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HIV/AIDS and Nutrition

HIV/AIDS and Nutrition. Jeanne Garber MS,RD,LN Yellowstone City-County Health Department. HIV and Aids 2002. 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

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HIV/AIDS and Nutrition

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  1. HIV/AIDS and Nutrition Jeanne Garber MS,RD,LN Yellowstone City-County Health Department

  2. HIV and Aids 2002

  3. 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

  4. 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

  5. Classification • HIV positive is when a person is infected with the virus • AIDS: CD4 cells less than 500 with an opportunistic disease.

  6. 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

  7. 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

  8. Healthful Dietary Principles • Healthy lifestyle changes. • 5-9 fruits and vegetables. • Increasing fiber • Limit fat to 30 % of total calories • Exercise

  9. Lean Body Mass • Height • Weight: usual, current, and ideal • Triceps Skin Fold • BMI • Bioelectric Impedance Analysis (BIA)

  10. Drug Therapies • Three types of drug therapies • Nucleoside Reverse Transcriptase Inhibitors • Non-nucleoside Reverse Transcriptase Inhibitors • Protease Inhibitors

  11. Food/Drug Interactions • Calorie, protein and fat recommendations • Barriers and solutions to meeting food requirements for medications • Antacids

  12. 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

  13. 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

  14. 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 A-through diet. Assess dietary intake.

  15. 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

  16. Diet and Exercise • Reduce lipodystrophy • Reduce triglyceride levels • Reduces other side effects due to HIV medications

  17. Substance Abuse • Poor food intake • Zinc deficiency • Low levels of vitamins A, C and E

  18. Food Safety • Food and waterborne diseases • Diarrhea • Enteric Infections • Salmonellosis • Listeriosis • Vibro vulnificus: Oysters, shellfish

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