Personality traits influence food cravings in pregnant women

The purpose of this study is to identify whether there is an association between food cravings and personality traits in pregnant women. If personality trait influences the food choice in pregnant women, it may subsequently influence the nutritional intake of the pregnant women and it may affect the offspring.

The Big Five model is generally used to understand an individual’s personality through the integration of all five factors, which are openness, conscientiousness, extraversion, agreeableness, and neuroticism. However, for this study, we analysed each factor independently to determine the specific influence of each trait on food cravings during pregnancy. By analysing each personality trait separately, we aimed to explore distinct relationship that may exist between a particular trait and the occurrence of food cravings, which could have been masked in a combined model.

In this study, a large number of pregnant women in the urban area of Jakarta had food cravings (63.8%). A food craving is defined as a strong desire to consume certain foods. This desire is specifically different from mere hunger and is very difficult to resist. If craved food is not obtainable, a feeling of anxiety will be awakened, and after it is obtainable, the speed of consumption is changed^21,23.

Our findings are in line with several studies exploring food cravings during pregnancy. A high prevalence of cravings (58.3%) among Ethiopian pregnant women was found⁵. Similarly, another study in Jordan found that 75.4% Jordanian women experienced cravings, particularly for sweets and salty foods, with associations between cravings and factors like education level and health conditions such as anemia²⁴.

It is generally known that pregnant women occasionally crave sweet food, fruit, or calorie-dense foods, as well as strange combinations such as pickles and ice cream. Even strange habits such as pica may also occur. This phenomenon is widely known, however, it is still not properly understood²⁵.

Traits consistent over time and traits influencing behaviour are relevant to the concept of personality²⁶. Personality is one of the psychological variables that can affect psychopathological development²⁷. Several psychological issues, such as healthy behaviour, happiness, academic and job performance, and antisocial and criminal conduct are associated with personality traits. Based on different perspectives in describing human differences in personality traits, several models have been applied and one of the most widely accepted structural personality models is the Big Five Factor, which categorizes individuals in five dimensions²⁸.

Various factors, such as health status, age, gender, genetics and socioeconomic status may determine body weight increment and for having appetite. These will form a dietary pattern, and it can represent the regulation of emotions, as well as the inability to resist food cravings or binge eating. Evidence suggests that individual personality traits are consistent with the increment of weight gain¹².

Many factors influence personality traits in populations. Gender, culture, geography, social status, and many others can form personality traits. We observed that the number of subjects with highly conscientious traits was the highest in our samples. This was different from other studies in this country, which collected samples from college students²⁹. In addition, the difference was also observed in a study in Great Britain³⁰. High conscientiousness is associated with neatness behaviour.

It is suggested that food cravings do not influence the total dietary intake during pregnancy, nor are they associated with more gestational weight gain, risk of maternal glycaemia or offspring outcome biometrics³¹. However, others found that first-trimester craving is associated with dietary intake and that the risk of gestational diabetes mellitus may be adjusted by the type of cravings³². Personality traits affect dietary intake and weight gain because these individual characteristics are related to patterns of thinking, feeling, and behaviour.

Many studies have reported on food cravings, but only this study has linked cravings with personality traits in pregnancy. Of all five types of personality traits, only neuroticism had a significant difference in food cravings. Therefore, women with high neuroticism traits should receive special attention when becoming pregnant. High neuroticism traits are represented by irritable behaviour, which is characterized by much stress, easy anger, anxiety, and always trying to exact revenge. Individuals with high neuroticism traits are easily threatened, have difficulties dealing with problems, and often experience negative emotions such as fear, shame, and anger. In correlation with the incidence of mental and physical health problems, a meta-analysis conducted by Malouff et al.³³found a strong correlation of high neuroticism with it in comparison with other personality traits. Therefore, it seems that this personality trait more easily obtains food cravings since food cravings usually reflect an unusual habit that cannot be controlled. In contrast, personal traits with low neuroticism are characterized by stable emotions and the ability to manage stress, happiness, and optimism. In a previous study, it was found that high neuroticism traits had a spontaneous tendency to food addiction¹⁴. In addition, this personality trait was also associated with obesity, binge eating, alcohol consumption, smoking, and substance abuse^{13,15,16,17,18}. Obesity in pregnancy can increase the risk of congenital anomalies such as heart defects and neural tube defects (NTD). While alcohol consumption, smoking, and substance abuse, as we know, can increase the risks of adverse pregnancy outcomes, such as miscarriage, preterm labour, stillbirth, etc.

Individuals with neuroticism personality traits are said to be easier to give in to enticement to eat and have difficulty following the discipline of healthy living habits such as exercise or physical activity. In addition, they also have difficulty following a strict schedule at meal times, so it will be difficult to reduce extra calorie intake outside of mealtimes¹³. Another study also found that individuals with high neuroticism have higher triglyceride levels and higher inflammation^34,35. An unbalanced lipid profile with high inflammation can influence pregnancy health, which can increase the risk of preeclampsia.

In previous studies, the personality opposite to neuroticism is the conscientiousness personality trait, and people with this trait are rarely obese. This personality trait is known to have a regular, disciplined, and healthy lifestyle, such as performing regular exercise, eating healthy foods, and avoiding alcohol. This is also reflected in other studies that show that people with conscientiousness personalities have lower levels of fat. They will have more organized and scheduled time to eat and healthy choices of food. They are also able to resist cravings such as drinking alcohol and binge eating^12,13,19,20.

The weakness of this study is that the subjective questionnaire relies on the patient’s memory so recall bias may occur. The personality traits assessment instrument is based on self-assessment that is done in a short time and does not provide enough time to observe the subject. Selection bias may also happen due to the urban setting of sample. The participants were recruited from an urban area, which may not be representative of pregnant women living in rural or less developed regions of Indonesia. Consequently, the findings may not be generalizable to all pregnant women in Indonesia, particularly those in rural areas who may face different socio-cultural and economic influences.

In addition, a large proportion of our study subjects were in their first trimester, during which morning sickness is common. It is possible that the observed association between neurocitism and food cravings may be influenced by the physiological and emotional effects of morning sickness, rather than reflecting pre-pregnancy personality traits. Future studies should consider assessing personality traits before pregnancy.

Another potential limitation of this study is the influence of confounding variables. Factors such as maternal age, gestational age, socioeconomic status, pre-pregnancy BMI, and psychological stress could all contribute to the observed associations. For instance, socioeconomic status might affect dietary choices and access to certain types of foods, and pre-existing mental health conditions or stress levels could exacerbate neurotic tendencies, potentially increasing cravings. Future studies should control for these confounding factors to clarify the causal pathway.

This study implies that if we detect the personality traits of women before pregnancy, we should provide appropriate antenatal care for women with food cravings, especially those with high neuroticism traits, to prevent adverse pregnancy outcomes, as reported above. Antenatal care providers could consider screening for personality traits to identify women who may be more susceptible to unhealthy eating behaviours. Tailored interventions could include stress management techniques, nutritional counseling, and behavioural strategies to manage food cravings, particularly for those with high neurocitism. By integrating personalized care approaches, antenatal programs can more effectively support pregnant women in maintaining balanced diets, benefiting both maternal and fetal health.

Further research should explore the long-term effects of food cravings and personality traits during pregnancy on both maternal and offspring outcomes. Longitudinal studies that track mothers and their children from pregnancy through early childhood could provide valuable insights. Expanding this research to include diverse populations, such as rural communities and different cultural backgrounds, could also help identify whether these relationship vary across different socio-cultural contexts.