Eating in the Absence of Hunger Is Related to Worse Diet Quality throughout Pregnancy

Abstract

Background: Scant research has examined whether laboratory assessments of eating in the absence of hunger (EAH) relates to long-term diet quality.

Objective: This study investigates the association of EAH with diet quality during pregnancy.

Design: Pregnancy diet quality was assessed using 24-hour diet recalls collected in each pregnancy trimester. EAH was assessed in a counterbalanced, crossover laboratory feeding substudy in which participants completed two free access eating occasions following a standardized meal during their second pregnancy trimester.

Participants/setting: Data were collected from March 2015 to December 2016 from a subsample of participants (n = 46) enrolled at ≤12 weeks' gestation in an observational, prospective cohort study (the Pregnancy Eating Attributes Study) in North Carolina.

Intervention: Participants were presented with highly processed (HP) and minimally processed (MP) foods in two separate assessments.

Main outcome measures: Scores for total Healthy Eating Index-2015 (HEI-2015) and adherence to adequacy and moderation components were calculated from the diet recalls. Higher scores reflect better diet quality.

Statistical analyses performed: Linear regressions estimated associations of pregnancy diet quality with EAH (energy, EAH-kcal; and percent offered, EAH-%) in each condition for all foods, and separately for sweet and savory foods.

Results: Lower pregnancy diet quality (all indicators) was associated with greater EAH (EAH-kcal and EAH-%) of all foods and sweet foods in the HP condition. Each 100-kcal increase in EAH of HP foods was associated with a 2- to 3-point decrease (standard error = 0.7 to 0.8) in HEI-2015 (P < 0.01); each 10% increase in EAH of HP foods was associated with a 5- to 7-point decrease (standard error = 2.0) in HEI-2015 (P < 0.01). Greater EAH (energy and percent offered) of savory food intake in the HP condition was associated with a lower HEI-2015 adequacy component score, but was not associated with the HEI-2015 or HEI-2015 moderation component scores. EAH in the MP condition was not associated with pregnancy diet quality.

Conclusions: Greater EAH of HP, especially sweet, foods was related to worse pregnancy diet quality. Consuming HP sweets after meal termination may reflect a tendency for eating beyond satiation and may be a useful intervention target for improving maternal diet quality.

Trial registration: ClinicalTrials.gov NCT02217462.

Keywords: Appetite; Diet quality; Eating in the absence of hunger; Food intake; Pregnancy.

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts to declare.

Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.