Abstract
Background/objectives: Body composition changes markedly during reproduction. In sub-Saharan Africa, impacts of HIV infection on body composition across pregnancy and lactation in the context of Option B+ antiretroviral therapy are unknown. Therefore, we sought to evaluate the role of HIV infection on body composition during pregnancy and lactation among Kenyan women. Subjects/methods: A cohort of pregnant women (n = 333; 50.5% HIV+, receiving ART) were enrolled at seven clinics in western Kenya. Two prenatal (mean ± SD: 23.6 ± 4.4 and 33.4 ± 2.0 weeks gestation) and three postpartum (6, 14, and 36 weeks) measurements included: individual-level food insecurity, height, weight, fat mass (FM), and fat-free mass (FFM) by bioimpedance analysis (BIA), mid-upper arm circumference (MUAC), and triceps skinfold (TSF), allowing for AMA (arm muscle area) and AFA (arm fat area) derivation. Multivariable longitudinal regression models were used to relate HIV to body composition changes. Results: In longitudinal models, HIV-infected women had lower weight (ß = −3.0 kg, p = 0.003), fat mass (ß = −1.5 kg, p = 0.02), fat-free mass (ß = −1.5 kg, p = 0.01), TSF (ß = −2.6 mm, p < 0.001), AFA (ß = −3.9 cm 3 , p < 0.001), and MUAC (ß = −1.0 cm, p = 0.001), but not AMA (p = 0.34), across all observations. Food insecurity was inversely associated with AMA and MUAC postpartum (AMA ß-range = −0.47 to −0.92 cm 3 ; MUAC ß-range = −0.09 to −0.15 cm, all p < 0.05). Conclusions: HIV infection was associated with lower weight, fat mass, fat-free mass, TSF, AFA, and MUAC values during pregnancy and lactation, while food insecurity was intermittently associated with body composition. This suggests that pregnant and lactating women living with HIV and food insecurity could benefit from nutritional support.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 474-482 |
| Number of pages | 9 |
| Journal | European Journal of Clinical Nutrition |
| Volume | 73 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2019 |
Funding
Acknowledgements We would like to thank the Kenya Medical Research Institute (KEMRI) for providing space within the FACES clinics for the work to be conducted, ethical and logistic support to conduct this research, and oversight in Kenya. We would also like to warmly thank our study nurses: Joyce Boke, and Tobias Odwar, and our study trackers: Benter Ogwana, Teresa Owade, and Sarah Obaje, as well as the mothers and their infants who participated in this study. Research activities and SLY were supported by the National Institute of Mental Health (NIH/NIMH K01MH098902). EW was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NIH/NICHD K99HD086304), the National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK T32DK091227; T32 DK007559), and by an unrestricted grant to support research in maternal and child health from PepsiCo Global R + D. This trial was registered at clinicaltrials.gov as NCT02974972. Conflict of interest Research activities and Sera Young were supported by the National Institute of Mental Health. EMW has received funding from the National Institutes of Health, and the Thrasher Research Fund. From August 2014 to July 2015, Widen was supported by an unrestricted postdoctoral fellowship from PepsiCo Global R+D. SDW has received funding from NIMH, NIAID, and Kaiser Community Benefits. The other authors declare no conflict of interest.
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
