The rising prevalence of maternal overweight/obesity and excessive gestational weight gain poses serious public health concerns due to the contribution of these factors to increased risk of adverse maternal and child health outcomes. The poor diet quality of the U.S. population, characterized by excessive intake of total energy, added sugar, fat and sodium, and inadequate intake of fruits, vegetables and whole grains also is well-documented. Dietary interventions in the general population and pregnant women alike have achieved only marginal success, indicating the need to identify more effective modifiable targets and strategies. An emerging hypothesis posits that energy homeostatic processes are overridden by hedonic eating, in which food intake is motivated by the neural reward response to food in the absence of energetic requirements. The relative strength of this reward response (food reward sensitivity) varies between individuals and has been positively associated with body weight and weight change in small samples, supporting the need for further investigation in population-based samples. The Pregnancy Eating Attributes Study (PEAS) is an observational prospective cohort study investigating relationships of food reward sensitivity, behavioral control, and the home food environment with dietary intake and weight change during pregnancy, postpartum, and infancy. Participants were enrolled early in pregnancy (before 12 weeks gestation) and followed, with their infants, until 1 year postpartum. Data collection was completed in fall 2018, and primary analyses are currently underway. The study includes data on dietary intake, anthropometrics, biospecimens, medical records, self-reported eating and other health-related behaviors, functional magnetic resonance imaging, focus groups, and an experimental measure of overeating. The overarching goal is to identify neurobehavioral and environmental determinants of excessive gestational weight gain and postpartum weight retention, and inform best practices for supporting optimal diet quality and weight management during this critical developmental period, leading to improved maternal and child health trajectories.
