Say it isn't so! Indulging while pregnant linked to excess weight gain

A new University at Albany study may have pregnant women thinking twice before reaching for the pickles and ice cream.

Published in the journal Appetite, a team of researchers led by UAlbany psychology assistant professor Julia Hormes have found the frequency of food cravings to be a strong predictor of excess weight gain during pregnancy.

Experts believe anywhere from 50 to 90 percent of expectant moms experience food cravings, especially during the first semester. Recent studies have also shown more than half of women gain above the Institute of Medicine (IOM) guidelines for pregnancy weight gain.

"Our research is motivated by the fact that excess weight gain in pregnancy has rapidly become a major public health concern," Hormes said. "It has significant implications for the health of mothers and their children, including increased risk of gestational diabetes, preeclampsia, a range of complications in delivery, difficulties initiating breastfeeding, increased postpartum weight retention in the mothers, and overweight offspring."

Hormes, along with graduate student Natalia Orloff, undergrads Sarah Liquorman and Josette Hartnett, and Drs. Amy Flammer and Renee Samelson of Albany Medical College, recruited two diverse samples of pregnant women to conduct their research. One, a group of 40, was gathered online via Facebook and other social media sites. The second, a group of 43, volunteered through Albany Medical Center's Department of Obstetrics, Gynecology, and Reproductive Sciences.

The women completed online surveys regarding diverse aspects of their eating behavior. It included questions about how often the women craved food from different categories (sweets, carbohydrates and starches, fast food and high-fat food), as well as how often they gave into those cravings. The women also indicated their weight prior to the start of pregnancy, current weight, and stage of gestation at the time of survey completion.

Frequency in which women experienced food cravings was found to account for a significant proportion of the variances in excess weight gain for both groups of women – 25 and 32 percent, respectively. Interestingly, the rate at which cravings were satisfied was only associated with weight gain in the online group. Hormes said more research needs to be done, but one possible explanation is that women in the hospital group started out, on average, at a higher weight.

Measurements were validated using the Food Craving Inventory (FCI). The most commonly craved foods were chocolate, pizza, cookies, and ice cream.

"We tested the hypothesis that food cravings account for at least some of the variance in weight gain observed, in the hope that we may be able to identify novel targets for interventions," Hormes said. "The fact that we obtained comparable findings in two demographically diverse groups is encouraging. It further backs our claims that targeting food cravings could prove to be a powerful tool in combatting excess pregnancy weight gain for a wide range of women."

As detailed in her previous research, Hormes believes food cravings are driven by psychosocial, and/or cultural factors, not physiological. For example, a pregnant woman who typically eats in moderation may feel that it's ok to "eat for two" or indulge in foods that the fetus "wants" or "needs." This perception may be further reinforced by those around them who expect to hear stories of strange cravings and indulgence in odd combinations of food.

Hormes advises women to implement healthy eating habits, and learn to reduce cravings, even before pregnancy. She also encourages those expecting to get informed and speak to their medical provider about appropriate weight gain targets, healthy nutrition, and safe ways to stay active during pregnancy.

"Women should avoid buying into those prevalent myths around eating habits during pregnancy," Hormes said. "Cravings are very fleeting experiences that come and go relatively quickly. It's important to work on being able to sit through a craving without either trying to push the thoughts aside or act on them."

The research team plans to continue adding to its findings, including longitudinal work (following women across the entire duration of their pregnancy). They are also beginning to develop specific intervention techniques to target food cravings.