Transcript The Nutrition and HIV Link - I-TECH

Session 1:
The Nutrition and HIV Link
Nutrition Management with HIV and AIDS:
Practical Tools for Health Workers
Objectives
• Define nutrition
• List foods from each food group, and at
least one nutrient that each food contains
• Identify locally available foods from each
food group
• Identify important vitamins and minerals
and their function
• Explain the connections between HIV and
AIDS, the immune system, and nutrition
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 2
Definition of Nutrition
• Nutrition is the science of foods
• Involves the action, interaction, and balance of
nutrients in relationship to health and disease
• Involves the processes by which food is
digested, absorbed, transported, utilised, and
excreted in the body
• Nutrition is concerned with social, economic,
cultural, and psychological implications of food
and eating
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 3
Gastro-Intestinal Tract
• Tube that runs from mouth to anus where
food is ingested, digested, and absorbed
into the body
• Foods enter through mouth, travel down
through stomach and intestines, are
absorbed into blood at various stages,
then the unused food waste is excreted in
faeces
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 4
Nutrition Basics
Foods contain nutrients in various
quantities
• Macronutrients
• Carbohydrates
• Protein
• Fats
• Micronutrients
• Vitamins
• Minerals
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 5
Nutrition Basics (2)
• Include water every day
• Calories or Energy
• Come from macronutrients – carbohydrates,
proteins, and fats
• Provide energy to move and stay healthy
• People with HIV and AIDS need more calories
than others
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Food Groups
4 Food Groups
• Cereals and Staple Grains
• Animal Foods, Milk Products, and Beans
• Fruits and Vegetables
• Fats and Sugar
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Cereals and Staple Grains
• Provide energy, fibre, vitamins and
minerals
• Starches or cereals: white or brown bread,
mahangu, mealie-pap, macaroni, rice, or
Weet-bix
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 8
Typical Grain in Natural Form
Bran:
Husk
Protein,
Vitamins &
Minerals
Starch
Germ:
Many
Nutrients
Courtesy of Nordin S. Permaculture, Nutrition and HIV Files CD Rom. 2006
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Grains: Maize
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Courtesy of Linda Larsdotter, 2005
Slide 10
Animal Foods, Milk Products, and Beans
• Protein to build immune system and
muscles
• Iron to prevent anaemia (iron deficiency)
• Animal Sources: meat (beef, game, etc),
chicken, fish, eggs, insects, milk, cheese,
yoghurt, sour milk
• Non-animal Sources: beans, lentils, peas,
nuts and soy products (soy mince)
• Most sources contain some fat
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 11
Dried Fish
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
© I-TECH, 2005
Slide 12
Dried Mopani Worms
© I-TECH, 2005
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 13
Fats and Sugars
• Fats: butter, margarine, and oils
• Fat is a concentrated form of energy, some
oils contain vitamins A and E
• Helps with weight gain
• Fat also naturally found in meats, fish and
milk products
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 14
Fats and Sugars
• Sugars: add calories (energy), but no
protein, vitamins or minerals
• Sugars include cool drinks (Coke, Fanta),
sweets, cakes, cookies, etc.
• Too much sugar can lead to cavities and
promotes yeast and bacteria growth
• Cool drinks like Coke also have caffeine,
which can dehydrate the body
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Fruits and Vegetables
• Provide mostly vitamins and minerals
• Essential for body functions, building the
immune system and helping heal
wounds and infections
• Provide carbohydrate-fibre for good
digestive health
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 16
Spinach
© I-TECH, 2005
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 17
Dried Eenyandi Fruit
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
© I-TECH, 2005
Slide 18
Important Vitamins and Minerals
Vitamin A
• Function: improves vision, immune system by
strengthening cells
• Foods: yellow, orange, and dark green fruits and
vegetables, milk, liver, eggs and fish oil
• Deficiencies: blindness, poor skin, teeth and
nails
• Give vitamin A supplement as part of treatment
of severe malnutrition and diarrhoea in children
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Important Vitamins and Minerals
Vitamin C
• Function: promotes healthy cells and tissues,
strong immune system, wound healing
• Foods: oranges, lemons, grapefruit, paw-paw,
guava, green leafy vegetables, baobab fruit,
eembe, and potatoes
• Deficiencies: decreased immune function,
scurvy, poor wound healing, bleeding gums,
bruising
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Important Vitamins and Minerals
Vitamin E
• Function: forms and protects cells
• Foods: vegetable oils, nuts, seeds, grains,
eggs, legumes, dark green vegetables
• Deficiencies: decreased immune function
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Important Vitamins and Minerals
Iron
• Function: carries oxygen through body,
builds immune system
• Foods: Liver, meat, chicken, fish, eggs,
dried beans, green vegetables, cereals
• Deficiencies: anaemia, fatigue, weakness
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 22
Important Vitamins and Minerals
Calcium
• Function: keeps bones and teeth strong, helps
muscles and heart work better
• Foods: milk, cheese, yoghurt/sour milk, fish (with
bones), dark green leafy vegetables
• Need calcium-rich foods every day
• Deficiencies: poor growth and bone
development, frequent leg cramps
• HIV medications can interfere with calcium
absorption, causing weakened bones
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Important Vitamins and Minerals
Zinc
• Function: protects and strengthens immune
system, heals wounds
• Foods: seeds and nuts, grains, green leafy
vegetables, eggs, liver, seafood
• Deficiencies: skin problems, low appetite, no
wound healing, slow growth in children
• Give short-term zinc supplement as part of
treatment for diarrhoea, especially for children
• 20mg/day for no more than 10-14 days
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 24
Antioxidants
• Oxidation is when cells breakdown and release
“free radicals” or substances that are harmful to
cells
• Antioxidants are substances that prevent cell
breakdown by slowing oxidation
• Vitamins and minerals found in fruits and
vegetables act as antioxidants (vitamins A, C, E
and Selenium)
• Oxidation occurs over time as we age, but faster
with a disease or unhealthy lifestyle
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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The Nutrition and HIV Link
• The Immune System:
• Cells to fight infections
• HIV attacks these cells
• Causes weakening of immune system and
infections
• Nutrition helps keep the cells healthy and fight
infections
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 26
The Immune System and HIV
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
© ITECH, 2006
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CD4 and Viral Load Counts
• Poor nutrition status contributes to
decrease in CD4 count and/or increase in
viral load
• As CD4 counts decrease and viral load
counts increase, greater need for nutrition
to protect cells
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 28
HIV Impact on Nutrition
• What’s the problem?
• Extra burden on body
• Decreased food intake and decreased
absorption due to disease and/or side effects
from medications
• What can we do?
• Early nutrition assessment, education and
treatment of nutrition-related problems
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 29
Nutrition Requirements for HIV
• Calories/Energy: increase to fight
infections and prevent weight loss
• 10 percent increase for all HIV patients
• 20-30 percent increase with other infections
and co-infections such as TB, malaria, and
pneumonia
• Protein: 12-15% of total calories from
protein
• Increase with infections only
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Nutrition Advice for Persons with HIV
• Eat at least 3 times a day to:
• Maintain weight
• Prevent side-effects and nutrient deficiencies
• If 3 large meals are not possible, try 5-6
smaller meals/snacks per day (every four
to five hours)
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Healthy Eating
• Try to eat foods from each food group
• What is a “balanced” diet?
• Most meals contain all nutrients (food groups)
• How do we “balance” our meals?
• Use locally available foods
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Use Namibian Food Groups
Grains:
spices,
herbs
Fats:
oilseeds,
oil, butter,
avocado
mahangu, sorghum,
cassava, maize,
wheat, rice, potato
Balanced Meal
equals
Healthy Meal
Fruit:
paw-paw,
banana,
eenyandi,
eembe, guava,
etc
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Vegetables:
Protein
Foods:
beans, peas,
nuts etc. or
animal food
like milk,
Mopani
worms, egg,
meat, fish,
etc.
pumpkin,
spinach,
carrots, etc
Slide 33
Stay Hydrated
• Drink at least 2 litres of liquids per day:
boiled water, juice, non-caffeinated or nonalcoholic drinks
• Important for the cells in body to function
• Caffeine and alcohol are dehydrating
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Exercise
Why exercise?
• Keep muscles strong
• Keep bones strong and prevent
osteoporosis
• Maintain weight
• Keep immune system strong
• Improve appetite
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 35
Types of Exercise
• Walking or light jogging can improve appetite
• Gardening or Farming
• Uses different muscles
• Also provides food and source of income
• Stretching
• Improves blood circulation and appetite
• Only need 15-20 minutes a day
• See Handout 1.3: Exercises and Moving
Bedridden Patients
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 36
Cycle of Good Nutrition
Optimal food
intake,
balanced
diet
Slower
Maintain
progression
weight and
of HIV
prevent
and better
side
health Stronger
effects
immune
system to
fight
infections
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 37
Key Points
1. Balanced meals with variety of
locally available foods are essential
and include:
• Cereals and staple grains
• Animal foods, milk products, and
beans
• Fruits and vegetables
• Fats and sugars
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
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Key Points (2)
2. Provide nutrition counselling for clients
with HIV on how to improve nutrition,
including information regarding:
•
•
•
Use of Mixed Meal model for planning meals
Hydration
Exercise
Session 1: The Nutrition and HIV Link
Nutrition Management with HIV and AIDS Training
Slide 39