FOOD AND NUTRITION LITERATURE SEARCH
Nutrition and the client with AIDS.
Davidhizar R, Dunn C.
The nutritional problems that go along with HIV infection and AIDS are significant and in fact contribute to
death. Nutrition not only affects overall health but one's ability to respond to therapies and quality of life.
Malnutrition and "wasting syndrome" result from compromised nutritional status. Early detection and
intervention can decrease the dramatic problems caused by these conditions. Regardless of the stage of illness,
Medical Nutrition Therapy needs to be individualized and prioritized as an integral part of one's total care.
PMID: 9573975 [PubMed - indexed for MEDLINE]
Moving beyond the clinic: nutritional intervention in a human immunodeficiency virusinfected pregnant population.
Seifert C, Reich K, Nachman S.
Department of Pediatrics, Division of Infectious Diseases, University Hospital at Stony Brook, HSC T-11031, Stony Brook, NY 11794, USA.
10: AIDS Behav. 2006 Nov;10(6):659-70. Epub 2006 Jun 1.
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Improving dietary habits in disadvantaged women with HIV/AIDS: the SMART/EST
women's project.
Segal-Isaacson CJ, Tobin JN, Weiss SM, Brondolo E, Vaughn A, Wang C, Camille J, Gousse Y, Ishii
M, Jones D, Laperriere A, Lydston D, Schneiderman N, Ironson G.
Albert Einstein College of Medicine of Yeshiva University, 1308C Belfer Building 1300, Morris Park Avenue
Bronx, New York 10461, USA. isaacson@aecom.yu.edu
There is a lack of information on whether brief nutrition education can succeed in improving longer-term
dietary patterns in disadvantaged populations with HIV/AIDS. In the SMART/EST II Women's Project 466
disadvantaged women with HIV/AIDS were randomized to one of four groups and received a two-phase
training consisting of a coping skills/stress management and nutrition education provided either in a group or
individually. At baseline the majority of participants had excessive fat and sugar consumption and suboptimal
intakes of vegetables, fruits, calcium-rich foods and whole grains. Dietary patterns for all participants
improved after the nutrition intervention primarily due to decreases in high fat and high sugar foods such as
soda and fried foods and were still significantly better 18 months later. There were only short-term differences
in improvements between the four groups. These findings support the value of even brief nutrition education
for disadvantaged women living with HIV/AIDS.
11: Med J Aust. 2006 Apr 17;184(8):389-92.
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13: Prev Chronic Dis. 2004 Oct;1(4):A14. Epub 2004 Sep 15.
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The eHealth Behavior Management Model: a stage-based approach to behavior change and
management.
Bensley RJ, Mercer N, Brusk JJ, Underhile R, Rivas J, Anderson J, Kelleher D, Lupella M, de Jager
AC.
Western Michigan University, Kalamazoo, MI 49008, USA. robert.bensley@wmich.edu
Although the Internet has become an important avenue for disseminating health information, theory-driven
strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior
Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of
Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stagespecific information. It is here - at the point of stage-specific information - that behavioral intent in moving
toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three
demonstration projects that focus on behavior management issues: parent-child nutrition education among
participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women,
Infants and Children; asthma management among university staff and students; and human immunodeficiency
virus prevention among South African women. Preliminary results have found the eHealth Behavior
Management Model to be promising as a model for Internet-based behavior change programming. Further
application and evaluation among other behavior and disease management issues are needed.
14: J Am Diet Assoc. 2004 Oct;104(10):1554-60.
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J Am Diet Assoc. 2004 Oct;104(10):1549-53.
HIV-infected US youth are at high risk of obesity and poor diet quality: a challenge for
improving short- and long-term health outcomes.
Kruzich LA, Marquis GS, Wilson CM, Stephensen CB.
Department of Food Science and Human Nutrition, Iowa State University, Ames 50011, USA.
lkruzich@iastate.edu <lkruzich@iastate.edu>
OBJECTIVE: To examine the relationships among dietary quality, weight status, and human
immunodeficiency virus (HIV) infection in US adolescents and young adults. DESIGN: This cross-sectional
study was embedded in the Reaching for Excellence in Adolescent Care and Health cohort study of HIVinfected and HIV-uninfected, at-risk youth. Biochemical, clinical, and sociodemographic data were available.
Dietary intake was collected using the Block Food Frequency Questionnaire and a modified Healthy Eating
Index was calculated to measure diet quality. SUBJECTS/SETTING: Participants included 264 HIV-infected
and 127 HIV-uninfected youth 13 to 23 years old (75.2% women, 67.3% African American/non-Hispanic,
20.5% Hispanic, 12.3% other) at 14 clinic sites. STATISTICAL ANALYSES PERFORMED: Determinants
of obesity and the modified Healthy Eating Index were tested using logistic and generalized linear regression.
RESULTS: About half (51.7%) of participants were overweight or obese. Obesity was positively associated
with being a woman, living independently, watching television >or=3 hours per day, previous dieting, and
being from the northeastern or southern United States. Youth who were HIV uninfected or HIV infected with
CD4 + T cells >or=500 cells/microL had similar obesity rates; overweight (25%) and obesity (20%) was
prevalent among women even with CD4 + T cells <200 cells/microL. The modified Healthy Eating Index
score was 56.2+/-0.6, reflecting a diet needing improvement. HIV infection, watching television >or=3
hours/day, and being from the Chicago, IL, area were associated with a lower-quality diet. CONCLUSIONS:
Obesity is a common nutrition problem for both HIV-infected and uninfected youth; however, HIV-infected
youth are at increased risk of developing metabolic abnormalities. Culturally appropriate, client-focused
nutrition education will help youth improve their diet and increase physical activity to reduce health
consequences associated with both obesity and HIV infection.
15: HIV Clin. 2004 Spring;16(2):9.
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Nutrition counseling is important for HIV-infected diabetics.
18: J Paediatr Child Health. 2006 Oct;42(10):583-93.
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Obesity in HIV-infection: dietary correlates.
Hendricks KM, Willis K, Houser R, Jones CY.
Department of Community Health and Family Medicine, Tufts University School of Medicine, Boston MA
02111, USA. Kristy.Hendricks@tufts.edu
OBJECTIVE: To describe the prevalence of obesity among a cohort of individuals living with HIV infection,
and to determine differences in dietary intake among those subjects who are normal weight, overweight, and
obese. DESIGN: A cross-sectional study among participants enrolled in the Nutrition for Healthy Living
(NFHL) study. SETTING: Eligible participants included HIV-positive adults living in the greater Boston, MA
and Providence, RI, areas. Subjects and Measures of Outcome: In total, 321 (265 males, 56 females) subjects
were studied. Body composition measurements, demographic and health data, and fasting blood samples were
analyzed. Dietary intake was assessed by three-day food records. Statistical analyses were performed using
Statistical Package for Social Science (SPSS). RESULTS: 13% of males and 29% females were found to be
obese. Energy intake per kilogram decreased by body mass index (BMI) category for both men and women (p
<0.05). Although not different between groups, mean total fat and saturated fat intakes were above
recommendations for both men and women in all BMI categories, while total grams dietary fiber decreased as
BMI increased. Individuals in all BMI groups had micronutrient intakes below the Dietary Reference Intakes.
Serum markers of insulin resistance were significantly different by BMI category among men and women, as
well as triglycerides and total cholesterol for the males. CONCLUSIONS: Obesity and diet in individuals
living with HIV-infection needs to be addressed, as quality of dietary intake may have future implications
regarding cardiovascular disease, metabolic syndrome, and other health risks associated with overweight and
obesity.
22: J Am Diet Assoc. 2006 May;106(5):728-32.
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Dietary glycemic index of human immunodeficiency virus-positive men with and without fat
deposition.
Dong KR, Wanke CA, Tang AM, Ding B, Hendricks KM.
Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA 02111,
USA. kimberly.dong@tufts.edu
This study focused on dietary glycemic index because insulin resistance can be important in the pathogenesis
of fat deposition in human immunodeficiency virus (HIV). We evaluated differences in past dietary glycemic
intake between men with HIV who developed fat deposition and those who did not. This was a nested casecontrol study consisting of 37 cases and 37 controls from the Nutrition for Healthy Living cohort. Food
records from 6 to 24 months prior to development of fat deposition in cases were analyzed and compared with
controls. Cases were defined as men with a waist-to-hip ratio >0.95 and body mass index (calculated as
kg/m(2)) between 23 and 26. Controls were matched by age, race, body mass index, highly active
antiretroviral therapy use, and CD4 count. Food records were analyzed using t tests for normally distributed
nutrients and Wilcoxon rank-sum tests for nutrients with skewed distributions. Glycemic index was calculated
for each meal and day. There was no significant difference in glycemic index for meals and day between
participants with or without fat deposition. Both groups had a moderate dietary glycemic index intake. This
study showed no association between dietary glycemic index and development of fat deposition in HIV.
Instead, results of this study depict the potential benefits associated with eating high-quality diets, primarily
adequate fiber and protein intake. Diet can be important in preventing development of fat deposition in
patients with HIV.
23: HIV Clin Trials. 2005 Jul-Aug;6(4):203-12.
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Ethical issues in nutrition and human immunodeficiency virus.
Maillet JO, Vyas A, Rodrigues J.
University of Medicine and Dentistry of New Jersey, Newark, NJ 07107, USA. maillet@umdnj.edu
Ethical dilemmas often arise in the provision of healthcare. In view of the advances in human
immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) medical management since the
late 1990s, many of the challenges and ethical dilemmas encountered by healthcare professionals have
changed from terminal or end-of-life issues to long-term management issues. This article presents 5 case
scenarios on common ethical issues faced by those providing nutrition care to people living with HIV/AIDS
and addresses key questions to ask in the ethical deliberative process. Ethical dilemmas surrounding the use of
complementary and alternative medicine, providing aggressive nutrition support, dealing with third-party
payers for supplement reimbursement, and managing patients with mental health disorders and substance
abuse issues are discussed, with possible solutions presented from an ethics point of view.
PMID: 16215127 [PubMed]
25: Nutr Clin Pract. 2004 Aug;19(4):330-9.
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Evaluation of nutrition assessment parameters in the presence of human immunodeficiency
virus infection.
Earthman CP.
Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota 55108-6099, USA.
cearthma@umn.edu
Malnutrition, weight loss, and body cell mass (BCM) depletion have long been observed in individuals with
HIV infection and acquired immunodeficiency syndrome and are associated with increased morbidity and
mortality. Nutritional status may be adversely affected by many factors, including inadequate intake,
gastrointestinal disturbances, altered nutrient metabolism, and medication-related side effects. Increasing
numbers of HIV-infected individuals are exhibiting fat redistribution characterized by any combination of
changes including peripheral fat atrophy, visceral or dorsocervical adiposity, or other changes, and these
changes have been shown to be associated with increased cardiovascular disease risk. A complete nutrition
assessment is key to effective patient management in HIV infection. This review focuses on the evaluation of
anthropometry (including BCM and fat redistribution), biochemistries, medication-related issues,
medical/social/dietary histories, and physical examination and clinical findings. A discussion of BCM, its
significance as a parameter of nutritional status, and methodological issues concerning its measurement by
available technologies is presented in light of current research. Methods for assessing fat redistribution are
discussed. Recommendations for biochemical assessment and medical, social, and dietary histories are
reviewed. Finally, medication-related side effects for common antiretroviral therapies and clinical findings
that may affect nutritional status are presented. Clearly, nutrition assessment in HIV infection is a complex
process involving many factors.
PMID: 16215124 [PubMed]
26: Nutr Clin Care. 2005 Jan-Mar;8(1):6-15.
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Nutrition assessment in HIV infection.
Gerrior JL, Neff LM.
Nutrition/Infection Unit, Department of Public Health and Family Medicine, Tufts University School of
Medicine, Boston, Massachusetts 02111, USA. jul.gerrior@tufts.edu
Nutrition assessment is a vital component of the general care of HIV-infected adults. With access to highly
active antiretroviral therapy (HAART), HIV infection may become a chronic, manageable disease. Nutritional
and metabolic complications traditionally associated with HIV infection such as hypertriglyceridemia, low
levels of high-density lipoprotein (HDL) cholesterol, and weight loss continue to occur. However, emerging
abnormalities such as regional alterations in body shape (fat re-distribution syndrome or HIV-associated
lipodystrophy), increasing body weight, high levels of low-density lipoprotein (LDL) cholesterol, insulin
resistance, and other metabolic derangements may also be present. In addition, as patients are living longer,
they may be susceptible to other age-related diseases such as diabetes, cardiovascular disease, and obesity. In
this article, we review strategies for nutrition assessment and management in HIV-infected adults. Attention is
focused on specific symptoms such as weight loss and diarrhea and specific disorders such as lipodystrophy,
micronutrient deficiencies, and dyslipidemia, which commonly affect HIV-infected individuals. Proper
attention to nutritional status may help to reduce the burden of disease and promote an enhanced quality of
life in HIV-infected individuals.
27: Int J Vitam Nutr Res. 2005 Jan;75(1):19-27.
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Dietary intake in human immunodeficiency virus-infected adults: a comparison of dietary
assessment methods.
Hendricks K, Tang A, Spiegelman D, Skinner S, Woods M.
Department of Family Medicine and Community Health, Tufts University, Boston, MA 02111, USA.
kristy.hendricks@tufts.edu
OBJECTIVE: The objective of this study was to compare estimated nutrient intakes from 3-day food records
vs Food Frequency Questionnaire (FFQ) in a large cohort of individuals living with human immunodeficiency
virus (HIV) infection. DESIGN: Dietary data from 315 HIV-positive participants enrolled in a longitudinal
cohort study were collected. Nutrient intake data estimated from the Block FFQ were compared with multiple
3-day food records done over the same time period. SUBJECTS/SETTING: Participants enrolled in Nutrition
for Healthy Living, an ongoing cohort study based in Boston, MA, were studied. STATISTICAL
ANALYSES PERFORMED: Using 3-day food records as the gold standard, we compared estimated nutrient
intakes between the two assessment methods by (a) median of individual differences in intake, (b) correlation
coefficients, (c) quintile ranking, and (d) intakes less than the Dietary Reference Intakes. Nutrient intake
estimates between the two methods were compared using Spearman, Pearson, and deattenuated correlation
coefficients. RESULTS: Median reported intakes of all macronutrients and most micronutrients were
significantly less on the FFQ for both men and women. Deattenuated correlations were less than 0.5 for 86%
of the men and for 68% of the women. Mean percent agreement for quintile ranking was 30%.
CONCLUSIONS: In this large cohort of HIV-infected adults, we found significant differences between FFQs
and food records in estimates of absolute dietary intakes, correlation coefficients, quintile rankings, and
proportions of subjects consuming less than the Dietary Reference Intakes. These findings have implications
for the interpretation and application of dietary intake data from FFQs in specialized populations.
31: Public Health Nutr. 2004 Oct;7(7):863-70.
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Dietary intake and body mass index in HIV-positive and HIV-negative drug abusers of
Hispanic ethnicity.
Forrester JE, Tucker KL, Gorbach SL.
Department of Familly Medicine and Community Health, Tufts University School of Medicine, Boston, MA
02111, USA. janet.forrester@tufts.edu
OBJECTIVE: Malnutrition in drug abusers has been attributed to poor diet. However, previous studies are
conflicting. Many studies have not considered possible concurrent HIV disease. The purpose of this study was
to determine the relationship between drug abuse and dietary intake in Hispanic Americans with and without
HIV infection. DESIGN: Dietary intake was measured using 3-day food records and 24-hour dietary recalls in
three groups: HIV-positive drug abusers, HIV-negative drug abusers and HIV-positive persons who do not
use drugs ('non-drug abusers'). SETTING: The baseline data from a prospective cohort study of the role of
drug abuse in HIV/AIDS weight loss and malnutrition conducted in Boston, Massachusetts, USA.
SUBJECTS: The first 284 participants to enroll in the study. RESULTS: HIV-positive drug abusers had a
body mass index (BMI) that was significantly lower than that of HIV-positive non-drug abusers. Reported
energy, fat and fibre intakes did not differ between groups. All groups had median reported intakes of vitamin
A, vitamin B6, vitamin B12, selenium and zinc that were in excess of the dietary reference values (DRI).
Intakes of alpha-tocopherol were below the DRI, but did not differ from intakes of the general US population.
However, increasing levels of drug abuse were associated with lower reported intakes of vitamin B6, vitamin
B12, selenium and zinc. CONCLUSIONS: Overall, this study does not support the notion that dietary intake
can explain the lower BMI of HIV-positive drug abusers. Further studies examining non-dietary determinants
of nutritional status in drug abusers are warranted.
32: J Am Diet Assoc. 2004 Sep;104(9):1425-41.
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Position of the American Dietetic Association and Dietitians of Canada: nutrition intervention in the care of
persons with human immunodeficiency virus infection.
Fields-Gardner C, Fergusson P; American Dietetic Association; Dietitians of Canada.
Infection with the human immunodeficiency virus (HIV) and the development of acquired immunodeficiency
syndrome (AIDS) have had a significant impact on domestic and global health, social, political, and economic
outcomes. Prevention and treatment efforts to control HIV infection are more demanding than in previous
decades. Achieving food and nutrition security, and managing nutrition-related complications of HIV
infection and the multiple aspects of disease initiated by or surrounding HIV infection, referred to as HIV
disease, remain challenges for patients and for those involved with HIV/AIDS prevention, care, and treatment
efforts. Confounding clinical issues include medication interactions, coinfection with other infections and
diseases, wasting, lipodystrophy, and others. Dietetics professionals, other health care professionals, and
people infected with HIV will need to understand and address multiple complex aspects of HIV infection and
treatment to improve survival, body functions, and overall quality of life. Individualized nutrition care plans
will be an essential feature of the medical management of persons with HIV infection and AIDS.