scholarly journals FRAILTY, FOOD INSECURITY, AND NUTRITIONAL STATUS IN PEOPLE LIVING WITH HIV

2015 ◽  
pp. 1-7
Author(s):  
E. SMIT ◽  
C. WANKE ◽  
K. DONG ◽  
A. GROTHEER ◽  
S. HANSEN ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Food Insecurity ◽  
Daily Living ◽  
Average Weight ◽  
People Living With Hiv ◽  
Unintentional Weight Loss ◽  
Average Weight Loss ◽  
Living With Hiv

Background: Nutritional status and food insecurity are associated with frailty in the general U.S. population, yet little is known about this in the aging population of people living with HIV (PLWH). Objectives: Given the potential importance of nutrition and the amenability to intervention, we examined the association between nutritional status, food insecurity, and frailty in PLWH. Design: Cross sectional study. Setting: Boston, Massachusetts, U.S.A. Participants: 50 PLWH, age ≥45 years, recruited from a cohort study examining risk factors for cardiovascular disease. Measurements: Frailty, duration of HIV, use of antiretroviral therapy, disease history, food insecurity, physical function, and physical activity were assessed by questionnaire. Dietary intake was assessed using 3-day food records. Blood was drawn for CD4+ cell count, hemoglobin, hematocrit, and lipid levels. Physical measurements included height, weight, and skinfold thickness. Results: The prevalence of frailty was 16% (n=8), 44% were pre-frail (n=22) and 40% were not frail (n=20). The number of reported difficulties with 20 activities of daily living was highest in frail (mean 10.4±3.9 SD), followed by pre-frail (6.5±4.6), and lowest in not frail participants (2.0±2.3). Seven (88%) of the frail PLWH lost weight with an average weight loss of 22.9 pounds; 6 (75%) reported unintentional weight loss, and all 6 of these met the frailty criteria for weight loss of 10 or more pounds. Nine (45%) of the not frail PLWH reported losing weight with an average weight loss of 6.2 pounds; 5 (23%) reported unintentional weight loss of <10 pounds. Frail PLWH were more likely to report being food insecure than not frail PLWH (63% vs. 10%, p=0.02), and tended to have lower energy intake than not frail PLWH. Conclusion: Research is needed on targeted interventions to improve food security and activities of daily living in PLWH for both the prevention and improvement of frailty.

scholarly journals Relapse of undernutrition and food insecurity in a nutritional program in HIV care: mixed-methods study in Tigray region, Ethiopia.

2020 ◽  
Author(s):  
Fisaha Tesfay ◽  
Anna Ziersch ◽  
Sara Javanparast ◽  
Lillian Mwanri
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Nutritional Status ◽  
Food Insecurity ◽  
Functional Status ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Tigray Region ◽  
Nutritional Recovery ◽  
Living With Hiv

Abstract Background Food insecurity is one of the major contributors to poor attainment of nutritional recovery among people living with HIV who are enrolled in nutritional programs. Nevertheless, nutritional programs in HIV care settings implemented in many countries are not designed to address food insecurity. This study in Tigray region Ethiopia examined relapse of undernutrition, and in particular how food insecurity had an impact on effectiveness of the nutritional program, specifically relapse of undernutrition after nutritional recovery Methods This study employed mixed-methods approach involving quantitative and qualitative methods. In the quantitative part, hospital records were collected of 1757 adults and 236 children living with HIV who were enrolled in the nutritional program. Logistic and cox-regression analysis were used to analyse the data. In the qualitative study, data was collected through in-depth interviews with 20 adults, 15 caregivers of children living with HIV, and 13 health providers and program managers. Thematic framework analysis was used to analyse the qualitative data. Results Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed. Lower educational status (primary and secondary), no membership of a community HIV support group, ambulatory and bedridden functional status, longer periods on ART (more than 24 months), presence of an opportunistic infection and poor baseline nutritional status were associated with relapse. Furthermore, those from rural areas, who did not attend formal education, were employed and had bedridden functional status, anaemia and worst nutritional status were likely to have more frequent episodes of relapse than their counterparts. Findings of the qualitative study also highlighted that poverty, poor livelihood, and food insecurity were the fundamental challenges to the effectiveness of nutritional programs in HIV care including relapse. Household food insecurity contributed to the selling and sharing of the nutritional supports and negatively impacted program effectiveness by contributing to relapse of undernutrition. Conclusions Unless nutritional programs take into consideration the underlying determinants of food insecurity in the design, implementation, and funding of nutritional programs in HIV care, the success of the nutritional programs like those implemented in Ethiopia will be undermined.

Influence of Acupuncture on Bioelectrical Impedance Measures in Patients with Gastrointestinal Cancer: Results of a Pilot Study

2015 ◽  
Vol 33 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Oliver Grundmann ◽  
Saunjoo L Yoon ◽  
Joseph J Williams
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Pilot Study ◽  
Nutritional Status ◽  
Bioelectrical Impedance ◽  
Small Sample ◽  
Controlled Study ◽  
Average Weight ◽  
Gastrointestinal Cancers ◽  
Average Weight Loss

Background Patients with gastrointestinal cancers often suffer from malnutrition and cachexia caused by inflammatory processes due to malignancy and therapeutic intervention. Evaluation of nutritional status and well-being of patients is essential to prevent or slow down the progression of cachexia. In addition, acupuncture as a complementary intervention may help reduce cachexia and unintentional weight loss. Methods Seven patients with cancers of the gastrointestinal tract enrolled in this pilot study were provided with eight acupuncture sessions in addition to their regular treatment schedule. Bioelectrical impedance analysis (BIA) measurements were taken at every other acupuncture session to evaluate the body composition of patients. BIA is a fast, inexpensive and non-invasive method for evaluating fluid, fat and muscle mass distribution which correlates with nutritional status. Results All patients enrolled in the pilot study completed the acupuncture intervention and BIA measurements. The average weight loss and reduction in body weight was 1.3%, which is less than the average weight loss of 5% reported in the literature. Both phase angle and fat-free mass decreased in patients, indicating a worsening of the condition. However, a shift from intracellular to extracellular fluid was not observed, which is usually associated with a loss of cell integrity. Conclusions This pilot study indicates that patients tolerate acupuncture treatments well. The BIA results should be interpreted with caution due to the small sample size. A larger randomised placebo-controlled study is currently being conducted to further investigate the influence of acupuncture and to provide insights into BIA as a reliable tool for evaluating body composition in patients with gastrointestinal cancers.

scholarly journals Relapse of undernutrition and food insecurity in a nutritional program in HIV care: mixed-methods study in Tigray region, Ethiopia.

2020 ◽  
Author(s):  
Fisaha Haile Tesfay ◽  
Anna Ziersch ◽  
Sara Javanparast ◽  
Lillian Mwanri
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Nutritional Status ◽  
Food Insecurity ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Tigray Region ◽  
Nutritional Recovery ◽  
Time To Relapse ◽  
Living With Hiv

Abstract Introduction Food insecurity is one of the major contributors to poor attainment of nutritional recovery among people living with HIV who are enrolled in nutritional programs. Food insecurity also significantly contributes to high rates of relapse after nutritional recovery among the beneficiaries nutritional programs. Nevertheless, nutritional programs in HIV care settings implemented in many countries are not designed to address food insecurity. This study examined a nutritional program delivered in HIV care settings in the Tigray region, Ethiopia. It explored the factors that contributed to relapse of undernutrition, and in particular how food insecurity had an impact on effectiveness of the nutritional program, specifically relapse of undernutrition after nutritional recovery. Methodology This study employed mixed-methods approach involving quantitative and qualitative methods. In the quantitative part, hospital records were collected of 1757 adults and 236 children people living with HIV who were enrolled in the nutritional program. Logistic and cox-regression analysis were used to examine the frequency and determinants of relapse of undernutrition. In the qualitative study, data was collected through in-depth interviews with 20 adults, 15 caregivers of children living with HIV, and 13 health providers and program managers. Thematic framework analysis was used to analyse the qualitative data. Results Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed to undernutrition. The mean time to relapse for adults was 68.5 months (95% CI, 67.0–69.9). It was not possible to calculate the average time to relapse in children because of the small sample size. Lower educational status (primary and secondary), no membership of a community HIV support group, ambulatory and bedridden functional status, longer periods on ART (more than 24 months), presence of an opportunistic infection and poor baseline nutritional status were associated with relapse of undernutrition. Furthermore, those from rural areas, who did not attend formal education, were employed, and had bedridden functional status, anemia and worst nutritional status were likely to have more frequent episodes of relapse than their counterparts. Findings of the qualitative study also highlighted that poverty, poor livelihood, and food insecurity were the fundamental challenges to the effectiveness of nutritional programs in HIV care. Household food insecurity contributed to the selling and sharing of the nutritional supports and negatively impacted the program effectiveness, delaying nutritional recovery and contributing to relapse of undernutrition. Conclusion and recommendation Unless nutritional programs take into consideration the underlying determinants of food insecurity in the design, implementation, and funding of nutritional programs in HIV care, the success of the nutritional programs like those implemented in Ethiopia will be undermined and the vicious cycle of undernutrition amongst people living with HIV will continue.

scholarly journals Food access and diet quality independently predict nutritional status among people living with HIV in Uganda

2012 ◽  
Vol 16 (1) ◽  
pp. 164-170 ◽  
Author(s):  
Suneetha Kadiyala ◽  
Rahul Rawat
Keyword(s):  
Food Security ◽  
Nutritional Status ◽  
Food Insecurity ◽  
Diet Quality ◽  
Dietary Diversity ◽  
People Living With Hiv ◽  
Arm Circumference ◽  
Effect Of Food ◽  
Mid Upper Arm Circumference ◽  
Living With Hiv

AbstractObjectiveAlthough undernutrition is recognized as a risk factor for mortality among people living with HIV (PLWHIV), even among those initiating antiretroviral therapy, few studies have explored the underlying determinants of undernutrition. The objectives of the present study were to: (i) examine the independent association between household food security, individual diet quality and nutritional status; and (ii) determine if any association between food security and nutritional status is mediated through diet quality.DesignCross-sectional baseline survey.SettingGulu and Soroti districts, Uganda.SubjectsNine hundred and two PLWHIV recruited into a study evaluating the impact of a food assistance programme supported by the World Food Programme.ResultsFood security and diet quality were measured using the Household Food Insecurity Access Scale (HFIAS) and the Individual Dietary Diversity Score (IDDS), respectively. Multivariate regression results demonstrated that HFIAS and IDDS independently predict BMI (P < 0·01) and mid upper-arm circumference (P < 0·05). The adjusted odds ratio of being underweight (BMI < 18·5 kg/m2) among individuals living in severely food-insecure households was 1·92 (P < 0·0 0 1); individuals consuming a highly diverse diet had an adjusted odds ratio of being underweight of 0·56 (P < 0·05) compared with those consuming a diet of low diversity. Similar results were observed when mid upper-arm circumference and wasting were modelled as outcomes. Using path analysis, we observed that the indirect effect of food insecurity on BMI mediated through dietary diversity is negligible, and mostly a result of the direct effect of food insecurity on BMI.ConclusionsOur results provide an empirical basis for focused efforts on improving food access and diet quality among PLWHIV. Addressing the broader structural determinants of food security of people infected and affected by HIV is crucial.

Nutritional status, activities of daily living and physical activity in aged residents in 10 German nursing homes*

2007 ◽  
Vol 32 (03) ◽  
Author(s):  
J Bai ◽  
S Lesser ◽  
S Paker-Eichelkraut ◽  
S Overzier ◽  
S Strathmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Nursing Homes ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Daily Living

Inflammation, Functional Status, and Weight Loss During Recovery From Cardiac Surgery in Older Adults

2013 ◽  
Vol 16 (3) ◽  
pp. 344-352 ◽  
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Eileen M. Sullivan-Marx ◽  
Charlene Compher
Keyword(s):  
Weight Loss ◽  
Cardiac Surgery ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Grip Strength ◽  
Daily Living ◽  
Community Dwelling ◽  
Chair Stand ◽  
Prospective Longitudinal ◽  
Over Time

Objective: To determine the nutritional, inflammatory, and functional aspects of unintentional weight loss after cardiac surgery that warrant further investigation. Research Methods and Procedures: Twenty community-dwelling adults > 65 years old undergoing cardiac surgery (coronary artery bypass graft [CABG] or CABG + valve) were recruited for this prospective longitudinal (preoperative and 4–6 weeks postdischarge) pilot study. Anthropometrics (weight, standing height, and mid-arm and calf circumference), nutritional status (Mini-Nutritional Assessment™ [MNA]), appetite, physical performance (timed chair stand), muscle strength (hand grip) and functional status (basic and instrumental activities of daily living), and inflammatory markers (plasma leptin, ghrelin, interleukin [IL]-6, high-sensitivity[hs] C-reactive protein, and serum albumin and prealbumin) were measured. Results: Participants who completed the study ( n = 11 males, n = 3 females) had a mean age 70.21 ± 4.02 years. Of these, 12 lost 3.66 ± 1.44 kg over the study period. Weight, BMI, activities of daily living, and leptin decreased over time ( p < .05). IL-6 increased over time ( p < .05). Ghrelin, hs-CRP, and timed chair stand increased over time in those who underwent combined procedures ( p < .05). Grip strength decreased in those who developed complications ( p = .004). Complications, readmission status, and lowered grip strength were found in those with low preoperative MNA scores ( p < .05). Conclusion: After cardiac surgery, postdischarge weight loss occurs during a continued inflammatory response accompanied by decreased physical functioning and may not be a positive outcome. The impacts of weight loss, functional impairment, and inflammation during recovery on disability and frailty warrant further study.

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