Nutrition and Dietary Status of the HIV patient


• The HIV epidemic in South Africa is one of the fastest growing epidemics in the world – it is
estimated that 6 million South Africans shall be infected by 2005 and 1 million children shall be
orphaned because their mothers will have died of AIDS. 1, 2

• The high cost of AIDS in the workforce strengthens the argument for investing in HIV prevention
programmes and in care for employees. These strategies should help keep knowledgeable,
experienced individuals healthier for longer and thus more able to contribute fully to the workforce for
as long as possible 3.

• A nutritional support programme at the work place will ultimately have the benefit of improving and
maintaining the health of employees with HIV and keeping such employees productive and
contributing to the economy for a longer period 3.

• In people with HIV/AIDS, nutritional deficits precipitate a cycle that results in a downward spiral of
weight loss, mal-absorption, diarrhoea, anorexia, body image disturbances and increased risk for
morbidity and mortality4, 5, 6, 7, 10, 13, 16, 26, 37.

• The deterioration of the nutritional status of HIV patients has an important effect on the course of
disease 14, 17, 18, 25.

• Research has shown that achieving an adequate nutrient and energy intake for as long as possible,
minimizes disease symptoms, enhances quality of life and slows HIV disease progression. HIV
positive people have double the protein requirement per day than an uninfected person 18-28.

• Oral nutritional supplements have a greater role than dietary advice in the improvement of body
weight and energy intake 6,12,17

• The use of a high-energy, high-protein nutrition supplement should be the primary nutritional
treatment for malnourished HIV patients without secondary infections.30, 31

• Multiple nutritional abnormalities occur relatively early in the course of HIV infection and therefore
early and continued nutritional supplementation may be beneficial in maintaining adequate plasma
nutrient levels 13.

• Certain micronutrients are preferentially lost in HIV infection and AIDS. These are vitamin A,
thiamine, vitamin B6, vitamin B12, vitamin C, beta-carotene, iron, selenium, copper and zinc. Vitamin
A, zinc and iron supplementation should not exceed the recommended daily allowances as studies
have shown that high doses of these micronutrients can promote HIV disease progression 17.

• A way to improve and maintain the nutritional status of HIV/AIDS patients, especially in a developing
country, is to fortify a basic food with micronutrients while ensuring that staple food provides the
energy, protein and lipids required for adequate nutrition 34.

• Soya Life nutritionally enhanced and fortified products39 help with the nutritional requirements of HIV
patients, but also supplies excellent nutrition for healthy persons. The products can be used as meal
replacements but also as meal supplements35, 36, 38, 40 Health benefits of the SPP products include:
1. The products are lactose free. 90-95% of the South African population is lactose intolerant.
2. The protein in the product is of high biological value. The PDCAAS of SP500 is 0.9, the maximum
PDCAAS is 1 and equal to egg albumin and casein.
3. The oil in the product is not hydrogenated. 85% of the soy oil is omega 2 and omega 3 fatty acids.
Omega-3 fatty acids are the type found in fish and few plant oil sources. They are essential for
development of nerve tissues and have many other functions.
4. There are natural phospholipids in the products.
5. The soy oil also contains natural -sitosterols that help to build the immune system.
6. Soya Life soy products contain large amounts of natural plant sterols (Isoflavones) in the products.
7. SPP soy products are whole food products with all the natural wholesomeness with high-energy
values.
8. A natural water extraction process, utilizing whole bean technology without any hexane or alcohol
extraction, is used to process soybeans.
9. There are no unnecessary preservatives in the products.
10. Soya Life distributes products fortified with additional vitamins and minerals
11. The products are convenience (instantised) products that do not need any cooking or food
preparation before eating.

Medical References

1. AIDS epidemic update December 2000. UNAIDS/WHO
2. HIV/AIDS & STD. Strategic Plan for South Africa 2000-2005
3. UNAIDS Best Practice Collection. Summary Booklet of Best Practice. Issue 2.2000.
4. Thuita FM, Mirie W. Nutrition in the management of acquired immunodeficiency
syndrome. East Afr Med J. 1999;76;(9):507-9
5. Ed. Position of the American Dietetic Association and the Canadian Dietetic
Association: Nutrition intervention in the care of person with human immunodeficiency
virus infection, J Am Diet Assoc 1994;94;(9):1042-5
6. Baldwin C, Parsons T, Logan S. Dietary advice of illness-related malnutrition in adults
(Cochrane Review). In: The Cochrane Library, Issue 2, 2001. Oxford: Update Software.
7. Clader'on E, Ram'irez MA, Arrieta MI, Fern'andez-Caldas E, Russel DW, Lockey FR.
Nutritional disorders in HIV disease. Prog Food Nutri Sci, 1990;14;(4):371-402
8. Timbo BB, Tollefson L. Nutrition: a cofactor in HIV disease. J Am Diet Assoc;
1994;94;(9):1918-22.
9. Macallan DC. Nutrition and immune function in human immunodeficiency virus
infection. Proc Nutr Soc; 1999;58;(3):743-8
10. Fields-Gardner C, Ayoob KT. Position of the American Dietetic Association and
Dieticians of Canada: Nutrition intervention in the care of persons with human
immunodeficiency virus infection. J Am Diet Assoc; 2000;100;(6):708-717.
11. Casey KM. Malnutrition associated with HIV/AIDS. Part One: Definition and scope,
epidemiology and pathophysiology. AIDS Care 1998;9;(2)
12. Burger B, Schwenk A, Junger H, Olienschlager G, Wessel D, Diehl V, Schrappe M. Oral
supplements in HIV-infected patients with chronic wasting. A prospective trail. Med Klin
1994;89;(11):579-81
13. Guenter P, Muurahainen N, Simons G, Kosok A, Cohan GR, Rubenstein R, Turner JL.
Relationships among nutritional status, disease progression and survival in HIV
infection. J Acquir Immune Defic Syndr 1993;6;(q0):1130-8
14. Dannhauser A, van Staden AM, van der Ryst E, Nel M, Marais M, Erasmus E, Attwood,
EM, Barnard HC, le Roux GD. Nutritional status of HIV-1 seropostitive patients in the
Free State Province of South Africa: anthropmetirc and dietary profile: Eur J Clin
Nutr;1999;53;(3);165-73.
15. Chlebowski RT, Beall G, Grosvenor M, Lillington L, Weintraub N, Ambler C, Richards
EW, Abbruzzese BC, McCamish MA, Cope FO. Long term effect of early nutritional
support with new enterotropic peptide-based formula vs. standard enteral formular in
HIV-infected patients: randomized prospective trail. Nutrition 1993;9/(6):507-12
16. Baum M, Cassetti I, Bonvehi P, Shor-Posner G, Lu Y, Sauberlich H. Inadequate dietary
intake and altered nutrition status in early HIV-1 infection. Nutrition 1994;10;(1);16-20.
17. Vitamin Information Centre, Medical Update 1998;31
18. Delmas-Beauvieux MC, Peuchant E, Coucheron A et al. The enzymatic anti-oxidant
system in blood and glutathione status in human immunodeficiency virus (HIV)-infected
patients: Effects of supplementation with selenium or beta-carotene. American Journal
of Clinical Nutrition 1996;64;(1):101-7.
19. Baum MK, Shor-Posner G, Lai S et al. High risk of HIV-related mortality is associated
with selenium deficiency. J Acquir Immune Defic Syndro Hum Retrovirol
1997;15(5):370-4
20. Muti RM, Von Overbeck J, Furrer J, Ballmer PE. Thiamin deficiency in HIV-positive
patients: evaluation by erythrocyte transketolase activity and thiamin pyrophosphate
effect. Clin Nutr 1999;18;(6):375-8.