Nutritional status of HIV-infected adults in Maseru, Lesotho

[摘要] English: The main aim of this study was to determine the nutritional status and lifestyle behaviors of HIV infected adults in Maseru Lesotho. Dietary intake, lifestyle (smoking and alcohol consumption), anthropometry, physical examination and associations between these variables were determined. To determine the dietary intake, 24- hour recalls of usual food intake and food frequency In general dietary intake was below the recommendations. Over 90% of patients ate less than the recommended two servings of milk and milk products, 82.5% consumed less than the recommended two servings of meat and meat alternatives and more than 80% ate less than the recommended three servings of fruits and vegetables. Most patients ate the daily recommended fat intake and consumed the recommended number of bread and cereal exchanges. Median energy and macronutrient intakes were low (energy questionnaires were used. To determine the adequacy of the diet, patient's intake was compared with the recommendations from the Food Guide Pyramid. For the anthropometric assessment weight and height was used to calculate BMI. Waist and hip circumferences were determined for waist circumference and waist-to-hip ratio (fat distribution) and skin fold measurements to determine percentage fat. All anthropometric variables were measured using standardised techniques. Lifestyle factors (including smoking and alcohol consumption), and socio-demographic factors were obtained using questionnaires completed in a personal interview with each patient. A nutrition related physical examination to determine signs of malnutrition was performed on each participant by the researcher. The sample included 160 HIV -infected patients attending four different clinics in the Maseru district (Bophelong, Sen katana, Mabote and Ratjomose). Of these patients, 27.5% were males and 72.5% were females. The median age of the patients was 36 years. Fifty percent of patients were married and 55% were unemployed. Majority (82%) of patients had only primary education as their highest educational qualification. In general dietary intake was below the recommendations. Over 90% of patients ate less than the recommended two servings of milk and milk products, 82.5% consumed less than the recommended two servings of meat and meat alternatives and more than 80% ate less than the recommended three servings of fruits and vegetables. Most patients ate the daily recommended fat intake and consumed the recommended number of bread and cereal exchanges. Median energy and macronutrient intakes were low (energy 3462.5kJ/day, carbohydrates 43g, proteins 35g and fats 13g). Only ten percent of patients were underweight (BMI <18.5kg/m2), while 17% were overweight and 8.8% were obese (BMI �? 30kg/m2). Most patients (more than 60%) had a normal weight (BMI 18.5kg/m2 - 24.5kg/m2). Almost fifty percent of women had a high risk waist-to-hip ratio (�?0.08). Only 9% of male patients had a waist circumference above 102cm. The majority of patients did not smoke (82%). About 40% consumed alcohol and of those 78% consumed alcohol monthly with beer as the most consumed type of alcohol. The median number of drinks consumed was three drinks/day with eight drinks/day as the maximum. Patients with a dangerous to harmful consumption of alcohol had a significantly higher median energy intake than patients with a low to moderate alcohol consumption. The median BMI of low to moderate alcohol consumers and of the dangerous to harmful alcohol consumers differed significantly, with patients that used the most alcohol having a higher median BMI. There was a tendency for subjects with lower room density to have higher energy intake. BMI was strongly associated with fat percentage, with patients that had the lowest BMI, also having the lowest percentage fat. Female patients had a significantly higher fat percentage than male patients. More than 60% of patients had clinical signs of malnutrition, including symptoms related to the mouth (angular stomatitis, smooth and sore tongue and bleeding gums). Sixty percent of patients reported night blindness. Nutrition interventions should be included in programmes aiming at improving the nutritional status of HIV-infected persons. Nutrition education programmes should be implemented at community level and should concentrate on improving knowledge related to nutrition, preserving locally available and affordable foods and encouraging production of different types of crops that can improve access to food in Lesotho.

[发布机构] University of the Free State