Nutrition and HIV/AIDS: A Training Manual - Linkages Project
Nutrition and HIV/AIDS: A Training Manual - Linkages Project
Nutrition and HIV/AIDS: A Training Manual - Linkages Project
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What Is Not KnownComparison of <strong>Nutrition</strong>al RisksIncreased requirements for energy, protein,<strong>and</strong> other nutrients for the <strong>HIV</strong>- positivepregnant <strong>and</strong> lactating woman• 2003 WHO technical consultation on <strong>HIV</strong> <strong>and</strong> nutritionfound no data to suggest increased energyrequirements for <strong>HIV</strong>-infected pregnant or lactatingwomen compared with non-infected pregnant <strong>and</strong>lactating women; stated that increased energy needs inpregnancy <strong>and</strong> lactation were the same as for otherinfected adults<strong>HIV</strong>+ mother• Increased energy, protein <strong>and</strong> othernutrients secondary to dem<strong>and</strong>s ofpregnancy or lactation• Increased energy <strong>and</strong> micronutrientneeds secondary to <strong>HIV</strong> infection• Increased risk of opportunisticinfections <strong>and</strong> therefore ofmalnutrition• Increased risk of weight loss <strong>and</strong>delivery of a low-birth weight babybecause of <strong>HIV</strong> infection• Increased risk of inadequate dietaryintake <strong>and</strong> therefore of malnutritionbecause of depression, isolation, orstigmatization• Increased risk of MTCT with poornutritional status <strong>and</strong> throughbreastfeeding<strong>HIV</strong>- mother• Increased energy, protein <strong>and</strong> othernutrients secondary to dem<strong>and</strong>s ofpregnancy or lactationRecommended Energy <strong>and</strong> ProteinRequirements in PregnancyRecommended Energy <strong>and</strong> ProteinRequirements during LactationFAO/WHO1985Energy requirements285 kcal/day abovenon-pregnant levels ifphysical activity ismaintained200 kcal/day abovenon-pregnant levels ifphysical activity isreducedProtein requirements3.3g/day of high qualityprotein throughoutpregnancyFAO/WHO1985Energy requirementsExtra 500 Kcal/dayabove non-lactatinglevels (increase ifbreastfeeding morethan one child)Protein requirementsExtra 16g/day for the first 6months of lactation,12g/day for the second 6months, <strong>and</strong> 11g/daythereafterInstitute of 300 kcal/day aboveMedicine 1990 non-pregnant levels60g/day of proteinSource: FAO/WHO/UNU. 1985. Energy <strong>and</strong> protein requirements. Report ofa Joint FAO/WHO/UNU Expert Consultation. Geneva.Recommended MicronutrientSupplementationWHO/UNICEF recommend iron <strong>and</strong> folate duringpregnancy <strong>and</strong> lactationWhere anemia prevalence is < 40 %• 60mg iron + 400mcg folic acid daily for 6 months inpregnancy• If started late, extended 6 months post-natally• If impossible, dose increased to 120mg iron in pregnancyWhere anemia prevalence is > 40%• 60 mg iron + 400 mcg folic acid daily for 6 months inpregnancy• Continued 3 months post-partum• Daily multivitamin supplement where available<strong>Nutrition</strong>al Requirements for <strong>HIV</strong>+Pregnant <strong>and</strong> Lactating WomenIncreased energy requirements for <strong>HIV</strong>-infectedpregnant <strong>and</strong> lactating women are the same as forother <strong>HIV</strong>-infected adults• 10% increase in energy requirements during asymptomatic<strong>HIV</strong> infection• 20%30% increase during symptomatic <strong>HIV</strong> infectionThe additional increment in energy is added to thebasic energy requirement for age/activity/weight,not to the additional calories for pregnancy orlactation
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