SBSB Research: Eating Behavior from Pregnancy through Early Childhood

PEAS logo
Sprouts logo - Development of eating behaviors in early childhood

Poor diet quality is the leading contributor to global disease burden, and clinical and public health approaches to improve diet quality have been minimally successful, indicating the need to identify more effective modifiable targets. Pregnancy, postpartum, and early childhood are critical developmental periods during which dynamic changes in weight and diet occur.

In pregnancy, poor maternal diet quality and excessive gestational weight gain are prevalent across racial/ethnic groups and income levels, and are modifiable risk factors for numerous adverse maternal and child health outcomes. In the offspring, poor diet quality begins early in childhood, affecting the development of lifelong eating behaviors and preferences, with multiple adverse health consequences.

Differences in appetitive traits between individuals may influence risk of poor diet quality and overeating in conducive environments. Highly palatable foods and food cues stimulate activation of neural reward circuitry, promoting overconsumption and potentially displacing intake of more nutrient-dense foods. The strength of the neural food reward response varies between individuals and has been associated with higher body weight and greater weight change as well as with selecting and consuming more discretionary foods and beverages. In addition, neuroadaptations to repeated exposure to highly palatable foods may condition the food reward system based on learned reward expectancies, which may be particularly important in early life.

The Pregnancy Eating Attributes Study (PEAS) is an observational cohort study that examines the roles of maternal reward-related eating, self-control, and the home food environment in maternal dietary intake and weight change as well as infant feeding and growth. The overarching goal is to identify neurobehavioral and environmental determinants of excessive gestational weight gain and postpartum weight retention to inform best practices for supporting optimal diet quality and weight management during this critical developmental period, leading to improved maternal and child health trajectories. The study enrolled 458 women prior to 12 weeks gestation and collected self-report data, dietary recalls, anthropometrics, clinical data, and biospecimens across pregnancy and the first year postpartum. Additionally, three substudies collected data via focus groups, neuroimaging, and a laboratory feeding paradigm. The primary aims of PEAS were to test relationships of maternal reward-related eating, self-control, and the home food environment with maternal diet and weight outcomes, and to test whether self-control or the home food environment modifies the relationship of reward-related eating with maternal diet and weight outcomes. 

The SPROUTS study follows this cohort through early childhood, enabling the examination of the relative influences of neurobehavioral, behavioral, and environmental factors on child diet and weight outcomes. Annual assessments include behavioral measures of reward-related eating and executive function, anthropometrics, and parent-reported dietary intake, feeding, eating, and health behaviors. With this well-characterized cohort followed from early pregnancy through early primary school, we will investigate how prenatal and infant exposures influence the development of child reward-related eating behaviors, diet, and growth.

Principal Investigator

Tonja Nansel, Ph.D.

Division Collaborators

External Collaborators

  • Kyle Burger, Ph.D., University of North Carolina Chapel Hill
  • Myles Faith, Ph.D., University at Buffalo, SUNY
  • Wanda Nicholson, M.D., University of North Carolina Chapel Hill
  • Anna Maria Siega-Riz, Ph.D., University of Massachusetts
  • Grace Shearrer, Ph.D., University of Wyoming
  • Alison Stuebe, M.D., University of North Carolina Chapel Hill

Publications

  • Temmen, C. D., Lipsky, L. M., Faith, M. S., & Nansel, T. R. (2021). Prospective relations between maternal emotional eating, feeding to soothe, and infant appetitive behaviors. The International Journal of Behavioral Nutrition and Physical Activity, 18(1), 105. PMID: 34380499
  • Schwedhelm, C., Lipsky, L. M., Shearrer, G. E., Betts, G. M., Liu, A., Iqbal, K., Faith, M. S., & Nansel, T. R. (2021). Using food network analysis to understand meal patterns in pregnant women with high and low diet quality. The International Journal of Behavioral Nutrition and Physical Activity, 18 (1), 101. PMID: 34301273
  • Mooney, J., Lipsky, L. M., Liu, A., & Nansel, T. R. (2021). Does stress attenuate motivation for healthful eating in pregnancy and postpartum?. Appetite, 163, 105207. PMID: 33737210
  • Terry, N., Lipsky, L. M., Siega-Riz, A. M., Liu, A., & Nansel, T. R. (2021). The effect of remuneration schedule on data completion and retention in the pregnancy eating attributes study (PEAS). PloS One, 16(5), e0251533. PMID: 33984020
  • Betts, G. M., Lipsky, L. M., Temmen, C. D., Siega-Riz, A. M., Faith, M. S., & Nansel, T. R. (2021). Poorer mental health and sleep quality are associated with greater self-reported reward-related eating during pregnancy and postpartum: An observational cohort study. The International Journal of Behavioral Nutrition and Physical Activity, 18(1), 58. PMID: 33933087
  • Hill, C., Lipsky, L. M., Betts, G. M., Siega-Riz, A. M., & Nansel, T. R. (2021). A prospective study of the relationship of sleep quality and duration with gestational weight gain and fat gain. Journal of Women's Health (2002), 30(3), 405–411. PMID: 32945728
  • Lipsky, L. M., Burger, K. S., Faith, M. S., Shearrer, G. E., & Nansel, T. R. (2021). Eating in the absence of hunger is related to worse diet quality throughout pregnancy. Journal of the Academy of Nutrition and Dietetics, 121(3), 501–506. PMID: 33158801
  • Lipsky, L. M., Burger, K. S., Faith, M. S., Siega-Riz, A. M., Liu, A., Shearrer, G. E., & Nansel, T. R. (2021). Pregnant women consume a similar proportion of highly vs. minimally processed foods in the absence of hunger, leading to large differences in energy intake. Journal of the Academy of Nutrition and Dietetics, 121(3), 446–457. PMID: 33109504
  • Nansel, T. R., Lipsky, L. M., Faith, M., Liu, A., & Siega-Riz, A. M. (2020). The accelerator, the brake, and the terrain: Associations of reward-related eating, self-regulation, and the home food environment with diet quality during pregnancy and postpartum in the pregnancy eating attributes study (PEAS) cohort. The International Journal of Behavioral Nutrition and Physical Activity, 17(1), 149. PMID: 33228724
  • Nansel, T. R., Lipsky, L. M., Burger, K., Faith, M., Nicholson, W., Stuebe, A., Liu, A., & Siega-Riz, A. M. (2020). Reward-related eating, self-regulation, and weight change in pregnancy and postpartum: The Pregnancy Eating Attributes Study (PEAS). International Journal of Obesity (2005), 44(12), 2444–2454. PMID: 32958906
  • Blau, L. E., Lipsky, L. M., Dempster, K. W., Eisenberg Colman, M. H., Siega-Riz, A. M., Faith, M. S., & Nansel, T. R. (2020). Women's experience and understanding of food cravings in pregnancy: A qualitative study in women receiving prenatal care at the University of North Carolina-Chapel Hill. Journal of the Academy of Nutrition and Dietetics, 120(5), 815–824. PMID: 31813756
  • Shearrer, G. E., Nansel, T. R., Lipsky, L. M., Sadler, J. R., & Burger, K. S. (2019). The impact of elevated body mass on brain responses during appetitive prediction error in postpartum women. Physiology & Behavior, 206, 243–251. PMID: 30986423
  • Nansel, T. R., Lipsky, L. M., Siega-Riz, A. M., Burger, K., Faith, M., & Liu, A. (2016). Pregnancy Eating Attributes Study (PEAS): A cohort study examining behavioral and environmental influences on diet and weight change in pregnancy and postpartum. BMC Nutrition, 2, 45. PMID: 28663822
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