Open Access

Maternal mindful eating as a target for improving metabolic outcomes in pregnant women with obesity

Karen L Lindsay1,2,*,Jasper Most3,4,Kerrie Buehler5,Maryam Kebbe4,Abby D Altazan4,Leanne M Redman4
Susan Samueli Integrative Health Institute, University of California Irvine, Costa Mesa, CA 92696, USA
Department of Pediatrics, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA 92697, USA
Zuyderland Medical Center, Sittard/Geleen, 6162 BG, The Netherlands
Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
Department of Medicine, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA 92697, USA
DOI: 10.52586/5048 Volume 26 Issue 12, pp.1548-1558
Submited: 28 July 2021 Revised: 07 October 2021
Accepted: 25 October 2021 Published: 30 December 2021
*Corresponding Author(s):  
Karen L Lindsay
Copyright: © 2021 The author(s). Published by BRI. This is an open access article under the CC BY 4.0 license (

Background: Maternal diet and eating behaviors have the potential to influence the metabolic milieu in pregnancies complicated by obesity, with implications for the developmental programming of offspring obesity. Emerging evidence suggests that mindfulness during eating may influence metabolic health in non-pregnant populations, but its effects in the context of pregnancy is less well understood. This study explored the individual and combined effects of mindful eating and diet quality on metabolic outcomes among pregnant women with obesity. Methods: In 46 pregnant women (body mas index >>30 kg/m22) enrolled in the MomEE observational study, mindful eating (Mindful Eating Questionnaire, MEQ) and energy-adjusted dietary inflammatory index (DII, from 7 days of food photography) was assessed at two time points and the mean pregnancy values computed. Rate of gestational weight gain (GWG) and fat mass gain per week were determined from measured weight and body composition using a three-compartment method, respectively, at each assessment. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and ghrelin concentrations were determined from fasting blood samples in late gestation (35–37 weeks). Linear regression was used to examine the association of the MEQ and its subscales (where higher values indicate more mindful eating) with metabolic outcomes, adjusting for covariates: maternal age, pregravid body mass index, race, parity, DII. The effects of the MEQ*DII interaction was also tested. Results: Total MEQ scores were not associated with rate of weight or fat mass gain, although greater distracted eating behavior was associated with greater adiposity gain (weight and fat mass). Mindful eating was inversely associated with insulin resistance, although this was attenuated to non-significance after additional adjustment for GWG. Total MEQ and the external eating subscale was significantly inversely associated with fasted ghrelin, such that less tendency to eat under the influence of external cues was associated with lower ghrelin concentrations. After false discovery rate adjustment for multiple testing, only the association of the total MEQ and external eating subscale with ghrelin levels trended towards significance. The DII was not associated with MEQ scores or outcome variables, nor did it moderate the effect of MEQ on any of the outcomes. Conclusion: This study generates early evidence to suggest that mindful eating holds potential as a tool to improve metabolic health outcomes in pregnant women with obesity, although further research is required on this topic. Prenatal lifestyle interventions should consider including mindfulness during eating to determine its efficacy for reducing adverse pregnancy and offspring health outcomes associated with maternal obesity.

Key words

Pregnancy; Maternal obesity; Mindful eating; Dietary inflammatory index; Gestational weight gain; Adi-posity; Insulin resistance; Ghrelin

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Karen L Lindsay, Jasper Most, Kerrie Buehler, Maryam Kebbe, Abby D Altazan, Leanne M Redman. Maternal mindful eating as a target for improving metabolic outcomes in pregnant women with obesity. Frontiers in Bioscience-Landmark. 2021. 26(12); 1548-1558.