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Session 1: The Nutrition and HIV Link

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

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Session 1: The Nutrition and HIV Link

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  1. Session 1:The Nutrition and HIV Link Nutrition Management with HIV and AIDS: Practical Tools for Health Workers

  2. 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

  3. 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

  4. 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

  5. Nutrition Basics Foods contain nutrients in various quantities • Macronutrients • Carbohydrates • Protein • Fats • Micronutrients • Vitamins • Minerals

  6. 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

  7. Food Groups 4 Food Groups • Cereals and Staple Grains • Animal Foods, Milk Products, and Beans • Fruits and Vegetables • Fats and Sugar

  8. 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

  9. Typical Grain in Natural Form Courtesy of Nordin S. Permaculture, Nutrition and HIV Files CD Rom. 2006 Bran: Protein, Vitamins & Minerals Husk Starch Germ: Many Nutrients

  10. Grains: Maize Courtesy of Linda Larsdotter, 2005

  11. 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

  12. Dried Fish © I-TECH, 2005

  13. Dried Mopani Worms © I-TECH, 2005

  14. 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

  15. 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

  16. 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

  17. Spinach © I-TECH, 2005

  18. Dried Eenyandi Fruit © I-TECH, 2005

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. The Immune System and HIV © ITECH, 2006

  28. 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

  29. 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

  30. 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

  31. 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)

  32. 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

  33. Use Namibian Food Groups Grains: mahangu, sorghum, cassava, maize, wheat, rice, potato Balanced Meal equals Healthy Meal Protein Foods: beans, peas, nuts etc. or animal food like milk, Mopani worms, egg, meat, fish, etc. spices, herbs Fats: oilseeds, oil, butter, avocado Fruit: paw-paw, banana, eenyandi, eembe, guava, etc Vegetables: pumpkin, spinach, carrots, etc

  34. Stay Hydrated • Drink at least 2 litres of liquids per day: boiled water, juice, non-caffeinated or non-alcoholic drinks • Important for the cells in body to function • Caffeine and alcohol are dehydrating

  35. Exercise Why exercise? • Keep muscles strong • Keep bones strong and prevent osteoporosis • Maintain weight • Keep immune system strong • Improve appetite

  36. 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

  37. Optimal food intake, balanced diet Slower progression of HIV and better health Maintain weight and prevent side effects Stronger immune system to fight infections Cycle of Good Nutrition

  38. 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 Key Points

  39. Key Points (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

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