Abstract
Background: Body composition is an important indicator of nutritional status and health. How body composition changes during 12 mo of breastfeeding in HIV-infected women receiving antiretroviral therapy (ART) is unknown. Objective: We assessed whether HIVor food insecurity was associated with adverse postpartum body-composition changes in Ugandan women. Design: A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, midupper arm circumference, triceps skinfold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIVand food insecurity and changes in body composition over time. Results: At baseline, HIV+ women compared with HIV-negative women had a higher mean 6 SD food-insecurity score (11.3 ± 5.5 compared with 8.6 ± 5.5, respectively; P < 0.001) and lower AMA (40.6 ± 5.7 compared with 42.9 ± 6.9 cm3, respectively; P = 0.03). Participants were thin at 1 wk postpartum [body mass index (BMI; in kg/m2): 22.9 ± 2.9]. From 1 wk to 12 mo, the weight change was 21.4 ± 4.4 kg. In longitudinal models of body-composition outcomes, HIV was not associated with body composition (all P. 0.05), whereas food insecurity was inversely associated with body weight and BMI at 6, 9, and 12 mo and with AFA at ± and 12 mo (all P < 0.05). At ± mo, every 1-unit increase in the food-insecurity score was associated with a 0.13-kg lower body weight (P < 0.001) and a 0.26-cm3 lower AFA (P < 0.01). Conclusions: Body-composition changes are minimal during lactation. HIV is not associated with body composition; however, food insecurity is associated with changes in body composition during lactation. This trial was registered at clinicaltrials. gov as NCT02922829 and NCT02925429.
Original language | English (US) |
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Pages (from-to) | 361-368 |
Number of pages | 8 |
Journal | American Journal of Clinical Nutrition |
Volume | 105 |
Issue number | 2 |
DOIs | |
State | Published - Feb 1 2017 |
Funding
Supported in part by the Feed the Future Innovation Laboratory for Nutrition, which is funded by the United States Agency for International Development (USAID) and based at Tufts University (USAID OAA-L-10-00006), and by a seed grant for collaborations between Cornell University-Ithaca and Weill Cornell Medical College faculty. EMW was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; NIH/NICHD K99HD086304), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; NIH/NIDDKT32DK091227 and T32DK007559), and PepsiCo Global R+D (unrestricted grant to support research in maternal and child health). SLY was supported by the National Institute of Mental Health (NIMH; NIH/NIMH K01MH098902).
Keywords
- BMI
- Body composition
- Postpartum
- Pregnancy
- Uganda
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics