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.

Eating Behaviors in Postpartum: A Qualitative Study of Women with Obesity

“…The results of this study also call attention to the type of care provided by the mother for her baby, since unhealthy food choices are often made, including when considering the weaning, which corroborates other studies that focus on the influence of food during the mother-child relationship [47,48]. …”

Disordered eating and the perinatal period: A systematic review and best evidence synthesis of mental health and psychosocial correlates

“…One high‐quality and one fair‐quality prospective cohort study found that disordered eating during the post‐partum period was associated with depressive symptoms (Carter et al, ; Lai et al, ), however, only one study demonstrated direction of association with disordered eating at 4 months post‐partum, predicting depressive symptoms at 14 months post‐partum (Carter et al, ). One high‐quality cross sectional study demonstrated an association between disordered eating during the post‐partum period and depressive symptoms within the year after birth (Emerson et al, ). There was not enough evidence to determine a direction of association.…”

“…There was no evidence to support an association between disordered eating and anxiety during the post‐partum period, as one fair‐quality prospective cohort study did not find an association between disordered eating and anxiety during the post‐partum period (Carter et al, ). One high‐quality cross sectional study found that emotional eating, but not restrained eating, was associated with anxiety within the year after birth (Emerson et al, ).…”

Biobehavioral Factors That Shape Nutrition in Low-Income Populations

“…62 In a larger sample of postpartum women who participated in the program (n¼711), anxiety, depression, and perceived stress were strongly associated with emotional eating; depression was associated with dietary restraint. 63 Furthermore, stressful events were linked to emotional eating in qualitative study of low-income overweight/obese mothers. 64 The consistency of findings in these studies suggests that interventions aimed at improving dietary intake should consider stress and eating behaviors.…”