In the proposed project we will evaluate the effect of protein and micronutrients in meat on the health and nutritional well being of rural Kenyan women living with HIV and the health and development of their children, by means of a randomized nutrition intervention. Our long- term goal is to determine if a """"""""right mix"""""""" of food, that is sustainable, will protect the immune system, prevent severe infection and loss of body mass and enhance the quality of life of HIV-infected rural Kenyan women who are not yet experiencing nutritional and metabolic challenges associated with advanced HIV infection as well as protect the growth and development of their children who are certainly affected and may be infected from HIV. Our central hypothesis is that drug na?ve HIV-infected women and their HIV negative (affected) children and their HIV-infected children in rural Kenya, provided a meat derived supplement, have improved nutritional and clinical outcomes, growth and development in children and ability to carry out tasks of daily living in women compared to those given isocaloric soya supplements and those in a control group. We plan to test our central hypothesis and accomplish the overall objective of the application by pursuing the following specific aims that will provide a comprehensive assessment of the impact of meat.
Specific aim #1 : Measure the impact of a meat supplements on overall health, micronutrient status, body composition and progression of infection in drug na?ve HIV- infected Kenyan women and their children in a rural setting in Western Kenya. Our hypothesis is that meat in the diet, possibly due to the amounts of lysine and vitamin B12 and the enhanced bioavailability of iron and zinc, results in improved clinical outcomes, B weight gain, lean body mass, resistance to opportunistic infections, growth and development in children and ability to carry out normal tasks of daily living in women. We will accomplish this aim by means of a randomized clinical trial in which we compare the effect of a meat based supplement vs. isocaloric soya and wheat based supplements.
Specific aim #2 : Contribute to improved monitoring of changes in body composition and strength of HIV-infected women and children in field settings in rural Kenya. Our hypothesis is that accurate estimates of lean body mass and strength in HIV- infected women and children can be easily obtained in field settings in rural Kenya. We will accomplish this aim by comparing bioimpedance (BIA) methodology and hand grip and finger pinch dynamometry measures with arm muscle area calculated from triceps skin fold and mid- arm circumference measures. Methodologies (BIA and anthropometry) will be validated with isotope dilution (2H2O) in a sub-sample of the enrolled drug na?ve HIV-infected Kenyan women.
-Relevance Preliminary evidence suggests that improved nutrition early in human immunodeficiency virus (HIV) infection may delay progression to acquired immunodeficiency syndrome (AIDS) and delay the initiation or improve the effectiveness of antiretroviral drug therapy (ART). However, there are few studies that evaluate how to optimize nutrition in HIV infected individuals. Evaluation of the role of animal source foods (ASF) which are known to provide nutrients that support maintenance of lean tissue, child growth and development, and immune function in particular, are lacking.
|Ernst, Judith; Ettyang, Grace; Neumann, Charlotte G (2014) High-nutrition biscuits to increase animal protein in diets of HIV-infected Kenyan women and their children: a study in progress. Food Nutr Bull 35:S198-204|