Research
Original Research
Women’s Experience and Understanding of Food Cravings in Pregnancy: A Qualitative Study in Women Receiving Prenatal Care at the University of North Carolina–Chapel Hill

https://doi.org/10.1016/j.jand.2019.09.020Get rights and content

Abstract

Background

Although the occurrence of food cravings during pregnancy is well established, there is a paucity of qualitative data on pregnant women’s perceptions of and responses to food cravings. This study sought to assess and describe pregnant women’s experiences and behaviors pertaining to food cravings.

Methods

Eight focus groups were conducted with 68 pregnant women in their second trimester from March 2015 to October 2016. Using a semistructured approach, the facilitator asked women open-ended questions regarding their experience of eating behaviors and food cravings. The content from the focus groups was analyzed using a bottom-up approach based on grounded theory and constant comparison analysis.

Results

Participants described cravings as urgent, food-specific, and cognitively demanding occurrences that were differentiated from hunger. They described beliefs surrounding the physiological causes of cravings and rationales for satisfying their cravings. Strategies used to manage cravings included environmental modifications to limit proximity and availability of craved foods, cognitive and behavioral strategies like distraction, and acceptance through satisfying the craving. Participants described food cravings as a psychologically salient aspect of their pregnancy, reporting a variety of emotional precursors and reactions surrounding their cravings.

Conclusions

A better understanding of food cravings may assist with the development of interventions to improve eating behaviors and reduce eating-related distress during pregnancy. Acceptance regarding food cravings was indicated as a way to diffuse pregnancy-related stress. These findings contribute to our understanding of psychological influences on eating behaviors in pregnant women.

Section snippets

Participants

Focus group participants were a subsample of participants of the Pregnancy Eating Attributes Study (PEAS), an observational, prospective cohort study examining the associations of food reward sensitivity with pregnancy-related diet and weight change.29 PEAS participants were recruited from the obstetrics clinics at the University of North Carolina at Chapel Hill Healthcare System. Details on enrollment and recruitment of PEAS are described elsewhere.29 Eligibility criteria included: gestational

Results

The Table describes the demographics of the focus group sample in comparison with the main study population. The majority of focus group participants were non-Hispanic white and had a bachelor’s degree or higher.

Discussion

In focus group discussions, pregnant women described cravings as highly salient experiences that they associate with their own eating behaviors and emotional experiences. They described cravings as urgent, food-specific, all-consuming occurrences that were differentiated from hunger. Consistent with previous findings,16,21 common types of foods craved by this sample of Western women were sweets such as chocolate and ice cream or salty foods like chips.1 Women discussed their beliefs surrounding

Conclusion

Pregnant women reported food cravings as a common and psychologically salient aspect of their pregnancy. They indicated using a variety of cognitive and behavioral strategies to manage these cravings, including acceptance. An understanding of the emotional precursors and responses to food cravings may assist with the development of interventions to improve eating behaviors and reduce eating-related distress during pregnancy.

L. E. Blau is an intramural research fellow, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

References (42)

  • E.M. Forman et al.

    Comparison of acceptance-based and standard cognitive-based coping strategies for craving sweets in overweight and obese women

    Eat Beh

    (2013)
  • S.L. Mumford et al.

    Dietary restraint and gestational weight gain

    J Am Diet Assoc

    (2008)
  • A.J. Hill et al.

    Food craving, dietary restraint and mood

    Appetite

    (1991)
  • L.E. Blau et al.

    Food craving frequency mediates the relationship between emotional eating and excess weight gain in pregnancy

    Eat Behav

    (2018)
  • C.H. Jordan et al.

    Mindful eating: Trait and state mindfulness predict healthier eating behavior

    Pers Individ Dif

    (2014)
  • N.C. Orloff et al.

    Pickles and ice cream! Food cravings in pregnancy: Hypotheses, preliminary evidence, and directions for future research

    Front Psychol

    (2014)
  • D. Sotres-Alvarez et al.

    Maternal dietary patterns are associated with risk of neural tube and congenital heart defects

    Am J Epidemiol

    (2013)
  • S.L. Carmichael et al.

    Reduced risks of neural tube defects and orofacial clefts with higher diet quality

    Arch Pediatr Adolesc Med

    (2012)
  • V.K. Knudsen et al.

    Major dietary patterns in pregnancy and fetal growth

    Eur J Clin Nutr

    (2008)
  • H. Okubo et al.

    Maternal dietary patterns in pregnancy and fetal growth in Japan: the Osaka Maternal and Child Health Study

    Br J Nutr

    (2012)
  • J.M. Thompson et al.

    Maternal dietary patterns in pregnancy and the association with small-for-gestational-age infants

    Br J Nutr

    (2010)
  • Cited by (11)

    View all citing articles on Scopus

    L. E. Blau is an intramural research fellow, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

    K. W. Dempster is an intramural research fellow, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

    L. M. Lipsky is a staff scientist, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

    T. R. Nansel is a senior investigator, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

    M. H. Eisenberg Colman is a senior researcher, Fors Marsh Group, Arlington, VA; at the time of the study, she was a postdoctoral fellow, Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.

    A. M. Siega-Riz is dean and professor, Department of Nutrition and Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst.

    M. S. Faith is chair and professor, Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo–The State University of New York.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Intramural Research Program (contract #HHSN275201300015C and #HHSN275201300026I/HHSN27500002).

    AUTHOR CONTRIBUTIONS T. R. Nansel, M. S. Faith, A. M. Siega-Riz, and L. M. Lipsky conceived of the study and developed the research design. L. E. Blau, L. M. Lipsky, K. W. Dempster, M. H. Eisenberg Colman, and T. R. Nansel were involved in the analysis of data. L. E. Blau, L. M. Lipsky, and T. R. Nansel were involved in the writing of the manuscript. All authors approve of the submission of the manuscript in its current form.

    View full text