Neri Daniela, Oliveira Fernanda L C, Carvalho Aline M, Somarriba Gabriel A, Scott Gwendolyn B, Miller Tracie L
*Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL †Discipline of Nutrition, Department of Pediatrics, Escola Paulista de Medicina - EPM, Universidade Federal de São Paulo - UNIFESP ‡Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil §Division of Pediatric Infectious Disease and Immunology, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL.
J Pediatr Gastroenterol Nutr. 2017 Nov;65(5):e104-e109. doi: 10.1097/MPG.0000000000001607.
HIV-exposed, uninfected (HEU) infants are potentially at risk for cardiovascular disease due to in utero exposures. Feeding practices of the infant could compound this risk. Few studies have, however, evaluated dietary intake of HEU infants. We determined dietary factors associated with rapid weight gain (RWG) among HEU infants from birth to 6 months followed at the University of Miami HIV Screening Program.
In this cross-sectional analysis, logistic regression was used to determine dietary factors associated with RWG defined as a >0.67 SD change in weight-for-age z score from birth to assessment (0.3-6 months). Other covariates included demographics, birth, maternal and gestational characteristics, and antiretroviral exposures.
A total of 86 full-term HEU infants with a mean age of 3.4 months (SD 1.8 months) were included in this analysis. Fifty-five percent of mothers were obese. Overall, 39.5% of infants exhibited RWG. A significant association between consumption of infant cereal and RWG (odds ratio, 3.52; 95% confidence interval, 1.02-12.10) was found after adjusting for birth weight, current age, and energy intake. Those infants who consumed the highest tertile of protein were less likely to gain weight rapidly after adjusting for the same covariates (odds ratio, 0.15; 95% confidence interval, 0.02-0.94).
Overall differences in weight gain during early infancy are at least partly explained by means of infant feeding in young HEU infants in the United States. Dietary counseling for families of HEU should reinforce current feeding practice recommendations of the American Academy of Pediatrics.
由于子宫内暴露,暴露于HIV但未感染(HEU)的婴儿有患心血管疾病的潜在风险。婴儿的喂养方式可能会加剧这种风险。然而,很少有研究评估HEU婴儿的饮食摄入量。我们确定了迈阿密大学HIV筛查项目中从出生到6个月随访的HEU婴儿中与快速体重增加(RWG)相关的饮食因素。
在这项横断面分析中,使用逻辑回归来确定与RWG相关的饮食因素,RWG定义为从出生到评估(0.3 - 6个月)时年龄别体重z评分变化>0.67标准差。其他协变量包括人口统计学、出生、母亲和妊娠特征以及抗逆转录病毒暴露情况。
本分析纳入了86名足月HEU婴儿,平均年龄为3.4个月(标准差1.8个月)。55%的母亲肥胖。总体而言,39.5%的婴儿出现了RWG。在调整出生体重、当前年龄和能量摄入后,发现婴儿谷物摄入量与RWG之间存在显著关联(优势比,3.52;95%置信区间,1.02 - 12.10)。在调整相同协变量后,蛋白质摄入量处于最高三分位数的婴儿体重快速增加的可能性较小(优势比,0.15;95%置信区间,0.02 - 0.94)。
美国低龄HEU婴儿在婴儿期早期体重增加的总体差异至少部分可通过婴儿喂养方式来解释。应为HEU家庭提供饮食咨询,强化美国儿科学会目前的喂养实践建议。