Dietary patterns and nutrient intakes of a South African population and asymptomatic people infected with Human Immunodeficiency Virus: The transition health and urbanisation in South Africa (Thusa) study

Abstract

There is increased emphasis on the quality of food and the overall pattern of micronutrient intake as an integral consideration for food security particularly among people living with HIV/AIDS (PLWHA). However, limited data exist on food consumption and nutrient intakes for populations in sub-Saharan Africa. The study examined dietary patterns and their relationship with nutrient intakes in HIV uninfected (HIV-) and infected (HIV+) adults in North-West Province, South Africa. In this cross-sectional study, dietary and nutrient intakes were assessed with Quantitative Food Frequency Questionnaire (QFFQ) and FoodFinder software, respectively. Dietary patterns were determined using Principal Component Analysis. Participants’ scores for the dietary patterns were related to nutrient intakes using Spearman Rank correlation and Generalised Linear Modelling (GENLIN). Four main dietary patterns were found in each population. The first three patterns were similar between the HIV- and HIV+ populations: “animal-based”, associated with intake of foods of animal origin; “recommended” associated with a varied diet; and “staple-based”. The fourth pattern was described as either ‘eggs-and-breakfast-cereals’ for the HIV- group or ‘legumes-and-vegetables’ for HIV+ group. Scores for animal-based pattern showed strongest correlations (r) with nutrient intakes for both populations, notably zinc (r=0.54), calcium (r=0.5), potassium (r=0.54), vitamin A (r=0.5), and vitamin C (r=0.5), (p<0.001 for all). In the HIV+ group, the legumes-and-vegetables pattern was strongly associated with energy (r=0.64), vitamins D (r=0.51), E (0.51) and B1 (r=0.55) (p<0.001 for all). Compared with the other patterns, the Staple-based and the recommended patterns showed the weakest associations with nutrient intakes. Generalised Linear Modelling confirmed stronger positive linear associations between scores of the animal-based diet and nutrients intake, compared with the other patterns. The findings suggest that the animal-based pattern was strongly associated with nutrients intake in both HIV + and HIV- populations. This raises the need for studies into dietary recommendations for promoting nutritional wellbeing for PLWHA in sub-Saharan Africa.

Keywords: Dietary patterns; HIV/AIDS; THUSA, Nutrients