Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Falmouth Building, Anzio Road, Observatory, Cape Town, Western Cape, 7925, South Africa.
Division of Human Nutrition, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa.
BMC Public Health. 2021 Aug 4;21(1):1504. doi: 10.1186/s12889-021-11566-2.
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/m) 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.
尽管由于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广泛流行趋势的主要原因之一，但在南非，患有 HIV 的孕妇的数据有限。我们研究了首次产前保健就诊时患有和不患有 HIV 的孕妇的基于食物的饮食摄入情况，以及这些因素与孕妇超重/肥胖和妊娠体重增加（GWG）之间的关系。
在南非一个城市社区，连续招募了患有（n=479）和不患有（n=510）HIV 的孕妇，并进行前瞻性随访至分娩。使用访谈者管理的非定量食物频率问卷评估登记时的饮食摄入情况（淀粉、蛋白质、乳制品、水果、蔬菜、豆类、油/脂肪）。使用逻辑回归模型检查与母体体重指数（BMI）和 GWG 的关联。
在（中位数年龄 29 岁，IQR 25-34）的女性中，首次 ANC 时肥胖（BMI≥30kg/m）的患病率为 43%，总体上过度 GWG（按 IOM 指南）的患病率为 37%；HIV 患病率为 48%。在没有 HIV 的女性中，每周食用 1-3 天的土豆（任何形式）（OR 1.98，95%CI 1.02-3.84）和南瓜/冬南瓜（OR 2.13，95%CI 1.29-3.49）会增加超重/肥胖的几率，而不食用任何这些食物；每周食用 1-3 天的茶/咖啡中的牛奶（OR 6.04，95%CI 1.37-26.50）会增加过度 GWG 的几率。每周食用 1-3 天鸡蛋（任何形式）（OR 0.52，95%CI 0.32-0.86）会降低超重/肥胖的几率，而每周食用 4-7 天花生和坚果会降低超重/肥胖的几率（OR 0.34，95%CI 0.14-0.80）。在患有 HIV 的女性中，每周食用 1-3 天牛奶/酸奶/马萨（OR 0.35，95%CI 0.18-0.68）、番茄（生/熟）（OR 0.50，95%CI 0.30-0.84）、绿豆（OR 0.41，95%CI 0.20-0.86）、混合蔬菜（OR 0.49，95%CI 0.29-0.84）和豆类，例如烤豆、扁豆（OR 0.50，95%CI 0.28-0.86），每周食用 4-7 天，会降低超重/肥胖的几率；番茄（生/熟）（OR 0.48，95%CI 0.24-0.96）和混合蔬菜（OR 0.38，95%CI 0.18-0.78）也降低了过度 GWG 的几率。
饮食改变可能会促进患有和不患有 HIV 的孕妇保持健康的体重。
