Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, Baton Rouge, LA 70817, USA.
Clinical Trials Unit, Pennington Biomedical Research Center, Baton Rouge, LA 70817, USA.
Nutrients. 2019 Jun 26;11(7):1446. doi: 10.3390/nu11071446.
Interventions to promote healthy pregnancy in women with obesity by improving diet quality have been widely unsuccessful. We hypothesized that diet quality is determined by eating behaviors, but evidence in women with obesity is lacking. We evaluated diet quality and eating behavior in 56 women with obesity (mean ± SEM, 36.7 ± 0.7 kg/m2, 46% White, 50% nulliparous) early in pregnancy (14.9 ± 0.1 weeks). Diet quality was objectively assessed with food photography over six days and defined by Healthy Eating Index. Eating behaviors were assessed by validated questionnaires. Women reported consuming diets high in fat (38 ± 1% of energy) and the HEI was considered "poor" on average (46.7 ± 1.3), and for 71% of women. Diet quality was independently associated with education level ( 0.01), food cravings ( < 0.01), and awareness towards eating ( 0.01). Cravings for sweets and fast foods were positively correlated with respective intakes of these foods ( < 0.01 and 0.04, respectively), whereas cravings for fruits and vegetables did not relate to diet intake. We provide evidence of the determinants of poor diet quality in pregnant women with obesity. Based on this observational study, strategies to improve diet quality and pregnancy outcomes are to satisfy cravings for healthy snacks and foods, and to promote awareness towards eating behaviors.
干预措施旨在通过改善饮食质量来促进肥胖女性的健康妊娠，但效果甚微。我们假设饮食质量取决于饮食行为，但肥胖女性的相关证据不足。我们评估了 56 名肥胖孕妇（平均 ± SEM，36.7 ± 0.7 kg/m2，46%为白人，50%为初产妇）在妊娠早期（14.9 ± 0.1 周）的饮食质量和饮食行为。饮食质量通过六天的食物摄影进行客观评估，并通过健康饮食指数定义。饮食行为通过经过验证的问卷进行评估。研究对象报告摄入高脂肪饮食（占能量的 38 ± 1%），健康饮食指数平均被认为“较差”（46.7 ± 1.3），且 71%的女性属于这种情况。饮食质量与教育水平（ 0.01）、食物渴望（ < 0.01）和饮食意识（ 0.01）独立相关。对甜食和快餐的渴望与这些食物的摄入量呈正相关（分别为 < 0.01 和 0.04），而对水果和蔬菜的渴望与饮食摄入量无关。我们为肥胖孕妇饮食质量差的决定因素提供了证据。基于这项观察性研究，改善饮食质量和妊娠结局的策略是满足对健康零食和食物的渴望，并促进对饮食行为的认识。
