Nutrition and HIV/AIDS: A Training Manual - Linkages Project

IncreaseVitamin and Mineral IntakeStrategies to increase vitamin and mineral intake toreplenish or build body stores and optimize immunefunction• Food-based approaches− Include local vegetables, vitamin-enriched or fortified localproducts (maize meal, wheat or soy flour, margarine, cereals)− Have no undesirable side effects− Are affordable• Nutrient supplements− Are more absorbable by sick person− Multivitamin and multiple-micronutrient supplements arebetter than than single vitamins and mineralsSuggested Nutrient SupplementIntake in HIV/AIDSVitamin ARDA=5,000 IU)Vitamin EVitamin BVitamin CSeleniumZinc2-4 RDA (13,000-20,000IU)400-800 IUHigh-potency B complex(e.g., B-25 or B-50 withniacin and B6)1,500-2,000mg200mcg1 RDA (12-19mg)Source: Serono 1999; Tang et al 1996. Excerpts from Eat upAdverse Effects of Too MuchIntake of Nutrient SupplementsVitamin E: Malabsorption of vitamins A and K andgastrointestinal upsetsVitamin C: Gastrointestinal upsets, iron overabsorptionand abdominal bloatingIron: Gastrointestinal bleeding (manifested by vomiting andbloody diarrhea) and possible stimulation of viral replicationZinc: Gastric distress, nausea, reduced immunefunction that favors viral replication (HDL reported insupplements of > 300mg/day)Vitamin B: Gastrointestinal upsetsSelenium: Skin lesions, nausea, and vomitingPromote Food Safetyto Prevent Food-Borne IllnessEducate clients to avoid products that• Contain raw or undercooked meat• Have expired• Are in damaged or bulging packing• Are displayed unsafely (e.g., mixing raw and cookedfoods or meats with fruits and vegetables)• Are sold in unsanitary conditions or by workers withpoor personal hygiene or food handling practicesSource: Afacan et al 2002, Tang et al 1996; Ziegler and Filler 1996Monitor the Client’s Well-beingFollow up and ReviewFollow up• Integrate with other care and support activities whereavailable• Do continuously in facility and home• Include monitoring of health, nutrition, and dietaryindicators• Include counseling to address barriers to good nutrition• Offer support and encouragementReview• Meal plans• Exercise regimens• Use of medicines• Compliance with meal requirements