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Effects on body composition and handgrip strength of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy: a randomised controlled trial.
- Source :
-
Journal of nutritional science [J Nutr Sci] 2019 May 16; Vol. 8, pp. e19. Date of Electronic Publication: 2019 May 16 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m <superscript>2</superscript> were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium ( <superscript>2</superscript> H) diluted water (D <subscript>2</subscript> O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D <subscript>2</subscript> O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D <subscript>2</subscript> O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI -0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D <subscript>2</subscript> O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.
- Subjects :
- Adolescent
Adult
Aged
Anti-Retroviral Agents therapeutic use
Body Mass Index
CD4 Lymphocyte Count
Deuterium
Electric Impedance
Female
HIV Infections drug therapy
Humans
Lipids administration & dosage
Lipids therapeutic use
Male
Malnutrition complications
Malnutrition diet therapy
Middle Aged
Minerals administration & dosage
Minerals therapeutic use
Plethysmography
Tanzania
Treatment Outcome
Vitamins administration & dosage
Vitamins therapeutic use
Young Adult
Zambia
Anti-Retroviral Agents adverse effects
Body Composition drug effects
Dietary Supplements
HIV Infections complications
Hand Strength
Subjects
Details
- Language :
- English
- ISSN :
- 2048-6790
- Volume :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of nutritional science
- Publication Type :
- Academic Journal
- Accession number :
- 31143445
- Full Text :
- https://doi.org/10.1017/jns.2019.15