Maternal and Child Health Journal

, Volume 22, Issue 5, pp 670–678 | Cite as

Novel Interventions to Reduce Stress and Overeating in Overweight Pregnant Women: A Feasibility Study

  • B. A. Laraia
  • N. E. Adler
  • K. Coleman-Phox
  • C. Vieten
  • L. Mellin
  • J. L. Kristeller
  • M. Thomas
  • N. E. Stotland
  • R. H. Lustig
  • M. F. Dallman
  • F. M. Hecht
  • N. R. Bush
  • C. L. de Groat
  • E. Epel
Article

Abstract

Background High stress and depression during pregnancy are risk factors for worsened health trajectories for both mother and offspring. This is also true for pre-pregnancy obesity and excessive gestational weight gain. Reducing stress and depression may be one path to prevent excessive caloric intake and gestational weight gain. Study Purpose We tested the feasibility of two novel interventions aimed at reducing stress and overeating during pregnancy. Reflecting different theoretical underpinnings, the interventions target different mechanisms. Mindful Moms Training (MMT) uses mindfulness to improve awareness and acceptance of experiences and promote conscious rather than automatic behavior choices. Emotional Brain Training (EBT) uses active coping to change perceptions of negative experience and promote positive affective states. Methods Forty-six overweight/obese low-income women were assigned to either MMT (n = 24) or EBT (n = 22) for an 8-week feasibility study. Pre-post changes in perceived stress, eating and presumed mechanisms were assessed. Results Women reported high levels of stress at baseline. Both interventions were well attended and demonstrated clinically significant pre-post reductions in stress, depressive symptoms, and improved eating behaviors. MMT significantly decreased experiential avoidance, whereas EBT significantly increased positive reappraisal; these changes were marginally significantly different by group. Conclusions This feasibility study found that both interventions promoted meaningful reductions in stress and depressive symptoms and improved reported eating behaviors in a high-risk group of pregnant women. Each intervention has a potentially different pathway—acceptance for MMT and reappraisal for EBT. Larger studies are needed to test efficacy on longer term reductions in stress and overeating.

Keywords

Mindfulness Stress-reduction Stress Depression Pregnancy Eating behavior Obesity 

Supplementary material

10995_2018_2435_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 KB)

References

  1. Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91(4), 449–458.CrossRefGoogle Scholar
  2. Bickel, G., Price, C., Hamilton, W., & Cook, J. (2000). Guide to measuring household food security, revised 2000. USDA Food and Nutrition Service: Alexandria, VA.Google Scholar
  3. Bombard, J. M., Dietz, P. M., Galavotti, C., England, L. J., Tong, V. T., Hayes, D. K., et al. (2012). Chronic diseases and related risk factors among low-income mothers. Maternal and Child Health Journal, 16(1), 60–71.CrossRefPubMedGoogle Scholar
  4. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., et al. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688.CrossRefPubMedGoogle Scholar
  5. Brawarsky, P., Stotland, N. E., Jackson, R. A., Fuentes-Afflick, E., Escobar, G. J., Rubashkin, N., et al. (2005). Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. International Journal of Gynecology & Obstetrics, 91(2), 125–131.CrossRefGoogle Scholar
  6. Cohen, S., & Janicki-Deverts, D. (2012). Who’s Stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009. Journal of Applied Social Psychology, 42(6), 1320–1334.CrossRefGoogle Scholar
  7. Cole-Lewis, H. J., Kershaw, T. S., Earnshaw, V. A., Yonkers, K. A., Lin, H., & Ickovics, J. R. (2014). Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women. Health Psychology, 33(9), 1033–1045.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Coleman-Phox, K., Laraia, B. A., Adler, N., Vieten, C., Thomas, M., & Epel, E. (2013). Recruitment and retention of pregnant women for a behavioral intervention: Lessons from the maternal adiposity, metabolism, and stress (MAMAS) study. Preventing Chronic Disease, 10, 120096.  https://doi.org/10.5888/pcd10.120096.CrossRefGoogle Scholar
  9. Czajkowski, S. M., Powell, L. H., Adler, N., Naar-King, S., Reynolds, K. D., Hunter, C. M., et al. (2015). From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychology, 34(10), 971–982.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Daubenmier, J., Kristeller, J., Hecht, F. M., Maninger, N., Kuwata, M., Jhaveri, K., et al. (2011). Mindfulness intervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: An exploratory randomized controlled study. Journal of Obesity, 2011, 651936.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564–570.CrossRefPubMedGoogle Scholar
  12. Davis, E. P., Glynn, L. M., Waffarn, F., & Sandman, C. A. (2011). Prenatal maternal stress programs infant stress regulation. Journal of Child Psychology and Psychiatry, 52(2), 119–129.CrossRefPubMedGoogle Scholar
  13. Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2009). Food addiction: An examination of the diagnostic criteria for dependence. Journal of Addiction Medicine, 3(1), 1–7.CrossRefPubMedGoogle Scholar
  14. Goldberg, J. H., & Kiernan, M. (2005). Innovative techniques to address retention in a behavioral weight-loss trial. Health Education Research, 20(4), 439–447.CrossRefPubMedGoogle Scholar
  15. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362.CrossRefPubMedGoogle Scholar
  16. Guardino, C. M., & Schetter, C. D. (2014). Coping during pregnancy: A systematic review and recommendations. Health Psychology Review, 8(1), 70–94.CrossRefPubMedGoogle Scholar
  17. Gunderson, E. P. (2009). Childbearing and obesity in women: Weight before, during, and after pregnancy. Obstetrics and Gynecology Clinics of North America, 36(2), 317-+.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Hedderson, M. M., Gunderson, E. P., & Ferrara, A. (2010). Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and Gynecology, 115(3), 597–604.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Hill, B., Skouteris, H., McCabe, M., Milgrom, J., Kent, B., Herring, S. J., et al. (2013). A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain. Midwifery, 29(2), 110–114.CrossRefPubMedGoogle Scholar
  20. Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. University of Massachusetts Medical Center/Worcester. Stress Reduction Cliniced. New York: Delta Trade PaperbacksGoogle Scholar
  21. Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4(3), 357–363.CrossRefPubMedGoogle Scholar
  22. Kristeller, J. L., & Wolever, R. Q. (2011). Mindfulness-based eating awareness training for treating binge eating disorder: The conceptual foundation. Eating Disorders, 19(1), 49–61.CrossRefPubMedGoogle Scholar
  23. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Laraia, B., Epel, E., & Siega-Riz, A. M. (2013). Food insecurity with past experience of restrained eating is a recipe for increased gestational weight gain. Appetite, 65, 178–184.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Mellin, L. (2010). Wired for Joy: A revolutionary method for creating happiness from within. Carlsbad, CA: Hay House, Inc.Google Scholar
  26. Mellin, L., Croughan-Minihane, & Dickey, M., L (1997). The Solution Method: 2-year trends in weight, blood pressure, exercise, depression, and functioning of adults trained in development skills. Journal of the American Dietetic Association, 97(10), 1133–1138.CrossRefPubMedGoogle Scholar
  27. Mitrovic, I., Fish-de Pena, L., Frassetto, L., & Mellin, L. (2011). Rewiring the stress response: A new paradigm for health care. Hypothesis, 9(1), 1–7.CrossRefGoogle Scholar
  28. Perry, B. D., & Hambrick, E. P. (2008). The neurosequential model of therapeutics. Reclaiming Children and Youth, 17(3), 38–43.Google Scholar
  29. Rini, C. K., Dunkel-Schetter, C., Wadhwa, P. D., & Sandman, C. A. (1999). Psychological adaptation and birth outcomes: The role of personal resources, stress, and sociocultural context in pregnancy. Health Psychology, 18(4), 333–345.CrossRefPubMedGoogle Scholar
  30. Segal, Z. V., Teasdale, J. D., Williams, J. M., & Gemar, M. C. (2002). The mindfulness-based cognitive therapy adherence scale: Inter-rater reliability, adherence to protocol and treatment distinctiveness. Clinical Psychology & Psychotherapy, 9(2), 131–138.CrossRefGoogle Scholar
  31. Shloim, N., Hetherington, M. M., Rudolf, M., & Feltbower, R. G. (2015). Relationship between body mass index and women’s body image, self-esteem and eating behaviours in pregnancy: A cross-cultural study. Journal of Health Psychology, 20(4), 413–426.CrossRefPubMedGoogle Scholar
  32. Vanstrien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders, 5(2), 295–315.CrossRefGoogle Scholar
  33. Vieten, C. (2009). Mindful motherhood: Practical tools for staying sane during pregnancy and your child’s first year. Petaluma, CA/Oakland, CA: Noetic Books/New Harbinger Publications.Google Scholar
  34. Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women’s Mental Health, 11(1), 67–74.CrossRefPubMedGoogle Scholar
  35. Wright, C., Bilder, D., DeBlasis, T., Mogul, M., Rubin, D., & Shea, J. A. (2013). Psychosocial factors associated with gestational weight gain in a low-income cohort. Journal of Health Care for the Poor and Underserved, 24(1), 332–343.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • B. A. Laraia
    • 1
  • N. E. Adler
    • 2
    • 3
  • K. Coleman-Phox
    • 3
  • C. Vieten
    • 4
    • 5
  • L. Mellin
    • 6
    • 7
  • J. L. Kristeller
    • 8
  • M. Thomas
    • 2
  • N. E. Stotland
    • 9
  • R. H. Lustig
    • 10
  • M. F. Dallman
    • 11
  • F. M. Hecht
    • 12
  • N. R. Bush
    • 2
    • 3
    • 10
  • C. L. de Groat
    • 3
  • E. Epel
    • 2
    • 3
  1. 1.Public Health Nutrition, School of Public HealthUniversity of California, BerkeleyBerkeleyUSA
  2. 2.Department of PsychiatryUCSF School of MedicineSan FranciscoUSA
  3. 3.Center for Health and CommunitySan FranciscoUSA
  4. 4.Institute of Noetic SciencesPetalumaUSA
  5. 5.California Pacific Medical Center Research InstituteSan FranciscoUSA
  6. 6.Family & Community Medicine and PediatricsSan FranciscoUSA
  7. 7.Emotional Brain Training Center of ExcellenceSan FranciscoUSA
  8. 8.Department of PsychologyIndiana StateTerre HauteUSA
  9. 9.Department of Ob/Gyn, Reproductive Sciences, San Francisco General HospitalUCSF School of MedicineSan FranciscoUSA
  10. 10.Department of PediatricsUCSF School of MedicineSan FranciscoUSA
  11. 11.UCSF Department of PhysiologySan FranciscoUSA
  12. 12.Osher Center for Integrative MedicineSan FranciscoUSA

Personalised recommendations