative study has been conducted using a grounded theory approach by analyzing data collected from in-depth interviews with clients of Tehran's public health care centers for prenatal care. The criteria for selecting participants were excessive weight gain during the first two trimesters of pregnancy, low socioeconomic status, and willingness to share their experiences. A semi-structured guide consisting of open-ended questions was asked in a private room. Open, axial, and selective coding were applied to the data. FINDINGS Four main themes emerged from data, each of which has some subcategories: 1) personal factors (unpleasant emotions and feelings, personal tastes/hobbies, workload and responsibilities, and history of diseases), 2) pregnancy status (unintended and high-risk pregnancy), 3) interpersonal relationships and support (lack of a spouse's support and unhealthy role modeling of relatives), 4) socio-cultural factors/influences (social norms and values, lack of access to health services, and unreliable information channels). CONCLUSIONS This study provides an overview of the barriers to the weight management of pregnant women from low socioeconomic backgrounds. The results could help develop appropriate health strategies for low socioeconomic women with obesity. Also, health care providers for this group of women could use these findings as a guide to consider their conditions and background.
Collapse
Affiliation(s)
- Fahimeh Mehrabi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Najva Ahmaripour
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
| |
Collapse
|
16
|
Groth SW, Meng Y, Yeh KL, Fernandez ID. Influence of Appetite and Perceived Ability to Control Cravings on Excessive Gestational Weight Gain. J Obstet Gynecol Neonatal Nurs 2021; 50:669-678. [PMID: 34474006 PMCID: PMC8594632 DOI: 10.1016/j.jogn.2021.08.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To explore whether appetite is associated with gestational weight gain (GWG) and to assess the effect of perceived ability to control cravings on excessive GWG. DESIGN Secondary data analysis. SETTING Rochester, New York, United States. PARTICIPANTS Women who were pregnant (N = 1,005) and participated in a randomized controlled trial to test the effect of electronically mediated interventions to prevent excessive GWG and postpartum weight retention. METHODS We used two questions to assess appetite and perceived ability to control cravings before 28 weeks gestation: "How would you describe your appetite now compared to times when you are not pregnant?" and "How sure are you that you will be able to avoid overeating when you have cravings?" We conducted logistic regression to assess the relationships between appetite, perceived ability to control cravings, and excessive GWG. RESULTS More than 47% of participants gained excessive weight during pregnancy. Approximately 62% of participants reported being hungrier, and more than 42% indicated that they were unsure they could avoid overeating with cravings. Participants who reported similar/less appetite than before pregnancy were less likely to gain excessive weight (p < .05). Participants who were sure they could control cravings were less likely to gain excessive weight (p = .02). CONCLUSION Our results show that appetite and perceived ability to control cravings may affect GWG. Additional research is needed to assess if interventions targeting appetite and craving control could limit GWG.
Collapse
|
17
|
Giacobbi P, Symons Downs D, Haggerty T, Pidhorskyi S, Long DL, Clemmer M, Steinman SA, Olfert MD, Kinnamon K, Rao N, Staggs H, Adjeroh D. Feasibility and Acceptability of Guided Imagery to Sequentially Address Multiple Health Behaviors During Pregnancy. J Midwifery Womens Health 2021; 66:664-670. [PMID: 34510697 DOI: 10.1111/jmwh.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 03/26/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Pregnancy presents health challenges related to well-being, physical activity, dietary regulation, and body image. There is evidence to support the use of guided imagery to address these concerns during pregnancy. The purpose of this study was to analyze the use and short-term outcomes of a multiple-behavior guided imagery intervention delivered through a mobile health (mHealth) application for pregnant women. METHODS A single-arm, 5-week feasibility trial was conducted, and participants were instructed to listen to an audio file every day for 35 days on an mHealth application. Measurements included ongoing assessments of the participants' use of the guided imagery audio files and pre- and post-test measures of depression, anxiety, stress, physical activity, food cravings, and body image. Postintervention qualitative interviews were conducted to assess whether participants would continue to use guided imagery. RESULTS Fifty-eight participants (mean age, 28.5 years) were enrolled from January to June of 2018. Cloud analytics data showed an average of 4.96 audio downloads per week with the Sleep and Relaxation file being the most widely used (mean weekly usage, 5.67) and reported favorite during follow-up interviews. Paired-sample t tests from pre- to post-test showed significant reductions in depression, anxiety, and stress, increased physical activity, and sedentary behavior along with some changes in body image. DISCUSSION Future scalable guided imagery interventions are justified to test for efficacy. Guided imagery may also be delivered in person by health care providers or by using widely available technologies.
Collapse
Affiliation(s)
- Peter Giacobbi
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia.,Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Danielle Symons Downs
- Department of Kinesiology, College of Health and Human Development, Penn State University, State College, Pennsylvania.,Department of Obstetrics and Gynecology, College of Health and Human Development, Penn State University, State College, Pennsylvania
| | - Treah Haggerty
- Department of Family Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Stanislav Pidhorskyi
- Lane Department of Computer Science and Electrical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama Birmingham, Birmingham, Alabama
| | - Melanie Clemmer
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Shari A Steinman
- Department of Psychology, College of Liberal Arts and Sciences, West Virginia University, Morgantown, West Virginia
| | - Melissa D Olfert
- Department of Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, West Virginia
| | - Kelsey Kinnamon
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Neel Rao
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Hannah Staggs
- Department of Sport Sciences, College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, West Virginia
| | - Donald Adjeroh
- Lane Department of Computer Science and Electrical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia
| |
Collapse
|
18
|
Patel P, Mannion C. Maternal Impressions of the New 2019 Canadian Food Guide Snapshot. CAN J DIET PRACT RES 2021; 82:192-195. [PMID: 34286616 DOI: 10.3148/cjdpr-2021-014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This qualitative study explored the impressions of pregnant Canadian women toward Canada's Food Guide (CFG) snapshot released in January 2019. Semi-structured interviews were conducted with 8 physically active pregnant women. Interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis. Three themes emerged: (i) pregnancy changes what I eat; (ii) what is healthy to me? and (iii) a connection with people and food. Pregnancy was the primary factor influencing dietary changes, and messages in the snapshot reinforced some dietary behaviours that participants had already incorporated. Participants wanted information specific to pregnancy but were not aware of available resources pertaining to nutrition on existing websites. Dietitians and other health care professionals should take steps to raise awareness of and ensure wider dissemination of reliable resources on healthy eating during pregnancy including Canada's Food Guide website.
Collapse
Affiliation(s)
- Palak Patel
- Undergraduate Student, Faculty of Kinesiology, University of Calgary, Calgary, AB
| | | |
Collapse
|
19
|
Kibr G. A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia. ScientificWorldJournal 2021; 2021:5580039. [PMID: 34248425 PMCID: PMC8236338 DOI: 10.1155/2021/5580039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
Collapse
Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, P. O. Box: 38, Shambu, Ethiopia
| |
Collapse
|
20
|
Giesbrecht GF, Bagshawe M, van Sloten M, MacKinnon AL, Dhillon A, van de Wouw M, Vaghef-Mehrabany E, Rojas L, Cattani D, Lebel C, Tomfohr-Madsen L. Protocol for the Pregnancy During the COVID-19 Pandemic (PdP) Study: A Longitudinal Cohort Study of Mental Health Among Pregnant Canadians During the COVID-19 Pandemic and Developmental Outcomes in Their Children. JMIR Res Protoc 2021; 10:e25407. [PMID: 33848971 PMCID: PMC8080963 DOI: 10.2196/25407] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and countermeasures implemented by governments around the world have led to dramatically increased symptoms of depression and anxiety. Pregnant individuals may be particularly vulnerable to the negative psychological effects of COVID-19 public health measures because they represent a demographic that is most affected by disasters and because pregnancy itself entails significant life changes that require major psychosocial and emotional adjustments. OBJECTIVE The PdP study was designed to investigate the associations among exposure to objective hardship caused by the pandemic, perceived stress and psychological distress in pregnant individuals, and developmental outcomes in their offspring. METHODS The PdP study comprises a prospective longitudinal cohort of individuals who were pregnant at enrollment, with repeated follow-ups during pregnancy and the postpartum period. Participants were eligible if they were pregnant, ≥17 years old, at ≤35 weeks of gestation at study enrollment, living in Canada, and able to read and write in English or French. At enrollment, participants completed an initial survey that assessed demographic and socioeconomic characteristics, previous pregnancies and births, prepregnancy health, health conditions during pregnancy, medications, psychological distress, social support, and hardships experienced because of the COVID-19 pandemic (eg, lost employment or a loved one dying). For the first three months following the initial survey, participants received a monthly email link to complete a follow-up survey that asked about their experiences since the previous survey. After three months, follow-up surveys were sent every other month to reduce participant burden. For each of these surveys, participants were first asked if they were still pregnant and then routed either to the next prenatal survey or to the delivery survey. In the postpartum period, surveys were sent at 3, 6, and 12 months of infant age to assess maternal stress, psychological distress, and infant development. RESULTS Participant recruitment via social media (Facebook and Instagram) began on April 5, 2020, and is ongoing. As of April 2021, more than 11,000 individuals have started the initial survey. Follow-up data collection is ongoing. CONCLUSIONS This longitudinal investigation seeks to elucidate the associations among hardships, maternal psychological distress, child development during the COVID-19 pandemic, and risk and resilience factors that amplify or ameliorate these associations. The findings of this study are intended to generate knowledge about the psychological consequences of pandemics on pregnant individuals and point toward prevention and intervention targets. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25407.
Collapse
Affiliation(s)
- Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | | | - Anna L MacKinnon
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Ashley Dhillon
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | | | - Laura Rojas
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Danielle Cattani
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
21
|
What stops us from eating: a qualitative investigation of dietary barriers during pregnancy in Punjab, Pakistan. Public Health Nutr 2021; 25:760-769. [PMID: 33866982 DOI: 10.1017/s1368980021001737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab. DESIGN In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis. SETTING Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan. PARTICIPANTS Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n 12). RESULTS We identified a combination of physiological, socio-cultural and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified. CONCLUSIONS Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake and that antenatal health education programmes and structural interventions are needed to support healthful dietary practices during this critical period.
Collapse
|
22
|
Gyimah LA, Annan RA, Apprey C, Edusei A, Aduku LNE, Asamoah-Boakye O, Azanu W, Lutterodt H. Dietary diversity and its correlates among pregnant adolescent girls in Ghana. PLoS One 2021; 16:e0247979. [PMID: 33684165 PMCID: PMC7939348 DOI: 10.1371/journal.pone.0247979] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/17/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Dietary diversity, a qualitative measure of dietary intake, which reflects the variety of foods consumed has been recommended to assuage nutritional problems related to insufficient micronutrients, and food insecurity. To better understand the underlying factors for poor birth outcomes in Ghana, we assessed factors associated with dietary diversity among rural and urban pregnant adolescents in the Ashanti Region of Ghana. METHODS As part of a larger longitudinal cohort of 416 pregnant adolescents, the FAO minimum dietary diversity for women index was used to determine the dietary diversity score (DDS) of the participants from a previous days' 24-hour dietary recall data. The household hunger scale (HHS) and lived poverty index (LPI) were used to determine hunger and socioeconomic status. Eating behavior and socio-demographic data were gathered using interviewer-administered questionnaires. RESULTS The mean age of the participants was 17.5 (±1.4) years with an MDD-W of 4.4 and 56% recording inadequate MDD score. More rural (63.6%) than urban dwellers (50.6%) had inadequate DDS (p = 0.008). Among all the multiple variables tests of associations on dietary diversity, only hunger status (p = 0.028) and both food aversion and poverty status (p = 0.003) had a significant effect on the adolescents' dietary diversity. Rural dwelling adolescents (AOR = 1.7, p = 0.035, 95% CI = 1.0-2.6) recorded higher odds for inadequate DD compared with the urban respondents. Pregnant adolescents with severe hunger had higher odds (Unadjusted OR = 1.9, p = 0.053, 95% CI 1.1-3.8) for inadequate dietary diversity compared with those with no hunger. CONCLUSIONS Inadequate DD is common among pregnant adolescents in this study and is associated with rural living, food insecurity, poverty, and food craving. Livelihood support for pregnant teenagers and nutrition education are recommended interventions to improve dietary quality and limit the consequences of poor dietary diversity.
Collapse
Affiliation(s)
- Linda Afriyie Gyimah
- Faculty of Biosciences, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Reginald Adjetey Annan
- Faculty of Biosciences, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- Faculty of Biosciences, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony Edusei
- Department of Community Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Nana Esi Aduku
- Faculty of Biosciences, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Odeafo Asamoah-Boakye
- Faculty of Biosciences, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Azanu
- Department of Obstetrics and Gynecology, University of Allied Health Sciences, Ho, Ghana
| | - Herman Lutterodt
- Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
23
|
Appiah PK, Naa Korklu AR, Bonchel DA, Fenu GA, Wadga-Mieza Yankey F. Nutritional Knowledge and Dietary Intake Habits among Pregnant Adolescents Attending Antenatal Care Clinics in Urban Community in Ghana. J Nutr Metab 2021; 2021:8835704. [PMID: 33628495 PMCID: PMC7896850 DOI: 10.1155/2021/8835704] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Proper nutrition during pregnancy is important for the wellbeing of the mother and foetus and supports health during pregnancy, delivery, and breastfeeding. However, there are little data on nutritional knowledge and dietary intake among adolescents who are pregnant in Ghana. Hence, the study assessed the nutritional knowledge and eating habits of this vulnerable group in the Ledzokuku-Krowor Municipality, Ghana. METHODS The study was cross-sectional and employed a multistage sampling technique to select 423 participants. The study was conducted between October and November 2019. A statistical software was used to analyse data and employed Pearson's chi-square and logistics regression to assess associations between the outcome and predictor variables. A p value <0.05 at a 95% confidence interval was considered statistically significant. RESULTS Less than half (44.9%) of the pregnant adolescents have high nutritional knowledge. About 19.4% of them have good eating habits, while 23.9%, 18.2%, and 6.4% of them do not take breakfast, lunch, and supper, respectively. However, 15.6%, 13.9%, and 9.2% do take snacks after breakfast, lunch, and supper, respectively. About 55.9%, 59.8%, and 23.0% do not take their breakfast, lunch, and supper on time, respectively. Additionally, only 3.8% of them do take fruits and vegetables daily, while 9.7%, 23.2%, 30.0%, and 26.5% of them do take animal products, energy drinks, carbonated drinks, and legumes/nuts/seeds daily, respectively. The study showed that educational level (p=0.014), occupation (p=0.016), ethnicity (p=0.017), and number of pregnancies (p=0.021) were associated with good eating habits. CONCLUSION Eating habit of adolescent pregnant women was not encouraging. Therefore, the municipal health authority with the concerned stakeholders should intensify efforts, including nutritional education to improve good eating habits, such as taking snacks in between meals, eating on time, and balance diet among pregnant adolescents, and to reduce adolescent pregnancy in the municipality.
Collapse
Affiliation(s)
- Prince Kubi Appiah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Anang Rhoda Naa Korklu
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | | | - Georgina Agartha Fenu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | | |
Collapse
|
24
|
Yu ZM, Van Blyderveen S, Schmidt L, Lu C, Vanstone M, Biringer A, Sword W, Beyene J, McDonald SD. Predictors of Gestational Weight Gain Examined As a Continuous Outcome: A Prospective Analysis. J Womens Health (Larchmt) 2021; 30:1006-1015. [PMID: 33439752 DOI: 10.1089/jwh.2020.8799] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Excess gestational weight gain (GWG) is common and adversely affects both mothers and offspring, including increasing the risk of maternal and childhood obesity. GWG is typically examined categorically, with women grouped into categories of those who gain above, within, and below guideline recommendations. Examining GWG as a continuous variable, rather than categorically, allows for a consideration of GWG at a finer level of detail, increasing precision. Methods: We collected exposure data among 970 pregnant women in early gestation using a standardized questionnaire in Ontario, Canada, from 2015 to 2017. Maternal weight and height were extracted from antenatal records. Continuous GWG was calculated using four methods: percentage of ideal weight gain, excess GWG, GWG adequacy ratio, and GWG z-score. We used the stepwise linear regression analyses to select variables associated with GWG. Results: We found that a common set of variables (parity, prepregnancy body mass index, planned pregnancy weight gain, smoking, pregnancy-related food cravings, and fast food intake) significantly predicted GWG in a manner consistent across the four GWG outcomes. Certain psychological factors, including the perception of families' and friends' attitudes toward the food cravings of pregnant women, emotion suppression, compensatory health beliefs coupled with eating unhealthy foods, frequent prepregnancy dietary restraint in carbohydrates, sugar, and meals, preferred prepregnancy body size image, agreeable and conscientious personalities, and depression, also were related with GWG. Conclusions: Our findings demonstrate that psychological factors play an important role in the magnitude of GWG, providing key avenues to inform interventions to support healthy weight gain in pregnancy.
Collapse
Affiliation(s)
- Zhijie Michael Yu
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Sherry Van Blyderveen
- New Leaf Psychology Centre, Milton, Canada.,Eating Disorders Program at Homewood Health Centre, Guelph, Canada
| | - Louis Schmidt
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Canada
| | - Cathy Lu
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Anne Biringer
- Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Toronto, Canada
| | - Wendy Sword
- School of Nursing, McMaster University, Hamilton, Canada
| | - Joseph Beyene
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Department of Radiology, McMaster University, Hamilton, Canada
| |
Collapse
|
25
|
Nansel TR, Lipsky LM, Faith M, Liu A, Siega-Riz AM. The accelerator, the brake, and the terrain: associations of reward-related eating, self-regulation, and the home food environment with diet quality during pregnancy and postpartum in the pregnancy eating attributes study (PEAS) cohort. Int J Behav Nutr Phys Act 2020; 17:149. [PMID: 33228724 PMCID: PMC7684737 DOI: 10.1186/s12966-020-01047-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/29/2020] [Indexed: 01/04/2023] Open
Abstract
Background Neurobehavioral factors, including reward-related eating and self-regulation, in conjunction with the food environment, may influence dietary behaviors. However, these constructs have not been examined in pregnancy and postpartum, a time of changing appetite and eating behaviors, and when dietary intake has implications for maternal and child health. This study examined associations of reward-related eating, self-regulation, and the home food environment with pregnancy and postpartum diet quality. Methods Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks gestation and followed through one-year postpartum. Pregnancy and postpartum Healthy Eating Index-2015 (HEI-total), and adequacy and moderation scores, respectively, were calculated by pooling 24-h diet recalls administered each trimester and during 2, 6, and 12 months postpartum. Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale (mYFAS), Power of Food Scale (PFS), Multiple Choice Procedure (MCP), and Reinforcing Value of Food Questionnaire (RVFQ); two measures of self-regulation – Barratt Impulsiveness Scale (BIS) and Delay of Gratification Inventory (DGI); and a Home Food Inventory (HFI), yielding obesogenic (OBES) and fruit/vegetables (FV) scores. Linear regression analyses estimated associations of reward-related eating, self-regulation, and home food environment with diet quality during pregnancy and postpartum, adjusting for sociodemographic characteristics. Results Pregnancy HEI-total was inversely associated with PFS (β = − 0.14 ± 0.05, p = 0.009), mYFAS(β = − 0.14 ± 0.06, p = 0.02), 2 of the 5 RVFQ indices, MCP (β = − 0.14 ± 0.05, p = 0.01), and DGI food subscale (β = 0.23 ± 0.05, p < 0.001), but associations of postpartum HEI-total with reward-related eating measures and self-regulation were small and not statistically significant. Pregnancy and postpartum HEI-total were associated inversely with HFI-OBES (β = − 0.17 ± 0.06, p = 0.004 and β = − 0.19 ± 0.07, p = 0.006, respectively), and positively with HFI-FV (β = 0.21 ± 0.05, p < 0.001 and β = 0.17 ± 0.06, p = 0.009, respectively). Conclusions Associations of poorer diet quality with greater reward-related eating during pregnancy but not postpartum suggests the need to better understand differences in the determinants of eating behaviors and approaches to circumvent or moderate reward-related eating to facilitate more optimal diet quality across this critical period. Trial registration Clinicaltrials.gov. URL – Registration ID – NCT02217462. Date of registration – August 13, 2014.
Collapse
Affiliation(s)
- Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA.
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA
| | - Myles Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, 420 Baldy Hall, University at Buffalo - SUNY, Buffalo, NY, 14250-1000, USA.,Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA
| | - Anna Maria Siega-Riz
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599, USA.,Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 109 Arnold House, 715 Pleasant St, Amherst, MA, 01003-9303, USA
| |
Collapse
|
26
|
Casas R, Castro Barquero S, Estruch R. Impact of Sugary Food Consumption on Pregnancy: A Review. Nutrients 2020; 12:E3574. [PMID: 33266375 PMCID: PMC7700555 DOI: 10.3390/nu12113574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity in pregnancy has been directly associated with an increased risk of almost all pregnancy complications such as gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and premature delivery. Thereby, according to current evidence available, life-style interventions to prevent pre-pregnancy overweight and obesity in women of fertile age are necessary to reduce the negative impact of obesity on mother and child health. Unhealthy dietary patterns, together with the increased consumption of processed foods rich in simple sugar and sweeteners are some of the responsible, among others, for the increase in obesity rates during the last years. Nevertheless, how its consumption can affect pregnancy outcomes and long-term children's health is still uncertain. This review aims to collate the available evidence about the consequences of unhealthy dietary patterns and sugary products consumption, including sweeteners, during pregnancy for obesity in childhood and mid-childhood. High simple sugar intake during gestation may contribute to an excessive gestational weight gain (GWG) as well as to develop other pregnancy complications such as GDM, preeclampsia and preterm birth. The heterogeneity of study populations, sample size, different approaches to measure GWG, GMD, preeclampsia, and birth weight, among other conditions, might explain the divergences observed among studies. Therefore, large, well-designed intervention-controlled trials with biological biomarkers to ensure dietary adherence are necessary to evaluate the effectiveness of lifestyle interventions in order to provide effective nutritional advice.
Collapse
Affiliation(s)
- Rosa Casas
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sara Castro Barquero
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; (S.C.B.); (R.E.)
- CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
27
|
Abstract
PURPOSE OF REVIEW Dieting is often blamed for causing food cravings. Such diet-induced cravings may be mediated by physiological (e.g., nutritional deprivation) or psychological (e.g., ironic effects of food thought suppression) mechanisms. However, this notion is often based on cross-sectional findings and, thus, the causal role of food deprivation on food cravings is unclear. RECENT FINDINGS Experimental studies suggest that a short-term, selective food deprivation seems to indeed increase cravings for the avoided foods. However, experimental studies also show that food craving can be understood as a conditioned response that, therefore, can also be unlearned. This is supported by intervention studies which indicate that long-term energy restriction results in a reduction of food cravings in overweight adults. Dieting's bad reputation for increasing food cravings is only partially true as the relationship between food restriction and craving is more complex. While short-term, selective food deprivation may indeed increase food cravings, long-term energy restriction seems to decrease food cravings, suggesting that food deprivation can also facilitate extinction of conditioned food craving responses.
Collapse
Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
- Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany.
| |
Collapse
|
28
|
Dietary Knowledge and Myths Vary by Age and Years of Schooling in Pregnant Mexico City Residents. Nutrients 2020; 12:nu12020362. [PMID: 32019156 PMCID: PMC7071333 DOI: 10.3390/nu12020362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 01/09/2023] Open
Abstract
Pregnancy is a stage in a woman’s life when she is more open to receiving health advice, especially related to diet. However, women are often caught between receiving scientifically unfounded myths and concrete empirical knowledge. Culturally perpetuated myths may be acted upon more than knowledge, but research on these concepts, especially in the Americas, is scarce. This cross-sectional study aimed to describe the frequency of diet and nutrition myths and knowledge and describe the associated factors in pregnant mothers receiving care in Mexico City. A total of 695 pregnant adults and 322 pregnant adolescents participated in this study, in which they responded to a questionnaire on nutrition and diet myths, knowledge, and practice during pregnancy and breastfeeding. The myths were examined individually, but for the purposes of statistical analysis, a score was obtained. We compared means of variables that could be associated to myth and knowledge scores, then calculated linear and logistical regressions. Forty-six percent of participants had below the mean myth scores. Ninety-two percent of participants had a knowledge score below the mean. Age (β = 0.025, SE 0.007, 95% CI 0.011–0.040, p = 0.001) and years of education (β = 0.166, SE 0.024, 95% CI 0.119–0.213, p = 0.001) explained the myth’s score, while age explained the knowledge score (β = 0.011, SE 0.020, 95% CI −0.032–−0.008, p = 0.002). We found that although most women reported not believing in the myths, they acted on them. The probability of practicing such myths as “You must eat for two during pregnancy” was associated with being an adolescent (OR 1.76, p = 0.001) and being married (OR 1.47, p = 0.007), “Not satisfying cravings leave a mark on the infant’s body” with being adolescent (OR 1.59, p = 0.003) and low socioeconomic level (OR 1.41, p = 0.038), “A frightened or angry mother should not nurse her baby” with being adult (OR 2.61, p = 0.004), and “Drinking atole or beer enhances breast milk production” with being single (OR 2.07, p = 0.001). The probability of not acting on some knowledge was associated with being an adolescent (p ≤ 0.003) and having a high school education or below (p ≤ 0.046). Almost all of our participants held at least one myth about nutrition and diet during pregnancy and breastfeeding; younger participants showed a higher frequency of holding myths. Years of schooling and age were associated with acting on myths and not acting on correct knowledge.
Collapse
|
29
|
Sebastiani G, Andreu-Fernández V, Herranz Barbero A, Aldecoa-Bilbao V, Miracle X, Meler Barrabes E, Balada Ibañez A, Astals-Vizcaino M, Ferrero-Martínez S, Gómez-Roig MD, García-Algar O. Eating Disorders During Gestation: Implications for Mother's Health, Fetal Outcomes, and Epigenetic Changes. Front Pediatr 2020; 8:587. [PMID: 33042925 PMCID: PMC7527592 DOI: 10.3389/fped.2020.00587] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Eating disorders (EDs) have increased globally in women of childbearing age, related to the concern for body shape promoted in industrialized countries. Pregnancy may exacerbate a previous ED or conversely may be a chance for improving eating patterns due to the mother's concern for the unborn baby. EDs may impact pregnancy evolution and increase the risk of adverse outcomes such as miscarriage, preterm delivery, poor fetal growth, or malformations, but the knowledge on this topic is limited. Methods: We performed a systematic review of studies on humans in order to clarify the mechanisms underpinning the adverse pregnancy outcomes in patients with EDs. Results: Although unfavorable fetal development could be multifactorial, maternal malnutrition, altered hormonal pathways, low pre-pregnancy body mass index, and poor gestational weight gain, combined with maternal psychopathology and stress, may impair the evolution of pregnancy. Environmental factors such as malnutrition or substance of abuse may also induce epigenetic changes in the fetal epigenome, which mark lifelong health concerns in offspring. Conclusions: The precocious detection of dysfunctional eating behaviors in the pre-pregnancy period and an early multidisciplinary approach comprised of nutritional support, psychotherapeutic techniques, and the use of psychotropics if necessary, would prevent lifelong morbidity for both mother and fetus. Further prospective studies with large sample sizes are needed in order to design a structured intervention during every stage of pregnancy and in the postpartum period.
Collapse
Affiliation(s)
- Giorgia Sebastiani
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Vicente Andreu-Fernández
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Valencian International University (VIU), Valencia, Spain
| | - Ana Herranz Barbero
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Victoria Aldecoa-Bilbao
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Xavier Miracle
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Eva Meler Barrabes
- Fetal i+D Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Arantxa Balada Ibañez
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Marta Astals-Vizcaino
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Silvia Ferrero-Martínez
- Hospital Sant Joan de Déu, Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - María Dolores Gómez-Roig
- Hospital Sant Joan de Déu, Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Oscar García-Algar
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain.,Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| |
Collapse
|
30
|
Blau LE, Lipsky LM, Dempster KW, Eisenberg Colman MH, Siega-Riz AM, Faith MS, Nansel TR. Women's Experience and Understanding of Food Cravings in Pregnancy: A Qualitative Study in Women Receiving Prenatal Care at the University of North Carolina-Chapel Hill. J Acad Nutr Diet 2019; 120:815-824. [PMID: 31813756 DOI: 10.1016/j.jand.2019.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although the occurrence of food cravings during pregnancy is well established, there is a paucity of qualitative data on pregnant women's perceptions of and responses to food cravings. This study sought to assess and describe pregnant women's experiences and behaviors pertaining to food cravings. METHODS Eight focus groups were conducted with 68 pregnant women in their second trimester from March 2015 to October 2016. Using a semistructured approach, the facilitator asked women open-ended questions regarding their experience of eating behaviors and food cravings. The content from the focus groups was analyzed using a bottom-up approach based on grounded theory and constant comparison analysis. RESULTS Participants described cravings as urgent, food-specific, and cognitively demanding occurrences that were differentiated from hunger. They described beliefs surrounding the physiological causes of cravings and rationales for satisfying their cravings. Strategies used to manage cravings included environmental modifications to limit proximity and availability of craved foods, cognitive and behavioral strategies like distraction, and acceptance through satisfying the craving. Participants described food cravings as a psychologically salient aspect of their pregnancy, reporting a variety of emotional precursors and reactions surrounding their cravings. CONCLUSIONS A better understanding of food cravings may assist with the development of interventions to improve eating behaviors and reduce eating-related distress during pregnancy. Acceptance regarding food cravings was indicated as a way to diffuse pregnancy-related stress. These findings contribute to our understanding of psychological influences on eating behaviors in pregnant women.
Collapse
|
31
|
Holtzman J. Rice, beer, and salad: Varying constructions of "craving" in Japan. Appetite 2019; 142:104344. [PMID: 31325475 DOI: 10.1016/j.appet.2019.104344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/22/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
Food cravings are an important phenomena/concept within approaches to overeating in Western contexts. However, the cross-cultural research on craving has so far been modest, despite a wide range of literature in anthropology and other fields that demonstrate the broad variations not only in eating practices but in the experiences and motivations for eating. This examines quantitative data collected using a variation of the Food Craving Inventory (FCI) collected in the context of a long-term ethnographic study of Japanese eating practices in order to examine cravings within a mixed age and gender Japanese sample. While the results show widespread experiences of craving, not only do the types of foods craved vary markedly from commonplace Western ones-which tend to be calorie dense and restricted-but also differ from one another in motivations for/experiences of craving. Beyond providing cross-cultural comparison, then, the study suggests a need for conceptual rethinking of craving itself and of the range of factors that drive it.
Collapse
|
32
|
Kozonova J, Telegenko L, Salavelis A. THE SWEET ICES FOR PREGNANT WOMEN. FOOD SCIENCE AND TECHNOLOGY 2019. [DOI: 10.15673/fst.v13i1.1309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Daily food consumption norms of an average woman and a pregnant woman have been analysed. It has been established that in a pregnant woman’s diet, it is necessary to increase the content of proteins, fibre, vitamins C, E, D, PP, and B, and reduce fats, carbohydrates (easily digestible), vitamins B5 and H, sodium, magnesium, salts, and water. Taking into account the above-mentioned requirements, eight recipe compositions of sweet ices based on plant raw materials have been suggested. The recipes were selected by linear programming using MS Excel. The products have a low calorific content (26–137 kcal per 80 g), and an increased nutritional value (due to vitamin C, carotene, etc.). For the first time, cereals, various types of seeds, nuts, have been put into the recipe of sweet ices, as well as raw materials, which eliminate physiological complications during pregnancy. The products developed differ in their composition and are made without sugar. However, some recipes include small quantities of honey as it is highly palatable. The chemical composition of the new sweet products has been studied and analysed in details and sugar/acid indices have been calculated. The developed ices have a slightly acidic taste or no acidity at all, which corresponds to the values of sugar/acid indices 13.4–26.6, while the sample from the store, selected for comparison, contains a large amount of sugars, as evidenced by the cloying taste and high sugar/acid index (more than 30). The source of fatty acids in sweet ice for pregnant women Joy is almond nuts. The results of the chromatographic study have shown that this product as for the quantitative fatty acid composition, meets the current requirements. We recommend introducing the sweet ice manufacture technology on the equipment already in use in canneries. The products are formed (poured into moulds where wooden sticks are then inserted) in a Hassia machine. One of the main operations, freezing, is done in a quick freezer GyroFreze. We also recommend manufacturing sweet ices using existing restaurant equipment.
Collapse
|
33
|
Fasunla AJ, Nwankwo U, Onakoya PA, Oladokun A, Nwaorgu OG. Gustatory Function of Pregnant and Nonpregnant Women in a Tertiary Health Institution. EAR, NOSE & THROAT JOURNAL 2019; 98:143-148. [PMID: 30864460 DOI: 10.1177/0145561319833914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Physiological changes in pregnancy may cause taste dysfunction. The aim of this study was to determine and compare gustatory function of pregnant women with nonpregnant women and also to investigate the effect of pregnancy on gustatory function. It was a case-control study of consecutive 70 healthy pregnant women (cases) and 70 healthy nonpregnant women (control). Participants scored their taste perception on a visual analogue scale (1-10) and their gustatory function was assessed using "taste strips" impregnated with graded concentration of sweet, sour, salty, and bitter taste substances applied on tongue surfaces. Subjective mean gustatory score, correct identification of taste in the strips and total taste strip (TTS) score were compared between both groups and analysis was done using appropriate statistics. The mean age of pregnant women (30.5 [3.9]) and controls (28.5 [6.6]) were comparable. Twenty-one (30%) pregnant women changed their diet in first trimester due to change in taste sensation. Almost all cases developed craving for spicy and salty foods and, aversions to fish, beans, and vegetables. There was a significant difference in the subjective rating of taste perception between the 2 groups ( P = .037). About 2.9% of pregnant women have hypogeusia. There was a significant difference between pregnant and nonpregnant women in sour taste ( P = .006; 2.90 [0.71] vs 3.92 [0.82]) and TTS ( P = .02; 27.50 [3.48] vs 29.21 [2.69]) scores, respectively. In conclusion, gustatory function was reduced in pregnancy compared to nonpregnant women and this led to dietary change in some pregnant women.
Collapse
Affiliation(s)
- Ayotunde James Fasunla
- 1 Department of Otorhinolaryngology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Ukamaka Nwankwo
- 1 Department of Otorhinolaryngology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Paul Adekunle Onakoya
- 1 Department of Otorhinolaryngology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Adesina Oladokun
- 2 Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Onyekwere George Nwaorgu
- 1 Department of Otorhinolaryngology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| |
Collapse
|
34
|
Dietary Intake and Beliefs of Pregnant Women with Gestational Diabetes in Cape Town, South Africa. Nutrients 2018; 10:nu10091183. [PMID: 30154387 PMCID: PMC6164942 DOI: 10.3390/nu10091183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 12/24/2022] Open
Abstract
This study investigated the dietary intake of pregnant women with gestational diabetes mellitus (GDM) and their beliefs relating to the consumption of fruits and vegetables (F&V) and sugary foods and drinks. A cross-sectional study was conducted on 239 pregnant women with GDM in Cape Town. Dietary intake was assessed using a quantified Food Frequency Questionnaire and beliefs relating to food choices were assessed using the Theory of Planned Behaviour (TPB). The mean energy intake was 7268 KJ, carbohydrate was 220 (±104.5) g, protein 60.3 (±27.5) g and fat 67.7 (±44.2) g. The macronutrient distribution was 55% carbohydrates, 14.5% protein and 30.5% fat of total energy. The majority of the sample had inadequate intakes of vitamin D (87.4%), folate (96.5%) and iron (91.3%). The median (IQR) amount of added table sugar and sugar sweetened beverages (SSBs) was 4.0 (0.00–12.5) g and 17.9 (0.0–132.8) mL per day, respectively. Only 31.4% met the recommendation (400 g per day) for F&V. Beliefs that it was not easy to exclude sugary foods/drinks and that knowing how to control cravings for sugary foods/drinks are areas to target messages on the sugar content of SSBs. In conclusion, the dietary intake of these women was not optimal and fell short of several nutritional guidelines for pregnant women with hyperglycaemia. The strongly held beliefs regarding sugary foods/drinks may contribute to poor adherence to nutritional guidelines among pregnant women with GDM in South Africa.
Collapse
|
35
|
Bannatyne AJ, Hughes R, Stapleton P, Watt B, MacKenzie-Shalders K. Signs and symptoms of disordered eating in pregnancy: a Delphi consensus study. BMC Pregnancy Childbirth 2018; 18:262. [PMID: 29940882 PMCID: PMC6019208 DOI: 10.1186/s12884-018-1849-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 05/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to establish consensus on the expression and distinction of disordered eating in pregnancy to improve awareness across various health professions and inform the development of a pregnancy-specific assessment instrument. METHODS A three-round modified Delphi method was used with two independent panels. International clinicians and researchers with extensive knowledge on and/or clinical experience with eating disorders formed the first panel and were recruited using structured selection criteria. Women who identified with a lived experience of disordered eating in pregnancy formed the second panel and were recruited via expressions of interest from study advertising on pregnancy forums and social media platforms. A systematic search of academic and grey literature produced 200 sources which were used to pre-populate the Round I questionnaire. Additional items were included in Round II based on panel feedback in Round I. Consensus was defined as 75% agreement on an item. RESULTS Of the 102 items presented to the 26 professional panel members and 15 consumer panel members, 75 reached consensus across both panels. Both panels clearly identified signs and symptoms of disordered eating in pregnancy and endorsed a number of clinical features practitioners should consider when delineating disordered eating symptomatically from normative pregnancy experiences. CONCLUSION A list of signs and symptoms in consensus was identified. The areas of collective agreement may be used to guide clinicians in clinical practice, aid the development of psychometric tools to detect/assess pregnancy-specific disordered eating, in addition to serving as starting point for the development of a core outcome set to measure disordered eating in pregnancy.
Collapse
Affiliation(s)
- Amy Jean Bannatyne
- School of Psychology, Bond University, 14 University Drive, Robina, QLD, 4229, Australia. .,Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia.
| | - Roger Hughes
- School of Medicine, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7001, Australia
| | - Peta Stapleton
- School of Psychology, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
| | - Bruce Watt
- School of Psychology, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
| | - Kristen MacKenzie-Shalders
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4229, Australia
| |
Collapse
|
36
|
Coffino JA, Heiss S, Hormes JM. Targeting acceptance in the management of food craving: The mediating roles of eating styles and thought suppression. Eat Behav 2018; 29:132-136. [PMID: 29665461 DOI: 10.1016/j.eatbeh.2018.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
Food craving is now widely considered to be a cognitively motivated state. Acceptance-based treatments are effective in reducing the adverse impact of food cravings on consumption, via a hypothesized decrease in experiential avoidance. The mechanisms that drive the success of acceptance-based management of craving remain to be empirically tested. This study examined the role of eating styles and thought suppression as mediators in the relationship between experiential avoidance and craving. Participants (n = 298, 51.5% female) completed the Food Craving Acceptance and Awareness Questionnaire (FAAQ), the Dutch Eating Behavior Questionnaire (DEBQ), the White Bear Suppression Inventory (WBSI; a measure of thought suppression), and the reduced version of the Food Craving Questionnaire- Trait (FCQ-T-r). Scores on the FAAQ were inversely associated with scores on the FCQ-T-r, DEBQ, and WBSI; FCQ-T-r scores were positively correlated with scores on the DEBQ and WBSI (all p < 0.001). The total indirect effect of acceptance on craving through the hypothesized mediators was significantly different from zero. Controlling for eating styles and thought suppression, acceptance remained a significant predictor of craving. Results thus provide initial evidence that eating styles and thought suppression mediate the relationship between food-specific experiential avoidance and food craving. Findings lay the foundation for future study of the proximal antecedents of food cravings and lend preliminary support for targeting thought suppression and eating styles in acceptance-based approaches to the management of craving.
Collapse
Affiliation(s)
- Jaime A Coffino
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Sydney Heiss
- Department of Psychology, University at Albany, State University of New York, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA
| |
Collapse
|
37
|
Placek C. A test of four evolutionary hypotheses of pregnancy food cravings: evidence for the social bargaining model. ROYAL SOCIETY OPEN SCIENCE 2017; 4:170243. [PMID: 29134058 PMCID: PMC5666241 DOI: 10.1098/rsos.170243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/18/2017] [Indexed: 05/04/2023]
Abstract
The onset of cravings for items not typically desired is often considered a hallmark of pregnancy. Given the ubiquity of cravings, this phenomenon remains surprisingly understudied. The current study tested four hypotheses of pregnancy food cravings: behavioural immune system, nutrient seeking, resource scarcity and social bargaining. The research took place in Tamil Nadu, South India, with pregnant women residing in rural villages (N = 94). Methods included structured interviews and anthropometric measures. Findings revealed that unripe mango and unripe tamarind were the two most frequently mentioned food cravings among this population, but were not sufficiently supported by the a priori models. Results confirmed that the social bargaining model was the best explanation for the etic category of toxic/pathogenic food items, suggesting that pregnant women crave dangerous foods when experiencing heightened social pressures. Finally, toxicity/pathogenicity was a confounding factor for the nutrient seeking and resource scarcity models, calling into question the validity of these models in adverse environments. Overall, these findings present important implications for research on pregnancy food cravings, such that in resource-scarce and pathogen-dense environments, cravings might target teratogenic items that signal a need for increased social support.
Collapse
|
38
|
Santos AMD, Benute GRG, Santos NOD, Nomura RMY, de Lucia MCS, Francisco RPV. Presence of eating disorders and its relationship to anxiety and depression in pregnant women. Midwifery 2017; 51:12-15. [DOI: 10.1016/j.midw.2017.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 10/19/2022]
|
39
|
Hormes JM, Niemiec MA. Does culture create craving? Evidence from the case of menstrual chocolate craving. PLoS One 2017; 12:e0181445. [PMID: 28723930 PMCID: PMC5517000 DOI: 10.1371/journal.pone.0181445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/30/2017] [Indexed: 01/26/2023] Open
Abstract
Craving is considered a key characteristic of diverse pathologies, but evidence suggests it may be a culture-bound construct. Almost 50% of American women crave chocolate specifically around the onset of menstruation. Research does not support popular accounts implicating physiological factors in menstrual chocolate craving etiology. We tested the novel hypothesis that greater menstrual craving prevalence in the U.S. is the product of internalized cultural norms. Women of diverse backgrounds (n = 275) reported on craving frequency and triggers and completed validated measures of acculturation. Foreign-born women were significantly less likely to endorse menstrual chocolate craving (17.3%), compared to women born to U.S.-born parents (32.7%, p = .03) and second generation immigrants (40.9%, p = .001). Second generation immigrant and foreign-born women endorsing menstrual chocolate craving reported significantly greater U.S. acculturation and lower identification with their native culture than non-menstrual cravers (all p < .001). Findings inform our understanding of food cravings, with important implications for the study of cravings in other domains.
Collapse
Affiliation(s)
- Julia M. Hormes
- University at Albany, State University of New York, Albany, New York, United States of America
- * E-mail:
| | - Martha A. Niemiec
- University at Albany, State University of New York, Albany, New York, United States of America
| |
Collapse
|
40
|
The Clinical Significance of Craving Across the Addictive Behaviors: a Review. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0138-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
41
|
Bayat F, Karimi-shahanjarini A, Bashirian S, Feradmal J. Assessment of Dental Care and its Related Barriers in Pregnant Women of Hamadan City. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2017. [DOI: 10.21859/jech-03013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
42
|
Duke CH, Williamson JA, Snook KR, Finch KC, Sullivan KL. Association Between Fruit and Vegetable Consumption and Sleep Quantity in Pregnant Women. Matern Child Health J 2017; 21:966-973. [DOI: 10.1007/s10995-016-2247-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
43
|
Shieh C, Yang Z, Haas DM, Carpenter JS. Feasibility and Potential Benefits of a Self-Monitoring Enhanced Lifestyle Intervention to Prevent Excessive Gestational Weight Gain in Women Who Are Overweight or Obese. J Obstet Gynecol Neonatal Nurs 2017; 46:182-196. [PMID: 28063804 DOI: 10.1016/j.jogn.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility and potential benefits of a self-monitoring enhanced lifestyle intervention to prevent excessive gestational weight gain in women who are overweight and obese. DESIGN A one-group, prospective design involving 8 weeks of healthy eating and physical activity and self-monitoring of weight, nutrition, and walking. SETTING Recruitment and enrollment in prenatal clinics and self-monitoring at home. PARTICIPANTS Women (N = 22) at 14 to 24 gestational weeks, with body mass indexes of 25 to 40 kg/m2, without medical and psychiatric diseases that affected cognition or walking. METHODS Participants self-monitored weight and nutrition intake for the first 4 weeks and weight, nutrition intake, and walking in the second 4 weeks. Feasibility data were collected weekly (attrition, self-monitoring adherence, program safety, participant feedback) or at the end of Week 8 (satisfaction ratings). Potential benefits included weight, nutrition, and physical activity, measured at baseline (T1), the end of Week 4 (T2), or the end of Week 8 (T3). RESULTS Attrition rates were 27.3% by T2 and 40.9% by T3. Adherence to log return was 100%. No adverse effects were noted, but food craving was persistent, and stress levels were high. Program satisfaction was high. Trends for improved activity and reduced trans fat consumption were seen. CONCLUSION Our findings indicate that the intervention is worthy of further development and testing with a randomized controlled trial.
Collapse
|
44
|
Ramírez-López MT, Arco R, Decara J, Vázquez M, Noemí Blanco R, Alén F, Suárez J, Gómez de Heras R, Rodríguez de Fonseca F. Exposure to a Highly Caloric Palatable Diet during the Perinatal Period Affects the Expression of the Endogenous Cannabinoid System in the Brain, Liver and Adipose Tissue of Adult Rat Offspring. PLoS One 2016; 11:e0165432. [PMID: 27806128 PMCID: PMC5091916 DOI: 10.1371/journal.pone.0165432] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/11/2016] [Indexed: 12/27/2022] Open
Abstract
Recent studies have linked gestational exposure to highly caloric diets with a disrupted endogenous cannabinoid system (ECS). In the present study, we have extended these studies by analyzing the impact of the exposure to a palatable diet during gestation and lactation on a) the adult expression of endocannabinoid-related behaviors, b) the metabolic profile of adult offspring and c) the mRNA expression of the signaling machinery of the ECS in the hypothalamus, the liver and the adipose tissue of adult offspring of both sexes. Exposure to a palatable diet resulted in a) sex-dimorphic and perinatal diet specific feeding behaviors, including the differential response to the inhibitory effects of the cannabinoid receptor inverse agonist AM251, b) features of metabolic syndrome including increased adiposity, hyperleptinemia, hypertriglyceridemia and hypercholesterolemia and c) tissue and sex-specific changes in the expression of both CB1 and CB2 receptors and in that of the endocannabinoid-degrading enzymes FAAH and MAGL, being the adipose tissue the most affected organ analyzed. Since the effects were observed in adult animals that were weaned while consuming a normal diet, the present results indicate that the ECS is one of the targets of maternal programming of the offspring energy expenditure. These results clearly indicate that the maternal diet has long-term effects on the development of pups through multiple alterations of signaling homeostatic pathways that include the ECS. The potential relevance of these alterations for the current obesity epidemic is discussed.
Collapse
Affiliation(s)
- María Teresa Ramírez-López
- Departamento de Psicobiología, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223 Pozuelo de Alarcón, Madrid, Spain
| | - Raquel Arco
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| | - Juan Decara
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| | - Mariam Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| | - Rosario Noemí Blanco
- Departamento de Psicobiología, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223 Pozuelo de Alarcón, Madrid, Spain
| | - Francisco Alén
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| | - Juan Suárez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| | - Raquel Gómez de Heras
- Departamento de Psicobiología, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223 Pozuelo de Alarcón, Madrid, Spain
| | - Fernando Rodríguez de Fonseca
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010, Málaga, Spain
| |
Collapse
|
45
|
Abstract
BACKGROUND Cravings in pregnancy are considered to alter dietary intake; however, the nutritional consequences are unknown. The present study aimed to investigate the prevalence of food cravings in pregnancy, and their contribution, as a potentially modifiable determinant of weight gain and the development of obesity in pregnancy. METHODS Healthy pregnant women were participants in the Belfast cohort of the Hyperglycaemia and Adverse Pregnancy Outcome study (HAPO), a prospective observational study examining maternal glycaemia and pregnancy outcome. Diet was assessed at an average of 29 weeks of gestation using a self-administered validated food frequency questionnaire over the previous 2 weeks that included questions on food cravings experienced at any time during pregnancy. Clinical measurements collected included, height, weight, blood glucose and neonatal outcomes. Mean daily nutrient intakes were analysed with appropriate software. RESULTS Food cravings were reported by 39% (n = 635) of women, with sweet foods, fruit and dairy products most frequently consumed. Those who craved foods had a higher mean (SD) energy intake [9721 (3016) kJ] (P = 0.002) even when under-reporters were removed [10131 (2875) kJ] (P = 0.008). However, no differences were found in nutrient or food intake between groups when adjusted for energy. Similarly, no differences were observed between groups and glycaemic control, anthropometric measurements or offspring outcome measures. CONCLUSIONS Cravings commonly occur in pregnancy and contributed to a small increase in energy intake; however, this did not impact on overall dietary intake, nor was it associated with excessive gestational weight gain, maternal glycaemia or offspring outcome measurements.
Collapse
Affiliation(s)
- A. J. Hill
- NICHE School of Biomedical SciencesUniversity of Ulster, Coleraine, Northern IrelandUK
| | - V. Cairnduff
- NICHE School of Biomedical SciencesUniversity of Ulster, Coleraine, Northern IrelandUK
| | - D. R. McCance
- Regional Centre for Endocrinology and DiabetesRoyal Victoria Hospital, BelfastNorthern IrelandUK
| |
Collapse
|
46
|
Orloff NC, Flammer A, Hartnett J, Liquorman S, Samelson R, Hormes JM. Food cravings in pregnancy: Preliminary evidence for a role in excess gestational weight gain. Appetite 2016; 105:259-65. [PMID: 27215835 DOI: 10.1016/j.appet.2016.04.040] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 11/25/2022]
Abstract
Currently, more than 50% of American women gain an excessive amount of weight during pregnancy as per guidelines established by the Institute of Medicine and American Congress of Obstetrics and Gynecology. This excess gestational weight gain (GWG) is associated with health complications in both mothers and children. This study sought to examine the hypothesized causal role of cravings in excess GWG. Pregnant women were recruited from a local hospital (n = 40) and via posts on pregnancy-related websites (n = 43). Weight (current and pregravid) and height data were collected to calculate body mass index (BMI) and recommended versus excess GWG. Participants completed the Food Craving Inventory (FCI), which quantifies "frequency" of cravings for specific foods and the likelihood of "giving in" to these cravings. Overweight/obesity prior to pregnancy was reported by 40.5%-57.9% of participants. At the time of survey completion, 19.5% of online and 31.6% of hospital respondents had gained more than the recommended amount of weight for their stage of gestation. All women had experienced and given in to at least one craving, with cravings for "sweets" and "fast foods" being most common. Craving "frequency" accounted for a substantial portion of variance in excess GWG (25.0% in the online sample and 32.0% in respondents recruited at the hospital). Frequency of "giving in" to cravings accounted for 35.0% of the variance in excess GWG in the online sample only. Findings suggest that both craving frequency and consumption of craved foods may increase risk of excess GWG, providing support for the development of interventions targeting cravings in pregnancy as potentially modifiable determinants of energy intake.
Collapse
Affiliation(s)
- Natalia C Orloff
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Amy Flammer
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Albany Medical College, USA
| | - Josette Hartnett
- Department of Psychology, University at Albany, State University of New York, USA
| | - Sarah Liquorman
- Department of Psychology, University at Albany, State University of New York, USA
| | - Renee Samelson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Albany Medical College, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, Albany Medical College, USA
| |
Collapse
|
47
|
Kimmel M, Ferguson E, Zerwas S, Bulik C, Meltzer-Brody S. Obstetric and gynecologic problems associated with eating disorders. Int J Eat Disord 2016; 49:260-75. [PMID: 26711005 PMCID: PMC5683401 DOI: 10.1002/eat.22483] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This article summarizes the literature on obstetric and gynecologic complications associated with eating disorders. METHOD We performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers. RESULTS Common obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder. DISCUSSION We focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years.
Collapse
Affiliation(s)
- M.C. Kimmel
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina,Correspondence to: M.C. Kimmel, Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
| | - E.H. Ferguson
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
| | - S. Zerwas
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
| | - C.M. Bulik
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - S. Meltzer-Brody
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
| |
Collapse
|
48
|
Examination of the reliability and validity of the Mindful Eating Questionnaire in pregnant women. Appetite 2016; 100:142-51. [PMID: 26879222 DOI: 10.1016/j.appet.2016.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 02/05/2016] [Accepted: 02/11/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Mindfulness is theorized to affect the eating behavior and weight of pregnant women, yet no measure has been validated during pregnancy. METHODS This study qualitatively and quantitatively evaluated the reliability and validity of the Mindful Eating Questionnaire (MEQ) in overweight and obese pregnant women. Participants completed focus groups and cognitive interviews. The MEQ was administered twice to measure test-retest reliability. The Eating Inventory (EI) and Mindful Attention Awareness Scale (MAAS) were administered to assess convergent validity, and the Neighborhood Environment Walkability Scale (NEWS) assessed discriminant validity. RESULTS Participants were 20 ± 8 weeks gestation (mean ± SD), 30 ± 2 years old, and 55% were obese. The MEQ total score had good test-retest reliability (r = .85). The total score internal consistency reliability was poor (Cronbach's α = .56). The external cues subscale (ECS) was not internally consistent (α = .31). Other subscales ranged from α = .59-.68. When the ECS was excluded, the MEQ total score internal consistency was acceptable (α = .62). Convergent validity was supported by the MEQ total score (with and without ECS) correlating significantly with the MAAS and the EI disinhibition and hunger subscales. Discriminant validity of the MEQ was supported by the MEQ and NEWS total scores and subscales not being significantly correlated. The quantitative results were supported by the qualitative context and content analysis. CONCLUSION With the exception of the ECS, the MEQ's reliability and validity was supported in pregnant women, and most of the subscales were more robust in pregnant women than in the original sample of healthy adults. The MEQ's use with overweight and obese pregnant women is supported.
Collapse
|
49
|
Anderson CK, Walch TJ, Lindberg SM, Smith AM, Lindheim SR, Whigham LD. Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:404-11.e1. [PMID: 26187348 PMCID: PMC4590982 DOI: 10.1016/j.jneb.2015.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 05/19/2015] [Accepted: 05/31/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Examine factors implicated in gestational weight gain (GWG) in low-income overweight and obese women. DESIGN Qualitative study. SETTING Community-based perinatal center. PARTICIPANTS Eight focus groups with women (black = 48%, white non-Hispanic = 41%, and Hispanic = 10%) in the first half (n = 12) and last half of pregnancy (n = 10) or postpartum (n = 7), 2 with obstetrician-gynecologists (n = 9). PHENOMENON OF INTEREST Barriers and facilitators to healthy eating and GWG within different levels of the Social Ecological Model: for example, intrapersonal, interpersonal, and organizational. ANALYSIS Coding guide was based on the Social Ecological Model. Transcripts were coded by 3 researchers for common themes. Thematic saturation was reached. RESULTS At an intrapersonal level, knowledge/skills and cravings were the most common barriers. At an interpersonal level, family and friends were most influential. At an organizational level, the Special Supplemental Nutrition Program for Women, Infants, and Children and clinics were influential. At the community level, lack of transportation was most frequently discussed. At a policy level, complex policies and social stigma surrounding the Special Supplemental Nutrition Program for Women, Infants, and Children were barriers. There was consensus that ideal intervention approaches would include peer-facilitated support groups with information from experts. Obstetrician-gynecologists felt uncomfortable counseling patients about GWG because of time constraints, other priorities, and lack of training. CONCLUSIONS AND IMPLICATIONS There are multilevel public health opportunities to promote healthy GWG. Better communication between nutrition specialists and obstetrician-gynecologists is needed.
Collapse
Affiliation(s)
- Cynthie K Anderson
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI
| | - Tanis J Walch
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND
| | - Sara M Lindberg
- Center for Women's Health and Health Disparities Research, University of Wisconsin, Madison, WI
| | | | - Steven R Lindheim
- Department of Obstetrics and Gynecology, Reproductive Endocrine Infertility, Boonshoft School of Medicine, Wright State University, Dayton, OH
| | - Leah D Whigham
- Paso del Norte Institute for Healthy Living, El Paso, TX.
| |
Collapse
|
50
|
Rodríguez-Martín BC, Meule A. Food craving: new contributions on its assessment, moderators, and consequences. Front Psychol 2015; 6:21. [PMID: 25657636 PMCID: PMC4302707 DOI: 10.3389/fpsyg.2015.00021] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/07/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Boris C Rodríguez-Martín
- Department of Psychology, Faculty of Psychology, Central University "Marta Abreu" of Las Villas Santa Clara, Cuba
| | - Adrian Meule
- Institute of Psychology, University of Würzburg Würzburg, Germany ; Hospital for Child and Adolescent Psychiatry, LWL University Hospital of the Ruhr University Bochum Hamm, Germany
| |
Collapse
|