The accelerator, the brake, and the terrain: associations of reward-related eating, self-control, and the home food environment with diet quality assessed by 24-hour recalls during pregnancy and postpartum in the Pregnancy Eating Attributes Study (PEAS) cohort

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Abstract Background. Neurobehavioral factors, including reward-related eating and self-control, in conjunction with the food environment, may influence dietary behaviors. However, these constructs have not been examined in pregnancy and postpartum, a time of changing appetite and eating behaviors, and when dietary intake has implications for maternal and child health. This study examined associations of reward-related eating, self-control, and the home food environment with pregnancy and postpartum diet quality. Methods. Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks gestation and followed through one-year postpartum. Pregnancy and postpartum Healthy Eating Index-2015 (HEI) was calculated by pooling 24-hour diet recalls during each trimester and during 2, 6, and 12 months postpartum. Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale (mYFAS), Power of Food Scale (PFS), Multiple Choice Procedure (MCP), and Food Reinforcement Questionnaire (FRQ); two measures of self-control – Barratt Impulsiveness Scale and Delay of Gratification Inventory; and a Home Food Inventory (HFI), yielding obesogenic (OBES) and fruit/vegetables (FV) scores. Linear regression analyses estimated associations of reward-related eating, self-control, and home food environment with diet quality during pregnancy and postpartum, adjusting for sociodemographic characteristics. Results. Pregnancy, HEI was inversely associated with PFS, mYFAS, MCP, and 2 of the 5 FRQ indices, but most associations of postpartum HEI with reward-related eating measures were not statistically significant. Associations of HEI with general self-control measures were not statistically significant. Pregnancy and postpartum HEI were associated inversely with HFI-OBES and positively with HFI-FV. Conclusions. Associations of diet quality with greater reward-related eating during pregnancy but not postpartum suggests the need to better understand differences in the determinants of eating behaviors and approaches to circumvent or moderate reward-related eating to facilitate more optimal diet quality across this critical period.

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