title: Food insecurity with past experience of restrained eating is a recipe for increased gestational weight gain.
abstract: Food insecurity is linked to higher weight gain in pregnancy, as is dietary restraint. We hypothesized that pregnant women exposed to marginal food insecurity, and who reported dietary restraint before pregnancy, will paradoxically show the greatest weight gain. Weight outcomes were defined as total kilograms, observed-to-recommended weight gain ratio, and categorized as adequate, inadequate or excessive weight gain based on 2009 Institute of Medicine guidelines. A likelihood ratio test assessed the interaction between marginal food insecurity and dietary restraint and found significant. Adjusted multivariate regression and multinomial logistic models were used to estimate weight gain outcomes. In adjusted models stratified by dietary restraint, marginal insecurity and low restraint was significantly associated with lower weight gain and weight gain ratio compared to food secure and low restraint. Conversely, marginal insecurity and high restraint was significantly associated with higher weight gain and weight gain ratio compared to food secure and high restraint. Marginal insecurity with high restraint was significantly associated with excessive weight gain. Models were consistent when restricted to low-income women and full-term deliveries. In the presence of marginal food insecurity, women who struggle with weight and dieting issues may be at risk for excessive weight gain.
authors: Division of Community Health & Human Development, School of Public Health, University of California Berkeley, 207-B University Hall, Berkeley, CA, USA. blaraia@berkeley.edu
authors: Barbara
authors: B
authors: Laraia
authors: Elissa
authors: E
authors: Epel
authors: Anna Maria
authors: AM
authors: Siega-Riz
mesh_terms: D000328:Adult; D004038:Diet, Reducing; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005523:Food Supply; D006801:Humans; D006815:Hunger; D007182:Income; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000209:etiology*; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications; D015430:Weight Gain; D055815:Young Adult
references: Appetite. 1991 Feb;16(1):45-55
references: 2018403
references: Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504
references: 10993420
references: Am J Public Health. 1990 Nov;80(11):1376-8
references: 2240310
references: J Consult Clin Psychol. 2005 Apr;73(2):195-202
references: 15796626
references: Soc Sci Med. 2002 Jan;54(1):119-32
references: 11820676
references: Am J Clin Nutr. 2004 Jan;79(1):6-16
references: 14684391
references: J Am Diet Assoc. 2005 Jun;105(6):963-6
references: 15942549
references: J Nutr. 2004 Sep;134(9):2330-5
references: 15333724
references: Ann Epidemiol. 1992 Sep;2(5):715-21
references: 1342323
references: Int J Eat Disord. 2006 Jul;39(5):369-75
references: 16528729
references: J Pers. 1975 Dec;43(4):647-60
references: 1206453
references: Pediatrics. 2004 Feb;113(2):298-304
references: 14754941
references: Am J Clin Nutr. 2005 Jul;82(1 Suppl):222S-225S
references: 16002825
references: J Nutr. 2003 Apr;133(4):1070-4
references: 12672921
references: Pediatrics. 1995 May;95(5):766-7
references: 7724321
references: J Clin Epidemiol. 1993 Dec;46(12):1403-11
references: 8263567
references: J Am Diet Assoc. 1992 Jan;92(1):85-7
references: 1728630
references: J Abnorm Psychol. 2000 Aug;109(3):438-44
references: 11016113
references: Am J Clin Nutr. 2008 Sep;88(3):693-9
references: 18779285
references: J Nutr. 1999 Feb;129(2S Suppl):521S-524S
references: 10064322
references: J Am Diet Assoc. 1996 Oct;96(10):1019-24; quiz 1025-6
references: 8841164
references: J Consult Clin Psychol. 1999 Dec;67(6):967-74
references: 10596518
references: Physiol Behav. 2007 Jul 24;91(4):449-58
references: 17543357
references: Obstet Gynecol. 1994 Oct;84(4):565-73
references: 8090394
references: Am J Epidemiol. 2009 Mar 15;169(6):756-60
references: 19211620
references: Pediatrics. 1998 Jan;101(1):E3
references: 9417167
references: J Am Diet Assoc. 2010 May;110(5):692-701
references: 20430130
references: J Nutr. 2003 Jan;133(1):120-6
references: 12514278
references: J Nutr. 2006 May;136(5):1395-400
references: 16614436
references: J Nutr. 2001 Jun;131(6):1738-45
references: 11385061
references: Health Rep. 2001 Aug;12(4):11-22
references: 15069808
references: J Nutr. 1990 Nov;120 Suppl 11:1559-600
references: 2243305
references: Public Health Nutr. 2007 Feb;10(2):145-51
references: 17261223
references: J Am Diet Assoc. 2008 Oct;108(10):1646-53
references: 18926129
references: Behav Res Ther. 1983;21(3):253-8
references: 6615391
references: J Nutr. 2006 Jan;136(1):177-82
references: 16365079
references: Diabetes Care. 2012 Feb;35(2):233-8
references: 22210570
references: Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17312-5
references: 15574496
references: Appetite. 1994 Aug;23(1):27-41
references: 7826055
references: Eur J Clin Nutr. 1999 Nov;53(11):849-53
references: 10556996
references: J Nutr. 1996 Jan;126(1):146-53
references: 8558295