Rosalee Brown - DIETITIAN'S DESK

We have been seeing improved management and clinical outcomes among people diagnosed with HIV/AIDS. A major part of this success is attributed to the advent of antiretroviral therapy.

However, there is another significant contributor to therapy and outcomes — this is nutrition intervention.

Nutrition intervention

There is evidence which supports nutrition intervention. It has been shown that one's nutritional status affects the immune system's function and resistance to infection. With HIV infection, energy requirement is increased and there is often reduced dietary intake, nutrient mal-absorption and loss and numerous metabolic changes.

It is recommended that nutrition intervention begins as soon as someone is diagnosed with HIV. This is important for assessment and identification of nutritional risk status so that an appropriate individual strategy for care can be developed. Energy requirements are likely to be increased to approximately 10 per cent in asymptomatic individuals, can grow to 30 per cent in symptomatic people and even between 50 and 100 per cent more than normal in children experiencing weight loss.

There is evidence to support supplementation with some vitamins and minerals, but this should be guided based on the result of a thorough nutritional assessment. The individual intervention is crucial to address these issues and guide the patient to make the necessary informed decisions concerning dietary intake to improve his status and quality of life.

A nutrient-dense diet coming from a variety of foods is important to bolster the immune system. Often, people succumb to the many myths that prevail and eliminate important food groups from their diets and compromise their nutrient intake. This eventually leads to a suboptimal nutritional state.

Cost of food

A patient who is symptomatic will need aggressive nutrition therapy to improve outcome. A major issue facing many people living with HIV AIDS is the cost of food. People with limited income or no income at all find it very difficult to prepare nutritious meals.

There is a major role here for corporate Jamaica to respond to requests by individuals and organisations to supply assistance with feeding programmes and offering job-creation projects so that affected people can feed themselves and families with dignity.

Make a blend or shake

Soy milk (dairy milk if tolerated)

Peanuts/peanut butter

Vegetable and/or fruit

Oatmeal

A combination of these items can be blended to offer a calorie-dense meal in a glass for persons who might be too fatigued to prepare a meal or might just prefer a drink.

There is a publication by the Caribbean Food and Nutrition Institute Healthy eating for better living - A Caribbean Handbook which gives some recipes for quick, nutritious and inexpensive meals which are suitable for people living with HIV/AIDS.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.

There is evidence to support supplementation of some vitamins and minerals.