Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Subjects
2.2. Measures
2.2.1. Demographic Characteristics
2.2.2. Weight and Physical Activity Measures
2.2.3. Psychosocial Measures
2.2.4. Self-Reported Energy Intake
2.3. Calculating Underreporting of Energy Intake
2.4. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. Error in Reporting of Energy Intake
3.3. Change in Reporting Error across Pregnancy
3.4. Independent Factors Associated with Reporting Error
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | N(%) 1 |
---|---|
Maternal Age, years | 30.7 ± 3.0 |
Preconception BMI, kg/m2 | 32.7 ± 6.8 |
% BMI = 24.5–29.9 | 10 (48%) |
% BMI ≥ 30 | 11 (52%) |
Gestational Age at Baseline (Weeks) | 10.0 ± 1.7 |
Gestational Weight Gain, kg | 21.5 ± 15.4 |
Race | |
White | 21 (100%) |
Ethnicity | |
Non-Hispanic | 21 (100%) |
Marital Status | |
Divorced | 1 (5%) |
Married | 19 (90%) |
Single | 1 (5%) |
Maternal Education | |
High School | 1 (5%) |
College | 11 (52%) |
Graduate/Professional School | 9 (43%) |
Gravidity | |
1 | 11 (52%) |
2 | 8 (38%) |
3 | 2 (10%) |
Parity | |
0 | 13 (62%) |
1 | 8 (38%) |
Employment | |
Full-Time | 17 (81%) |
Part-Time | 2 (9%) |
Self-Employed | 1 (5%) |
Other | 1 (5%) |
Household Income | |
<$20,000 | 1 (5%) |
$20,000–$40,000 | 4 (19%) |
$40,000–100,000 | 8 (38%) |
≥$100,000 | 8 (38%) |
Characteristic | Self-Reported EI (kcal/d) Mean ± SD | Back-Calculated EI, (kcal/d) Mean ± SD | Difference between Back-Calculated and Self-Reported EI, (kcal/d) Mean ± SD | % Underreporting Mean ± SD |
---|---|---|---|---|
Overall (n = 21) | 1696 ± 481 | 2950 ± 142 | 1263 ± 162 | 38% ± 4 |
Gestational Age (Trimester) | ||||
First Trimester | 1702 ± 70 a | 2688 ± 144 a | 986 ± 166 a | 32% ± 4 a |
Second Trimester | 1681 ± 67 a | 2960 ± 141 b | 1280 ± 162 b | 39% ± 4 b |
Third Trimester | 1692 ± 68 a | 3077 ± 142 c | 1386 ± 164 c | 40% ± 4 b |
Pre-Pregnancy BMI | ||||
BMI 25–29.9 (n = 10) | 1743 ± 97 a | 2537 ± 165 a | 794 ± 190 a | 28% ± 5 a |
BMI ≥ 30 (n = 11) | 1637 ± 92 a | 3324 ± 157 b | 1688 ± 181 b | 47% ± 4 b |
Total GWG Classified by Institute of Medicine Guidelines | ||||
Not Exceeding (n = 12) | 1736 ± 88 a | 3006 ± 191 a | 1271 ± 220 a | 35% ± 5 a |
Exceeding (n = 9) | 1622 ± 102 a | 2874 ± 221 a | 1253 ± 254 a | 41% ± 6 a |
Parity | ||||
0 (n = 13) | 1672 ± 86 a | 3000 ± 184 a | 1329 ± 210 a | 40% ± 5 a |
1 (n = 8) | 1712 ± 110 a | 2867 ± 234 a | 1156 ± 340 a | 36% ± 6 a |
Annual Household Income | ||||
$10,000–$20,000 (n = 1) | 1465 ± 315 a | 4286 ± 613 a | 2821 ± 61 a | 65% ± 17 a |
$20,000–$40,000 (n = 4) | 1689 ± 158 a | 2695 ± 307 b | 1007 ± 346 b | 32% ± 9 a |
$40,000–$100,000 (n = 8) | 1624 ± 111 a | 2971 ± 216 b | 1348 ± 244 b | 41% ± 6 a |
>$100,000 (n = 8) | 1778 ± 111 a | 2888 ± 217 b | 1111 ± 244 b | 35% ± 6 a |
Treatment Group Assignment | ||||
Intervention (n = 11) | 1689 ± 94 a | 2902 ± 200 a | 1213 ± 229 a | 37% ± 5 a |
Control (n = 10) | 1686 ± 99 a | 3002 ± 210 a | 1318 ± 240 a | 40% ± 6 a |
Variable | Model Estimate | Standard Error | p-Value |
---|---|---|---|
Gestational Age (days) | −0.05372 | 0.009664 | <0.0001 |
Gestational Age (by trimester) (reference = Trimester 3) | <0.0001 | ||
Trimester (1) | 8.0931 | 1.6027 | |
Trimester (2) | 1.3743 | 1.1605 | |
Pre-Pregnancy BMI (kg/m2) | −1.4144 | 0.4943 | 0.0100 |
Pre-Pregnancy BMI classification (reference = BMI > 30) | 0.0075 | ||
BMI = 25.0–29.9 | 19.3786 | 6.4793 | |
Perceived Stress (within-person) | 0.2561 | 0.1033 | 0.0133 |
Perceived Stress (between-person) | −0.1708 | 0.6372 | 0.7915 |
Emotional Eating (within-person) | 7.3520 | 0.5073 | <0.0001 |
Emotional Eating (between-person) | −0.1734 | 0.6583 | 0.7950 |
Cognitive Restraint (within-person) | 0.6897 | 0.5186 | 0.1838 |
Cognitive Restraint (between-person) | −2.7578 | 3.2976 | 0.4134 |
Uncontrolled Eating (within-person) | −0.3294 | 0.2798 | 0.2393 |
Uncontrolled Eating (between-person) | −1.3742 | 1.1126 | 0.2318 |
Total GWG (in kg) (n = 19) | −0.5049 | 0.5856 | 0.4006 |
Total GWG (meeting vs. exceeding Institute of Medicine guidelines) (reference = meeting guidelines) | −6.5364 | 8.3740 | 0.4458 |
Weekly GWG (in kg) | −5.4802 | 0.9972 | <0.0001 |
Weekly GWG (meeting vs. exceeding Institute of Medicine guidelines) (reference = meeting guidelines) | 0.0007 | ||
Under | 5.0148 | 1.9283 | |
Over | 0.5328 | 1.9144 | |
Treatment group (reference = intervention) | 0.7294 | ||
Control | −2.7539 | 7.28448 | |
Maternal Age (yrs) | 0.3989 | 1.3283 | 0.7672 |
Parity (reference = 1) | 0.6131 | ||
Parity (0) | −4.1338 | 8.0404 | |
Household Income (yearly) (reference ≥ $100,000) | 0.3396 | ||
$10,000–$20,000 | −30.4517 | 18.3616 | |
$20,000–$40,000 | 2.8334 | 10.6118 | |
$40,000–100,000 | 6.9350 | 8.6440 |
Predictor | Relationship with underreporting |
---|---|
Gestational age | Greater underreporting in later pregnancy |
Pre-pregnancy BMI | Greater underreporting with higher BMI |
Gestational weight gain | Greater underreporting with greater weekly weight gain |
Maternal age | No association |
Parity | No association |
Household Income | No association |
Perceived stress | Less underreporting during weeks when participant indicated higher stress than their usual stress level |
Emotional eating | Less underreporting during months when participant indicated higher emotional eating than their usual level |
Cognitive restraint | No association |
Uncontrolled eating | No association |
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McNitt, K.M.; Hohman, E.E.; Rivera, D.E.; Guo, P.; Pauley, A.M.; Gernand, A.D.; Symons Downs, D.; Savage, J.S. Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity. Nutrients 2022, 14, 2326. https://doi.org/10.3390/nu14112326
McNitt KM, Hohman EE, Rivera DE, Guo P, Pauley AM, Gernand AD, Symons Downs D, Savage JS. Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity. Nutrients. 2022; 14(11):2326. https://doi.org/10.3390/nu14112326
Chicago/Turabian StyleMcNitt, Katherine M., Emily E. Hohman, Daniel E. Rivera, Penghong Guo, Abigail M. Pauley, Alison D. Gernand, Danielle Symons Downs, and Jennifer S. Savage. 2022. "Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity" Nutrients 14, no. 11: 2326. https://doi.org/10.3390/nu14112326