Association between food intake and obesity in pregnant women living with and without HIV in Cape Town, South Africa: a prospective cohort study.
Association between food intake and obesity in pregnant women living with and without HIV in Cape Town, South Africa: a prospective cohort study.
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DOI：
10.1186/s12889-021-11566-2
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发表时间：
2021-08-04
影响因子：
4.5
通讯作者：
Myer L
中科院分区：
文献类型：
--
作者：
Madlala HP;Steyn NP;Kalk E;Davies MA;Nyemba D;Malaba TR;Mehta U;Petro G;Boulle A;Myer L
虽然工业化和城市化导致的全球营养/饮食转变已被确定为肥胖症普遍趋势的主要原因，但关于孕妇的数据有限，包括南非艾滋病毒携带者。我们研究了感染和不感染HIV的孕妇在第一次产前检查(ANC)时基于食物的饮食摄入量，以及与母亲超重/肥胖和妊娠体重增加(GWG)的关系。在南非的一个城市社区，连续登记了艾滋病毒携带者(n= 479)和非艾滋病毒携带者(n= 510)的妇女，并对她们进行了前瞻性跟踪，直到分娩。在注册时，使用面试者管理的非定量食物频率问卷来评估膳食摄入量(淀粉、蛋白质、乳制品、水果、蔬菜、豆类、油脂/脂肪)。用Logistic回归模型检验母体质量指数(BMI)和GWG的相关性。在女性(年龄中位数29 岁，智商25-34)中，肥胖(BMI ≥ 30 kg/m2)的患病率为43%，GWG过多的患病率(根据国际移民组织指南)为37%，艾滋病毒患病率为48%。在没有感染艾滋病毒的女性中，每周食用土豆(任何制剂)(AOR1.98，95%可信区间1.02-3.84)和南瓜/胡萝卜(AOR2.13，95%可信区间1.29-3.49)1-3天 与不食用任何GWG相比，超重/肥胖的几率增加；茶/咖啡中的牛奶(AOR6.04，95%可信区间1.37-26.50)增加GWG过量的几率。每周食用鸡蛋1~3 (AOR0.52，95%CI0.32~0.86)可降低超重/肥胖的风险，而每周食用花生和坚果(ANY)4~7 可降低GWG过多的风险(AOR0.34，95%CI0.14~0.80)。在感染艾滋病毒的妇女中，饮用牛奶/酸奶/马来喝/吃谷物(AOR 0.35，95%CI 0.18-0.68)、西红柿(生/熟)(AOR 0.50，95%CI 0.30-0.84)、绿豆(AOR 0.41，95%CI 0.20-0.86)、混合蔬菜(AOR 0.49，95%CI 0.29-0.84)和豆类如烘豆、扁豆(AOR 0.50，每周4-7次 的95%可信区间0.28-0.86降低了超重/肥胖的几率；西红柿(生/熟)(AOR 0.48，95%CI 0.24-0.96)和混合蔬菜(AOR 0.38，95%CI 0.18-0.78)也降低了GWG过量的几率。修改饮食可能会促进携带和不携带艾滋病毒的孕妇的健康体重。网上版载有补充材料，可在10.1186/s12889-021-11566-2查阅。
Although global nutrition/dietary transition resulting from industrialisation and urbanisation has been identified as a major contributor to widespread trends of obesity, there is limited data in pregnant women, including those living with HIV in South Africa. We examined food-based dietary intake in pregnant women with and without HIV at first antenatal care (ANC) visit, and associations with maternal overweight/obesity and gestational weight gain (GWG). In an urban South African community, consecutive women living with (n = 479) and without (n = 510) HIV were enrolled and prospectively followed to delivery. Interviewer-administered non-quantitative food frequency questionnaire was used to assess dietary intake (starch, protein, dairy, fruits, vegetables, legumes, oils/fats) at enrolment. Associations with maternal body mass index (BMI) and GWG were examined using logistic regression models. Among women (median age 29 years, IQR 25–34), the prevalence of obesity (BMI ≥ 30 kg/m2) at first ANC was 43% and that of excessive GWG (per IOM guidelines) was 37% overall; HIV prevalence was 48%. In women without HIV, consumption of potato (any preparation) (aOR 1.98, 95% CI 1.02–3.84) and pumpkin/butternut (aOR 2.13, 95% CI 1.29–3.49) for 1–3 days a week increased the odds of overweight/obesity compared to not consuming any; milk in tea/coffee (aOR 6.04, 95% CI 1.37–26.50) increased the odds of excessive GWG. Consumption of eggs (any) (aOR 0.52, 95% CI 0.32–0.86) for 1–3 days a week reduced the odds of overweight/obesity while peanut and nuts consumption for 4–7 days a week reduced the odds (aOR 0.34, 95% CI 0.14–0.80) of excessive GWG. In women with HIV, consumption of milk/yoghurt/maas to drink/on cereals (aOR 0.35, 95% CI 0.18–0.68), tomato (raw/cooked) (aOR 0.50, 95% CI 0.30–0.84), green beans (aOR 0.41, 95% CI 0.20–0.86), mixed vegetables (aOR 0.49, 95% CI 0.29–0.84) and legumes e.g. baked beans, lentils (aOR 0.50, 95% CI 0.28–0.86) for 4–7 days a week reduced the odds of overweight/obesity; tomato (raw/cooked) (aOR 0.48, 95% CI 0.24–0.96) and mixed vegetables (aOR 0.38, 95% CI 0.18–0.78) also reduced the odds of excessive GWG. Diet modification may promote healthy weight in pregnant women living with and without HIV. The online version contains supplementary material available at 10.1186/s12889-021-11566-2.
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