The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review.

Annica F Dörsam,Nadia Micali,Katrin E Giel,Sophia B Lörcher,Hubert Preißl,Stephan Zipfel

doi:10.3390/nu11040840

Abstract

Maternal nutrition in pregnancy has a key influence on optimum fetal health. Eating disorders (EDs) during pregnancy may have detrimental effects on fetal growth and the child’s early development. There is limited knowledge concerning the eating behavior, dietary intake and derived nutritional biomarkers as well as the nutrient supplementation in women with EDs during pregnancy. We performed a systematic review according to the PRISMA statement to synthesize current evidence in this field. Of N = 1203 hits, 13 full-texts were included in the qualitative synthesis. While women with current Binge Eating Disorder (BED) showed higher energy and fat intakes during pregnancy, women with a lifetime Anorexia Nervosa (AN), Bulimia Nervosa (BN) or both (AN + BN) had similar patterns of nutrient intake and dietary supplement use as healthy women. There is evidence, that women with a history of EDs have a sufficient diet quality and are more likely to be vegetarian. Dieting and bingeing improved substantially with pregnancy. The highlighted differences in the consumption of coffee/caffeine and artificially sweetened beverages as well as the elevated prevalence of iron deficiency anemia in women with a past or active ED during pregnancy might have an important impact on fetal development.

Highlights

In pregnancy, a lifestyle characterized by regular exercise and a balanced and diverse diet is a significant determinant of the course of pregnancy, the child’s development, and the short- and long-term health of the mother and child [1]
Based on our four research questions investigated in the present systematic review, our main findings are as follows: (1) considering the drawback that dietary intakes were assessed by self-report, pregnant women with a history of eating disorder (ED) show a similar dietary intake to healthy pregnant women; there is evidence that women with EDs have a sufficient diet quality and are more likely to follow a vegetarian dietary pattern
Women with Binge Eating Disorder (BED) seem to be an exception as they show inadequate energy and fat intakes; (2) the startling caffeine and coffee consumption, especially in pregnant women with

Summary

Introduction

A lifestyle characterized by regular exercise and a balanced and diverse diet is a significant determinant of the course of pregnancy, the child’s development, and the short- and long-term health of the mother and child [1]. For the nutrients folate and iodine, a markedly increased intake is recommended from the beginning of pregnancy or, ideally, before conception [2]. There is substantial interest in nutrition during pregnancy, due to the extensive research in the area of early nutrition programming [3], arisen from the initial work by Barker Health and Disease’ (DOHaD) [5], which postulates that exposure to certain environmental influences during critical periods of development (e.g., intrauterine deficiency or oversupply of nutrients) and growth may have a significant impact on the development of non-communicable diseases (NCDs), such as obesity, diabetes mellitus, cardiovascular and mental disorders, as well as cancer in later life [5,6,7].

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Discussion

Conclusion