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Session 3
Purpose
1. Nutritional
assessment
2. Intervention
Anthropometry
Laboratory tests
Clinical assessments
Diet history and lifestyle
Anthropometric Measurements
in HIV/AIDS
To assess and monitor weight
Weight and height
Percentage of weight and/or body mass index
changes over time
To assess and monitor body composition
Lean body mass
Body cell mass
Skinfold (triceps, biceps, mid-thigh)
Circumferences (waist, mid-upper arm, hips
[buttocks], mid-thigh, breast size for women,
neck circumferencve (buffalo hump])
Laboratory Measurements
in HIV/AIDS
To assess and monitor nutrient levels
Serum micronutrients (e.g. retinol, zinc)
Haemoglobin (and ferritin)
To assess and monitor body composition
Fasting blood sugar,
Lipid profiles (e.g., cholesterol and
triglycerides)
Serum insulin
Clinical Assessments in HIV/AIDS
Symptoms and illnesses associated
with HIV/AIDS
Diarrhea and vomiting
Fever (temperature)
Mouth and throat sores
Oral thrush
Muscle wasting
Fatigue and lethargy
Skin rashes
Edema
Palm pallor
Diet History in HIV/AIDS
24-hour food consumption or food
frequency recalls can be used (in the
absence of acute food stress) to assess
Types and amounts of food eaten (including
food access and utilization and food handling)
Use of supplements and medications
Factors affecting food intake (appetite, eating
patterns, medication side effects, lifestyle,
taboos, hygiene, psychological factors, stigma,
economic factors)
Interventions
Stages of HIV Disease and
Nutrition
Specific nutrition recommendations vary
according to underlying nutritional
status and HIV disease progression
Early stage: No symptoms, stable weight
Middle stage: Weight loss, opportunistic
infections associated effects
Late stage: Symptomatic AIDS
Nutrition Care and Support
Priorities by Stage of Disease
Asymptomatic: Counsel to stay healthy
Encourage building stores of essential nutrients and
maintaining weight and lean body mass
Ensure understanding of food and water safety
Encourage physical activity
Middle stage – Counsel to minimize consequences
Counsel to maintain dietary intake during acute illness
Advise increased nutrient intake to recover and gain weight
Encourage continued physical activity
Late stage: Provide comfort
Advise on treating opportunistic infections
Counsel to modify diet according to symptoms
Encourage eating and physical activity
Nutrition Actions for HIV-
Infected People
To prevent weight loss
Promote adequate energy and protein intake
Individualize meal plan and modify to match medication
regime or health changes
Advise changing lifestyles that negatively affect energy
and nutrient intake
To improve body composition
Promote regular exercise to preserve muscle mass
Promote steroids
To improve immunity and prevent infections
Promote increased vitamin and mineral intake
Promote food safety
Promote use of ARVs to reduce viral load
Algorithm for Managing Weight
Loss in Patients with HIV/AIDS
Energy OK Diarrhea or mal- NO Metabolic Etiology unknown
intake? absorption? parameters Normal or unclear
RX=Continue to
LOW YES Abnormal
feed and observe