Dietary patterns and nutrient intakes of a South African population and asymptomatic people infected with human immunodeficiency virus: The transition health and urbanisation in South Africa (THUSA) study.

Abstract

There is increased emphasis on the quality of food and the overall pattern of micronutrient intake as an integral consideration for food security particularly among people living with HIV/AIDS (PLWHA). However, limited data exist on food consumption and nutrient intakes for populations in sub-Saharan Africa. The study examined dietary patterns and their relationship with nutrient intakes in HIV uninfected (HIV-) and infected (HIV+) adults in North-West Province, South Africa. In this cross-sectional study, dietary and nutrient intakes were assessed with Quantitative Food Frequency Questionnaire (QFFQ) and FoodFinder software, respectively. Dietary patterns were determined using Principal Component Analysis. Participants’ scores for the dietary patterns were related to nutrient intakes using Spearman Rank correlation and Generalised Linear Modelling (GENLIN). Four main dietary patterns were found in each population. The first three patterns were similar between the HIV- and HIV+ populations: “animal-based”, associated with intake of foods of animal origin; “recommended” associated with a varied diet; and “staple-based”. The fourth pattern was described as either ‘eggs-and-breakfast-cereals’ for the HIV- group or ‘legumesand-vegetables’ for HIV+ group. Scores for animal-based pattern showed strongest correlations(r) with nutrient intakes for both populations, notably zinc (r=0.54), calcium (r=0.5), potassium (r=0.54), vitamin A (r=0.5), and vitamin C (r=0.5), (p<0.001 for all). In the HIV+ group, the legumes-and-vegetables pattern was strongly associated with energy (r=0.64), vitamins D (r=0.51), E (0.51) and B1 (r=0.55) (p<0.001 for all). Compared with the other patterns, the Staple-based and the recommended patterns showed the weakest associations with nutrient intakes. Generalised Linear Modelling confirmed stronger positive linear associations between scores of the animal-based diet and nutrients intake, compared with the other patterns. The findings suggest that the animal-based pattern was strongly associated with nutrients intake in both HIV + and HIV- populations. This raises the need for studies into dietary recommendations for promoting nutritional wellbeing for PLWHA in sub-Saharan Africa.

Maternal dietary pattern and its association with birthweight in Northern Ethiopia: A hospital‐based cross‐sectional study

“…Three dietary patterns-animal-based, plant-based, and grainbased-were discovered in another study conducted in Malawi among pregnant HIV-positive women (Ramlal et al, 2015). Four dietary patterns-animal-based, staple-based, recommended diet, egg and breakfast cereals, legumes, and vegetables-were also discovered in a second study on the HIV-infected population in South Africa (Annan et al, 2015). A study on Danish women also identified three categories of food habits: western, intermediate, and healthconscious patterns (Knudsen et al, 2008).…”

Dietary pattern association with CD4 cells count in patients living with human immunodeficiency virus: A cross-sectional study

“…Annan et al’s 36 study showed a strong association between animal-based dietary patterns and micronutrient intake in HIV individuals. These studies suggested that inadequate nutritional intake (reduced or increased food intake) impacts the immune system, which is of substantial importance among HIV-infected patients.…”

“…[44][45][46] The principal reason is overall vitamin D deficiencies in HIV-infected patients and the Iranian population in general. 16,36,47,48 Furthermore, there are many non-HIV-related risk factors for Vitamin D deficiency, including sex, advanced age, limited sunlight exposure, low levels of dietary Vitamin D intake, gastrointestinal absorption disorders, hepatic and renal diseases, higher body mass index, diabetes mellitus, and alcohol consumption. 42,43 We found no significant correlation between education level, marital status, employment status, smoking, medication usage, physical activity levels, depression history, disease duration, economic condition, participants' average energy and protein intake, and CD4 cell count.…”

“…These studies suggested that inadequate nutritional intake (reduced or increased food intake) impacts the immune system, which is of substantial importance among HIV-infected patients. 31,36 Nutritional status can affect the overall health and longevity of PLWH. Several epidemiologic studies investigated the impact of being underweight or overweight on the nutritional status of HIV-infected patients.…”

“… 34 , 35 Our results align with another study in Malawi on a population of pregnant women infected with HIV. 36 …”