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Pregnant Women Consume a Similar Proportion of Highly vs Minimally Processed Foods in the Absence of Hunger, Leading to Large Differences in Energy Intake

Published:October 24, 2020DOI:https://doi.org/10.1016/j.jand.2020.09.036

      Abstract

      Background

      The eating in the absence of hunger (EAH) experimental paradigm measures intake of highly palatable, highly processed foods when sated. However, no studies have examined EAH in pregnant women.

      Objective

      The objectives were to investigate whether EAH in pregnant women differs by level of food processing and to examine relationships of EAH with hedonic hunger, addictive-like eating, and impulsivity.

      Design

      EAH was assessed in a counterbalanced crossover feeding substudy in which participants completed two free-access eating occasions following a standardized meal during their second pregnancy trimester. Hedonic hunger (Power of Food Scale), addictive-like eating (modified Yale Food Addiction Scale), and impulsivity (Barratt Impulsiveness Scale-15) were assessed by self-report during early pregnancy.

      Participants and setting

      Data were collected from March 2015 through September 2016 from a subsample of participants (n = 46) enrolled at ≤12 weeks gestation in an observational, prospective cohort study (the Pregnancy Eating Attributes Study) in North Carolina.

      Intervention

      Participants were presented with highly processed and minimally processed foods in two separate assessments.

      Main outcome measures

      Energy intake (EAH-kcal) and percent consumed (EAH-%) (calculated as 100 × [amount consumed (g) / amount served (g)]) was measured overall and separately for sweet and savory foods.

      Statistical analyses performed

      Linear mixed models estimated the effect of condition on EAH. Hedonic hunger, addictive-like eating, impulsivity and their interaction were examined separately.

      Results

      EAH-% was similar across conditions (16.3% ± 1.1% highly processed vs 17.9% ± 1.2% minimally processed; P = 0.76), resulting in 338.5 ± 34.2 kcal greater energy intake in the highly processed vs minimally processed condition (P < 0.001). Hedonic hunger was not significantly associated with EAH; reward-related eating was positively associated with EAH-kcal and EAH-% of savory foods, and Barratt Impulsivity was positively associated with EAH-kcal and EAH-% overall, and with EAH-% of sweet foods (P < 0.05). There was little evidence of an interaction of Barratt Impulsivity with hedonic hunger or reward-related eating.

      Conclusions

      EAH in pregnant women occurs for both highly processed and minimally processed foods and correlates positively with self-reported addictive-like eating, but not hedonic hunger. Impulsivity did not modify associations of addictive-like eating with EAH in this sample.

      Keywords

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      References

        • Bodnar L.M.
        • Simhan H.N.
        • Parker C.B.
        • et al.
        Racial or ethnic and socioeconomic inequalities in adherence to national dietary guidance in a large cohort of US pregnant women.
        J Acad Nutr Diet. 2017; 117: 867-877 e863
        • Shin D.
        • Lee K.W.
        • Song W.O.
        Pre-pregnancy weight status is associated with diet quality and nutritional biomarkers during pregnancy.
        Nutrients. 2016; 8: 162
        • Johnson J.L.
        • Farr S.L.
        • Dietz P.M.
        • Sharma A.J.
        • Barfield W.D.
        • Robbins C.L.
        Trends in gestational weight gain: The Pregnancy Risk Assessment Monitoring System, 2000-2009.
        Am J Obstet Gynecol. 2015; 212: 806.e801-806.e808
        • Kominiarek M.A.
        • Peaceman A.M.
        Gestational weight gain.
        Am J Obstet Gynecol. 2017; 217: 642-651
        • Gilmore L.A.
        • Butte N.F.
        • Ravussin E.
        • Han H.
        • Burton J.H.
        • Redman L.M.
        Energy intake and energy expenditure for determining excess weight gain in pregnant women.
        Obstet Gynecol. 2016; 127: 884-892
        • Ramakrishnan U.
        • Grant F.
        • Goldenberg T.
        • Zongrone A.
        • Martorell R.
        Effect of women's nutrition before and during early pregnancy on maternal and infant outcomes: A systematic review.
        Paediatr Perinat Epidemiol. 2012; 26: 285-301
        • Hall K.D.
        • Hammond R.A.
        • Rahmandad H.
        Dynamic interplay among homeostatic, hedonic, and cognitive feedback circuits regulating body weight.
        Am J Public Health. 2014; 104: 1169-1175
        • Kenny P.J.
        Reward mechanisms in obesity: New insights and future directions.
        Neuron. 2011; 69: 664-679
        • Berthoud H.R.
        • Munzberg H.
        • Morrison C.D.
        Blaming the brain for obesity: Integration of hedonic and homeostatic mechanisms.
        Gastroenterol. 2017; 152: 1728-1738
        • Flint A.J.
        • Gearhardt A.N.
        • Corbin W.R.
        • Brownell K.D.
        • Field A.E.
        • Rimm E.B.
        Food-addiction scale measurement in 2 cohorts of middle-aged and older women.
        Am J Clin Nutr. 2014; 99: 578-586
        • Appelhans B.M.
        • Woolf K.
        • Pagoto S.L.
        • Schneider K.L.
        • Whited M.C.
        • Liebman R.
        Inhibiting food reward: Delay discounting, food reward sensitivity, and palatable food intake in overweight and obese women.
        Obesity (Silver Spring). 2011; 19: 2175-2182
        • Schulte E.M.
        • Avena N.M.
        • Gearhardt A.N.
        Which foods may be addictive? The roles of processing, fat content, and glycemic load.
        PLoS One. 2015; 10e0117959
        • Epstein L.H.
        • Carr K.A.
        • Lin H.
        • Fletcher K.D.
        Food reinforcement, energy intake, and macronutrient choice.
        Am J Clin Nutr. 2011; 94: 12-18
        • Berridge K.C.
        • Ho C.Y.
        • Richard J.M.
        • DiFeliceantonio A.G.
        The tempted brain eats: Pleasure and desire circuits in obesity and eating disorders.
        Brain Res. 2010; 1350: 43-64
        • Taha S.A.
        Preference or fat? Revisiting opioid effects on food intake.
        Physiol Behav. 2010; 100: 429-437
        • Smith D.G.
        • Robbins T.W.
        The neurobiological underpinnings of obesity and binge eating: A rationale for adopting the food addiction model.
        Biol Psychiatry. 2013; 73: 804-810
        • Schulte E.M.
        • Sonneville K.R.
        • Gearhardt A.N.
        Subjective experiences of highly processed food consumption in individuals with food addiction.
        Psychol Addict Behav. 2019; 33: 144-153
        • Poti J.M.
        • Mendez M.A.
        • Ng S.W.
        • Popkin B.M.
        Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households?.
        Am J Clin Nutr. 2015; 101: 1251-1262
        • Small D.M.
        • Difeliceantonio A.G.
        Processed foods and food reward.
        Science. 2019; 363: 346-347
        • Lowe M.R.
        • Butryn M.L.
        • Didie E.R.
        • et al.
        The Power of Food Scale. A new measure of the psychological influence of the food environment.
        Appetite. 2009; 53: 114-118
        • Cappelleri J.C.
        • Bushmakin A.G.
        • Gerber R.A.
        • et al.
        Evaluating the Power of Food Scale in obese subjects and a general sample of individuals: Development and measurement properties.
        Int J Obes (London). 2009; 33: 913-922
        • Schuz B.
        • Schuz N.
        • Ferguson S.G.
        It's the power of food: Individual differences in food cue responsiveness and snacking in everyday life.
        Int J Behav Nutr Phys Act. 2015; 12: 149
        • Nansel T.R.
        • Lipsky L.M.
        • Eisenberg M.H.
        • Haynie D.L.
        • Liu D.
        • Simons-Morton B.
        Greater food reward sensitivity is associated with more frequent intake of discretionary foods in a nationally representative sample of young adults.
        Front Nutr. 2016; 3: 33
        • Pursey K.M.
        • Collins C.E.
        • Stanwell P.
        • Burrows T.L.
        Foods and dietary profiles associated with 'food addiction' in young adults.
        Addict Behav Rep. 2015; 2: 41-48
        • Schulte E.M.
        • Jacques-Tiura A.J.
        • Gearhardt A.N.
        • Naar S.
        Food addiction prevalence and concurrent validity in African American adolescents with obesity.
        Psychol Addict Behav. 2018; 32: 187-196
        • Monteiro C.A.
        • Cannon G.
        • Moubarac J.-C.
        • Levy R.B.
        • Louzada M.L.C.
        • Jaime P.C.
        The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing.
        Public Health Nutr. 2018; 21: 5-17
        • Spinella M.
        Normative data and a short form of the Barratt Impulsiveness Scale.
        Int J Neurosci. 2007; 117: 359-368
        • Coskunpinar A.
        • Dir A.L.
        • Cyders M.A.
        Multidimensionality in impulsivity and alcohol use: A meta-analysis using the UPPS model of impulsivity.
        Alcohol Clin Exp Res. 2013; 37: 1441-1450
        • Friedel J.E.
        • DeHart W.B.
        • Madden G.J.
        • Odum A.L.
        Impulsivity and cigarette smoking: Discounting of monetary and consumable outcomes in current and non-smokers.
        Psychopharmacology (Berlin). 2014; 231: 4517-4526
        • Guerrieri R.
        • Nederkoorn C.
        • Jansen A.
        How impulsiveness and variety influence food intake in a sample of healthy women.
        Appetite. 2007; 48: 119-122
        • Guerrieri R.
        • Nederkoorn C.
        • Stankiewicz K.
        • et al.
        The influence of trait and induced state impulsivity on food intake in normal-weight healthy women.
        Appetite. 2007; 49: 66-73
        • Guerrieri R.
        • Nederkoorn C.
        • Jansen A.
        The interaction between impulsivity and a varied food environment: Its influence on food intake and overweight.
        Int J Obes. 2008; 32: 708-714
        • Kakoschke N.
        • Kemps E.
        • Tiggemann M.
        External eating mediates the relationship between impulsivity and unhealthy food intake.
        Physiol Behav. 2015; 147: 117-121
        • Meule A.
        • Kubler A.
        Double trouble. Trait food craving and impulsivity interactively predict food-cue affected behavioral inhibition.
        Appetite. 2014; 79: 174-182
        • Clark M.
        • Ogden J.
        The impact of pregnancy on eating behaviour and aspects of weight concern.
        Int J Obes Relat Metab Disord. 1999; 23: 18-24
        • Davies K.
        • Wardle J.
        Body image and dieting in pregnancy.
        J Psychosom Res. 1994; 38: 787-799
        • Blau L.E.
        • Orloff N.C.
        • Flammer A.
        • Slatch C.
        • Hormes J.M.
        Food craving frequency mediates the relationship between emotional eating and excess weight gain in pregnancy.
        Eat Behav. 2018; 31: 120-124
        • Groth S.W.
        • Morrison-Beedy D.
        • Meng Y.
        How pregnant African American women view pregnancy weight gain.
        J Obstet Gynecol Neonatal Nurs. 2012; 41: 798-808
        • Forbes E.L.
        • Graham E.J.
        • Berglund C.
        • Bell C.R.
        Dietary change during pregnancy and women’s reasons for change.
        Nutrients. 2018; 10: 1032
        • Padmanabhan U.
        • Summerbell C.D.
        • Heslehurst N.
        A qualitative study exploring pregnant women's weight-related attitudes and beliefs in UK: The BLOOM study.
        BMC Pregnancy Childbirth. 2015; 15: 99
        • Emery R.L.
        A Perspective on the potential associations among impulsivity, palatable food intake, and weight gain in pregnancy: Arguing a need for future research.
        Curr Addict Rep. 2018; 5: 251-256
        • Nansel T.R.
        • Lipsky L.M.
        • Siega-Riz A.M.
        • Burger K.
        • Faith M.
        • Liu A.
        Pregnancy eating attributes study (PEAS): A cohort study examining behavioral and environmental influences on diet and weight change in pregnancy and postpartum.
        BMC Nutr. 2016; 2: 45
      1. Stata Statistical Software [computer program]. Release 14. Stata Corp LP, College Station, TX2015
        • Semega J.L.
        • Fontenot K.R.
        • Kollar M.A.
        Income and poverty in the United States: 2016. 2017.
        • Olson C.M.
        • Strawderman M.S.
        Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain.
        J Am Diet Assoc. 2003; 103: 48-54
        • Burger K.S.
        • Sanders A.J.
        • Gilbert J.R.
        Hedonic hunger is related to increased neural and perceptual responses to cues of palatable food and motivation to consume: Evidence from 3 independent investigations.
        J Nutr. 2016; 146: 1807-1812
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders.
        (text rev)4th ed. American Psychiatric Association, Washington, DC2000
        • Francis L.A.
        • Susman E.J.
        Self-regulation and rapid weight gain in children from age 3 to 12 years.
        Arch Pediatr Adolesc Med. 2009; 163: 297-302
        • Kishinevsky F.I.
        • Cox J.E.
        • Murdaugh D.L.
        • Stoeckel L.E.
        • Cook 3rd, E.W.
        • Weller R.E.
        fMRI reactivity on a delay discounting task predicts weight gain in obese women.
        Appetite. 2012; 58: 582-592
        • Seeyave D.M.
        • Coleman S.
        • Appugliese D.
        • et al.
        Ability to delay gratification at age 4 years and risk of overweight at age 11 years.
        Arch Pediatr Adolesc Med. 2009; 163: 303-308
        • Nederkoorn C.
        • Jansen E.
        • Mulkens S.
        • Jansen A.
        Impulsivity predicts treatment outcome in obese children.
        Behav Res Ther. 2007; 45: 1071-1075
        • Pauli-Pott U.
        • Albayrak O.
        • Hebebrand J.
        • Pott W.
        Association between inhibitory control capacity and body weight in overweight and obese children and adolescents: Dependence on age and inhibitory control component.
        Child Neuropsychol. 2010; 16: 592-603
        • Ledikwe J.H.
        • Ello-Martin J.A.
        • Rolls B.J.
        Portion sizes and the obesity epidemic.
        J Nutr. 2005; 135: 905-909
        • Birch L.L.
        • Fisher J.O.
        • Davison K.K.
        Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger.
        Am J Clin Nutr. 2003; 78: 215-220
        • Fisher J.O.
        • Birch L.L.
        Eating in the absence of hunger and overweight in girls from 5 to 7 y of age.
        Am J Clin Nutr. 2002; 76: 226-231
        • Chamoun E.
        • Mutch D.M.
        • Allen-Vercoe E.
        • et al.
        A review of the associations between single nucleotide polymorphisms in taste receptors, eating behaviors, and health.
        Crit Rev Food Sci Nutr. 2018; 58: 194-207
        • Desor J.
        • Greene L.
        • Maller O.
        Preferences for sweet and salty in 9- to 15-year-old and adult humans.
        Science. 1975; 190: 686-687
        • Drewnowski A.
        Taste preferences and food intake.
        Annu Rev Nutr. 1997; 17: 237-253
      2. Food Patterns Equivalents Database [database online]. Version 2015-2016. US Dept of Agriculture, Food Surveys Research Group, Beltsville Human Nutrition Research Center, Beltsville, MD2017
      3. US Dept of Agriculture Food and Nutrient Database for Dietary Studies [database online]. Version 2015-2016. US Dept of Agriculture, Agricultural Research Service, Food Surveys Research Group, Bethesda, MD2018
        • Amin T.
        • Mercer J.G.
        Hunger and satiety mechanisms and their potential exploitation in the regulation of food intake.
        Curr Obes Rep. 2016; 5: 106-112
        • Sclafani A.
        Gut–brain nutrient signaling. Appetition vs. satiation.
        Appetite. 2013; 71: 454-458
        • Volkow N.D.
        • Wise R.A.
        How can drug addiction help us understand obesity?.
        Nat Neurosci. 2005; 8: 555-560
        • Jaeger S.R.
        • Bava C.M.
        • Worch T.
        • Dawson J.
        • Marshall D.W.
        • The food choice kaleidoscope
        A framework for structured description of product, place and person as sources of variation in food choices.
        Appetite. 2011; 56: 412-423
        • Fay S.H.
        • White M.J.
        • Finlayson G.
        • King N.A.
        Psychological predictors of opportunistic snacking in the absence of hunger.
        Eat Behav. 2015; 18: 156-159
        • Feig E.H.
        • Piers A.D.
        • Kral T.V.E.
        • Lowe M.R.
        Eating in the absence of hunger is related to loss-of-control eating, hedonic hunger, and short-term weight gain in normal-weight women.
        Appetite. 2018; 123: 317-324
        • Mallan K.M.
        • Nambiar S.
        • Magarey A.M.
        • Daniels L.A.
        Satiety responsiveness in toddlerhood predicts energy intake and weight status at four years of age.
        Appetite. 2014; 74: 79-85
        • Carnell S.
        • Wardle J.
        Measuring behavioural susceptibility to obesity: Validation of the child eating behaviour questionnaire.
        Appetite. 2007; 48: 104-113
        • Epstein L.H.
        • Temple J.L.
        • Neaderhiser B.J.
        • Salis R.J.
        • Erbe R.W.
        • Leddy J.J.
        Food reinforcement, the dopamine D2 receptor genotype, and energy intake in obese and nonobese humans.
        Behav Neurosci. 2007; 121: 877-886
        • Nederkoorn C.
        • Dassen F.C.
        • Franken L.
        • Resch C.
        • Houben K.
        Impulsivity and overeating in children in the absence and presence of hunger.
        Appetite. 2015; 93: 57-61
        • Hughes S.O.
        • Power T.G.
        • O'Connor T.M.
        • Orlet Fisher J.
        Executive functioning, emotion regulation, eating self-regulation, and weight status in low-income preschool children: How do they relate?.
        Appetite. 2015; 89: 1-9
        • Rollins B.Y.
        • Dearing K.K.
        • Epstein L.H.
        Delay discounting moderates the effect of food reinforcement on energy intake among non-obese women.
        Appetite. 2010; 55: 420-425
        • Fowles E.R.
        • Stang J.
        • Bryant M.
        • Kim S.
        Stress, depression, social support, and eating habits reduce diet quality in the first trimester in low-income women: A pilot study.
        J Acad Nutr Diet. 2012; 112: 1619-1625
      4. Allison PD. Handling Missing Data by Maximum Likelihood. Oral presentation at: SAS Global Forum; April 2012; Orlando, FL. https://support.sas.com/resources/papers/proceedings12/312-2012.pdf, Accessed October 8, 2020.

      Biography

      K. Burger is an assistant professor, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.

      Biography

      L. M. Lipsky is a staff scientist, Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child health and Human Development, Bethesda MD.

      Biography

      M. S. Faith is a professor, Department of Counseling, School, and Educational Psychology, University at Buffalo Graduate School of Education, Buffalo, NY.

      Biography

      A. M. Siega-Riz is dean and a professor, School of Public Health and Health Sciences, University of Massachusetts, Amherst; at the time of the study, she was a professor and associate dean for academic affairs, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.

      Biography

      G. E. Shearrer is an assistant professor, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.

      Biography

      A. Liu is a senior investigator, Biostatistics and Bioinformatics Branch, Eunice Kennedy Shriver National Institute for Child health and Human Development, Bethesda, MD.

      Biography

      T. Nansel is a senior investigator, Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child health and Human Development, Bethesda, MD.