Abstract
BACKGROUND: Poor dietary quality and weekday-weekend differences in eating patterns during pregnancy link to adverse outcomes. Mindfulness, a practice of non-judgmental awareness of present experience, associates with higher dietary quality, potentially through reduced depressive symptoms. This study examined whether dispositional mindfulness relates to dietary quality in pregnant individuals with pre-pregnancy body mass index (BMI)≥25, and whether depressive symptoms mediate this relationship. METHODS: Participants (N=308; M(age)±SD=31.02±4.9 years; M(BMI)±SD=32.8±6.07 kg/m(2); M(weeks gestation)±SD=13.6±2.7 weeks) from a perinatal lifestyle intervention trial self-reported mindfulness (Mindful Attention Awareness Scale [MAAS]) and depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS]) at baseline. The Healthy Eating Index (HEI)-2020 was derived from a dietary recall on one weekday and one weekend day. MAAS and EPDS effects on HEI scores were analyzed in three separate models (HEI weekday, weekend, and average) using R's mediation package with bias-corrected bootstrapped confidence intervals (BootCI; k=1,000). Models covaried for age, weeks of gestation, racial identity, education, income, and pre-pregnancy BMI. RESULTS: HEI scores were higher on weekdays than weekends (t(307)=2.48, p=.01; M(weekday)=47.14±14.34; M(weekend)=44.8±13.05). Higher MAAS scores predicted higher weekend (β=0.13, p=.02) but not weekday (β=0.01, p=.84) or average (β=0.07, p=.20) HEI scores. Higher MAAS scores associated with higher weekend HEI scores through lower EPDS scores (average causal mediation effect=0.747, BootCI=0.07-1.53, p=.04). CONCLUSIONS: Findings suggest dispositional mindfulness relates to weekend dietary quality among pregnant individuals with pre-pregnancy BMI≥25 and may help maintain dietary patterns through lowered depressive symptoms.