SBSB Research: Eating Behavior in Pregnancy and Postpartum

PEAS logoThe 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. Weight management interventions in the general population and pregnant women alike have achieved only marginal success characterized by suboptimal initial and/or long-term maintenance of weight control and diet change, 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 cohort study that will examine the roles of maternal food reward sensitivity, behavioral control, and the home food environment in maternal dietary intake and weight change as well as infant feeding behavior and growth. 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. The study will follow 450 women from the first trimester of pregnancy (prior to 12 weeks gestation) until 1 year postpartum. Infants also will be enrolled and assessed. Data collection methods include multiple non-consecutive 24-hour diet recalls, anthropometrics, biospecimens, medical record abstraction, questionnaires, functional magnetic resonance imaging (fMRI), focus groups, and the laboratory-based eating in the absence of hunger (EAH) paradigm. Primary exposures of interest include maternal food reward sensitivity, behavioral control and the home food environment. Primary outcomes include gestational weight gain, postpartum weight retention and maternal diet quality.

Principal Investigator

Tonja Nansel, Ph.D.

DIPHR 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 Virginia
  • Alison Stuebe, M.D., University of North Carolina Chapel Hill


Nansel TR, Lipsky LM, Siega-Riz AM, Burger K, Faith M, Liu A. Pregnancy Eating Attributes Study (PEAS): a cohort study examining behavioral and environmental influences on diet and weight change in pregnancy and postpartum. BioMed Central Nutrition. 2016; 2. pii: 45. PMID: 28663822. PMCID: PMC5486996

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