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. 2019 Nov;31(6):e23308.
doi: 10.1002/ajhb.23308. Epub 2019 Aug 9.

Decreased consumption of common weaning foods is associated with poor linear growth among HIV-exposed infants participating in the Kigali antiretroviral and breastfeeding assessment for the elimination of HIV (Kabeho) study

Charlotte Lane  1 , Emily A Bobrow  2 , Dieudonne Ndatimana  2 , Gilles F Ndayisaba  2 , Linda S Adair  1
Affiliations

Decreased consumption of common weaning foods is associated with poor linear growth among HIV-exposed infants participating in the Kigali antiretroviral and breastfeeding assessment for the elimination of HIV (Kabeho) study

Charlotte Lane et al. Am J Hum Biol. 2019 Nov.

Abstract

Objective: The World Health Organization recommends that complementary foods that are adequate, safe, and appropriate be introduced to infants at age 6 months. Using an innovative modeling technique, we examine patterns of nutrient intake in HIV-exposed and uninfected (HEU) infants and establish their relationship with growth.

Methods: Single-day dietary recalls and anthropometrics were collected every two to 3 months from 543 infants living in Kigali, Rwanda, and attending clinics for the prevention of mother-to-child HIV transmission. A common weaning food index (CWFI) was calculated in grams and nutrient density for infants to reflect the extent to which the infants consumed the weaning foods typical of this population at ages 6 to 10, 11 to 15, and 16 to 20 months. Regressions among the CWFI, length-for-age z-scores (LAZ), and weight-for-length z-scores (WLZ) were conducted to estimate the relationship between the dietary patterns and growth.

Results: Mean absolute intake of zinc and calcium from complementary foods was insufficient. Increasing CWFI was related to increasing cow milk consumption. The density CWFI showed a decrease in the density of iron and folate as infants consume more of the weaning foods typical of this population. Density CWFI, breastfeeding, and caloric intake act on early LAZ and WLZ and interact with one another. Among breastfed infants, those who consume little of the common weaning foods and have a high caloric intake develop deficits in LAZ and have an elevated WLZ.

Conclusions: A diet that is more dominated by the typical weaning foods of this population may support a healthy growth pattern.

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Figures

Figure 1:
Figure 1:
CONSORT diagram of participant recruitment and follow-up.
Figure 2:
Figure 2:
Model for latent variable construction
Figure 3
Figure 3
Description of the foods consumed by tertile of CWFI.
Figure 4
Figure 4
Patterns in growth by density CWFI, breastfeeding, and caloric intake. Estimated values are for a male infant whose mother was 29 years old, had 2.4 children, and completed primary school. High values were defined as the 90th percentile while low values were the 10th.
See this image and copyright information in PMC

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