Transcript HIV/AIDS and Nutrition

HIV/AIDS and Nutrition
Jeanne Garber
MS,RD,LN
Yellowstone City-County Health
Department
HIV and Aids 2002
World
Living with HIV or Aids
42,000,000
United
States
850,000
Newly infected with HIV
5,000,000
40,000
Aids Deaths
3,100,000
14,500
• Bringing a new perspective to the international AIDS crisis.
• 37,800,000 people living with HIV/AIDS globally at the end of 2003
• 35,000,000 people who travel to Las Vegas every year
• 26,900,000 people living with AIDS in developing countries
• 27,000,000 people reached by Yahoo News and Google News
• 4,800,000 new infections globally in 2003:
• 4,900,000 Americans who had non-surgical cosmetic procedures in
2002
• 2,900,000 people globally who died of AIDS in 2003
• 2,200,000 people in SubSaharan Africa who died of AIDS in 2003
• 18,144,000 women living with HIV/AIDS globally
• 18,000,000 Americans living with diabetes
• 14,250,000: women living with HIV/AIDS in sub-Saharan
Africa
• 200,000: women living with HIV/AIDS in North America
• 12,000,000: (Estimated) children in SubSaharan Africa
who have lost one or both parents to AIDS
• 18,400,000: children worldwide expected to have lost
parents to HIV/AIDS by 2010
• 25,000,000: people in SubSaharan Africa living with
HIV/AIDS at the end of 2003
• 7,400,000: Asians living with HIV/AIDS at the end of
2003
• 1,300,000: people in Eastern Europe and Central Asia
living with HIV/AIDS
• 950,000: people living with AIDS in the United States
Classification
• HIV positive is when a person is infected
with the virus
• AIDS: CD4 cells less than 500 with an
opportunistic disease.
Nutritional risk
• HIV-infected patients may be at nutritional
risk at any point in their illness
– Delayed weight gain in children
– Weight loss
– Loss of lean tissue
– Severe malnutrition
– Developing fat-redistribution syndrome
– Diabetes heart disease and stroke
Nutrition Education
 Healthful dietary principles
 Maintain lean body mass
 Drug therapies
 Drug/nutrient interactions
 Gastrointestinal interactions
 Herbal and/or nutritional supplements
 Exercise
 Substance Abuse
 Food Safety
Healthful Dietary Principles
Healthy lifestyle changes.
5-9 fruits and vegetables.
Increasing fiber
Limit fat to 30 % of total
calories
Exercise
Lean Body Mass
Height
Weight: usual, current, and ideal
Triceps Skin Fold
BMI
Bioelectric Impedance Analysis (BIA)
Drug Therapies
 Three types of drug therapies
1. Nucleoside Reverse Transcriptase Inhibitors
2. Non-nucleoside Reverse Transcriptase
Inhibitors
3. Protease Inhibitors
Food/Drug Interactions
Calorie, protein and fat recommendations
Barriers and solutions to meeting food
requirements for medications
Antacids
Herbal Products
 Cat’s claw, chamomile, echinacea, goldenseal
inhibition of CYP3A4
 St. John’s wort decreases levels of indinavir and
cyclosporine
 Ginkgo, Dong quai, and ginseng increases INR
when combined with warfarin
 Ephedra: toxicity when combined with caffeine
and other stimulants
 Glucosamine: decreased glucose tolerance
Supplements
General recommendations
Multivitamin w/o extra iron
Vitamin E if taking drugs toxic to the bone
marrow. Not for anyone taking Agenerase
Correct Vit. A deficiencies can increase CD4
counts. Best to do so by food.
Vit B 12 associated with dementia,
neuropathy, and are at risk due to diarrhea.
Vit. B complex take 2 times daily
Supplementation
Vit. C: in smokers with ppd hx > 15 years
500mg bid. Not more than 3g/day
Alcohol: Vit.A, B12, B-complex and
thiamine deficiencies. Also nutrient
deficient due to poor diet.
Substance abuse: Zinc, Vit. C, Vit Athrough diet. Assess dietary intake.
GI interactions
Many meds particularly protease
inhibitors, cause diarrhea
Nausea/vomiting can occur when starting
HAART meds, or w/o adequate food
GERD: triggered by caffeine, alcohol,
citrus, tomatoes, mint, garlic and onions
Diet and Exercise
Reduce lipodystrophy
Reduce triglyceride levels
Reduces other side effects due to HIV
medications
Substance Abuse
Poor food intake
Zinc deficiency
Low levels of vitamins A, C and E
Food Safety
Food and waterborne diseases
Diarrhea
Enteric Infections
Salmonellosis
Listeriosis
Vibro vulnificus: Oysters, shellfish