Nutritional challenges of HIV/AIDS
People living with HIV/AIDS face increased challenges in maintaining proper
Some of the side effects from HAART that may affect how the body absorbs and utilizes nutrients include
The nutritional needs of people with HIV/AIDS are also greater due to theirHIV/AIDS and nutritional needs
Energy requirements
Monitoring caloric intake is important in ensuring that energy needs are met. For people with HIV/AIDS, energy requirements often increase in order to maintain their regular body weight.[4] A classification system revised by the Centers for Disease Control and Prevention (CDC), categorizes HIV-infection into three clinical stages and addresses the suggested caloric requirements for each stage.[5]
- 1. Clinical Category A: Asymptomatic HIV
- This stage is characterized by Acute HIV. People in this category have estimated needs of 30-35 kg.
- 2. Clinical Category B: Symptomatic HIV
- This stage is characterized by complications that arise from HIV symptoms. People in this category have estimated needs of 35-40 kcals/kg.
- 3. Clinical Category C: Presence of AIDS condition
- This stage is characterized by having a T-cell count under 200, signaling the presence of an AIDS defining condition and/or an opportunistic infection. People in this category have estimated needs of 40–50 kcals/kg and are at an increased risk of malnourishment.[citation needed]
Micronutrient requirements
Multivitamins and supplementation
The World Health Organization (WHO) issued consultative recommendations regarding nutrient requirements in HIV/AIDS.[6] A generally healthy diet was promoted. For HIV-infected adults, the WHO recommended micronutrient intake comes from a good diet at RDA levels; higher intake of vitamin A, zinc, and iron can produce adverse effects in HIV positive adults, and these were not recommended unless there is documented deficiency.[6][7][8][9]
Despite the WHO recommendations, recent reviews have highlighted the absence of a simple consensus regarding the effects of
Some studies have looked into the use of implementing daily multivitamins into the diet regimens of HIV/AIDS patients. One study done in Tanzania involved a trial group with one thousand HIV positive pregnant women. Findings showed that daily multivitamins benefited both the mothers and their babies. After four years, the multivitamins were found to reduce the women's risk of AIDS and death by approximately 30%.[11] Another trial in Thailand revealed that the use of multivitamins led to fewer deaths, but only among people in advanced stages of HIV.[12] However, not all studies have provided a positive correlation. A small trial done in Zambia found no benefits from multivitamins after one month of use.[13]
Regarding individual vitamin and mineral supplementation, research shows mixed results. Vitamin A supplementation has been shown to reduce mortality and morbidity rates among African children with HIV. The WHO recommends vitamin A supplements for all young children 6 to 59 months old that are at high risk of vitamin A deficiency every 4 to 6 months.[14] In contrast, a trial from Tanzania found that the use of vitamin A supplements increased the risk of mother-to-child transmission by 40%.[15][16] With the inconsistency of these results, scientists have not reached a consensus regarding vitamin A supplementation and its possible benefits for HIV/AIDS patients. Other vitamins to be taken by HIV-infected adults are vitamins C and E.[citation needed]
Evidence for supplementation with selenium is mixed with some tentative evidence of benefit.[17] There is some evidence that vitamin A supplementation in children reduces mortality and improves growth.[18] For nutritionally compromised pregnant and lactating women, a multivitamin supplementation has improved outcomes for both mothers and children.[19]
Thus, further research is required to determine the relationship between supplements and HIV/AIDS in order to develop effective nutritional interventions.[citation needed].
Effects of HIV/AIDS on nutrition
Statistics show that
Food security
Food security is present "when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life", as defined by the World Food Summit of 1996. It is set on the basis of food availability, food access, and proper food use.[22] The difficulty for some people with HIV and AIDS involves how they must obtain food security because the virus increases fatigue, compromising their ability to work in order to provide food and food preparation. This impact is even greater on those living in poverty in rural areas, where providing food is largely based on farming and other household chores.[23]
Case study in Malawi
In
Malnutrition
Food safety
For other uses, see food safety
People living with AIDS have impaired immune systems and therefore are more susceptible to infections and diseases due to foodborne pathogens. Food safety includes food handling, food preparation and food storage, all to be dealt with carefully to ensure safety from food-borne bacteria. Those that are more prevalent in people with AIDS include Salmonella, which is the most common cause of illness, being 100 times more prevalent in AIDS patients than healthy individuals.[28] Another example is listeriosis caused by Listeria monocytogenes, with severe and often fatal consequences when encountered by a person with AIDS. Simple measures can be used to increase food safety and prevent food-borne illnesses for those with affected with HIV/AIDS. Washing your hands, the food about to be prepared, kitchen utensils and kitchen surfaces is effective against bacterial growth. Keeping raw meat and cooked meat separate and cooking foods thoroughly, using a food thermometer to be sure. And lastly, storing leftover foods in the refrigerator within two hours to ensure minimal risk of food-borne illnesses.[29]
Research
There are some areas of research that have either not been explored or researched in-depth that are related to the area of HIV/AIDS treatment.
Food sustainability and agriculture
With food security also having an impact in rural areas affected by HIV/AIDS, another area of research involves agriculture in subsistence economies. More specifically, in these areas where households affected by HIV/AIDS may suffer from food insecurity, focuses for future research may include looking into ways to improve agricultural practices in order to enhance the household
References
- ^ Johansen, Diana. (2007). "Practical Guide to Nutrition for People Living with HIV" Archived 2011-01-07 at the Wayback Machine, Canadian Aids Treatment Information Exchange
- PMID 12799406.
- ^ Thomson, Caspar (2010) retrieved from: "AIDS map" Archived 2018-09-04 at the Wayback Machine.
- ^ Parento, Joy. USDA(2009). Diet and Disease. Retrieved from http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=2&tax_subject=278&topic_id=1380 Archived 2010-10-12 at the Wayback Machine
- ^ Dean, E., Glynn H., House, A., et al. Association of Nutrition Service Agencies. (2002). Nutrition Guidelines For Agencies Providing Food to People with HIV. Retrieved from http://www.ansanutrition.org/uploads/documents/ansanutritionguides.pdf Archived 2011-09-04 at the Wayback Machine
- ^ a b World Health Organization (May 2003). Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation (PDF). Geneva. Archived (PDF) from the original on March 25, 2009. Retrieved March 31, 2009.
{{cite book}}
: CS1 maint: location missing publisher (link) - PMID 22089440.
- ^ PMID 22652651.
- ^ PMID 21895892.
- PMID 28518221.
- ^ Fawzi WW et al., for the Tanzania Vitamin and HIV Infection Trial Team. Randomized trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet 1998; 351:1477-1482.
- PMID 17176350.
- S2CID 41800432.
- ^ World Health Organization (WHO). (1998) "Integration of Vitamin A Supplementation with Immunization: Policy and Program Implications".
- PMID 7625499.
- ^ Semba RD et al. Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet, 1994, 343:1593-1597.
- PMID 20961297.
- PMID 21154354.
- PMID 22419344.
- ^ a b Regional statistics for HIV & AIDS, end of 2008. (2008). Worldwide HIV and AIDS Statistics. Retrieved from http://www.avert.org/worldstats.htm
- ^ FAO Hunger Map 2010. (2010). Food and Agricultural Organization. Retrieved from http://www.fao.org/fileadmin/templates/es/Hunger_Portal/Hunger_Map_2010b.pdf
- ^ World Health Organization. (2010). Food Security. Retrieved from
- ^ Food and Agriculture Organization (FAO) of the United Nations. (2006). HIV/AIDS and Food Security. Retrieved from http://www.fao.org/hivaids/impacts/food_en.htm Archived 2009-08-08 at the Wayback Machine
- ^ Mtika, Mike "The AIDS Epidemic in Malawi and It's Threat to Household Food Security" Archived 2012-03-13 at the Wayback Machine, Society for Applied Anthropology, (60):2-2001.
- ^ Image uploaded to Wikimedia Commons by: Malnourishedtwat / Graeme Dott. Retrieved from: http://commons.wikimedia.org/wiki/File:Malnourished_child.jpg
- ^ Undernourishment Around the World. (2009). The State of Food Insecurity in the World. Retrieved from ftp://ftp.fao.org/docrep/fao/012/i0876e/i0876e02.pdf[permanent dead link]
- ^ Porter, C. (2006). HIV/AIDS and Malnutrition Locked in "Vicious Cycle":International community working to address hunger among people with HIV/AIDS. America.gov. Retrieved from http://www.america.gov/st/washfile-english/2006/October/20061016151256cmretrop0.9265253.html
- ^ At-Risk Populations: Food Safety for Persons with AIDS. (2006). United States Department of Agriculture: Food Safety and Inspection Service. Retrieved from http://www.fsis.usda.gov/Fact_Sheets/Food_Safety_for_Persons_with_AIDS/ Archived 2010-12-10 at the Wayback Machine
- ^ Cichocki, Mark R.N. (2009). Food Safety Basics: Food Safety is the Key to Healthy Eating. About.com: AIDS/HIV. Retrieved from http://aids.about.com/od/nutrition/a/foodbasics.htm Archived 2011-07-07 at the Wayback Machine
- ^ World Health Organization. (2005). Macronutrients and HIV/AIDS: a review of current evidence. Retrieved from [1]