Healthy Food Density is Not Associated With Diet Quality Among Pregnant Women With Overweight/Obesity in South Carolina

Examine the association and moderating effect of residential location (urban/rural) on the relationship between neighborhood healthy food density and diet quality. Cross-sectional analysis of baseline data from the Health in Pregnancy and Postpartum study, a randomized trial designed to prevent excessive gestational weight gain. Pregnant women in South Carolina with prepregnancy overweight/obesity (n = 228). Healthy Eating Index-2015 (HEI) was used to measure diet quality from 2 24-hour dietary recalls. The HEI total scores and 11 binary HEI components (those that met the standard for maximum component score vs those that did not) were calculated as dependent variables. Multiple linear and logistic regression models were used to examine the association between healthy food density and HEI total scores and meeting the standards for maximum component scores. Healthy food density × residential location tested for moderation. P < 0.05 indicated significance. Participants' diet quality was suboptimal (mean, 52.0; SD, 11.7; range, 27-85). Healthy food density was not significantly related to HEI total scores or components, and residential location was not a moderator. Diet quality was suboptimal, and there was no relationship between healthy food density and diet quality among Health in Pregnancy and Postpartum study participants. These data support examining behavioral factors that could influence diet quality.