Advertisement

Obesity Risk Knowledge, Weight Misperception, and Diet and Health-Related Attitudes among Women Intending to Become Pregnant

      Abstract

      Objective

      Our aim was to evaluate obesity risk knowledge, weight misperception, and diet and health-related attitudes among women intending to become pregnant compared to those not intending to become pregnant.

      Design

      We conducted a cross-sectional survey of health behaviors, including obesity risk knowledge, weight misperception, and diet and health-related attitudes among women (aged 16 to 40 years) attending reproductive health clinics in southeast Texas. Data were collected through self-administered questionnaires and chart review. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and obesity risk knowledge, weight misperception, and health-related attitudes after adjusting for age, race, income, and gravidity.

      Results

      Overall, 1,726 women completed the survey, of which 1,420 responded to a question on pregnancy intention. Of these, 126 stated they were intending to become pregnant. Obesity risk knowledge (adjusted odds ratio=1.14; 95% confidence interval [CI] 0.74 to 1.77) and weight misperception (adjusted odds ratio=1.17; 95% CI 0.75 to 1.83) did not differ between women intending and not intending to become pregnant. In addition, diet and health-related attitudes did not differ between these two groups (P>0.05 for all). Among women intending to become pregnant, 51% had low obesity risk knowledge and 31% misperceived their body weight. Further, 76% of these women felt confused about what constitutes a healthy diet, although 47% believed that their current diet was healthy and saw no reason to change their current eating patterns. While weight misperception did not differ significantly between the two groups, overweight women intending to become pregnant were more likely to misperceive their weight than obese women intending to become pregnant (71% vs 10%; P<0.001).

      Conclusions

      There is a need for improved preconception counseling, especially for women intending to become pregnant, regarding the risks associated with being overweight or obese, misperception of body weight, and negative diet and health-related attitudes.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Flegal K.M.
        • Carroll M.D.
        • Kit B.K.
        • Ogden C.L.
        Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010.
        JAMA. 2012; 307: 491-497
        • Krummel D.A.
        Postpartum weight control: A vicious cycle.
        J Am Diet Assoc. 2007; 107: 37-40
        • Gaillard R.
        • Durmuş B.
        • Hofman A.
        • et al.
        Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy.
        Obesity. 2013; 21: 1046-1055
        • Rosenberg T.J.
        • Garbers S.
        • Chavkin W.
        • Chiasson M.A.
        Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population.
        Obstet Gynecol. 2003; 102: 1022-1027
        • Whitaker R.C.
        Predicting preschooler obesity at birth: The role of maternal obesity in early pregnancy.
        Pediatrics. 2004; 114: e29-e36
        • Kral J.G.
        • Biron S.
        • Simard S.
        • et al.
        Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years.
        Pediatrics. 2006; 118: e1644-e1649
        • Pirkola J.
        • Pouta A.
        • Bloigu A.
        • et al.
        Risks of overweight and obdominal obesity at age 16 years associated with prenatal exposures to maternal prepregnancy overweight and gestational diabetes mellitus.
        Diabetes Care. 2010; 33: 1115-1121
        • Ehrlich S.F.
        • Rosas L.G.
        • Ferrara A.
        • et al.
        Pregnancy glucose levels in women without diabetes or gestational diabetes and childhood cardiometabolic risk at 7 years of age.
        J Pediatr. 2012; 161: 1016-1021
        • Johnson K.
        • Posner S.F.
        • Biermann J.
        • et al.
        Recommendations to improve preconception health and health care—United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care.
        MMWR Recomm Rep. 2006; 55: 1-23
        • Zera C.
        • McGirr S.
        • Oken E.
        Screening for obesity in reproductive-aged women.
        Prev Chronic Dis. 2011; 8: A125
        • Rahman M.
        • Berenson A.B.
        Self-perception of weight and its association with weight-related behaviors in young, reproductive-aged women.
        Obstet Gynecol. 2010; 116: 1274-1280
        • Rahman M.
        • Justiss A.A.
        • Berenson A.B.
        Racial differences in obesity risk knowledge among low-income reproductive-age women.
        J Am Coll Nutr. 2012; 31: 397-400
        • Swift J.A.
        • Glazebrook C.
        • Macdonald I.
        Validation of a brief, reliable scale to measure knowledge about the health risks associated with obesity.
        Int J Obes (Lond). 2006; 30: 661-668
      1. US Department of Agriculture. What We Eat in America: 1994-1996. Diet and Health Knowledge Survey questionnaire. Rockville, MD: Westat, Inc: 1996. http://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/dhks.pdf. Accessed May 12, 2010.

        • Schumann N.L.
        • Brinsden H.
        • Lobstein T.
        A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy.
        Clin Obes. 2014; 4: 197-208
        • Finer L.
        • Zolna M.
        Unintended pregnancy in the United States: Incidence and disparities, 2006.
        Contraception. 2011; 84: 478-485
        • Berenson A.B.
        • Pohlmeier A.M.
        • Laz T.H.
        • Rahman M.
        • McGrath C.J.
        Nutritional and weight management behaviors in low-income women trying to conceive.
        Obstet Gynecol. 2014; 124: 579-584
        • Hinkle S.N.
        • Sharma A.J.
        • Kim S.Y.
        • et al.
        Prepregnancy obesity trends among low-income women, United States, 1999-2008.
        Matern Child Health J. 2012; 16: 1339-1348
        • Ovesen P.
        • Rasmussen S.
        • Kesmodel U.
        Effect of prepregnancy maternal overweight and obesity on pregnancy outcome.
        Obstet Gynecol. 2011; 118: 305-312
        • Catalano P.M.
        • Farrell K.
        • Thomas A.
        • et al.
        Perinatal risk factors for childhood obesity and metabolic dysregulation.
        Am J Clin Nutr. 2009; 90: 1303-1313
        • Boney C.M.
        • Verma A.
        • Tucker R.
        • Vohr B.R.
        Metabolic syndrome in childhood: Association with birth weight, maternal obesity, and gestational diabetes mellitus.
        Pediatrics. 2005; 115: e290-e296
        • Kuchler F.
        • Variyam J.N.
        Mistakes were made: Misperception as a barrier to reducing overweight.
        Int J Obes Relat Metab Disord. 2003; 27: 856-861
        • Schummers L.
        • Hutcheon J.A.
        • Bodnar L.M.
        • Lieberman E.
        • Himes K.P.
        Risk of adverse pregnancy outcomes by prepregnancy body mass index: A population-based study to inform prepregnancy weight loss counseling.
        Obstet Gynecol. 2015; 125: 133-143
        • Athukorala C.
        • Rumbold A.R.
        • Willson K.J.
        • Crowther C.A.
        The risk of adverse pregnancy outcomes in women who are overweight or obese.
        BMC Pregnancy Childbirth. 2010; 10: 56
        • Herring S.J.
        • Oken E.
        • Haines J.
        Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: Findings from a US cohort study.
        BMC Pregnancy Childbirth. 2008; 8: 54
        • Yaemsiri S.
        • Slining M.M.
        • Agarwal S.K.
        Perceived weight status, overweight diagnosis, and weight control among US adults: The NHANES 2003-2008 Study.
        Int J Obes. 2011; 35: 1063-1070
        • Honein M.A.
        • Devine O.
        • Sharma A.J.
        • et al.
        Modeling the potential public health impact of prepregnancy obesity on adverse fetal and infant outcomes.
        Obesity. 2013; 21: 1276-1283
        • Lawrence J.M.
        • Contreras R.
        • Chen W.
        • Sacks D.A.
        Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999-2005.
        Diabetes Care. 2008; 31: 899-904
        • Gilbert W.M.
        • Young A.L.
        • Danielsen B.
        Pregnancy outcomes in women with chronic hypertension: A population-based study.
        J Reprod Med. 2007; 52: 1046-1051
        • Morgan M.A.
        • Anderson B.L.
        • Lawrence H.
        • Schulkin J.
        Well-woman care among obstetrician-gynecologists: Opportunity for preconception care.
        J Matern Fetal Neonatal Med. 2012; 25: 595-599
        • Tobias D.K.
        • Zhang C.
        • Chavarro J.
        • et al.
        Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus.
        Am J Clin Nutr. 2012; 96: 289-295
        • Grieger J.A.
        • Grzeskowiak L.E.
        • Clifton V.L.
        Preconception dietary patterns in human pregnancies are associated with preterm delivery.
        J Nutr. 2014; 144: 1075-1080
        • Moredich C.A.
        • Kessler T.A.
        Physical activity and nutritional weight loss interventions in obese, low-income women: An integrative review.
        J Midwifery Women's Health. 2014; 59: 380-387
        • Gardiner P.M.
        • Nelson L.
        • Shellhaas C.S.
        • et al.
        The clinical content of preconception care: Nutrition and dietary supplements.
        Am J Obstet Gynecol. 2008; 199: S345-S356

      Biography

      A. B. Berenson is a professor, Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston.

      Biography

      A. M. Pohlmeier is a postdoctoral research fellow, Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston.

      Biography

      T. H. Laz is a research scientist, Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston.

      Biography

      M. Rahman is an associate professor, Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston.

      Biography

      G. Saade is a professor, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Medical Branch, Galveston.