Stress, Depression, Social Support, and Eating Habits Reduce Diet Quality in the First Trimester in Low-Income Women: A Pilot Study

Published:September 25, 2012DOI:


      Maternal diet quality influences birth outcomes. Yet, little research exists that assesses women's diet quality during the first trimester of pregnancy, a crucial time of placental and fetal development. This cross-sectional study, describing diet quality and its relationship with stress, depression, social support, and eating habits in the first trimester, may identify low-income women needing intensive dietary intervention. Seventy-one low-income women completed validated instruments measuring stress, depression, social support, and eating habits; had their height and weight measured; received training on portion-size estimation; and completed three 24-hour dietary recalls (1 weekend day and 2 nonconsecutive weekdays) from July 2009 to February 2010. Comparative and correlational analyses were done. Women with diet quality scores below the median (n=35) had more depression (9.6±5.1 vs 6.7±5.1) and stress (22.1±5.4 vs 19.3±4.8) and less control over meal preparation (5.0±1.5 vs 4.2±1.5) and support from others (52.0±12.0 vs 57.4±7.2) than did women with high diet quality scores (n=36). Diet quality was negatively related to depression (r=−0.41), stress (r=−0.35), skipping meals (r=−0.41), and control over meal preparation (r=−0.33), and positively related to support from others (r=0.38). Low-income women experiencing life stressors represent an at-risk group for low diet quality and may need intensive dietary intervention before and during pregnancy. More research designed to improve diet quality in low-income pregnant women is needed.


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      E. R. Fowles is retired; at the time of the study, she was an assistant professor at the University of Texas at Austin, School of Nursing, Austin.


      J. Stang is an associate professor, and chair of the Public Health Nutrition Program, Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.


      M. Bryant is a research project coordinator, Cedars-Sinai, Los Angeles, CA; at the time of the study, she was the project director, Nutrition in Pregnancy Study, University of Texas at Austin, School of Nursing, Austin.


      S. Kim is an assistant professor, St Francis College, Brooklyn, NY; at the time of the study, he was a graduate research assistant, University of Texas at Austin, School of Nursing, Austin.