Journal article
A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding
The American journal of clinical nutrition, Vol.95(3), pp.759-765
03/01/2012
DOI: 10.3945/ajcn.111.018812
PMCID: 3278250
PMID: 22258269
Abstract
Background: Breastfeeding increases metabolic demands on the mother, and excessive postnatal weight loss increases maternal mortality.
Objective: We evaluated the efficacy of a lipid-based nutrient supplement (LNS) for prevention of excess weight loss in breastfeeding, HIV-infected women.
Design: The BAN (Breastfeeding, Antiretrovirals, and Nutrition) Study was a randomized controlled trial in Lilongwe, Malawi. At delivery, HIV-infected mothers and their infants were randomly assigned according to a 2-arm (with and without LNS) by 3-arm (maternal triple-antiretroviral prophylaxis, infant-nevirapine prophylaxis, or neither) factorial design. The 28-wk LNS intervention provided daily energy (700 kcal), protein (20 g), and micronutrients (except for vitamin A) to meet lactation needs. Women were counseled to breastfeed exclusively for 24 wk and to wean by 28 wk. Weight change (0-28 wk) was tested in an intent-to-treat analysis by using 2-factor ANOVA and with longitudinal mixed-effects models.
Results: At delivery, the LNS (n = 1184) and control (n = 1185) groups had similar mean weights and BMIs. Women receiving the LNS had less 0-28-wk weight loss (21.97 compared with 22.56 kg, P = 0.003). This difference remained significant after adjustment for maternal antiretroviral drug therapy and baseline BMI. Women receiving antiretroviral drugs had more weight loss than did those not receiving antiretroviral drugs (-2.93 compared with -1.90 kg, P < 0.001). The benefit of the LNS for reducing weight loss was observed both in those receiving antiretroviral drugs (-2.56 compared with -3.32 kg, P = 0.019) and in those not receiving antiretroviral drugs (-1.63 compared with -2.16 kg, P = 0.034).
Conclusions: The LNS reduced weight loss among HIV-infected, breastfeeding women, both in those taking maternal antiretroviral prophylaxis to prevent postnatal HIV transmission and in those not receiving antiretroviral prophylaxis. Provision of an LNS may benefit HIV-infected, breastfeeding women in resource-limited settings. This trial was registered at clinicaltrials. gov as NCT00164762. Am J Clin Nutr 2012; 95: 759-65.
Details
- Title: Subtitle
- A lipid-based nutrient supplement mitigates weight loss among HIV-infected women in a factorial randomized trial to prevent mother-to-child transmission during exclusive breastfeeding
- Creators
- Dumbani Kayira - UNC Project, Lilongwe, MalawiMargaret E. Bentley - Univ N Carolina, Dept Nutr, Gillings Sch Global Publ Hlth, Chapel Hill, NC USAJeffrey Wiener - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USAChimwemwe Mkhomawanthu - UNC Project, Lilongwe, MalawiCaroline C. King - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USAPhindile Chitsulo - UNC Project, Lilongwe, MalawiMaggie Chigwenembe - UNC Project, Lilongwe, MalawiSascha Ellington - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USAMina C. Hosseinipour - University of North Carolina at Chapel HillAthena P. Kourtis - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USACharles Chasela - UNC Project, Lilongwe, MalawiMartin Tembo - UNC Project, Lilongwe, MalawiBeth Tohill - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USAEllen G. Piwoz - Univ N Carolina, Dept Nutr, Gillings Sch Global Publ Hlth, Chapel Hill, NC USADenise J. Jamieson - Ctr Dis Control & Prevent, Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA USACharles van der Horst - University of North Carolina at Chapel HillLinda Adair - Univ N Carolina, Dept Nutr, Gillings Sch Global Publ Hlth, Chapel Hill, NC USABreastfeeding, Antiretrovirals and Nutrition (BAN) Study Team
- Resource Type
- Journal article
- Publication Details
- The American journal of clinical nutrition, Vol.95(3), pp.759-765
- Publisher
- Oxford Univ Press
- DOI
- 10.3945/ajcn.111.018812
- PMID
- 22258269
- PMCID
- 3278250
- ISSN
- 0002-9165
- eISSN
- 1938-3207
- Number of pages
- 7
- Grant note
- USAID; United States Agency for International Development (USAID) NIAID P30-AI50410 / National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) Elizabeth Glaser Pediatric AIDS Foundation UNICEF DHHS/NIH/FIC 2-D43 Tw01039-06 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA D43TW001039 / FOGARTY INTERNATIONAL CENTER; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Fogarty International Center (FIC) World Food Programme Malawi Ministry of Health Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA P30AI050410 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) GlaxoSmithKline Abbott Laboratories P30-AI50410 / University of North Carolina Center for AIDS Research SIP 13-01 U48-CCU409660-09; SIP 26-04 U48-DP000059-01; SIP 22-09 U48-DP001944-01 / CDC; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA R24HD050924 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
- Language
- English
- Date published
- 03/01/2012
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446526702771
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