Diet, Weight Change, and Obesity in Pregnancy / Pregnancy Eating Attributes (PEAS)

产妇超重/肥胖和妊娠期体重增加过多的现象日益普遍，造成了严重的公共卫生问题，因为这些因素增加了孕产妇和儿童健康不良后果的风险。美国人的饮食质量很差，其特点是总能量、添加糖、脂肪和钠摄入过多，水果、蔬菜和全谷物摄入不足，这也是有充分证据的。饮食干预在普通人群和孕妇中都只取得了微小的成功，这表明需要确定更有效的可修改目标和策略。一种新出现的假设认为，能量稳态过程被“享乐性进食”所取代，即在没有能量需求的情况下，食物的摄入是由神经对食物的奖励反应所驱动的。这种奖励反应的相对强度因个体而异，并且在小样本中与体重和体重变化呈正相关，这支持了对基于人群的样本进行进一步研究的必要性。

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 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 reward-related eating, 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.