Association between household food environment and excessive gestational weight gain

Authors: PORTER, HANNAH - Rhodes University; WEST, DELIA - University Of South Carolina; CELEVES, MARIO - Arkansas Children'S Nutrition Research Center (ACNC); SAYLORS, MARIE - University Arkansas For Medical Sciences (UAMS); ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC); KRUKOWSKI, REBECCA - University Of Tennessee

Submitted to: Journal of Women's Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/25/2018
Publication Date: 8/1/2018
Citation: Porter, H., West, D.S., Celeves, M.A., Saylors, M.E., Andres, A., Krukowski, R.A. 2018. Association between household food environment and excessive gestational weight gain. Journal of Women's Health. 27(8):1064-1070. http://doi.org/10.1089/jwh.2017.6552.
DOI: https://doi.org/10.1089/jwh.2017.6552

Interpretive Summary: Gestational weight gain (GWG), the amount of weight that is gained during pregnancy, has significant health impacts for mother and child. The home food environment, types of foods available in the home and food storage techniques, has a significant influence on dietary intake. Understanding the role of home food environment on weight gain during pregnancy may provide a useful weight management strategy to reduce excessive GWG. We measured number of high-fat (i.e. cheese, cookies, and chips) and low-fat foods (i.e. fruits, vegetables) and food storage practices at the beginning and end of pregnancy of 228 pregnant women. We also calculated GWG to determine if participants gained above, within, or below the recommended weight range for a healthy pregnancy. We found that overweight and obese women stored more food visibly in their home (i.e. foods on counters instead of in a pantry) than normal weight women. Additionally, we found that having more low-fat foods items in the home was associated with a decreased risk of excessive GWG. Notably, number of high-fat foods in the home did not influence risk of excessive GWG. These findings suggests that increasing the number of low-fat food items in the home and storing food out of plain sight may impact GWG.

Technical Abstract: Understanding the role of home food environment on gestational weight gain (GWG) may provide a useful weight management strategy to help reduce excessive GWG. Pregnant women were recruited between 2011 and 2014 (N = 165; normal weight N= 65, overweight N= 62, obese N = 38) in Arkansas completed measures of high-fat food availability, low-fat food availability, and food storage practices at baseline (4–10 weeks) and 30 weeks gestation. GWG was calculated as the difference between weight at the first (4–10 weeks) and final (36 weeks) prenatal visit, and based on each participant's baseline body mass index (BMI) category, GWG was classified as being above or within the 2009 Institute of Medicine's GWG guidelines. Multivariable models were adjusted for mother's age, race, marital status, and household income. We found that there were no significant relationships between gaining above the guidelines and the home food environment variables. At baseline, after adjusting for covariates, overweight and obese pregnant women stored significantly more foods visibly in their home compared to normal weight women (overweight: b: 0.30, standard error [SE]: 0.13, p = 0.01; obese: b: 0.28, SE: 0.14, p = 0.04). At 30 weeks, obese pregnant women had significantly fewer low-fat foods in the home (b: -0.17; SE: 0.08, p = 0.04), although after adjusting for covariates, this relationship became a nonsignificant trend (p = 0.08). There were no significant relationships between BMI category and number of high-fat foods in the home. These findings are consistent with other studies in non-pregnant populations that demonstrate that home food environment may influence weight status of overweight and obese pregnant women, although we did not find a significant relationship between the home food environment and GWG.