HIV ReSource Review


Abstracts Of Featured
Nutrition Research Articles
Issues 1-13

 
B12: Dementia And Cognition Calories And Energy Needs-Full Issue
HIV And Exercise: Part One HIV And Exercise: Part Two
Micronutrients And HIV Progression Micronutrient Recommendations-
Full Issue
Nutritional Assessment Nutritional Care Guidelines
Pediatric Issues: Part One Pediatric Issues: Part Two
Protein Needs And HIV-
Full Issue
Women And HIV: Part One- Full Issue
Women And HIV: Part Two  

 
Issue 13: Women And HIV: Part Two
By Sharon Ann Meyer, AS, AA, DTR
Part Two of this article provides information on: micronutrient deficiencies found in HIV disease; detriments to nutritional status; body composition changes; micronutrient research; and HIV-savvy clinician micronutrient recommendations for HIV-positive women.

A reproducible handout for women is in this issue as well.

Issue 12
This issue is free in PDF
Women And HIV: Part One
By Sharon Ann Meyer, AS, AA, DTR
This two part research article reviews the various concerns affecting women living with HIV. It reviews the literature on HIV and women and concentrates on identifying their nutritional needs. Part One outlines the HIV epidemic among women. Major points of discussion are: issues affecting people living with HIV (PLWHIV); some concerns among HIV-positive women; various barriers to care; and the progression of HIV to AIDS.

Find information on where to obtain resources for more data on women living with HIV or AIDS in the Resources Section.

Issue 11
This issue is free in PDF
Protein Needs And HIV
By Sharon Ann Meyer, AS, AA, DTR
Adequate protein stores are vital for immune function and good health, especially for individuals who are challenged by the human immuno- deficiency virus (HIV). Recently the focus has been on maintaining adequate lean body mass (LBM) and many people living with HIV infection (PLWHIV) have begun exercise regimes. Some have initiated lifestyle changes that include a change in dietary habits as well. Recommendations for PLWHIV to follow high-calorie and high protein diets are common. Currently there are no standard protein recommendations for HIV challenged individuals. Protein guidelines vary considerably among nutrition professionals and others who seek to improve the nutritional status of this population group. 

This review serves to provide useful information on protein needs and recommendations for people living with HIV and AIDS. A focus on various issues to consider when recommending increased protein intakes are discussed as well.

Issue 10:
Nutritional Assessment Of The Person Living With HIV
By Sharon Ann Meyer, AS, AA, DTR
Nutritional care guidelines for people with the acquired immuno- deficiency syndrome (AIDS) have been available since 1989.  Throughout the years we have learned of many issues to consider when counseling people living with the human immunodeficiency virus (HIV). We know changes in nutritional status occur even in the early stages of HIV.  Nutritional requirements are higher and infection often leads to weight loss and nutritional deterioration.  Chronic infections may make it nearly impossible to maintain an adequate nutritional status just by increasing dietary intake. Hypermetabolism and malnutrition are common with fifty to ninety percent of the people living with HIV infection (PLWHIV) experiencing some form of malnutrition. Results from one survey note many PLWHIV simultaneously experience multiple symptoms affecting oral intake but still do not receive nutrition counseling.

This comprehensive review lists factors that affect nutritional status and highlights information relevant to the nutritional assessment of the person living with HIV disease.

Issue 9: A Review Of Nutritional Care Guidelines
By Sharon Ann Meyer, AS, AA, DTR
The association between nutritional status, the immune system, and HIV is strong.  Nutritional status has a greater effect than T4-cell counts on well-being, independence, physical performance, dementia, and longevity. Some note nutritional therapy is as crucial as drug treatment. We know good health and the ability to fight disease depends upon a hardy immune system.  The status of our immune system is dependant upon our nutritional state. Consequently,  malnourished individuals have increased infection rates. Specific nutrients influence immune function either directly through processes such as protein synthesis or indirectly through their roles in enzyme systems. A compromised immune system results in chronic illness and disease and increased mortality. In people who already have a weakened immune system, additional insults due to poor nutritional status can be highly detrimental. 

This report on the nutritional management of people living with the human immunodeficiency virus (HIV) reflects the views of HIV nutrition specialists, physicians working with HIV-positive individuals and the literature as of November 1997.

Issue 8
This issue is free in PDF
 Calories And Energy Needs
By Sharon Ann Meyer, AS, AA, DTR
Research documenting the relationship between nutrition and the immune system has increased steadily over the past several years. As a result, many people living with HIV now recognize the importance of reaching and maintaining optimal nutritional status. Most people know that they need to consume an adequate amount of certain nutrients to support their body processes. Yet, inadequate caloric intake is evident in a majority of those living with HIV.  Subsequent weight loss plays a role in decreasing nutritional status and quality of life is adversely affected. Kotler relates that decreased functional performance often accompanies nutritional depletion. Poor nutritional status affects quality of life, morbidity and mortality. HIV-positive individuals often experience a significant loss of body cell mass. The depletion of lean body mass, reported even in the early stages of HIV, detrimentally affects quality of life and is often caused by poor oral intake. Progressive loss of fat and lean body mass is evident in women as well as in men. HIV-challenged patients with progressed disease have both inadequate energy and protein intake. Many scientists report that substandard caloric intake is the most influential factor of weight loss.

A research review of various factors affecting the energy needs of people living with
the human immunodeficiency virus (HIV).

Issue 7: Pediatric Issues In HIV Disease: Part Two
By Sharon Ann Meyer, AS, AA, DTR
The acquired immunodeficiency syndrome (AIDS) was first observed in children  in 1982. Investigators now confirm that the human immuno- deficiency virus (HIV)  is  an  illness  of  young  children  with  50%  of  AIDS cases being diagnosed during the first year of life. AIDS is a leading cause of death among children worldwide. It's the fifth leading cause of death in children between the ages of one and four. Infants born to women who are HIV-positive are more likely to be premature, of low birth weight, and malnourished in their first few months of life.

In Lusaka, Zambia high rates of HIV infection are in children with tuberculosis, malnutrition, pneumonia, and diarrhea. Manifestations of HIV disease are varied. Clinical signs range from nonspecific infections to growth failure and malignancies. Researchers estimate 93% of the children living with HIV (CLWHIV) have developmental disabilities that result in some degree of physical and mental impairment. Cervi and colleagues note in AIDS the most common manifestations are oral candidiasis, severe pneumonia, neuromotor retardation, malnutrition, and chronic diarrhea. Surprisingly, Brazilian investigators report tuberculosis in children despite perinatal vaccination. French investigators find that marasmus, adenopathies and oral candidiasis indicates HIV infection in severely malnourished children who live in Burkina Faso. Regardless of location, CLWHIV suffer from a great number of manifestations that result in malnutrition. 

This article reviews the numerous
nutritional issues associated with HIV in children. 

Issue 6: Nutritional Implications Of Pediatric AIDS
By Dina Ranade, RD, LD, CNSD
Infection with HIV, which progresses to AIDS, is a growing and devastating disease process in children. The World Health Organization estimates the incidence of HIV infection in infants and children will reach ten million by the year 2000. Significant differences exist between adults and children living with HIV.  The progression from an asymptomatic state to a symptomatic one occurs more quickly in children.  Opportunistic infections, a risk for both adults and children, plagues children more frequently, especially as recurrent bacterial infection, cytomegalovirus, and chronic esophagitis. The nutritional implications of the disease are more severe in children because suboptimal intake and altered nutrient requirements contribute to delayed or halted growth and subsequently to increased morbidity and mortality.

This two part article on Pediatric HIV infection reviews current nutritional care issues among children living with HIV and AIDS. Information on where to obtain resources for more data on pediatric HIV infection is included in the Resources Section.

Issue 5: HIV And Exercise: Part Two
By Sharon Ann Meyer, AS, AA, DTR
Some individuals who engage in physical exercise believe  various compounds and nutritional supplements are necessary for increased muscle mass. HIV positive people who participate in physical exercise may consider it safe to use anabolic steroids and supplements without the benefit of a physician's supervision. Excessive consumption of protein products and vitamin megadosing is often considered safe by people living with HIV (PLWHIV). Few studies investigate the nutritional considerations one might wish to ponder before establishing an exercise program. People who are HIV positive can place themselves at increased nutritional risk if they do not develop a plan to meet increased nutrient needs. A lack of HIV-related research documenting the relationship between exercise and associated nutritional factors make it difficult for the nutrition-savvy person to guard against nutrient imbalances. 

Part Two contains a review of exercise and nutritional
considerations for HIV-challenged individuals. 

 Issue 4: HIV And Exercise: Part One
By Sharon Ann Meyer, AS, AA, DTR
Part One reviews the various benefits and costs associated with physical exercise. The benefits of exercise include: decreased anxiety; improved appetite; enhanced feelings of well-being; increased strength and endurance; increased lung capacity; improved bowel habits; decreased fatigue; and increased lean body mass. Habitual strength-type training can help the person with HIV to prevent and treat the deterioration of muscle tissue. Potential detrimental effects can also result from physical activity. Exercise- induced allergic reactions such as urticaria, and pyomyositis are two concerns. Overexertion during exercise can cause detrimental muscle breakdown. 

There are numerous nutritional issues and concerns regarding the practice of physical exercise performed by HIV challenged people. This two-part article reviews literature related to exercise and includes an outline of various nutritional concerns that may play a role in exercise programs for people living with HIV infection (PLWHIV). The review includes comprehensive information from literature searches and conference proceedings.

Issue 3: B12: Dementia And Cognition
By Sharon Ann Meyer, AS, AA, DTR
Research studies document the prevalence of vitamin B12 (cobalamin) deficiency in patients infected by the human immunodeficiency virus (HIV). Numerous studies note cobalamin deficiency even in the early stages of HIV disease. A number of investigators  associate decreased serum vitamin B12 levels with neurological and neuropsychiatric disorders. Furthermore, cobalamin deficiency is suspected to be an important and treatable cause of neurological dysfunction in HIV-positive people. 

This article reviews the research concerning HIV- related
B12 deficiency, cognition and dementia. 

Issue 2
This issue is free in PDF
Micronutrient Recommendations
By Sharon Ann Meyer, AS, AA, DTR
We know an adequate diet supplies all the required vitamins and minerals to a healthy individual but what about people challenged by the human immunodeficiency virus (HIV)? Many researchers study the micronutrient needs of HIV-challenged individuals. Numerous study results add to the growing documentation, which notes even if people living with HIV infection (PLWHIV) do happen to consume an adequate diet it doesn't necessarily mean they are meeting their micronutrient requirements. Research studies reveal single or multiple nutrient deficiencies can impair immunity, increase mortality, and influence susceptibility to infections. Several studies document one or more abnormally low concentrations of plasma micronutrients are likely to be present in the majority of those living with HIV. Micronutrient recommendations are commonplace, yet universal vitamin and mineral recommendations are not established for this population group. 

This is a review of micronutrient requirements, suggestions, and recommendations for the asymptomatic HIV-challenged individual.

Issue 1: Micronutrients And HIV Progression
By Sharon Ann Meyer, AS, AA, DTR
To date there are no standard vitamin mineral supplementation guidelines in place to meet the needs of HIV seropositive (HIV+) individuals. 

This article is a brief summary of research concerning
micronutrients and the progression of HIV.


 
A few words about HIV ReSources Products

The HIV ReSource Review (issues 1-30) and HIV Nutrition Update (issues 30-54) are peer-reviewed publications designed for nutrition professionals and others interested in nutrition and HIV/AIDS.
 

First published on July 1, 1996, the newsletters still provide important, time-saving, HIV-related nutrition information. Feature articles are the result of original research, scientific literature searches, and searches on the World Wide Web. Article information is supplemented by reviewing conference proceedings and expert recommendations.


 
 
HIV ReSource Review Editor-In-Chief
Sharon Ann Meyer, AA, AS, DTR,
Certified HIV Counselor About Sharon

Web Site Affiliation(s) 
HIV ReSources Homepage
The Woman's Place
Sharon's Homepage
Dean Allen DeLong's Homepage


 
 
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