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Associations Between Dietary Intake Before 6 Months of Age and Rapid Weight Gain Among HIV-exposed Uninfected Infants
Daniela Neri1, Fernanda L C Oliveira, Aline M Carvalho
1*Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL †Discipline of Nutrition, Department of Pediatrics, Escola Paulista de Medicina - EPM, Universidade Federal de São Paulo - UNIFESP ‡Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil §Division of Pediatric Infectious Disease and Immunology, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL.
Insights
Infant feeding practices significantly impact rapid weight gain in HIV-exposed, uninfected (HEU) infants. Consumption of infant cereal was linked to faster weight gain, while higher protein intake was associated with slower gain in HEU infants.
Area of Science:
- Pediatrics
- Nutrition Science
- Infectious Diseases
Background:
- HIV-exposed, uninfected (HEU) infants may face increased cardiovascular disease risk due to in utero exposures.
- Infant feeding practices could exacerbate health risks in HEU infants.
- Limited research exists on the dietary intake of HEU infants.
Purpose of the Study:
- To identify dietary factors associated with rapid weight gain (RWG) in HEU infants from birth to 6 months.
- To inform feeding recommendations for HEU infants.
Main Methods:
- Cross-sectional analysis of 86 full-term HEU infants.
- Logistic regression used to determine factors associated with RWG (defined as >0.67 SD change in weight-for-age z score).
- Covariates included demographics, birth, maternal, gestational, and antiretroviral characteristics.
Main Results:
- 39.5% of HEU infants exhibited RWG.
- Infant cereal consumption was significantly associated with RWG (OR, 3.52; 95% CI, 1.02-12.10).
- Highest tertile of protein intake was associated with less RWG (OR, 0.15; 95% CI, 0.02-0.94).
Conclusions:
- Infant feeding practices partially explain weight gain differences in young HEU infants.
- Dietary counseling for HEU infant families should align with AAP feeding recommendations.
Introduction:
HIV-exposed, uninfected (HEU) infants are potentially at risk for cardiovascular disease due to in utero exposures. Feeding practices of the infant could compound this risk. Few studies have, however, evaluated dietary intake of HEU infants. We determined dietary factors associated with rapid weight gain (RWG) among HEU infants from birth to 6 months followed at the University of Miami HIV Screening Program.
Methods:
In this cross-sectional analysis, logistic regression was used to determine dietary factors associated with RWG defined as a >0.67 SD change in weight-for-age z score from birth to assessment (0.3-6 months). Other covariates included demographics, birth, maternal and gestational characteristics, and antiretroviral exposures.
Results:
A total of 86 full-term HEU infants with a mean age of 3.4 months (SD 1.8 months) were included in this analysis. Fifty-five percent of mothers were obese. Overall, 39.5% of infants exhibited RWG. A significant association between consumption of infant cereal and RWG (odds ratio, 3.52; 95% confidence interval, 1.02-12.10) was found after adjusting for birth weight, current age, and energy intake. Those infants who consumed the highest tertile of protein were less likely to gain weight rapidly after adjusting for the same covariates (odds ratio, 0.15; 95% confidence interval, 0.02-0.94).
Conclusions:
Overall differences in weight gain during early infancy are at least partly explained by means of infant feeding in young HEU infants in the United States. Dietary counseling for families of HEU should reinforce current feeding practice recommendations of the American Academy of Pediatrics.