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

Published online by Cambridge University Press:  02 January 2007

Hester H Vorster ,
Annamarie Kruger ,
Barrie M Margetts ,
Christina S Venter ,
H Salomé Kruger ,
Frederick J Veldman  and
Una E MacIntyre
Hester H Vorster*
Affiliation:
School of Physiology and Nutrition, Faculty of Health Sciences, North-West University Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, Republic of South Africa
Annamarie Kruger
Affiliation:
School of Physiology and Nutrition, Faculty of Health Sciences, North-West University Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, Republic of South Africa
Barrie M Margetts
Affiliation:
Public Health Nutrition, Institute of Human Nutrition, University of Southampton, Southampton, UK
Christina S Venter
Affiliation:
School of Physiology and Nutrition, Faculty of Health Sciences, North-West University Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, Republic of South Africa
H Salomé Kruger
Affiliation:
School of Physiology and Nutrition, Faculty of Health Sciences, North-West University Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, Republic of South Africa
Frederick J Veldman
Affiliation:
Department of Paramedical Sciences, Free State Technikon, Bloemfontein, Republic of South Africa
Una E MacIntyre
Affiliation:
Department of Paediatrics, Medical University of South Africa, Pretoria, Republic of South Africa
*
*Corresponding author: Email vgehhv@puk.ac.za
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Abstract

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Objective:

To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIV-uninfected 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 HIV-uninfected 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 food-frequency 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 HIV-infected 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.

Keywords

HIV/AIDSAfricansDeveloping countriesDietNutritional statusSerum cholesterolHigh-density lipoproteincholesterolAlbumin

Information

Type
Research Article
Information
Public Health Nutrition , Volume 7 , Issue 8 , December 2004 , pp. 1055 - 1064
Copyright
Copyright © The Authors 2004

References

1Joint United Nations Programme on HIV/AIDS (UNAIDS). AIDS Epidemic Update: December 1998. Geneva: World Health Organization, 1998.Google Scholar
2Foster, G. Today's children – challenges to child health promotion in countries with severe AIDS epidemics. AIDS Care 1998; 10(1): S17–S23.CrossRefGoogle ScholarPubMed
3Fauci, AS. The AIDS epidemic. Considerations for the 21st century. New England Journal of Medicine 1999; 341(14): 1046–50.CrossRefGoogle Scholar
4 Anon. Health and related indicatorsk. In: Ntuli, A, ed. South African Health Review 1998. Durban: Health Systems Trust, 1998; 203–15.Google Scholar
5Day, C, Gra, A. Health and related indicators. In: Ijumba, P, Ntuli, A, Barron, P, eds. South African Health Review 2002. Durban: Health Systems Trust, 2002; 411–533.Google Scholar
6North West Province Department of Health. Results of the HIV sero-prevalence survey of women attending antenatal clinics in the North West Province, 1998. Mmabatho: Department of Health, North West Province of South Africa, 1999; 1–11.Google Scholar
7 South African Government Department of Health. HIV and AIDS Care, Management and Treatment for South Africa [online], 2003. Available at: http://www.gov.za/reports/ 2003/aidsplan/report.pdf. Accessed 8 03 2004.Google Scholar
8South African Government Department of Health. South African National Guidelines on Nutrition for People living with TB, HIV/AIDS and Other Chronic Debilitating Conditions. Pretoria: Department of Health, South Africa, 2001; 1–28.Google Scholar
9Morgan, D, Maude, GH, Malamba, SS, Okongo, MJ, Wagner, H-U, Mulde, D, et al. HIV-1 disease progression and AIDS-defining disorders in rural Uganda. Lancet 1997; 350: 245–50.CrossRefGoogle ScholarPubMed
10Macallan, DC. Wasting in HIV infection and AIDS. Journal of Nutrition 1999; 129(Suppl. 1S): 238S–42S.CrossRefGoogle ScholarPubMed
11Dannhauser, A, Van Staden, AM, Van der Ryst, E, Nel, M, Marais, N, Erasmus, E, et al. Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: anthropometric and dietary profile. European Journal of Clinical Nutrition 1999; 53: 165–73.CrossRefGoogle ScholarPubMed
12Romero-Alvira, D, Roche, E. The keys of oxidative stress in acquired immune deficiency syndrome apoptosis. Medical Hypotheses 1998; 51(2): 169–73.CrossRefGoogle ScholarPubMed
13Gramlich, LM, Mascioli, EA. Nutrition and HIV infection [Review]. Journal of Nutritional Biochemistry 1995; 6: 2–11.CrossRefGoogle Scholar
14Moscardini, C, Tonger-Decker, R, Ostroski, MB. Nutritional needs in the AIDS patients. Recognizing and treating wasting syndrome. Advance for Nurse Practitioners 1997; 5(6): 34–7.Google ScholarPubMed
15Casey, KM. Malnutrition associated with HIV/AIDS. Part two: Assessment and interventions. Journal of the Association of Nurses in AIDS Care 1997; 8(5): 9–48.CrossRefGoogle ScholarPubMed
16World Health Organization/Food and Agriculture Organization of the United Nations (FAO). Living Well with HIV/AIDS. A Manual on Nutritional Care and Support for People living with HIV/AIDS. Rome: FAO, 2002; 1–97.Google Scholar
17Vorster, HH, Wissing, MP, Venter, CS, Kruger, HS, Kruger, A, Malan, NT, et al. The impact of urbanisation on physical and mental health of South Africans in the Northwest Province of South Africa: the THUSA study. South African Journal of Science 2000; 96: 505–14.Google Scholar
18Wissing, M, Thekiso, S, Stapelberg, R, van Quickelberge, L, Choabi, P, Moroeng, C, et al. The psychometric properties of scales measuring psychological well-being in an African group. Presented at International Africa Psychology Congress, Durban, South Africa,18–2307 1999.Google Scholar
19MacIntyre, UE, Venter, CS, Vorster, HH. A culture-sensitive quantitative food frequency questionnaire used in an African population: 1. Development and reproducibility. Public Health Nutrition 2000; 4(1): 53–62.CrossRefGoogle Scholar
20Kotler, DP. Management of nutritional alterations and issues concerning quality of life. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1997; 16(Suppl. 1): S30–5.CrossRefGoogle ScholarPubMed
21Langenhoven, M, Kruger, M, Gouws, E, Faber, M. MRC Food Composition Tables, 3rd ed. Parow: Medical Research Council, 1991; 245.Google Scholar
22Food and Nutrition Board, National Research Council, National Academy of Sciences. Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press, 1989.Google Scholar
23James, WPT. Policy and a prudent diet. In: Garrow, JS, James, WPT, Ralph, A, eds. Human Nutrition and Dietetics, 9th ed. London: Churchill Livingstone, 1993; 767–75.Google Scholar
24Van Staden, AM, Barnard, HC, Nel, M, Attwood, EM, Oosthuizen, GM, Dannhauser, A, et al. Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa. Central African Journal of Medicine 1998; 44(10): 246–50.Google ScholarPubMed
25Constans, J, Peuchant, E, Pellegrin, JL, Sergeant, C, Hamon, C, Duboury, L, et al. Fatty acids and plasma antioxidants in HIV-positive patients: correlation with nutritional and immunological status. Clinical Biochemistry 1995; 28: 421–6.CrossRefGoogle ScholarPubMed
26Anes, WA, Warrier, R, Lybanon, JI, Sharma, R. Plasma nutritional changes antedate AIDS in hemophiliacs. Clinical Research 1989; 37: 467A.Google Scholar
27Grunfeld, C. Metabolic mechanisms for wasting in AIDS. In: Proceedings of the Second Annual Nutrition and AIDS Conference, Stanford University, Palo Alto, CA, USA, 1989; 13–6.Google Scholar