Lindsay Karen L, Most Jasper, Buehler Kerrie, Kebbe Maryam, Altazan Abby D, Redman Leanne M
Susan Samueli Integrative Health Institute, University of California Irvine, Costa Mesa, CA 92696, USA.
Department of Pediatrics, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA 92697, USA.
Front Biosci (Landmark Ed). 2021 Dec 30;26(12):1548-1558. doi: 10.52586/5048.
Maternal diet and eating behaviors have the potential to influence the metabolic milieu in pregnancies complicated by obesity, with implications for the developmental programming of offspring obesity. Emerging evidence suggests that mindfulness during eating may influence metabolic health in non-pregnant populations, but its effects in the context of pregnancy is less well understood. This study explored the individual and combined effects of mindful eating and diet quality on metabolic outcomes among pregnant women with obesity.
In 46 pregnant women (body mas index >30 kg/m2) enrolled in the MomEE observational study, mindful eating (Mindful Eating Questionnaire, MEQ) and energy-adjusted dietary inflammatory index (DII, from 7 days of food photography) was assessed at two time points and the mean pregnancy values computed. Rate of gestational weight gain (GWG) and fat mass gain per week were determined from measured weight and body composition using a three-compartment method, respectively, at each assessment. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and ghrelin concentrations were determined from fasting blood samples in late gestation (35-37 weeks). Linear regression was used to examine the association of the MEQ and its subscales (where higher values indicate more mindful eating) with metabolic outcomes, adjusting for covariates: maternal age, pregravid body mass index, race, parity, DII. The effects of the MEQ*DII interaction was also tested.
Total MEQ scores were not associated with rate of weight or fat mass gain, although greater distracted eating behavior was associated with greater adiposity gain (weight and fat mass). Mindful eating was inversely associated with insulin resistance, although this was attenuated to non-significance after additional adjustment for GWG. Total MEQ and the external eating subscale was significantly inversely associated with fasted ghrelin, such that less tendency to eat under the influence of external cues was associated with lower ghrelin concentrations. After false discovery rate adjustment for multiple testing, only the association of the total MEQ and external eating subscale with ghrelin levels trended towards significance. The DII was not associated with MEQ scores or outcome variables, nor did it moderate the effect of MEQ on any of the outcomes.
This study generates early evidence to suggest that mindful eating holds potential as a tool to improve metabolic health outcomes in pregnant women with obesity, although further research is required on this topic. Prenatal lifestyle interventions should consider including mindfulness during eating to determine its efficacy for reducing adverse pregnancy and offspring health outcomes associated with maternal obesity.
孕妇的饮食和进食行为有可能影响肥胖合并妊娠的代谢环境，这对后代肥胖的发育编程具有重要意义。新出现的证据表明，进食时的正念可能会影响非孕妇人群的代谢健康，但在妊娠背景下其影响尚不太清楚。本研究探讨了正念饮食和饮食质量对肥胖孕妇代谢结局的个体及综合影响。
在MomEE观察性研究纳入的46名孕妇（体重指数>30kg/m²）中，在两个时间点评估正念饮食（正念饮食问卷，MEQ）和能量调整饮食炎症指数（DII，根据7天的食物照片计算），并计算妊娠平均值。每次评估时，分别使用三室法根据测量的体重和身体成分确定妊娠体重增加（GWG）率和每周脂肪量增加。在妊娠晚期（35 - 37周），通过空腹血样测定胰岛素抵抗稳态模型评估（HOMA-IR）和胃饥饿素浓度。使用线性回归分析MEQ及其子量表（值越高表明饮食越正念）与代谢结局的关联，并对协变量进行调整：孕妇年龄、孕前体重指数、种族、产次、DII。还测试了MEQ*DII相互作用的影响。
尽管更多的分心进食行为与更高的肥胖增加（体重和脂肪量）相关，但MEQ总分与体重或脂肪量增加率无关。正念饮食与胰岛素抵抗呈负相关，尽管在对GWG进行额外调整后这种相关性减弱至无统计学意义。MEQ总分和外部进食子量表与空腹胃饥饿素显著负相关，即受外部线索影响下进食的倾向越小，胃饥饿素浓度越低。在对多次检验进行错误发现率调整后，只有MEQ总分和外部进食子量表与胃饥饿素水平的关联趋于显著。DII与MEQ评分或结局变量无关，也未调节MEQ对任何结局的影响。
本研究产生了早期证据，表明正念饮食作为改善肥胖孕妇代谢健康结局的工具具有潜力，尽管该主题还需要进一步研究。产前生活方式干预应考虑纳入进食时的正念，以确定其对减少与孕妇肥胖相关的不良妊娠和后代健康结局的功效。
