HIV infection and increased food insecurity are associated with adverse body composition changes among pregnant and lactating Kenyan women

Elizabeth M. Widen, Irene Tsai, Shalean M. Collins, Pauline Wekesa, Joy China, Natalie Krumdieck, Joshua D. Miller, Sheri D. Weiser, Maricianah Onono, Sera L. Young*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

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 languageEnglish (US)
Pages (from-to)474-482
Number of pages9
JournalEuropean Journal of Clinical Nutrition
Volume73
Issue number3
DOIs
StatePublished - Mar 1 2019

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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