The nutritional status of asymptomatic HIV-infected Africans: directions for dietary intervention?

Abstract

Objective: To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIVuninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection. Design: Cross-sectional population-based survey. Setting: North West Province, South Africa. Subjects: Two hundred and sixteen asymptomatic HIV-infected and 1550 HIVuninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites. Outcome measures: Food and nutrient intakes, measured with a validated foodfrequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology. Results: The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables. Conclusions and recommendations: This survey indicated that asymptomatic HIVinfected subjects who followed a diet rich in animal foods had smaller decreases in serum albumin, haemoglobin and lipid variables, and smaller increases in liver enzymes, than those who consumed a diet based on staple foods. This suggests that animal foods are associated with improved nutritional status in HIV-infected persons. These results should be confirmed with intervention studies before dietary recommendations for asymptomatic HIV-infected individuals can be made.

Integrated nutrition science: from theory to practice in South Africa

“…She showed that female-headed households, despite more limited resources, often attained better nutrition security, among other reasons because of fostering of social ties, networking and innovative informal sector activities to increase income. A comparison of the nutritional status of these asymptomatic infected subjects with uninfected subjects 12 showed no significant differences in nutrient intakes and anthropometric variables, but significantly lower levels of several biochemical variables indicative of nutritional status and higher levels of liver enzymes. A principal components analysis was used to summarise dietary patterns.…”

Intestinal Permeability, Vitamin A Absorption and Serum Alpha-Tocopherol in Gastrointestinal Stromal Tumor Patients Treated with Imatinib

“…A decrease in nutritional intake is reflected in lower serum albumin concentrations. The association between serum albumin and alpha-tocopherol that reflects the nutritional status is well characterized (36), and could be invoked as one of the factors responsible for the decrease of alpha-tocopherol observed in this study. However, while a significant decrease in total protein concentrations was evident throughout the course of imatinib therapy, the decrease of serum albumin was less pronounced, and it is unlikely that nutritional factors are solely responsible for the decrease of alphatocopherol.…”

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

“…Studies have shown that the current physical activity guideline for adults of 25-30 minutes of moderate intensity physical activity daily would limit health risks for chronic diseases but would likely be insufficient for preventing weight gain [21,22]. Moreover, even if evidence exist that mild-to-moderate obesity is associated with reduced rates of mortality in HIV patients [29,30], its later consequences on health are far more severe than advantages [8,11,24].…”