Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA 16802, USA.
Control Systems Engineering Laboratory, Arizona State University, Tempe, AZ 85281, USA.
Nutrients. 2022 Jun 1;14(11):2326. doi: 10.3390/nu14112326.
(1) Background: Energy intake (EI) underreporting is a widespread problem of great relevance to public health, yet is poorly described among pregnant women. This study aimed to describe and predict error in self-reported EI across pregnancy among women with overweight or obesity. (2) Methods: Participants were from the Healthy Mom Zone study, an adaptive intervention to regulate gestational weight gain (GWG) tested in a feasibility RCT and followed women (n = 21) with body mass index (BMI) ≥25 from 8−12 weeks to ~36 weeks gestation. Mobile health technology was used to measure daily weight (Wi-Fi Smart Scale), physical activity (activity monitor), and self-reported EI (MyFitnessPal App). Estimated EI was back-calculated daily from measured weight and physical activity data. Associations between underreporting and gestational age, demographics, pre-pregnancy BMI, GWG, perceived stress, and eating behaviors were tested. (3) Results: On average, women were 30.7 years old and primiparous (62%); reporting error was −38% ± 26 (range: −134% (underreporting) to 97% (overreporting)), representing an ~1134 kcal daily underestimation of EI (1404 observations). Estimated (back-calculated), but not self-reported, EI increased across gestation (p < 0.0001). Higher pre-pregnancy BMI (p = 0.01) and weekly GWG (p = 0.0007) was associated with greater underreporting. Underreporting was lower when participants reported higher stress (p = 0.02) and emotional eating (p < 0.0001) compared with their own average. (4) Conclusions: These findings suggest systemic underreporting in pregnant women with elevated BMI using a popular mobile app to monitor diet. Advances in technology that allow estimation of EI from weight and physical activity data may provide more accurate dietary self-monitoring during pregnancy.
(1) 背景：能量摄入（EI）少报是一个普遍存在且与公共健康密切相关的问题，但在孕妇中却描述不足。本研究旨在描述超重或肥胖孕妇在整个孕期自我报告 EI 的误差，并预测其误差。(2) 方法：参与者来自 Healthy Mom Zone 研究，这是一项调节妊娠体重增加（GWG）的适应性干预研究，在一项可行性 RCT 中进行了测试，并在 8-12 周至约 36 周妊娠期间对 BMI≥25 的女性（n=21）进行随访。移动健康技术用于测量每日体重（Wi-Fi 智能秤）、身体活动（活动监测器）和自我报告 EI（MyFitnessPal App）。从测量的体重和身体活动数据中每日回推估计 EI。测试了少报与孕龄、人口统计学、孕前 BMI、GWG、感知压力和饮食行为之间的关系。(3) 结果：平均而言，女性年龄为 30.7 岁，初产妇（62%）；报告误差为-38%±26（范围：-134%（少报）至 97%（多报）），代表 EI 每日约 1134 千卡的低估（1404 个观察值）。估计（回推）但不是自我报告的 EI 随着孕期的增加而增加（p<0.0001）。较高的孕前 BMI（p=0.01）和每周 GWG（p=0.0007）与更大的少报有关。与自己的平均水平相比，参与者报告的压力更高（p=0.02）和情绪性进食（p<0.0001）时，少报率较低。(4) 结论：这些发现表明，使用流行的移动应用程序监测饮食的 BMI 升高的孕妇中存在系统性少报。允许从体重和身体活动数据估计 EI 的技术进步可能会在怀孕期间提供更准确的饮食自我监测。
