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

Tonja R Nansel, Leah M Lipsky, Myles Faith, Aiyi Liu, Anna Maria Siega-Riz, Tonja R Nansel, Leah M Lipsky, Myles Faith, Aiyi Liu, Anna Maria Siega-Riz

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.

Keywords: Delay of gratification; Diet quality; Home food environment; Impulsivity; Postpartum; Pregnancy; Reward-related eating; Self-regulation.

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Flow of recruitment and participation in the Pregnancy Eating Attributes Study (PEAS)
Fig. 2
Fig. 2
Interactions of home food environment and self-regulation with reward-related eating on diet quality. RVFQ, Reinforcing Value of Food Questionnaire; MCP, Multiple Choice Procedure; HFI-FV, fruit and vegetable home food environment score; HFI-OBES, obesogenic home food environment score; BIS-15, Barratt Impulsiveness Scale; DGI, Delaying Gratification Inventory

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