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Food and non-food reinforcement among pregnant women
- Kong, Kai Ling, Epstein, Leonard H., Phillips, Julie K., Carr, Katelyn A., Paluch, Rocco A., Gerard, Katherine S.
- Appetite 2018 v.131 pp. 155-159
- cross-sectional studies, educational status, food reinforcement, gestational age, guidelines, medicine, pregnancy, pregnant women, products and commodities, questionnaires, surveys, weight gain
- Excessive gestational weight gain (GWG) in pregnancy may be driven in part by greater motivation to eat, and studying the relative reinforcing value of food versus non-food commodities may provide insight into factors important for excessive GWG. This study was a cross-sectional examination of the relationship between women meeting the Institute of Medicine (IOM) guidelines for GWG and the relative reinforcing value of food vs. non-food commodities during pregnancy. Two-hundred and thirty-three pregnant women (1st trimester, n = 44; 2nd trimester, n = 105; 3rd trimester, n = 84), aged 18–40, were recruited via a crowdsourcing platform and completed an online survey. Relative food reinforcement (RRVfood), relative non-food activity reinforcement (RRVactive) and relative non-food cognitively enriching activity reinforcement (RRVcognitive) were measured by a questionnaire at the point of contact. Self-reports of gestational age and weight gain during pregnancy were collected. The relationship between food and non-food reinforcement was assessed based on IOM classifications for weight gain during pregnancy. After adjustment for women's education level and parity, higher RRVfood (p = 0.036) and lower RRVcognitive (p = 0.040) responses were associated with greater GWG. Food reinforcing ratio (FRR) analysis was then conducted to systematically examine the effect of non-food behaviors on GWG when food reinforcement was accounted for. Women who gained below the IOM weight gain guidelines had significantly higher FRRcognitive than those gaining above (p = 0.013), indicating cognitively enriching activities may better compete with food among pregnant women. Interventions that help to increase the reinforcing value of cognitively enriching activities may be a new avenue to regulate eating to minimize GWG.