session 1: the nutrition and hiv link nutrition management with hiv and aids: practical tools for...
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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
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Nutrition BasicsNutrition Basics
Foods contain nutrients in various quantities
• Macronutrients• Carbohydrates• Protein• Fats
• Micronutrients• Vitamins• Minerals
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Food GroupsFood Groups
4 Food Groups
• Cereals and Staple Grains
• Animal Foods, Milk Products, and Beans
• Fruits and Vegetables
• Fats and Sugar
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Grains: MaizeGrains: Maize
Courtesy of Linda Larsdotter, 2005
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Dried FishDried Fish
© I-TECH, 2005
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Dried Mopani WormsDried Mopani Worms
© I-TECH, 2005
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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SpinachSpinach
© I-TECH, 2005
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Dried Eenyandi FruitDried Eenyandi Fruit
© I-TECH, 2005
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Important Vitamins and MineralsImportant Vitamins and Minerals
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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Important Vitamins and MineralsImportant Vitamins and Minerals
Vitamin E
• Function: forms and protects cells
• Foods: vegetable oils, nuts, seeds, grains, eggs, legumes, dark green vegetables
• Deficiencies: decreased immune function
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Important Vitamins and MineralsImportant Vitamins and Minerals
Iron
• Function: carries oxygen through body, builds immune system
• Foods: Liver, meat, chicken, fish, eggs, dried beans, green vegetables, cereals
• Deficiencies: anaemia, fatigue, weakness
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Important Vitamins and MineralsImportant Vitamins and Minerals
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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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Important Vitamins and MineralsImportant Vitamins and Minerals
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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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The Immune System and HIVThe Immune System and HIV
© ITECH, 2006
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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)
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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ExerciseExercise
Why exercise?
• Keep muscles strong
• Keep bones strong and prevent osteoporosis
• Maintain weight
• Keep immune system strong
• Improve appetite
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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
Session 1: The Nutrition and HIV LinkNutrition Management with HIV and AIDS Training
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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