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Dietary Inadequacies in HIV-infected and Uninfected School-aged Children in Johannesburg, South Africa.

Shiau, Stephanie; Webber, Acadia; Strehlau, Renate; Patel, Faeezah; Coovadia, Ashraf; Kozakowski, Samantha; Brodlie, Susan; Yin, Michael T.; Kuhn, Louise; Arpadi, Stephen M.
Journal of Pediatric Gastroenterology & Nutrition: Post Acceptance: March 22, 2017
doi: 10.1097/MPG.0000000000001577
Original Article: Nutrition: PDF Only

Objectives: The World Health Organization (WHO) recommends that HIV-infected children increase energy intake and maintain a balanced macronutrient distribution for optimal growth and nutrition. Few studies have evaluated dietary intake of HIV-infected children in resource-limited settings.

Methods: We conducted a cross-sectional analysis of the dietary intake of 220 perinatally HIV-infected children and 220 HIV-uninfected controls ages 5-9 years in Johannesburg, South Africa. A standardized 24-hour recall questionnaire and software developed specifically for the South African population was used to estimate intake of energy, macronutrients, and micronutrients. Intake was categorized based on recommendations by the WHO and Acceptable Macronutrient Distribution Ranges (AMDRs) established by the Institute of Medicine (IOM).

Results: The overall mean age was 6.7 years and 51.8% were boys. Total energy intake was higher in HIV-infected than HIV-uninfected children (1341 vs. 1196 kcal/day, p = 0.002), but proportions below the recommended energy requirement were similar in the two groups (82.5 vs. 85.2%, p = 0.45). Overall, 51.8% of the macronutrient energy intake was from carbohydrates, 13.2% from protein, and 30.8% from fat. The HIV-infected group had a higher percentage of their energy intake from carbohydrates and lower percentage from protein compared to the HIV-uninfected group. Intakes of folate, vitamin A, vitamin D, calcium, iodine, and selenium were suboptimal for both groups.

Conclusions: Our findings suggest that the typical diet of HIV-infected children as well as uninfected children in Johannesburg, South Africa does not meet energy or micronutrient requirements. There appear to be opportunities for interventions to improve dietary intake for both groups.

(C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,