Pickles and ice cream! Food cravings in pregnancy: hypotheses, preliminary evidence, and directions for future research

Abstract

Women in the United States experience an increase in food cravings at two specific times during their life, (1) perimenstrually and (2) prenatally. The prevalence of excess gestational weight gain (GWG) is a growing concern due to its association with adverse health outcomes in both mothers and children. To the extent that prenatal food cravings may be a determinant of energy intake in pregnancy, a better understanding of craving etiology could be crucial in addressing the issue of excessive GWG. This paper reviews the available literature to corroborate and/or dispute some of the most commonly accepted hypotheses regarding the causes of food cravings during pregnancy, including a role of (1) hormonal changes, (2) nutritional deficits, (3) pharmacologically active ingredients in the desired foods, and (4) cultural and psychosocial factors. An existing model of perimenstrual chocolate craving etiology serves to structure the discussion of these hypotheses. The main hypotheses discussed receive little support, with the notable exception of a postulated role of cultural and psychosocial factors. The presence of cravings during pregnancy is a common phenomenon across different cultures, but the types of foods desired and the adverse impact of cravings on health may be culture-specific. Various psychosocial factors appear to correlate with excess GWG, including the presence of restrained eating. Findings strongly suggest that more research be conducted in this area. We propose that future investigations fall into one of the four following categories: (1) validation of food craving and eating-related measures specifically in pregnant populations, (2) use of ecological momentary assessment to obtain real time data on cravings during pregnancy, (3) implementation of longitudinal studies to address causality between eating disorder symptoms, food cravings, and GWG, and (4) development of interventions to ensure proper prenatal nutrition and prevent excess GWG.

Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study

“…Our findings identified several barriers to healthy GWG that have also been suggested by previous research, including the powerful effect of family members and cultural and social norms promoting the desirability of large babies and the need to “eat for two,” 28 the challenge of coping with food cravings during pregnancy, 29,30 and poor food environments, including ubiquitous fast food and unhealthy foods, and lack of transportation. 29 Our findings also corroborate previous reports that a desire to return to a thinner pre-pregnancy weight is a strong motivating factor and may reduce risk for excess GWG, 31,32 that women are motivated to eat healthy for the sake of their babies, 32 and that personal experience with excess GWG and postpartum weight retention during a prior pregnancy is a salient motivator of healthy GWG.…”

Exposure to a Highly Caloric Palatable Diet during the Perinatal Period Affects the Expression of the Endogenous Cannabinoid System in the Brain, Liver and Adipose Tissue of Adult Rat Offspring

“…Thus, it has been shown that malnourished rats could modify their food preferences according to their nutrient deficiency [52]. Additionally, it has been reported that craving during pregnancy may be associated to the nutritional requirements during this specific period of life [53,54]. …”

Examination of the reliability and validity of the Mindful Eating Questionnaire in pregnant women

“…This may be due to changes in hormones, senses, or cultural or psychosocial factors (Cooksey, 1995; Hook, 1978; Orloff & Hormes, 2014). Certain foods are reported to cause nausea, a symptom reported by many women early in pregnancy, while later in pregnancy, many women report that foods are craved.…”

“…It was suggested craving of sweets and soft drinks caused increased gestational weight gain but food cravings were not tested (Renault, et al, 2015). However others have found that food cravings increase during pregnancy (Belzer, Smulian, Lu, & Tepper, 2010; Orloff & Hormes, 2014; Pope, Skinner, & Carruth, 1992) leading to increased food intake and thereby increased gestational weight gain. Food cravings and emotional eating are thought to decrease with mindfulness (May, Andrade, Batey, Berry, & Kavanagh, 2010; Paolini, et al, 2014) but this has not been empirically tested in pregnant women.…”