Eating Behaviors and Skin Carotenoids in Pregnant Women: The Moderating Influence of Depressive Symptoms and Income

Background: Fruit and vegetable (FV) intake is critical for optimizing pregnancy outcomes. Several socio-demographic factors are associated with FV intake, but less is known about behavioral and mental health correlates. Furthermore, existing knowledge is largely based on self-reported FV intake. The current cross-sectional study examined depressive symptoms and income as moderators of the association between eating behaviors and skin carotenoids (FV status biomarker) in pregnancy. Methods: Participants living in an urban area of the south-astern part of the U.S. (N = 299) and who were in their third trimester of pregnancy were recruited for lab visits between 2019 and 2022 and completed the Dutch Eating Behavior Questionnaire and the Center for Epidemiological Studies Depression Scale. FV status was assessed using a pressure-mediated reflection spectroscopy to determine skin carotenoids. Hypotheses were tested via multiple regression. Results: There was an interaction between dietary restraint and depressive symptomatology such that greater restraint predicted higher skin carotenoids at low levels of depressive but not high levels. There was an interaction between restrained eating and family income in predicting skin carotenoids that was significant at high- but not low-income level. External and emotional eating did not predict skin carotenoids. Conclusions: Restrained eating might positively influence skin carotenoids during pregnancy. However, those who suffer from higher levels of depressive symptoms and/or live in lower-income households face additional barriers that might impede FV status. Further research is warranted to advance our understanding of the interplay between mental health, restrained eating and income on FV status in pregnancy.