Relationship between HIV infection and the dietary intakes of Ghanaian pregnant and lactating women
Maternal energy and nutrient deficiencies increase the risk of poor pregnancy outcomes and, among women with HIV, hasten the progression of disease. We identified factors associated with dietary intakes of Ghanaian women by HIV status. We also assessed women's dietary habits, food beliefs and compliance with nutrition recommendations received from the Ghana Health Services (GHS). A total of 92 pregnant and lactating women (23 HIV-infected, 33 HIV-uninfected, and 36 of unknown status) completed the study. Most women (86%) reported receiving nutrition recommendations. The recommendations most complied with included eating more protein foods and consuming more soups and stews, especially palm soup and kontomire (a green leafy vegetable) stew. The latter two foods are rich in [Beta]-carotene, a precursor of vitamin A. About 9% of participants in this study practiced pica, 59% sought specific foods, and 24% avoided certain foods. Nearly half (47%) of the women believed some foods were beneficial for HIV infected individuals. Reported energy intake did not differ by HIV status (2780 ± 800; 2980 ± 1140; and 2880 ± 1020 kcal for infected, uninfected, and unknown, respectively) or by physiological status (2670 ± 570 and 2960 ± 1100 kcal for pregnancy and lactation, respectively). Protein and micronutrient intakes (vitamins A, B1, B2, and C, calcium, and iron) were also similar by HIV and physiological status. After controlling for health, economic, and dietary recommendation indicators, being unmarried was negatively associated with intake of energy, protein, thiamin, and niacin (P < 0.04), while stress was associated with decreased intake of energy, fat, iron, vitamins A, B1, B2, B3, and C (P < 0.03) and tended to be associated with protein intake (P< 0.06). Absence of gastrointestinal discomfort was also positively associated with energy intake (P < 0.02) and tended to be associated with fat intake (P < 0.06). Ghanaian women were amenable to nutrition recommendations given by Ghana Health Services. However, food beliefs that could limit women's dietary intakes need to be examined. This is especially true for HIV-positive pregnant and lactating women who may have higher nutrient requirements than their contemporaries who are HIV-uninfected.