Micronutrients and HIV Infection (Modern Nutrition)

Micronutrients Modern Nutrition
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Anaemia was observed in 35 Respiratory With severe malnutrition being an alarming consequence of HIV, prophylactic nutritive care should be considered for integration into HIV care strategies besides initiation of ART to improve the nutritional status and quality of life of these children. Technical report: India HIV estimates. Body composition in HIV-infected children: relations with disease progression and survival. Am J Clin Nutr ; 69 : Beisel WR. Nutrition and immune function: Overview. J Nutr ; : S-5S. Report on the global AIDS epidemic Investigating the empirical evidence for understanding vulnerability and the associations between poverty, HIV infection and AIDS impact.

AIDS ; 21 Suppl. Clin Infect Dis ; 46 : AIDS Care ; 20 : Clinical profile of pediatric HIV infection from India. Arch Med Res ; 36 : Clinical profile of HIV infection. Indian J Pediatr ; 38 : Micronutrient supplementation for children with HIV infection. Geneva, Switzerland: WHO; Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on men and women aged from 16 to 72 years. Br J Nutr ; 32 : World Health Organization.

Geneva, Switzerland: World Health Organization, Nutritive value of Indian foods. Haemoglobin colour scale: Practical answer to a vital need. Geneva: WHO; The good news is that the goal of nutritional intervention is usually to preserve lean body mass and provide adequate nutrients as well as minimize symptoms of malabsorption and thereby improve quality of life.

This is why specific nutritional therapy ranges from oral supplements to home total parenteral nutrition TPN which is individualized [ 21 , 22 ]. Following interventions proffered by several organizations and researchers to reduce malnutrition among persons living with HIV, the definition of wasting developed by the Centers for Disease Control and Prevention CDC in has been adopted by researchers. Because of the uncertainty as to which of these definitions given above should be adopted as the standard definition of wasting for intervention, the three presented criteria are now being used.

Studies have been done to determine whether specific nutrient abnormalities occur in earlier stages of HIV infection, thereby preceding the marked wasting and malnutrition that accompany later stages of the infection. It has been found that even as life expectancy increases with antiretroviral therapy ART , age-related comorbidities now contribute to the main burden of disease associated with HIV infection. These comorbidities have been reported to occur regularly among HIV-infected individuals, thereby resulting in conditions associated with nutritional deficiencies that are typically seen in the elderly and in middle-aged HIV-infected individuals.

This suggests that age decline occurs independent of chronological age in the HIV-infected individuals.

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These observations have led to the conclusion that HIV infection accelerates the biological aging process. Therefore, aging in HIV infection is a multifactorial process involving complex interplay of biological and non-biological constructs which may differ depending on the socioeconomic and nutritional statuses of HIV individuals. The prolonged nutritional deficiencies with chronic coinfections and exposures to more toxic antiretroviral drugs constitute risks to people living with HIV and AIDS [ 24 ].

However, evidence has shown that patients who enrolled in food supplement intervention while on treatment regimens self-reported greater adherence to their medications, fewer side effects, increased weight gain, recovery of physical strength and the resumption of labor activities.

Therefore, promoting sound feeding practices is one of the strategies to ensure good health for people living positively with HIV and AIDS. Ideally, good nutrition lays the foundation for healthy and productive environments for people living positively with HIV infection. Well-nourished HIV individuals are more resistant to diseases and crises, and can perform their daily duties better than those that are poorly nourished.

This shows that well-nourished HIV persons are better able to participate in and contribute to the development of their communities. Therefore, good nutrition is more than just about ending hunger: it also includes achieving many SDG targets, such as ending poverty, achieving gender equality, ensuring healthy lives, promoting lifelong learning, improving economic growth, building inclusive societies and guaranteeing sustainable consumption of quality foods. This will reduce inequalities among persons living with HIV and make sure that guidelines on appropriate feeding are available to all, including those with limited access to health care services.

Convinced that it is now time for governments in developing countries to renew their commitment to protect and promote optimal feeding that will guarantee good health for persons living with HIV and AIDS. The level of total intake diet plus supplements for all nutrients that would guarantee optimal health for persons living with HIV should be clearly emphasized to achieve normal plasma nutrient values since persons living with HIV and AIDS appear to require nutrient intake in multiples of the recommended dietary allowance RDA for vitamins A, E, B6, B12, iron, zinc and others.

Therefore, effective program for nutritional supplements may be beneficial in maintaining adequate plasma nutrient levels for persons living with HIV and AIDS. This means that the biochemical measurements of nutrient status, dietary history, anthropometry, clinical signs or symptoms that will show nutritional excesses or deficiencies among persons living with HIV and AIDS should be regularly done to ascertain their health statuses since provision of nutritional supplements acts as an adjunct to ART.

Though studies have identified the fear of persons living with HIV developing too much appetite but not having enough to eat as the major obstacle to their non-acceptance of nutritional supplements, it should be emphasized that this obstacle should not preclude the provision of adequate dietary supplements to improve both adherence and prognosis to those living positively with HIV and AIDS [ 25 , 26 ].

Therefore, the need to increase and integrate nutritional supplements into ART programs to improve adherence and maximize the benefits of therapy should not be underestimated. This means that the principles of healthy eating for HIV-positive persons to ensure sustainable development will require that all the necessary food nutrients are added in the daily meals and in the right proportions. Therefore, meals that will guarantee optimal health for HIV-positive persons should include: a diet high in vegetables, fruits, whole grains and legumes.

Specifically, the HIV-positive individuals should be encouraged to add foods rich in calories. Foods rich in calories will provide the body with fuel to maintain lean body mass. To get enough calories, they need to consume the following in these proportions: 17 calories per pound of the body weight so as to maintain body weight.

Protein will help to build the muscles and organs and guarantee strong immune system for HIV-positive persons and should be consumed in enough quantity. To get the right proportion and types of protein, HIV-positive persons should aim at having these in the diet: — grams a day, if an HIV-positive man. This is because too much of such calories will put stress on the kidney and thereby compromise kidney function. Also, lean meat such as pork, beef, skinless chicken, fish and low-fat dairy products should be consumed.

To get extra protein, there is need to add vegetable proteins such as legumes, nuts, vegetables and others.

For carbohydrates which will give energy, HIV-positive persons should eat the right types and proportions of carbohydrates by: Eating five to six servings of fruits and vegetables each day. Adding to the meals fruits with a variety of colors so as to get a wide range of nutrients. Eating legumes and whole grains, such as brown rice, corn and others.

However, if HIV individuals do not have gluten sensitivity, whole-wheat flour, oats and barley may be good enough for them. But if there is gluten sensitivity, whole-wheat flour should not be taken. Then, brown rice and potato should form useful sources of carbohydrate.

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If HIV individuals are diabetic or pre-diabetic or have insulin resistance, most of their carbohydrates should come from vegetables. The practice of consuming much of simple sugars, such as candy, cake, cookies and ice cream should be limited for HIV-positive persons. Fat will provide extra energy. Omega-3 fatty acids are essential fats that must be present in the diet of HIV-positive individuals. However, most HIV-positive people whose meals are mainly made up of standard Western diet end up not eating enough omega-3 fats. Omega-3 fatty acids are polyunsaturated fats that the body needs but cannot produce on its own.

For this reason, omega-3 fatty acids are classified as essential fatty acids. There are basically three important types of omega-3 fatty acids that are beneficial to the health of HIV-positive individuals. The first is eicosapentaenoic acid EPA.

Micronutrients and HIV Infection by Henrik Friis (ebook)

This is a carbon-long chain omega-3 fatty acid, primarily found in fatty fish, seafood and fish oils. EPA is important in the formation of signaling molecules like eicosanoids that will reduce inflammation. The second type of omega-3 is docosahexaenoic acid DHA.

DHA is a carbon-long chain omega-3 fatty acid primarily found in fatty fish, seafood, fish oils and algae.

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The main role of DHA is to serve as a structural component in cell membranes, particularly in the nerve cells of the brain and eyes. DHA is very important during pregnancy and breastfeeding. It helps in the development of the nervous system of the fetus. Breast milk contains significant amounts of DHA.

Health of HIV Infected People

The third type of omega-3 is alpha-linolenic acid ALA , an carbon-long chain omega-3 fatty acid found in high-fat plant foods like flax seeds, cotton seed, walnuts and others. Though it is the most common omega-3 fatty acid found in the diet, it is not very active in the body. Most of the ALA eaten is simply used for energy [ 27 — 29 ]. Omega-3 fatty acids have both negative and positive effects when consumed in certain proportions. On the positive side, omega-3 fatty acids have several health benefits in various body systems. For example, studies have shown that omega-3 supplements will significantly lower blood triglycerides.

Pharmacology

Primary outcomes Persistence of diarrhoea Time until cessation of diarrhoea Secondary outcomes: Plasma zinc and copper levels. Gastric hypochlorhydria and intestinal barrier dysfunction in HIV infection is not dependent on nutrition: a randomised controlled trial of supplementation. Insufficient information was available to permit judgment about the extent of bias due to selective outcome reporting in all but 11 included studies. Furthermore, the trial authors reported differential attrition between treatment groups. For a critical appraisal of the summary of evidence, see 'Summary of findings' table 2 Table 2. We documented the attrition rate for each included trial in the 'Risk of bias' table.

Consuming foods such as salmon, sardines, cod liver oil and others that contain enough amounts of omega-3 has been linked to reduced risk of colon, prostrate and breast cancers. Taking omega-3 fatty acid supplement helps to reduce excess fat in the liver. Consuming omega-3 supplements like fish oil helps to reduce symptoms of depression and anxiety. Inflammation, pain and other symptoms of autoimmune diseases such as in rheumatoid arthritis have been reduced using omega-3 supplements.

Seljeflot, I. Arnesen, H. Consumption of fruit and berries is inversely associated with carotid atherosclerosis in elderly men. British Journal of Nutrition, Vol. Koui, Eleni and Jago, Russell Associations between self-reported fruit and vegetable consumption and home availability of fruit and vegetables among Greek primary-school children.

Material & methods

Public Health Nutrition, Vol. Kellen, Eliane and Bekkering, Geertruida Handbook of Nutrition in the Aged, Fourth Edition. Linden, Gerard J. McClean, Kathy M. Woodside, Jayne V.