Food insecurity and perceived stress but not HIV infection are independently associated with lower energy intakes among lactating Ghanaian women

Matern Child Nutr. 2011 Jan;7(1):80-91. doi: 10.1111/j.1740-8709.2009.00229.x.


Human immunodeficiency virus (HIV) seropositive women living in low-income communities may have difficulty meeting the increased energy requirements that are associated with both lactation and HIV infection. Data on household food security and maternal socio-demographic characteristics, perceived stress, anthropometry, reported illness, dietary intakes and preferences, and exposure to nutrition education were collected from 70 lactating women [16 seropositive (HP), 27 seronegative (HN), and 27 who refused to be tested and had unknown HIV status (HU)]. Diet was assessed with three 24-h recalls (one market day, one weekend day, and one non-market weekday). Data were collected at 8.4 (SD = 4.7) months postpartum. Most women (74.3%) reported being in good health at the time of study. Three-day mean energy intakes did not differ by HIV status [HP: 12,000 kJ (SD = 3600), HN: 12,600 kJ (SD = 5100), and HU: 12,300 kJ (SD = 4800); P = 0.94]. Protein, fat, vitamin A, thiamin, riboflavin, niacin, vitamin C, calcium, iron, and zinc intakes also did not differ by group (P > 0.10). There was a higher proportion of women with high stress levels in food insecure households compared with food secure households (55.6% vs. 26.5%; P = 0.01). Energy intake was independently negatively associated with food insecurity [high: 11,300 kJ (SD = 3500) vs. low: 13,400 kJ (SD = 5400), respectively; P = 0.050] and stress [high: 10,800 kJ (SD = 2800) vs. low: 13,400 kJ (SD = 5300), P = 0.021]. These results suggest the need to integrate multi-dimensional interventions that address economic and mental health constraints which may limit some women's ability to meet their dietary needs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Cross-Sectional Studies
  • Diet* / psychology
  • Energy Intake*
  • Family Characteristics
  • Female
  • Ghana / epidemiology
  • HIV Infections / complications
  • Humans
  • Infant
  • Infant Nutrition Disorders / epidemiology
  • Lactation* / psychology
  • Malnutrition / complications
  • Malnutrition / epidemiology*
  • Malnutrition / psychology*
  • Nutritional Requirements
  • Poverty Areas
  • Risk Factors
  • Socioeconomic Factors
  • Stress, Psychological / complications*
  • Young Adult