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

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 HIVexposed 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.

Food Pattern Modeling as an Alternative Assessment Method to Multiday Dietary Recalls for Iron-Related Nutrients: A Proof-of-Concept Study

“…Food pattern modeling has been used to estimate community level nutrient intake through modeling methods like the present approach elsewhere [ 29 , 30 , 31 , 32 ]. However, this is the first study, to our knowledge, that has compared the effectiveness of food pattern modeling to repeated multiple-pass memory-based dietary assessment by comparing acute and chronic measurements of nutrient status by hematological outcomes.…”

“…Despite its definition in the Dietary Guidelines for Americans [ 2 ], there is no standardized approach to food pattern modeling as a form of dietary or nutrient assessment. In addition to the methodology from the present study, other studies reviewed suggested a variety of models and methods that were employed with characteristics that met the definition of food pattern modeling [ 3 , 4 , 6 , 7 , 8 , 30 , 31 , 32 ]. To use food pattern modeling broadly, methodology and further validation should be considered for research and programming moving forward.…”