埃塞俄比亚中北部医疗机构中接受抗逆转录病毒治疗的成年人的水果和蔬菜膳食摄入量及其估计消费量:一项多机构横断面研究。
Fruits and vegetables dietary intake and its estimated consumption among adults receiving antiretroviral therapy in health facilities in Northcentral Ethiopia: a multi-facility cross-sectional study.
作者信息
Boneya Dube Jara, Ahmed Ahmed Ali, Yalew Alemayehu Worku, Gebremedhin Samson
机构信息
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
Front Nutr. 2024 Jul 17;11:1380987. doi: 10.3389/fnut.2024.1380987. eCollection 2024.
BACKGROUND
Despite the significant role of fruit and vegetables (FAVs) in preventing a variety of chronic diseases and their potential to bolster immune responses and slow the progression of HIV infection to AIDS, there is a lack of studies on the dietary intake of FAVs among HIV-infected adults in Africa, including Ethiopia. Hence, this study aimed to investigate the magnitude of FAV intake and estimated consumption among HIV-infected adults receiving antiretroviral therapy (ART) in northcentral Ethiopia.
METHODS
A multifacility cross-sectional study was conducted on the FAV intake among 865 HIV-infected adults receiving ART. A Poisson regression model with robust variance was used to identify factors associated with FAVs dietary intake.
RESULTS
The study indicated that 655 (76.34%; 95% CI: 73.38, 79.07) HIV-infected adults reported consuming FAVs less than once per day, with 838 (97.67%, 95% CI: 96.41, 98.49) and 676 (78.79%, 95% CI: 75.92, 81.40) HIV-infected adults reporting consuming fruits and vegetables less than once per day, respectively. The median (IQR) total FAV intake was 271.3 (IQR: 92.5, 439.5) g/day, with the median (IQR) intake of fruits being 248.1 (IQR: 100.0, 400.0) g/day and vegetables being 273.78 (IQR: 82.44, 348.33) g/day, respectively. We found that being divorced (APR = 1.57, 95% CI: 1.16, 2.12), employed as a daily laborer (APR = 2.08, 95% CI: 1.36, 3.20), being employed (APR = 1.77, 95% CI: 1.10, 2.84), merchants (APR = 1.59, 95% CI: 1.03, 2.47), having children as caregivers (APR = 1.61, 95% CI: 1.02, 2.55), an advanced WHO clinical stage (APR = 1.32, 95% CI: 1.32(1.03, 1.69), and receiving ART for more than 8 years (APR = 1.78, 95% CI: 1.18, 2.67) were found to be independent predictors of FAV dietary intake among HIV-infected adults. From the findings, we understood that farmers were less likely to consume FAVs compared to employed individuals, daily laborers, and merchants.
CONCLUSION
The finding indicated a very low level of FAV dietary intake among HIV-infected adults receiving ART, falling well-below the minimum recommendation for physically active adults. Despite living in areas with surplus production and producing these items, farmers are less likely to consume FAV. The study emphasizes the importance of focusing on the early stage of ART treatment for patients and family therapy, including counseling and guidance on consuming healthy diets such as FAVs, to enhance the role of children as caregivers for their families. Additionally, there is a need for comprehensive nutritional counseling to improve FAV consumption, with a particular emphasis on educating individuals about portion size estimation for the consumption of FAVs.
背景
尽管水果和蔬菜在预防多种慢性疾病方面发挥着重要作用,并且具有增强免疫反应以及减缓艾滋病毒感染向艾滋病发展进程的潜力,但在非洲,包括埃塞俄比亚在内,缺乏针对感染艾滋病毒成年人的水果和蔬菜饮食摄入量的研究。因此,本研究旨在调查埃塞俄比亚中北部接受抗逆转录病毒治疗(ART)的感染艾滋病毒成年人的水果和蔬菜摄入量及估计消费量。
方法
对865名接受抗逆转录病毒治疗的感染艾滋病毒成年人的水果和蔬菜摄入量进行了多机构横断面研究。使用具有稳健方差的泊松回归模型来确定与水果和蔬菜饮食摄入量相关的因素。
结果
研究表明,655名(76.34%;95%置信区间:73.38,79.07)感染艾滋病毒的成年人报告每天食用水果和蔬菜的次数少于一次,其中838名(97.67%,95%置信区间:96.41,98.49)和676名(78.79%,95%置信区间:75.92,81.40)感染艾滋病毒的成年人分别报告每天食用水果和蔬菜的次数少于一次。水果和蔬菜的总摄入量中位数(四分位间距)为271.3(四分位间距:92.5,439.5)克/天,水果摄入量中位数(四分位间距)为248.1(四分位间距:100.0,400.0)克/天,蔬菜摄入量中位数(四分位间距)为273.78(四分位间距:82.44,348.33)克/天。我们发现,离婚(调整后风险比=1.57,95%置信区间:1.16,2.12)、从事日工工作(调整后风险比=2.08,95%置信区间:1.36,3.20)、有工作(调整后风险比=1.77,95%置信区间:1.10,2.84)、是商人(调整后风险比=1.59,95%置信区间:1.03,2.47)、有儿童作为照顾者(调整后风险比=1.61,95%置信区间:1.02,2.55)、世界卫生组织临床分期较晚(调整后风险比=1.32,95%置信区间:1.03,1.69)以及接受抗逆转录病毒治疗超过8年(调整后风险比=1.78,95%置信区间:1.18,2.67)是感染艾滋病毒成年人水果和蔬菜饮食摄入量的独立预测因素。从研究结果中我们了解到,与有工作的人、日工和商人相比,农民食用水果和蔬菜的可能性较小。
结论
研究结果表明,接受抗逆转录病毒治疗的感染艾滋病毒成年人的水果和蔬菜饮食摄入量非常低,远低于身体活跃成年人的最低建议摄入量。尽管生活在产量过剩且生产这些产品的地区,但农民食用水果和蔬菜的可能性较小。该研究强调了关注患者抗逆转录病毒治疗早期阶段以及家庭治疗的重要性,包括提供关于食用水果和蔬菜等健康饮食的咨询和指导,以增强儿童作为家庭照顾者的作用。此外,需要进行全面的营养咨询以提高水果和蔬菜的消费量,尤其要重点教育个人关于水果和蔬菜食用量估计的知识。