NUTRITION AND HEALTH STATUS OF HIV-INFECTED ADULTS ON ARVS AT AMREF CLINIC KIBERA URBAN SLUM, KENYA

The health of people living with HIV and AIDS (PLWHA) is nutritionally challenged in many nations of the world. The scourge has reduced socio-economic progress globally and more so in sub-Saharan Africa (SSA) where its impact has been compounded by poverty and food insecurity. Good nutrition with proper drug use improves the quality of life for those infected but it is not known how PLWHA exposed to chronic malnutrition and food shortages from developing nations adjust their nutrition with use of Anti-Retro-viral Drugs (ARVs). This study assessed nutritional status, dietary practices, and dietary management of common illnesses that hinder daily food intake by the patients and use of ARVs with food recommendations provided by the health care givers. A descriptive case study design was used to sample 120 HIV-infected patients using systematic sampling procedure. These patients sought health care from an urban slum, Kibera AMREF clinic. Data were collected by anthropometric measurements, bio-chemical analysis, semi-structured questionnaire and secondary data. The Statistical Package for Social Sciences (SPSS) and the Nutri-Survey software packages were used to analyze data. Dietary intakes of micro-nutrients were inadequate for >70% of the patients when compared to the Recommended Daily Requirements. When Body Mass Indices (BMI) were used, only 6.7% of the respondents were underweight (BMI<18.5kg/m2) and 9.2% were overweight (BMI> 25kg/m2), serum albumin test results (mean 3.34±0.06g/dl) showed 60.8% of the respondents were protein deficient and this was confirmed by low dietary protein intakes. The BMI was not related to dietary nutrient intakes, serum albumin and CD4 cell counts (p>0.05). It appeared that there was no significant difference in BMI readings at different categories of CD4 cell count (p>0.05) suggesting that the level of immunity did not affect weight gain with ARV as observed in many studies from developed countries. Malnutrition was, therefore, evident among the 60.8% of the cases as identified by serum albumin tests and food intake was not adequate (68%) for the patients as they ate once a day due to lack of food. National food and nutrition policy should incorporate food security boosting guidelines for the poor people infected with HIV and using ARVs.

FEEDING AND DIABETES MELLITUS: PERCEPTION AND FOOD CONSUMPTION BY ELDERLY PEOPLE IN THE HINTERLANDS OF PERNAMBUCO

Objective: To evaluate the knowledge of diabetes diet and identify factors that may interfere with the adherence to nutritional therapy and food choices of participants in a Community Center for the Elderly in Sairé, PE. Methods: A quantitative, descriptive and cross-sectional study, which evaluated 39 attendees of that center, from July to August 2014, with or without diabetes mellitus. Two questionnaires were applied to assess socioeconomic data, nutrition knowledge and cultural factors, and check the consumption of food with high and low glycemic index. Data was analyzed using the Assistat Program 7.0 Beta version. Results: The majority of the respondents have knowledge about types of foods that may influence the treatment of diabetes mellitus, as 51.2% (n=20) reported knowing some food that can reduce the risk for diabetes onset or assist in its treatment. Most of the participants reported having acquired such knowledge through the television 35% (n=7) and conversation with peers 35% (n=7). Evaluation of the food intake evidenced higher consumption of foods with high glycemic index. However, among diabetic patients, foods with low glycemic index are consumed more times per week. Conclusion: The knowledge about nutrition and diabetes mellitus was considered adequate, but socioeconomic and cultural factors may interfere in the adherence to diet therapy for diabetes or in the food choices made by the individuals. However, food consumption was considered appropriate among diabetics.

VITAMIN “A” FOOD CONSUMPTION BY PREGNANT WOMEN IN BRAZIL: A SYSTEMATIC REVIEW

Objective: To conduct a systematic review of the Vitamin “A” food consumption by pregnant women in Brazil. Methods: The review consisted of a search for articles published in the period from 1999 to 2015 in SciELO, PubMed, and LILACS databases. At the end, eight articles were selected for this review. Results: The methods used for the analysis of the intake of vitamin “A” were: food frequency questionnaire (FFQ) – considering the diet or only vitamin “A” foods and the dietary recall (24hDR). Only two articles estimated the adequacy of the Vitamin “A” food consumption by the population assessed. Some methodological limitations were quite frequent, emphasizing the lack and/or limitation of information on the sample representativeness, loss of studies, accuracy of the methods applied and the control of confounding variables. Conclusion: It is observed that there are still few studies that critically assess the Vitamin “A” food consumption by pregnant women in Brazil, and that the identification and control of possible biases of the dietary surveys can improve the reliability of the information found.

Complications associated with malnutrition in elective surgical patients in a Malaysian setting

Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A prospective, observational study was conducted with the objectives of identifying the degree of malnutrition, complications and the need for nutritional support in elective surgical patients. Collection of data was performed in local tertiary hospitals using a Patient Generated Subjective Global Assessment (PG - SGA) nutritional screening tool and medical records. Results: A total of 50 patients electively admitted for surgery were included. The results demonstrated that there was a significant increase in malnourished patients post-surgery compared to pre-surgery (p = 0.0001). Most interesting was the significant number of complications observed post-surgery compared to pre-surgery (p = 0.035) which was associated to the poor level of nutrition. The most common type of complications noted post-surgery were nosocomial infection, wound infection and readmission. Conclusion: Malnutrition is prevalent pre- and post-operatively in Malaysia. Therefore, focus on the outcome of these malnourished patients should be performed to reduce complications associated with poor nutrition.

Oral glutamate intake reduces acute and chronic effects of ethanol in rodents

Purpose: To assess the effects of oral glutamate intake on acute motor effects and chronic intake of ethanol in rodents. Methods: The acute effects of ethanol on motor function were studied in ICR mice by giving 2 or 6 g/kg of ethanol 2 h after distilled water or 2.5 g/kg glutamate per os. Thirty minutes after ethanol treatment, behavioral assays, including rotarod tests and foot print analysis were monitored. In chronic ethanol treatment, male Wistar rats were trained to consume ethanol-sucrose solution during a 2-h period daily, starting with 2 % ethanol/10 % sucrose and gradually increasing to 10 % ethanol/5 % sucrose solution over 56 days. After training session, the drug treatment phase was done for 10 days. The animals were force-fed 50 mg/kg/day topiramate or 2.5 g/kg/day glutamate 2 h before ethanol treatment sessions. Each day, ethanol intake, water intake, food intake and body weight were recorded. Results: Mice that received 2 or 6 g/kg of ethanol orally, showed a significant reduction in time on the rod in the rotarod test and a significant increase in both forelimb and hindlimb stride lengths when compared to control. Oral treatment with 2.5 g/kg of glutamate reversed the acute motor effects of ethanol. In chronic ethanol treatment, the intake of 10 % ethanol/5 % sucrose, accessible for 2 h, was significantly decreased in rats treated with either topiramate or glutamate. Conclusion: These results provide evidence that oral glutamate administration help to reduce the acute motor effects of ethanol in mice and ethanol intake in the chronic ethanol drinking rats.