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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
close this folderCHAPTER 15: HIV/AIDS AND NUTRITION
View the document15.1 Malnutrition and HIV/AIDS
View the document15.2 Nutrient Requirements for People Living with HIV/AIDS (PLHA)
View the document15.3 Good Dietary Practices
View the document15.4 Dietary Practices and Nutrition for Adult PLHA and AIDS Related Symptoms
View the document15.5 Nutritional Issues Associated with ARVs and Other Modern Medicines
View the document15.6 Guidance on Effective Nutrition/Medication Management for Antiretroviral Therapy (ART)
View the document15.7 AIDS-wasting Syndrome
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

15.3 Good Dietary Practices

Good dietary practices play an important role in maintaining a healthy lifestyle and healthy body. An HIV-infected person already has a weakened immune system. A nutritious diet can help maintain the proper functioning of the immune system and provides needed energy, protein, and micronutrients during all stages of the HIV infection. This can be obtained through a balanced meal.

Balanced Meal

There is no single food that contains all the nutrients that the body needs, except breast milk for infants up to six months of age. For a balanced meal use at least one food from each of the following food groups.

• Cereals, roots, tubers, bananas

These are mainly staples. They include maize, millet, rice, sorghum, cassava, yams, potatoes and bananas. Foods in this group provide energy

• Pulses, nuts and foods of animal origin

Foods in this group include groundnuts, cashew nuts, meat, fish, milk, eggs, insects e.g. senene, kumbikumbi, and caterpillars, beans, peas etc. These provide protein

• Fruits

This group includes all types of fruits such as mangoes, oranges, guava, tangerines, bananas, ubuyu, ukwaju, mabungo etc. They are good sources of vitamins and minerals

• Vegetables

This group includes all types i.e exotic and indigenous vegetables such as sweet potato leaves, pumpkin leaves, tomatoes, amaranth, okra, carrots, pumpkins, mlenda, figiri, mnavu. The foods in this group provide vitamins and minerals

• Sugar and fats

These are needed in small amounts; they include ghee, lard, butter, margarine, coconut oil, sunflower, sugars like honey etc. Such foods are very rich in energy

• Water

Although water is not part of the food groups it is important for life and is necessary everyday. Water aids digestion, absorption and transportation of nutrients in the body. It is recommended that a person should drink at least eight glasses (1.5 litres) a day.

It is important to eat variety of foods together, because some of the foods depend on each other for some nutrients to be utilized well by the body e.g. for absorption of iron from vegetables vitamin C is needed therefore vegetables should be eaten with fruits; also energy is utilized well in presence of vitamin B in the food.

Nutrient requirements for HIV+ Individuals (WHO 2003)

• Energy: is increased by 10% asymptomatic stage and 20-30% during symptomatic HIV
• Protein: No evidence of additional need
• Multiple Micronutrient Supplements:

- Best achieved through adequate diet. Where intakes cannot be achieved, micronutrient supplements may be needed. (at RDA levels).

- There is evidence that some micronutrient high dose supplements eg. Vit. A, Zinc and Iron can produce adverse outcomes in PLHA

- Iron-folate supplementation for pregnant and lactating women:

No change on the usual recommendation (400µg folate and 60 mg iron daily for prevention and X2 per day for treatment)

- The usual additional nutritional requirements for pregnant and lactating women apply.


TIPS FOR HEALTHY AND NUTRITIOUS LIFESTYLES for PLHA

• Eat variety of foods

• Eat small meals frequently (especially for a very sick person)

• Be physically active, avoid alcohol, avoid smoking

• Add nutrient-dense foods (nuts, oil, fat, milk, oil seeds)

• Use spices for appetite and absorption: ginger, garlic, cardamom, lemon

• Germination and sprouting; fermentation (increases nutrient content and improves digestions and absorption

• Observe food safety, improve cooking methods and hygiene principles


Table 15.1 describes the role of various micronutrients and their importance for maintaining a healthy body and provides examples of foods that are rich sources of micronutrients. Some of the foods listed are available only during specific seasons.

Table 19: The Role and Sources of Selected Micronutrients

Micronutrient

Role

Food sources

Vitamin A

Growth and function of T and B cells for immunity, maintenance of mucosal epithelial cells, including the lining of the respiratory, gastrointestinal and gastro urinary tracts; vitamin A deficiency is associated with increased adult mortality, higher infant mortality, and child growth failure.

Liver and dairy products, kidney, egg, some fishes, yellow sweet potato, pumpkin, palm oil, carrot, dark green leafy vegetables, fruits, such as papaya and mango.

Thiamine Vitamin B1

Important for energy metabolism; support appetite and nervous system functions

Whole- grain cereals, beans, meat, fish, chicken, egg

Riboflavin Vitamin B2

Important for energy metabolism; support normal vision, health, and integrity of skin

Milk, egg, liver, yogurt, meat, dark green leafy vegetables, whole grain cereals, fish and beans

Niacin Vitamin B3

Essential for energy metabolism, support health and integrity of the skin and nervous and digestive systems

Milk, egg, meat, poultry, peanuts, groundnuts, whole-grain cereals, fish

Pyridoxine Vitamin B6

Facilitates metabolism and absorption of fats and protein; helps make red blood cells

Sweet potato, white beans, avocado, cabbage, broccoli, meat, fish, green leafy vegetables

Cobalamin Vitamin B12

Important for new cell development and maintenance of the nerve cells

Red meat, fish, chicken, shellfish, cheese, eggs, milk, fermented products

Ascorbic Acid Vitamin C

Important for protein metabolism, immune and function and iron absorption; increases resistance to infections

Citrus fruits, such as orange, lemon, tangerine, guava, baobab, tomato

Vitamin E

Protects cell structures and facilitates resistance against diseases

Leafy vegetables, vegetable oils, peanut, egg yolk, vegetables, nuts, seeds, and liver

Calcium

Builds strong bones and teeth; important for functioning of heart and muscle functions, blood clotting and pressure and immune defences

Milk, dark green leafy vegetables, shrimp, dried fish, beans, lentils, peas, whole grain millet, oil seeds

Iodine

Ensures the development and proper functioning of the brain and the nervous system; important for growth development and metabolism

Fish and other seafood, salt with iodine

Iron

Transports oxygen to the blood, eliminates old red blood cells and builds new cells; required for utilization of energy and metabolism by cells

Red meat, poultry, shellfish, egg, peanut, groundnuts, leafy vegetables, lentils, beans, some cereals, dried fruits

Magnesium

Strengthens the muscles; important for nervous system function, involved in bone development, maintenance of teeth

Cereals, dark green vegetables, seafood, nuts, legumes, groundnuts

Selenium

Prevents impairment of the heart muscle; enhances the body’s antibacterial and antiviral defences

Seafood, liver, meat, nuts, unrefined grains, brown rice, wheat germ, whole grain cereals, carrot, onion, milk, egg

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