Pregnancy Eating Attributes Study (PEAS): A Study for Gestational and Postpartum Weight Gain

• People with higher food reward sensitivity are more likely to overeat, leading to excessive calorie consumption and subsequent obesity.
• Healthy eating habits during pregnancy ensure adequate maternal nutrition and growth and development of the fetus.
• Gestational weight gain is the most significant factor towards postpartum weight retention

While some weight gain during pregnancy and postpartum is natural, excessive gestational weight gain poses a serious public health concern since it puts both the mother and child at an increased risk of negative health outcomes. The Pregnancy Eating Attributes Study (PEAS) aims to understand the role of food reward sensitivity in maternal diet and weight change during pregnancy and postpartum by probing into the interplay of food reward sensitivity with behavioral control, home food environment and related aspects of eating behavior such as physical activity, stress, sleep and depression. It is a prospective observational study of 450 women without any psychiatric or eating disorders in the first trimester of their pregnancy and includes women who are of normal weight, overweight and obese. Food Reward Sensitivity

This study tries to explore the role of food reward sensitivity, food reinforcement and behavioral control in maternal weight change and dietary intake during pregnancy and postpartum. Food reward sensitivity has a direct impact on dietary intake and body weight. Individuals with higher food reward sensitivity are more likely to eat more food, which leads to excessive calorie consumption and subsequent obesity. Similarly, those with high food reward sensitivity but sufficiently high self-regulation of food intake may not consume excessively. The reinforcement value of foods in a person’s house also influences food reward sensitivity, behavioral control, dietary intake and weight. Women with high food reward sensitivity and low behavioral control who are exposed to highly palatable food are at an increased risk for excess calorie intake and weight gain. Factors like stress, sleep and depression also tend to have an impact on food reward sensitivity, behavioral control, dietary intake and weight.

Eating Behavior during Pregnancy

Healthy eating habits during pregnancy are recommended to promote adequate maternal nutrition and proper growth and development of the fetus. In order to obtain optimum nutrition, it is important to eat a balanced diet.

It is imperative to include at least 2 servings of fruits and 4 servings of vegetables to meet the Vitamin C and folic acid requirements. A minimum of 5 servings of whole grains and cereals is recommended for meeting the increasing needs of energy and B-complex vitamins. Three servings of protein-rich foods like fish, chicken, eggs, soy, legumes and sprouts are essential since proteins are made of amino acids which are necessary for a strong and healthy placenta to provide the adequate oxygen supply and nutrients to the fetus and production of red blood cells. Dairy products being an important source of calcium must be included since calcium helps build strong teeth and bones and facilitates proper functioning of muscles and nerves. Lack of calcium intake during pregnancy increases the risk of osteoporosis at a later stage.

Postpartum Weight Retention

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Postpartum weight retention can prove to be a significant contributor to long-term obesity and associated health risks like diabetes and cardiovascular ailments. Maximum weight loss occurs in the first three months postpartum and continues at a slow pace until six months postpartum.

Besides lactation, factors such as gestational weight gain, pregravid weight, age, smoking, exercise history, and employment have been studied for understanding postpartum weight loss. Out of all these factors, gestational weight gain is the most influential factor in postpartum weight retention.

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The Institute of Medicine recommends a weight gain of 11.5 – 16 kilograms for women with a normal pregravid body mass index (BMI) of 19.8 to 26. The study pregnancy-related weight gain and retention published in the American Journal of Public Health revealed that adolescents and black patients are at a greater risk for postpartum weight retention. It should become mandatory for family physicians to create awareness regarding the risks of excessive weight gain during pregnancy and subsequent obesity.

Conclusion

This study addresses many important knowledge gaps by understanding the implications of food reward sensitivity in maternal diet and weight change. However, the degree to which food reward sensitivity is associated with dietary intake and weight change during pregnancy or the interplay of food reward sensitivity with self-control, food environment, and other eating and health-related behaviors has not been explained clearly.

References:

1. Pregnancy Calculator - (http://www.americanpregnancy.org)
2. Preventing Postpartum Weight Retention - (http://www.aafp.org/afp/2002/0801/p380.html)
3. Pregnancy Eating Attributes Study (PEAS) - (https://clinicaltrials.gov/ct2/show/NCT02217462)

Source-Medindia