Session 1: The Nutrition and HIV Link Nutrition Management with HIV and AIDS: Practical Tools for Health Workers

Session 1:Session 1:The Nutrition and HIV LinkThe Nutrition and HIV Link

Nutrition Management with HIV and AIDS: Practical Tools for Health Workers

Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training

Slide 2

ObjectivesObjectives

• Define nutrition• List foods from each food group, and at

least one nutrient that each food contains • Identify locally available foods from each

food group • Identify important vitamins and minerals

and their function• Explain the connections between HIV and

AIDS, the immune system, and nutrition


Slide 3

Definition of NutritionDefinition of Nutrition

• Nutrition is the science of foods • Involves the action, interaction, and balance of

nutrients in relationship to health and disease• Involves the processes by which food is

digested, absorbed, transported, utilised, and excreted in the body

• Nutrition is concerned with social, economic, cultural, and psychological implications of food and eating


Slide 4

Gastro-Intestinal TractGastro-Intestinal Tract

• Tube that runs from mouth to anus where food is ingested, digested, and absorbed into the body

• Foods enter through mouth, travel down through stomach and intestines, are absorbed into blood at various stages, then the unused food waste is excreted in faeces


Slide 5

Nutrition BasicsNutrition Basics

Foods contain nutrients in various quantities

• Macronutrients• Carbohydrates• Protein• Fats

• Micronutrients• Vitamins• Minerals


Slide 6

Nutrition Basics (2)Nutrition Basics (2)

• Include water every day

• Calories or Energy• Come from macronutrients – carbohydrates,

proteins, and fats• Provide energy to move and stay healthy• People with HIV and AIDS need more calories

than others


Slide 7

Food GroupsFood Groups

4 Food Groups

• Cereals and Staple Grains

• Animal Foods, Milk Products, and Beans

• Fruits and Vegetables

• Fats and Sugar


Slide 8

Cereals and Staple GrainsCereals and Staple Grains

• Provide energy, fibre, vitamins and minerals

• Starches or cereals: white or brown bread, mahangu, mealie-pap, macaroni, rice, or Weet-bix


Slide 9

Typical Grain in Natural FormTypical Grain in Natural Form

Courtesy of Nordin S. Permaculture, Nutrition and HIV Files CD Rom. 2006

Starch

Husk

Germ:Many

Nutrients

Bran:Protein,

Vitamins & Minerals


Slide 10

Grains: MaizeGrains: Maize

Courtesy of Linda Larsdotter, 2005


Slide 11

Animal Foods, Milk Products, and BeansAnimal Foods, Milk Products, and Beans

• Protein to build immune system and muscles

• Iron to prevent anaemia (iron deficiency)• Animal Sources: meat (beef, game, etc),

chicken, fish, eggs, insects, milk, cheese, yoghurt, sour milk

• Non-animal Sources: beans, lentils, peas, nuts and soy products (soy mince)

• Most sources contain some fat


Slide 12

Dried FishDried Fish

© I-TECH, 2005


Slide 13

Dried Mopani WormsDried Mopani Worms

© I-TECH, 2005


Slide 14

FatsFats and Sugars and Sugars

• Fats: butter, margarine, and oils

• Fat is a concentrated form of energy, some oils contain vitamins A and E

• Helps with weight gain

• Fat also naturally found in meats, fish and milk products


Slide 15

Fats and Fats and SugarsSugars

• Sugars: add calories (energy), but no protein, vitamins or minerals

• Sugars include cool drinks (Coke, Fanta), sweets, cakes, cookies, etc.

• Too much sugar can lead to cavities and promotes yeast and bacteria growth

• Cool drinks like Coke also have caffeine, which can dehydrate the body


Slide 16

Fruits and VegetablesFruits and Vegetables

• Provide mostly vitamins and minerals• Essential for body functions, building the

immune system and helping heal wounds and infections

• Provide carbohydrate-fibre for good digestive health


Slide 17

SpinachSpinach

© I-TECH, 2005


Slide 18

Dried Eenyandi FruitDried Eenyandi Fruit

© I-TECH, 2005


Slide 19

Important Vitamins and MineralsImportant Vitamins and Minerals

Vitamin A• Function: improves vision, immune system by

strengthening cells• Foods: yellow, orange, and dark green fruits and

vegetables, milk, liver, eggs and fish oil• Deficiencies: blindness, poor skin, teeth and

nails• Give vitamin A supplement as part of treatment

of severe malnutrition and diarrhoea in children


Slide 20


Vitamin C• Function: promotes healthy cells and tissues,

strong immune system, wound healing• Foods: oranges, lemons, grapefruit, paw-paw,

guava, green leafy vegetables, baobab fruit, eembe, and potatoes

• Deficiencies: decreased immune function, scurvy, poor wound healing, bleeding gums, bruising


Slide 21


Vitamin E

• Function: forms and protects cells

• Foods: vegetable oils, nuts, seeds, grains, eggs, legumes, dark green vegetables

• Deficiencies: decreased immune function


Slide 22


Iron

• Function: carries oxygen through body, builds immune system

• Foods: Liver, meat, chicken, fish, eggs, dried beans, green vegetables, cereals

• Deficiencies: anaemia, fatigue, weakness


Slide 23


Calcium• Function: keeps bones and teeth strong, helps

muscles and heart work better• Foods: milk, cheese, yoghurt/sour milk, fish (with

bones), dark green leafy vegetables• Need calcium-rich foods every day

• Deficiencies: poor growth and bone development, frequent leg cramps

• HIV medications can interfere with calcium absorption, causing weakened bones


Slide 24


Zinc• Function: protects and strengthens immune

system, heals wounds• Foods: seeds and nuts, grains, green leafy

vegetables, eggs, liver, seafood• Deficiencies: skin problems, low appetite, no

wound healing, slow growth in children• Give short-term zinc supplement as part of

treatment for diarrhoea, especially for children• 20mg/day for no more than 10-14 days


Slide 25

AntioxidantsAntioxidants

• Oxidation is when cells breakdown and release “free radicals” or substances that are harmful to cells

• Antioxidants are substances that prevent cell breakdown by slowing oxidation

• Vitamins and minerals found in fruits and vegetables act as antioxidants (vitamins A, C, E and Selenium)

• Oxidation occurs over time as we age, but faster with a disease or unhealthy lifestyle


Slide 26

The Nutrition and HIV LinkThe Nutrition and HIV Link

• The Immune System:• Cells to fight infections• HIV attacks these cells • Causes weakening of immune system and

infections• Nutrition helps keep the cells healthy and fight

infections


Slide 27

The Immune System and HIVThe Immune System and HIV

© ITECH, 2006


Slide 28

CD4 and Viral Load CountsCD4 and Viral Load Counts

• Poor nutrition status contributes to decrease in CD4 count and/or increase in viral load

• As CD4 counts decrease and viral load counts increase, greater need for nutrition to protect cells


Slide 29

HIV Impact on NutritionHIV Impact on Nutrition

• What’s the problem? • Extra burden on body • Decreased food intake and decreased

absorption due to disease and/or side effects from medications

• What can we do?• Early nutrition assessment, education and

treatment of nutrition-related problems


Slide 30

Nutrition Requirements for HIVNutrition Requirements for HIV

• Calories/Energy: increase to fight infections and prevent weight loss• 10 percent increase for all HIV patients• 20-30 percent increase with other infections

and co-infections such as TB, malaria, and pneumonia

• Protein: 12-15% of total calories from protein• Increase with infections only


Slide 31

Nutrition Advice for Persons with HIVNutrition Advice for Persons with HIV

• Eat at least 3 times a day to: • Maintain weight• Prevent side-effects and nutrient deficiencies

• If 3 large meals are not possible, try 5-6 smaller meals/snacks per day (every four to five hours)


Slide 32

Healthy EatingHealthy Eating

• Try to eat foods from each food group• What is a “balanced” diet?

• Most meals contain all nutrients (food groups)

• How do we “balance” our meals? • Use locally available foods


Slide 33

Balanced Mealequals

Healthy Meal

Grains: mahangu, sorghum,

cassava, maize, wheat, rice,

potatoProtein Foods:beans,

peas, nuts etc. or

animal food like milk, Mopani

worms, egg, meat, fish,

etc.

Fats: oilseeds,

oil, butter, avocado

Fruit:paw-paw, banana,

eenyandi, eembe, guava,

etc

spices, herbs

Vegetables:pumpkin, spinach,

carrots, etc

Use Namibian Food GroupsUse Namibian Food Groups


Slide 34

Stay HydratedStay Hydrated

• Drink at least 2 litres of liquids per day: boiled water, juice, non-caffeinated or non-alcoholic drinks

• Important for the cells in body to function • Caffeine and alcohol are dehydrating


Slide 35

ExerciseExercise

Why exercise?

• Keep muscles strong

• Keep bones strong and prevent osteoporosis

• Maintain weight

• Keep immune system strong

• Improve appetite


Slide 36

Types of ExerciseTypes of Exercise

• Walking or light jogging can improve appetite• Gardening or Farming

• Uses different muscles• Also provides food and source of income

• Stretching• Improves blood circulation and appetite• Only need 15-20 minutes a day

• See Handout 1.3: Exercises and Moving Bedridden Patients


Slide 37

Maintain weight and

prevent side

effectsStronger immune

system to fight

infections

Slower progression

of HIV and better

health

Optimal food intake,

balanced diet

Cycle of Good NutritionCycle of Good Nutrition


Slide 38

Key PointsKey Points

1. Balanced meals with variety of locally available foods are essential and include:

• Cereals and staple grains• Animal foods, milk products, and

beans• Fruits and vegetables• Fats and sugars


Slide 39

Key Points (2)Key Points (2)

2. Provide nutrition counselling for clients with HIV on how to improve nutrition, including information regarding:

• Use of Mixed Meal model for planning meals• Hydration• Exercise

Documents

Session 1: The Nutrition and HIV Link Nutrition Management with HIV and AIDS: Practical Tools for Health Workers