title: Maternal mental health symptoms are positively related to emotional and restrained eating attitudes in a statewide sample of mothers participating in a supplemental nutrition program for women, infants and young children.
abstract: Postpartum, low-income mothers are at risk for mental health symptoms and obesity, and disordered eating attitudes may be associated with both mental health and obesity in this vulnerable population. The study objective is to determine whether higher levels of mental health symptoms are associated with increased odds of emotional and restrained eating attitudes in this sample of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participants. Data on 711 mothers of infants <13 months from a statewide sample of Maryland WIC participants were collected via telephone survey. Maternal mental health symptoms were measured on continuous scales for depression (PRIME-MD), stress (Perceived Stress Scale) and anxiety (Spielberger State-Trait Anxiety Inventory). Emotional and restrained eating attitudes were measured with questions adapted from the Dutch Eating Behavior Questionnaire. Multivariate logistic regression analysis was used. Obesity [body mass index (BMI) ≥ 30] was explored as a moderating variable. Mothers reporting higher levels of depression symptoms [odds ratio (OR) = 3.93, 95%CI: 2.71-5.69], anxiety symptoms (OR = 1.96, 95%CI: 1.47-2.65), stress symptoms (OR = 2.09, 95%CI: 1.67-2.61) and high overall mental health symptomatology (OR = 3.51, 95%CI: 2.43-5.3) had increased odds of emotional eating attitudes. There were significant associations between symptoms of depression (OR = 1.59, 95% CI: 1.12-2.25) and increased odds of restrained eating attitudes. Obesity did not moderate the association. Mothers with mental health symptoms are at risk for disordered eating attitudes, which may increase risk of poor diet. These findings underscore the need for greater focus on addressing maternal mental health status and eating attitudes in the postpartum period.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, Maryland, USA.
authors.forename: Jillian A
authors.initials: JA
authors.lastname: Emerson
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, Maryland, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Hurley
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, Maryland, USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Caulfield
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, 737 W. Lombard St., Baltimore, MD, 21201, Maryland, USA.
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Black
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D004032:Diet / Q000523:psychology*; D004644:Emotions; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000523:psychology; D005260:Female; D063105:Food Assistance; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008396:Maryland / Q000453:epidemiology; D008603:Mental Health; D009035:Mothers / Q000523:psychology; D009765:Obesity / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology; D011203:Poverty; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: attitudes; maternal mental health; obesity; overweight; postpartum; women's health