@article {3184,
	title = {Food insecurity and perceived stress but not HIV infection are independently associated with lower energy intakes among lactating Ghanaian women.},
	journal = {Maternal \& child nutrition},
	volume = {7},
	year = {2011},
	month = {2011 Jan},
	pages = {80-91},
	abstract = {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{\textquoteright}s ability to meet their dietary needs.},
	keywords = {Adolescent, Adult, Body Mass Index, Cross-Sectional Studies, Diet, Energy Intake, Family Characteristics, Female, Ghana, HIV Infections, Humans, Infant, Infant Nutrition Disorders, Lactation, Malnutrition, Nutritional Requirements, Poverty Areas, Risk Factors, Socioeconomic Factors, Stress, Psychological, Young Adult},
	issn = {1740-8709},
	doi = {10.1007/s11606-010-1323-z},
	author = {Addo, Adolphina A and Marquis, Grace S and Lartey, Anna A and P{\'e}rez-Escamilla, Rafael and Mazur, Robert E and Harding, Kimberly B}
}
