Medical nutrition therapy:

• For people living with HIV, adequate and balanced nutrition intake is essential to maintain a healthy immune system and prolong life .

• It has been documented that children and adults who are living with HIV have lower fat- free and total fitness.

• Proper nutrition may help maintain lean body mass ,reduce the severity of HIV related symptoms and improve quality of life.

      Important points to consider:

Some common nutrition diagnosis in this population include the following:

• Inadequate oral food and beverage intake.
• Increase nutrient needs.
• Altered Gastrointestinal (GI) function.
• Swallowing difficulty
• Food - medication interaction 
• Involuntary weight loss
• Overweight and obesity 
• Food and nutrition related knowledge deficit
• Over supplementation of nutrients
• Impaired ability to prepare food or meals
• Inadequate access to food
• Intake of unsafe or undercooked foods

      Nutrient recommendation:

• When collecting the diet history the clinician should include a review of current Intake, change in intake, limitation with food Access for preparation, food intolerances or allergies supplement use, current medications.

• In the early years of nutrition therapy for HIV the focus is on treatment and prevention of nutritional and intentional weight loss and wasting.

      Energy and fluid:

• When determining energy needs, the clinician must establish if the individual needs to gain, loss, or maintain weight.

• Other factors such as altered metabolism nutrient, deficiencies ,severity of diseases and it should be taken into account when developing energy needs..

• RMR energy expenditure is increased by 10% in HIV patients .

• Individual with well controlled HIV are encouraged to follow the same principles of healthy eating and fluid intake recommended for the general population.

       Protein:

• Deficiency of protein stores and abnormal protien metabolism occur in HIV and AIDS but no evidence exist for increased protein intake to a company for the required increase in energy.

• For people with HIV who have adequate weight and are not malnourished protein supplementation may not be sufficient to improve lean body mass.

• If other comorbidities such as renal insufficiency cirrhosis all pancreatitis are present protein recommendation should be adjusted accordingly.

       Fat:

• Evidence indicates that fat oxidation increase with HIV infection and thus dietary fat requirement may be different.

• But present, general heart -healthy guidelines should be the focus for dietary fat intake.

• Focus should be on immune function and Omega 3 fatty acid.

       Micronutrient;

• Nutrient deficiency can affect immune function and lead to disease progression.

• Micronutrient deficiencies are common in people with HIV infection as a result of malabsorption, drug - nutrient interaction and metabolism gut infection and altered gut barrier function.

• Vitamin A, zinc and selenium serum levels are often low during a response to infection , so it is important to assess dietary intake to determine whether correction of serum micronutrient is warranted.

       Special consideration:

       Wasting:

• Washing may be caused by by a combination of factors, including  inadequate dietary intake, malabsorption  and increase metabolic rates from viral replication or complications from the diseases.

• Wasting employees on his actual weight loss and loss of lean body mass and is strongly associated with an increased risk of disease progression and mortality.

• Inadequate dietary intake can be caused by several issues related to condition that affect the ability to chew or swallow food, gastro-intestinal  mortality, neurological diseases that affect a perception of hunger or ability to eat food insecurity related to psychosocial or perceptions of hunger or ability to eat, food insecurity related  to psychosocial or economic factors and anorexia from medication , malabsorption, systematic infections, or tumors.

      Obesity:

• Obesity in people with HIV also has been noted. Unintentional weight loss in HIV infection has been associated with the mortality, but more careful review in overweight or obese HIV-infected patients.

• Excess adiposity is associated with cardiovascular risk factor and inflammation so weight changes in either direction should be monitored closely.

What is medical nutrition therapy for HIV/AIDS?

What are nutrients requirement of HIV/AIDS patients?

What are special consideration of HIV/AIDS patients?

HIV and AIDS (Medical nutrition therapy)