Nutritional Management of Opportunistic Infections of HIV/Food Safety
United Nations System
Standing Committee on Nutrition
Nutritional management of opportunistic infections of HIV/food safety
NEW! Amadi B et al. Improved nutritional recovery on an elemental diet in Zambian children with persistent diarrhoea and malnutrition. Journal of Tropical Pediatrics, 2005, 51(1):5-10.
Persistent diarrhea-malnutrition syndrome remains a leading cause of morbidity and mortality in children in resource limited setting hospitals. This single randomized controlled trial compare 2 ways of feeding: exclusive diet of amino-based feed and standard nutritional rehabilitation (skimmed milk and then soya). Weight gain, recovery from diarrhea and mortality were the main outcomes. The treatment was given for 4 weeks in the malnutrition ward in the University Hospital in Lusaka. 196 severely malnourished children (106 HIV seropositive, 90 HIV Seronegative) were included for randomization. The amino-based feed group seems to have gained more weight than the other group even if the energy intake was lower. The benefit of the elemental diet was seen in both HIV seropositive and HIV seronegative children. Diarrhea frequency and global recovery scores improved equally in both treatment options, and mortality did not differ. It seems that a diet with a reduced molecular complexity was associated with a significant improved weight gain. However, the authors do not advise to adopt elemental feeds for treatment of these children due to the cost of these products. The authors call for research to establish whether locally available food that have a reduced molecular complexity have the same beneficial effect.
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Ambrus JL Sr, Ambrus JL Jr. Nutrition and infectious diseases in developing countries and problems of acquired immunodeficiency syndrome. Experimental Biology and Medicine, 2004, 229(6):464-472.
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Kaplan JE, Masur H, Holmes KK. Guidelines for preventing opportunistic infections among HIV-infected persons: Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. Morbidity and Mortality Weekly Report: Recommendations and reports, 2002, 51(RR-8):1-52.
These guidelines, developed by the US Public Health Services and the Infectious Diseases Society of America are to prevent opportunistic infections among HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing opportunistic infections among HIV infected adults and adolescents, including pregnant women, and HIV exposed or infected children. This document does not stress specifically on nutrition but on recommendations for preventing exposure to opportunistic pathogens. Some, like Salmonella and Campylobacter, are directly linked to food.
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WHO/FAO Living well with HIV/AIDS A manual on nutritional care and support for people living with HIV/AIDS. Geneva, World Health Organization; Rome, Food and Agriculture Organization of the United Nations, 2002.
This practical manual provides recommendations for healthy and balanced diet for people living with HIV/AIDS in countries or areas with a low resource base. The objective of this manual is to improve nutrition in a home-based settings. The food requirements for HIV/AIDS living people are described and recommendations given on foods and eating habits to meet these requirements. It explains how to address the nutritional aspects of HIV-related conditions. Practical recipes using locally available foods are suggested as well as some simple home remedies for easing some of the problems people with HIV/AIDS may meet.
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Websites:
NEW! Food Safety for Persons with AIDS
This United States Department of Agriculture's website offers different up-to-date fact sheets providing instructions on avoiding various food-related infections.
http://www.fsis.usda.gov/Fact_Sheets/Food_Safety_for_Persons_with_AIDS/index.asp