The accelerator, the brake, and the terrain: associations of reward-related eating, self-control, and the home food environment with diet quality assessed by 24-hour recalls during pregnancy and postpartum in the Pregnancy Eating Attributes Study (PEAS) cohort

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-hour 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.govURL – https://clinicaltrials.gov/ct2/show/NCT02217462Registration ID – NCT02217462Date of registration – August 13, 2014