Nutrition during pregnancy: the effects of an educational intervention program in Greece

An intervention program was undertaken to assess dietary habits and the impact of nutrition education among pregnant women in the rural county of Florina, northern Greece. Analysis of dietary habits, nutrient intake, hemoglobin, and serum vitamin concentrations in an intervention and control group indicated that the population was adequately nourished although nutrient intake was below recommended levels for pregnant women. Nutrition counseling was associated with improvements in dietary intake and significantly greater maternal weight gain (p less than 0.05). Mean birth weight was slightly higher in the intervention group but so was the incidence of low birth weight (4.5% vs 3.9%). The prematurity rate was marginally lower in the intervention group (p less than 0.04), as was the number of perinatal deaths (9 vs 11). The results indicate that nutrition counseling during pregnancy can improve dietary intake and maternal weight gain but the mediating influence on low frequency pregnancy outcomes is indeterminate in a population that is not nutritionally at risk.     

Maternal obesity and breast-feeding practices

BACKGROUND: Maternal obesity has been associated with poor lactation in animal models, but the results of related research in humans are inconclusive. OBJECTIVE: We tested the hypothesis that women who are obese before pregnancy or who gain excessive weight during pregnancy are less likely to initiate and maintain breast-feeding than are their normal-weight counterparts. DESIGN: We analyzed 124 151 mother-infant pairs from the Pediatric Nutrition Surveillance System and the Pregnancy Nutrition Surveillance System. Body mass index (BMI) before pregnancy and gestational weight gain were categorized according to guidelines from the Institute of Medicine. Multiple logistic regression was used to identify the association between maternal obesity and breast-feeding initiation (n = 51 329), and multiple linear regression was used to examine the effect of maternal obesity on breast-feeding duration among women who initiated breast-feeding (n = 13 234). RESULTS: Regardless of gestational weight gain, obese women were less likely to initiate breast-feeding than were women with a normal BMI before pregnancy who also gained the recommended weight during pregnancy. Maternal BMI before pregnancy and gestational weight gain were each independently associated with duration of breast-feeding. Women who were obese before pregnancy breast-fed approximately 2 wk less than did their normal-weight counterparts, and women who either failed to reach or exceeded the recommended gestational weight gain breast-fed approximately 1 wk less than did those who gained the recommended gestational weight. CONCLUSIONS: Both obesity before pregnancy and inadequate weight gain during pregnancy have a negative effect on breast-feeding practice. Women who are obese before pregnancy or who gain inadequate weight during pregnancy need extra support for breast-feeding.     

Association of Restraint and Disinhibition to Gestational Weight Gain among Pregnant Former Smokers

IntroductionGaining excessive weight during pregnancy is associated with immediate maternal and fetal complications as well as longer term obesity. Prepregnancy body mass index, age, and smoking cessation have been related to gestational weight gain (GWG); however, less is known about how eating behaviors, that may be amenable to modification and have been related to weight gain outside of pregnancy, affect GWG.MethodsThe present study evaluated the relationship of dietary restraint and disinhibition to GWG in a sample of women (n = 248) who quit smoking before or early in pregnancy. Women self-reported height and prepregnancy weight during their third trimester. GWG was calculated by subtracting prepregnancy weight from third trimester weight. The Three-Factor Eating Questionnaire assessed restraint and disinhibition.ResultsAverage GWG was 14.60 (±7.64) kg and 47% of women had a GWG greater than the Institute of Medicine recommendations. Linear regression models were used to examine restraint and disinhibition as correlates of GWG, and multinomial logistic regressions were utilized to determine whether eating behaviors were associated with inadequate or excessive GWG. Restraint was associated positively with total GWG, but disinhibition was not associated with GWG. Thus, conscious attempts to restrict intake were associated with GWG beyond the influence of covariates.ConclusionThese findings highlight the potential influence of modifiable eating behaviors on GWG and demonstrate the need for additional research to determine how these behaviors relate to GWG over the course of pregnancy.     

Weight gain, dietary restraint, and disordered eating in the freshman year of college

OBJECTIVE: The aims of the study were to assess whether women during the first year of college experience (1) significant weight gain; (2) a prospective relation between dietary restraint and weight gain; (3) an increase in disordered eating; and (4) a prospective relation between dietary restraint or concern about the Freshmen 15 (i.e., weight gain of 15 lbs during the freshman year of college) and disordered eating. METHOD: Participants were 336 female students in their first year of college who completed questionnaire measures of Body Mass Index (BMI), eating disorder pathology, dietary restraint, body image, and self-esteem. RESULTS: Participants' mean weight gain was approximately 3 lbs (1.5 kg), and among those who gained weight, the mean gain was 7.32 lbs (3.3 kg). Dietary restraint in September did not predict weight change in April, but participants who lost weight reported significantly greater dietary restraint than those participants who gained weight. Eating disorder symptoms increased significantly from September to April. Dietary restraint, concern about the "Freshman 15", and self-esteem in September uniquely predicted EDE-Q Weight and Shape Concern subscale scores in April. DISCUSSION: Female students in their first year of college gain a small but significant amount of weight, and weight gain was mostly unrelated to dietary restraint. Disordered eating increases during the first year of college and, is predicted by prospective dietary restraint and concerns about weight gain.     

Dietary folate intake during pregnancy and birth weight in Japan

BACKGROUND: Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption. AIM OF THE STUDY: The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies. METHODS: A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC). RESULTS: Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 +/- 113.1 microg/d in the first trimester to 275.4 +/- 100.2 microg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 microg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 microg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects. CONCLUSIONS: Our study shows that Japanese women's energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.     

Effect of intensive counselling on the quality of dietary fats in pregnant women at high risk of gestational diabetes mellitus

As part of a feasibility study to prevent gestational diabetes mellitus (GDM), we evaluated the effect of an intensive dietary therapy on quality of diet, weight gain and birth weight in women at high risk of GDM. Women with risk factors for GDM (n 54) were randomly assigned from April 2005 to May 2006 to a lifestyle intervention group (n 27) including dietary advice six times during pregnancy or to a close follow-up group (n 27) in a community-based setting in Finland. Dietary intake was recorded three times during pregnancy using 4?d food records. The main outcome was the incidence of GDM. The secondary outcomes were the changes in nutrient intake, weight gain and birth weight. Overall, seventeen (65?%) women in the intervention group and eighteen (69?%) women in the close follow-up group returned all three food records. PUFA intake increased (P?=?0·008) during pregnancy in the intervention as compared to the close follow-up group. There were no clear differences in the changes of saturated fat or fibre intake between the groups. Intensive dietary education resulted in a somewhat lower weight gain during pregnancy (P?=?0·062) and higher birth weights of the infants (P?=?0·047) without an effect on macrosomia as compared to the close follow-up group. Individualised counselling by a clinical nutritionist as part of a lifestyle intervention improved the quality of dietary fat intake in pregnant women at high risk of GDM.     

Dietary restraint and gestational weight gain

OBJECTIVE: To determine whether a history of preconceptional dieting and restrained eating was related to higher weight gains in pregnancy. DESIGN: Dieting practices were assessed among a prospective cohort of pregnant women using the Revised Restraint Scale. Women were classified on three separate subscales as restrained eaters, dieters, and weight cyclers. SUBJECTS: Participants included 1,223 women in the Pregnancy, Infection, and Nutrition Study. MAIN OUTCOME MEASURES: Total gestational weight gain and adequacy of weight gain (ratio of observed/expected weight gain based on Institute of Medicine recommendations). STATISTICAL ANALYSES PERFORMED: Multiple linear regression was used to model the two weight-gain outcomes, while controlling for potential confounders including physical activity and weight-gain attitudes. RESULTS: There was a positive association between each subscale and total weight gain, as well as adequacy of weight gain. Women classified as cyclers gained an average of 2 kg more than noncyclers and showed higher observed/expected ratios by 0.2 units. Among restrained eaters and dieters, there was a differential effect by body mass index. With the exception of underweight women, all other weight status women with a history of dieting or restrained eating gained more weight during pregnancy and had higher adequacy of weight gain ratios. In contrast, underweight women with a history of restrained eating behaviors gained less weight compared to underweight women without those behaviors. CONCLUSIONS: Restrained eating behaviors were associated with weight gains above the Institute of Medicine's recommendations for normal, overweight, and obese women, and weight gains below the recommendations for underweight women. Excessive gestational weight gain is of concern because of its association with postpartum weight retention. The dietary restraint tool is useful for identifying women who would benefit from nutritional counseling prior to or during pregnancy with regard to achieving targeted weight-gain recommendations.     

Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women

BACKGROUND: Although increased consumption of dietary fiber and grain products is widely recommended to maintain healthy body weight, little is known about the relation of whole grains to body weight and long-term weight changes. OBJECTIVE: We examined the associations between the intakes of dietary fiber and whole- or refined-grain products and weight gain over time. DESIGN: In a prospective cohort study, 74,091 US female nurses, aged 38-63 y in 1984 and free of known cardiovascular disease, cancer, and diabetes at baseline, were followed from 1984 to 1996; their dietary habits were assessed in 1984, 1986, 1990, and 1994 with validated food-frequency questionnaires. Using multiple models to adjust for covariates, we calculated average weight, body mass index (BMI; in kg/m(2)), long-term weight changes, and the odds ratio of developing obesity (BMI > or = 30) according to change in dietary intake. RESULTS: Women who consumed more whole grains consistently weighed less than did women who consumed less whole grains (P for trend < 0.0001). Over 12 y, those with the greatest increase in intake of dietary fiber gained an average of 1.52 kg less than did those with the smallest increase in intake of dietary fiber (P for trend < 0.0001) independent of body weight at baseline, age, and changes in covariate status. Women in the highest quintile of dietary fiber intake had a 49% lower risk of major weight gain than did women in the highest quintile (OR = 0.51; 95% CI: 0.39, 0.67; P < 0.0001 for trend). CONCLUSION: Weight gain was inversely associated with the intake of high-fiber, whole-grain foods but positively related to the intake of refined-grain foods, which indicated the importance of distinguishing whole-grain products from refined-grain products to aid in weight control.     

Maternal weight gain, diet and infant birth weight: correlations during adolescent pregnancy

Inadequate weight gain during pregnancy is an important risk factor for low birth weight (LBW), but the contribution of diet to weight gain is uncertain. Pregnancy weight gains were examined at 4-week intervals from 12 to 36 weeks' gestation, as well as total gain for gestation, in a cohort of over 2000 young pregnant women, aged less than or equal to 18 at entry to prenatal care. The effect of diet was studied in a 15% random sample of the cohort, using a 24-hour dietary recall obtained at entry to prenatal care (averaging 17 weeks' gestation). As early as 16 weeks' gestation, gains below the lower limit of a clinical standard were associated with a decrement in birth weight at delivery of more than -85 g (p less than 0.01), and after 24 weeks of approximately -180 g (p less than 0.001). After adjusting for potential confounding variables, teenagers who went on to develop inadequate total weight gain for gestation had consumed 1878 kcal vs 2232 for teenagers with adequate total gain (p less than 0.05). There were significant deficits in protein (p less than 0.05) and carbohydrate intake (p less than 0.05) associated with inadequate gain. However, there was no direct effect of nutrient intake on birth weight, LBW, or preterm delivery. This suggests that the relationship between nutrient intake during pregnancy and birth weight may be indirect and moderated by weight gain during pregnancy.     

Older pregnant women and adolescents: nutrition data after enrollment in WIC

Although there has been an increase in pregnancy in women over 35 years of age, the literature contains no information on dietary intakes of older pregnant women. Several studies have reported the nutritional status of pregnant adolescents who are considered to be at nutritional risk. This study investigated the energy, nutrient, and food intake patterns of 63 low-income pregnant women over 35 compared with 526 pregnant adolescents. Nutrient intake was assessed using a standardized 24-hour dietary recall protocol. Energy values for both groups were below recommended levels, and neither group gained the recommended amount of weight. Obesity may have been the reason for the lack of weight gain by the older pregnant women, since more than 50% of the older pregnant women were calculated to be obese prior to pregnancy. The younger women reported consuming less milk but more snack foods with lower nutrient densities, which significantly increased their energy values over those of the older group. In comparison with diets reported in other studies, the diets of the older pregnant women were more nutrient dense for most nutrients. Although all participants were enrolled in WIC, an equal number of women from both groups stated that they did not have the supplemental foods in their households at the time of interview.     

Nutrition of women in anticipation of pregnancy

A causal connection between maternal nutrient intake and birth outcome is not universally accepted. In this paper further empirical support is provided, particularly in relation to the impact of maternal nutrition around the time of conception or very early in pregnancy. It is argued that the hypothesis that maternal nutrition has no connection with birthweight is very easily refuted. It is suggested that there should be a new category of recommended dietary allowances; "women in anticipation of pregnancy". The diet of 513 pregnant London women were recorded for 7 days during the first trimester of their pregnancy. Birthweight and nutrient intakes were found to be significantly correlated but only over the lower half of the birthweight range. The optimum birthweight range with the lowest perinatal and infant mortalities is 3,500-4,500 g and it is suggested that the nutrient intake of th 165 women who had babies in this optimum weight range provide tentative values for nutrient intake recommendations in anticipation of pregnancy, but are not claimed to be representative. The need for adjustments of recommendations for the individual, for example for a low body mass index, is discussed. A body mass index of 24 kg/m2 is recommended based on the median of the 165 women.     

Fat gain during pregnancy in rural African women: the effect of season and dietary status

Body-fat gain during pregnancy (weight--total body water/0.73) was measured in 50 rural Gambian women exposed to seasonal energy demands of subsistence farming and to annual preharvest food shortages. Twenty-eight women received dietary supplements in amounts previously shown to increase birth weight. In unsupplemented women, fat gain was profoundly affected by the seasons through which the pregnancy progressed, ranging from an estimated loss of 4.7 kg to a net gain of 3 kg at various times of the year. Adjustment for season revealed, however, that pregnancy per se was without effect on body fat content. Supplementation increased fat gain during pregnancy by approximately 2 kg (p less than 0.05) and gave protection against the worst effects of season on energy balance. These findings contribute to our understanding of the consequences of low food intake during pregnancy and the effects of dietary supplementation on birth weight.     

Effet de l’alimentation maternelle sur le gain de poids au cours de la grossesse

ObjectivesTo assess maternal intakes of energy and nutrients in each trimester of pregnancy and their effect on gestational weight gain.Materials and methodsA prospective and longitudinal study of a cohort of 300 women was carried out during the entire period of pregnancy at antenatal consultation and monitoring centers in Constantine (Algeria) from December 2013 to July 2016. The estimation of energy and nutrient intakes was made by a three-day dietary record and repeated each trimester of pregnancy. Height and starting weight and weight at the end of pregnancy were measured. Statistics were performed using StatviewTM and SPSS software.ResultsThe majority of women (75.0%) had inadequate weight gain in late pregnancy. Intakes of energy, vitamines and minerals of women with low weight gain were lower than that of women with normal and excessive gain in the three trimesters of pregnancy (P < 0.0001). For all weight categories, average energy and nutrient intakes were lower in the first trimester then increase in the second trimester and stabilized in the third trimester. Between the first and third trimesters, 86 to 100% of women had vitamin and mineral intakes that were significantly lower than recommended dietary allowance.ConclusionOur study demonstrated the impact of maternal nutrition on gestational weight gain in relation to energy intake and specific nutrients, but the role of macronutrients was inconsistent. Pregnancy should be used as a ‘window of opportunity’ for changes in diet.     

Social factors and pregnancy weight gain in relation to infant birth weight: a study in public health centers in Rasht, Iran

OBJECTIVES: This study aimed to examine the relationship between total pregnancy weight gain, maternal educational level, working status and infant birth weight among mothers and infants in urban health centers in Rasht, Iran. DESIGN: Pregnant women from six different public health centers in urban areas were studied in a prospective design. Data on women's age, parity, level of education, working status, infant birth weight, mothers' height, and prepregnancy weight and total weight gain during pregnancy were collected. The subjects were grouped based on their prepregnancy BMI and according to Institute of Medicine (IOM) recommendation for total pregnancy weight gain. The subjects were also categorized based on their years of schooling as less, intermediately and highly educated. In this study women were considered as either housewives or employed. SETTING: Public health centers in urban areas in Rasht, Iran. SUBJECTS: A total of 1914 pregnant women were studied. RESULTS:These data showed that pregnancy weight gain was not different between women with normal prepregnancy weight and underweight when educational levels and working status were taken into account. Besides, pregnancy weight gain was positively related to the level of education. Analysis of variance showed that infant birth weights were not similar in mothers who gain weight less, within and above recommended ranges. In all, 60% of the normal weight women and 56.7% of the underweight women had weight gain less than the lower cutoffs of IOM recommendation. Results of logistic regression analysis showed that low level of mother's education was the only predictor for low birth weight (LBW) (>12 y education OR = 0.27(0.10-0.69)) and 5-12 y education OR = 0.62 (0.2-0.94). CONCLUSION: These results showed that pregnancy weight gain lower recommended ranges are highly prevalent in Iranian women in public health centers in urban areas in Rasht. Moreover, mother's level of educational level may be considered as the most important determinant of birth weight and LBW in this population.     

Energy stress during pregnancy and lactation: consequences for maternal nutrition in rural Bangladesh

OBJECTIVE: To assess the relationship of energy stress during pregnancy and lactation to maternal body stores in marginally nourished rural Bangladeshi women. SUBJECTS AND METHODS: Two-hundred and fifty-two women were followed from 5-7 months of pregnancy until 6 months postpartum. Energy intake was estimated during pregnancy and at 1, 3 and 6 month(s) postpartum using 24 h dietary recall. Body weight was measured on enrollment, another once or twice during pregnancy, and at 1, 3 and 6 month(s) postpartum. The weekly rates of pregnancy weight gain and postpartum weight changes were determined. Weight and length of the infants were measured at birth and at approximately 1, 3 and 6 month(s). RESULTS: Maternal energy intake at 5-7 months of gestation was 1464+/-416 kcal/day (mean+/-s.d.). Women gained a mean of 200 g/week or a total of 4 kg during the second half of pregnancy. An analysis of maternal weight showed no indication of accrual of fat stores during pregnancy. Dietary energy during lactation exceeded the intake during pregnancy by 248-354 kcal/day. Mothers lost an estimated average of 1 kg of weight during the first 6 months of lactation. The mean (+/-s.d.) birth weight was 2.55+/-0.38 kg, and the prevalence of low birth weight (<2500 g) was 48%. Infants exhibited some catch-up growth only during the first 3 months but overall growth during the first 6 months did not change from their relative status at birth when compared with NCHS reference. CONCLUSIONS: These rural Bangladeshi women failed to gain sufficient weight during the last half of pregnancy to maintain body weight during lactation when the energy demand is high. Poor growth of their primarily breastfed infants raises concern about the adequacy of lactation in this community.     

Healthy pregnant women in Canada are consuming more dietary protein at 16- and 36-week gestation than currently recommended by the Dietary Reference Intakes,primarily from dairy food sources

Adequate dietary protein intake throughout pregnancy is essential to ensure healthy fetal development. Insufficient and excessive maternal dietary protein intakes are both associated with intrauterine growth restriction, resulting in low birth weight infants. The aim of this study was to analyze the dietary protein intake patterns of healthy pregnant women in Vancouver, British Columbia, during early and late gestation. We hypothesized that women would be consuming higher protein during late stages of pregnancy compared with early stages of pregnancy. Interviewer-administered food frequency questionnaires were collected prospectively from 270 women at 16- and 36-week gestation; food frequency questionnaires from 212 women met study criteria. Maternal anthropometrics at both stages and infant weight at birth were collected. Wilcoxon signed rank tests were used to determine significant gestational differences in protein intakes. Spearman correlation was used to determine the influence of protein intakes and maternal anthropometrics on pregnancy outcomes. Median (25th and 75th percentiles) protein intakes adjusted for body weight were 1.5 (1.18 and 1.79) and 1.3 (1.04 and 1.60) g/kg per day at 16- than 36-week gestation, respectively. Primary protein sources were identified as dairy products. Protein intakes were negatively correlated with birth weight (P < .05), whereas maternal height, weight, body mass index, and weight gain to 36-week gestation were positively correlated with birth weight (P < .05). This study provides current dietary protein intake patterns among healthy Canadian women during pregnancy and indicates higher intakes than current Dietary Reference Intakes recommended dietary allowance of 1.1 g/kg per day, especially during early gestation.     

Serum zinc levels amongst pregnant women in a rural block of Haryana state, India

INTRODUCTION: Zinc deficiency is wide spread in developing countries. Its deficiency during pregnancy has been documented to be associated with growth retardation, congenital abnormalities, and low birth weight. Limited community based data is available on the serum zinc levels during pregnancy from Haryana State, India. Hence the present study was undertaken. METHODS: A community based cross sectional study was conducted amongst 283 pregnant women with gestational age of 28 weeks or more. Each pregnant woman was inquired about her age, obstetric profile, socio-economic status, and other demographic parameters by utilizing a pre-tested semi-structured questionnaire. Blood from the antecubital vein was drawn to assess the serum zinc levels utilizing the atomic absorption spectrophotometer. Nutrient intake was assessed by the standard 24-hr dietary recall method. Statistical tests were applied to the data collected. RESULTS: Mean serum zinc level was 61.1+/-16.6 microg/dL. Almost 64.6% of the women had zinc deficiency. The dietary data revealed that 58.9 % of the women were consuming calories less that 75% of the recommended, indicating an overall poor food intake. Dietary zinc intake revealed that 86.2 % of the women were consuming less than 50% of the recommended (15 mg). A high prevalence of zinc deficiency (64.6%) was found amongst the pregnant women possibly due to the low dietary intake of zinc. There is a need to undertake multi-centric studies in various parts of the country to assess the serum zinc levels, magnitude of zinc deficiency and factors leading to zinc deficiency amongst pregnant women in India.     

Dietary intake of energy and nutrients in relation to resting energy expenditure and anthropometric parameters of Czech pregnant women

Purpose

The aim of this study was to evaluate the dietary intake of energy and nutrients (DIEN) of Czech pregnant women and to assess relationships with body size variables during pregnancy.

Methods

One hundred and fifty-two randomly recruited healthy pregnant Czech women, who were normoglycemic, euthyroid, nonsmokers, not anemic, and not users of chronic medications or abusers of alcohol or drugs from countryside and city with different education, were recruited for the study. Anthropometric parameters were measured and resting energy expenditure obtained by indirect calorimetry after 12 h of fasting during four phases of pregnancy. DIEN was evaluated from self-reported dietary intake records over 7 days.

Results

Positive correlations were demonstrated between measured resting energy expenditure and intake of energy, substrates and some minerals and vitamins, and negative correlations between DIEN and anthropometric parameters. Lower dietary intake of energy and differences between dietary intake of nutrients and recommended daily allowances during pregnancy of Czech women were documented.

Conclusions

The difference between pregnancy body weight and ideal body weight was shown to be a determinant of DIEN. From recent knowledge on prevention of various pathological states, the supplementation or modification of nutritional intake of food with folate, iron, vitamin D, zinc, iodine and fiber for Czech pregnant women is recommended.     

Eating behavior correlates of adult weight gain and obesity in healthy women aged 55-65 y

BACKGROUND: The specific underlying causes of adult weight gain remain uncertain. OBJECTIVE: The objective was to determine the association of 3 measures of eating behavior with weight gain and body mass index (BMI; in kg/m(2)) in adults. DESIGN: Current dietary restraint, disinhibition, and hunger were assessed with the use of the Eating Inventory in 638 healthy, nonsmoking women aged 55-65 y. In addition, subjects reported their current weight and height, their weight for 6 age intervals, and changes in voluntary dietary energy restriction over the past 10 y. Current weight and height were validated in 10% of subjects. RESULTS: Current disinhibition strongly predicted weight gain and current BMI (partial r = 0.27 and 0.34, respectively, both P < 0.001). Neither restraint nor hunger was a significant independent predictor of either variable, but the positive associations between disinhibition and both weight gain and BMI were attenuated by restraint (P = 0.016 and 0.010, respectively, after adjustment for confounding variables). In the subpopulation of women who reported a stable level of voluntary dietary energy restriction, disinhibition also strongly predicted weight gain and higher BMI, and restraint was negatively associated with weight gain (partial r = -0.17, P = 0.019). CONCLUSIONS: Higher disinhibition is strongly associated with greater adult weight gain and higher current BMI, and dietary restraint may attenuate this association when disinhibition is high. These findings suggest that eating behavior has an important role in the prevention of adult-onset obesity and that further studies are warranted.