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Fusce aliquam nunc vitae purus. </td> </tr> </table></td> <td> <div class='adsense' style='text-align:center; padding: 0px 3px 0.5em 3px;'> <script type="text/javascript"></script> <script type="text/javascript" src="http://pagead2.googlesyndication.com/pagead/show_ads.js"> </script> </div> <table width="100%" border="0" cellspacing="4" cellpadding="0"> <tr> <td valign="top" class="ulang"><table width="100%" border="0" cellspacing="4" cellpadding="4"> <tr> <td class="judulpost"> NUTRITION MANAGEMENT OF HIV PATIENTS </td> </tr> <tr> <td class="tanggalpost"> Saturday, November 8, 2008 </td> </tr> <tr> <td class="isipost"><div style="clear:both;"></div>Achieving nutritional health and pereventing malnutrition are essential in maintaining positive health outcomes for person with HIV and medical nutrition therapy in HIV care must be included as primary component of total health care.<br /><br />Goal for nutrition intervention<br /><br /><br /><ol><li>To educate these individuals about the importance of consuming a well balance diet.</li><li>To provide adequate nutrition for maintainance or improvement in nutritional status.</li><li>To prevent PEM ( Protein Energy manitration ) and vitamin, mineral deficiences.</li></ol><p>ENERGY AND ACTIVITIY</p><p>Energy and protein needs very depending on the health status of the individual at the time of HIV infection, the progression of disease, and the development of complications that impair nutrient intake and utilization.Energy requirements increses by 13% and protein requirments by 10% for every degree celsius of temperature elevation above normal.</p><p><span style="color: rgb(0, 102, 0);">PROTEIN</span></p><p><span style="color: rgb(0, 0, 0);">High protein diet might safely promote positive nitrogen balance and lean body mas repletion. HIV infected person, like the uninfected, have unimpaired metabolic response to a high protein diet. Protein supplimentation stimulate protein metabolism.Protein contain carbon, hydrogen and O2 as well as nitogent and elements such as sulphur, phosphorus and iron.22 aminoacids are recognized as components of most proteins, 9 of these are essential and must be provided by diet. Protein requirements may be estimated at 1.0 to 1.49/kg for maintenance and 1.5 to 2 gr/kg for repletion.Because of the increased protein requirements, protein restriction is indicated only in persons with severe hepatic or renal disease.</span></p><p><span style="color: rgb(255, 255, 0);">FAT</span></p><p>Tolerance of fat varies from person to person. In individuals with malabsorption or diarrhoea, use of low fat diet may aid in management studies suggest that the use of MCT oil is better than long chain triglyceride based suppliments for decreasing stool fat and stool nitrogen contentand in reducing the number of bowel movements and abdominal symptoms. MCT is more readily absorbed than Long Chain triglycerides. Fish oil ( omega-3 fatty acids) when given with MCT oil, may improve immune function because this combination is less inflamation promoting than usual omega-6 fatty acids. How ever if tryglyceride and cholesterol levels are increased, leading clinicians have speculated that following the guidelines established in the national cholesteroleducation program could be beneficial.</p><p><span style="color: rgb(204, 102, 204);">FLUIDS AND ELECTROLYTES</span></p><p><span style="color: rgb(0, 0, 0);">Fluids needs of HIV infected individuals are similar to those of well individuals, and are calculated to be 30 - 35 ml/kg ( 8.12 cup)for adults, with additional amounts to compensate for losses from diarrhoea, nausea and vomiting, night swets and prolonged fever.Replacements of electrolytes losses ( sodium, pottasium, and chloride). Inthe presence of vomiting and diarrhoea are also recommended.</span></p><p>VITAMINS AND MINERALS</p><p>The exact requirement for the vitamins and minerals are still unknown at this time, it is suggested that. Person consuming on adequate diet use a vitamin mineral suppliment providing 100% of the RDAs ( Recommended Dietery Allowences) excellent nutritional status enhances the ability to fight subsequent infection.</p><p>NUTRITIONAL COMPLICATIONS</p><p>1. Diarrhoea and malnutrition : Person with the greatest risk of developing diarrhoea are those with a CD4+Cell Count of less than 200 - 250 cells/mm3. Diarrhoea and malabsorption are the mayor problem for this population, and they are often the most difficult problem to resolved.</p><p>2. Dissorder of the oral cavity and esophagus</p><p>3. Neurologic disorders</p><p>4. Tremendous decrease of weight loss</p><p><span style="color: rgb(204, 102, 204);"></span></p><p></p><p></p><p>SYMPTOM MANAGEMENT</p><ul><li>Nausea : Small frequent meals, avoidance of high fat, cool or room temperature foods. Avoidance of lying down flat after eating.</li><li>Sore mouth / throat : Soft moist food, avoid spicy food, avoid very hot or very cold food, use nutrient and energy - dense foods to maximize oral intake.</li><li>Xerostomia ( dry mouth) : Use of foods that are moist or served with sauce or grory . Consumption of liquids at meal times and extra fluids betweens meals.</li><li>Diarrhoea : Fluid and electrolytes replacement , low insoluble, high soluble fiber diet, avoidance of gas causing food and beverage. Avoid caffeine.</li><li>Constipation : Increased fluid intake, increase dietary fiber. Eat more bread, pasta, raw fruit, more vegetables.</li><li>Inadequate oral intake : Use of nutrient and energy dense foods, including nutritional suppliments. Use of small frequent meals and snacks consideration of alternative nutrition support, adequate sleep, relaxation, exercise, adequate diet especially food rich in vit B12, A, c, folate and carotene or zinc. As inadequate levels may cause fatique. Avoid caffeine, alcohol cigarette smoking and recreaticnal drug use. Avoidance of stress and treatment of anxiety or depression. Identification and management of possible causes for anemia.Insufficent irons leads to anemia, with its characteristic symptoms of tiredness and breathlessness.</li></ul><p>ALTERATION IN METABOLISM AND BODYSHAPE</p><p>The use of potent anti HIV therapies expecially protease inhibitors, has increased the insulin resistance type 2 diabetes, hypercholestremia, pancreatitis and hypertriglyceridimia in the HIV/AIDS population. Oral hypoglycemies and insulin are being used, as are lipid lowering drugs such as lipitor. Suppliments often promoted for these condition include omega3, fatty acids, alphalipoic acids and L.Carnitime.Body shape changes seen include increased abdominal fat, decrease peripheral subcutaneous fat stores ( arms, legs and face ), buffale hump and enlarged breast., prominent veins and in grown toe nails. Treatment in such cases difficult and confusing.<br /></p><div style="clear:both; padding-bottom:0.25em"></div><p class="blogger-labels">Labels: <a rel='tag' href="http://diet-herapy.blogspot.com/search/label/AIDS">AIDS</a></p></td> </tr> <tr> <td class="bawahpost"><em>posted by LUZNI NOVITA @ <a href="http://diet-herapy.blogspot.com/2008/11/nutrition-management-of-hiv-patients.html" title="permanent link">10:06 AM</a></em> <span class="item-control blog-admin pid-611408839"><a style="border:none;" href="https://www.blogger.com/post-edit.g?blogID=8753410125692364535&postID=2801750144140587298&from=pencil" title="Edit Post"><img class="icon-action" alt="" src="https://resources.blogblog.com/img/icon18_edit_allbkg.gif" height="18" width="18"></a></span></td> </tr> <tr> <td valign="top"> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td><a name="comments" id="comments"></a></td> </tr> <tr> <td>0 Comments:</td> </tr> <tr> <td><ul> </ul></td> </tr> <tr> <td><a class="comment-link" href="https://www.blogger.com/comment/fullpage/post/8753410125692364535/2801750144140587298">Post a Comment</a> </td> </tr> <tr> <td><a href="http://diet-herapy.blogspot.com/"><< Home</a> </td> </tr> <tr> <td> </td> </tr> </table>  </td> </tr> </table></td> </tr> </table>  <script type="text/javascript"> </script> <script type="text/javascript" src="http://pagead2.googlesyndication.com/pagead/show_ads.js"> </script> </td> <td width="200"><table width="100%" border="0" cellspacing="4" cellpadding="0"> <tr> <td class="judul">About Me </td> </tr> <tr> <td class="isi"> <p align="center"> <img src="//blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxtExUrRlIlpyVU9iZ-fjTEy_WrBbEo1yIbgm8juEdx90RvIQM8WgJDpezFtFkBFtc4Y8wuy06cPt8QN6GD0snHDRdOzzjQYSWT_hOSyLJdf_wpAe69ey4e5HJ0OP57w/s220/Picture1.jpg" width="150" height="150" border="1"></p> <strong>Name:</strong> LUZNI NOVITA<br /> <strong>Home:</strong> <br /> <strong>About Me:</strong> <br /> <a href="https://www.blogger.com/profile/09288061224039498844"></a> </td> </tr> <tr> <td class="judul">Previous Post </td> </tr> <tr> <td class="isi"><ul> </ul></td> </tr> <tr> <td class="judul">Archives</td> </tr> <tr> <td class="isi"></td> </tr> <tr> <td class="judul">Powered by </td> </tr> <tr> <td align="center" valign="top" class="isi"><p align="center"> <a href="http://www.blogger.com" ><img src="http://buttons.blogger.com/bloggerbutton1.gif" alt="BLOGGER" name="blogger" border="0"></a></p></td> </tr> </table></td> </tr> </table></td> </tr> <tr> <td><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="376"><img src="http://img214.imageshack.us/img214/9254/techbluer3c1hs0.jpg" width="376" height="50"></td> <td background="http://img149.imageshack.us/img149/4538/techbluer3c3gt9.jpg">© 2005 DIET <a href="http://www.blogspottemplate.com">Blogspot Template</a> by <a href="http://www.isnaini.com">Isnaini Dot Com</a></td> </tr> </table></td> </tr> </table> </body> </html>