The influence of a nutritional supplement on lung function and immune status of hiv-positive patients in the Mangaung metropolitan

Thesis (D. Tech. (Clinical Technology )) - Central University of Technology, Free State, 2013The HIV pandemic in South-Africa has created a new form of vulnerability for households with regards to food security and nutritional status which are vital components in the general care of HIV-infected individuals. The risk of nutritional deficiencies and malnutrition are predictors of disease progression and treatment in resource limited settings. Furthermore, HIV affects nutritional status by increasing the energy requirements, reducing food intake, affecting nutrient absorption and metabolism inadequacies due to cytokine activity and diarrhea. Several vitamins and minerals are important in fighting HIV infection because they are required by the immune system and major organs to attack infectious pathogens. Many of these micronutrients have been found to be deficient in HIVinfected persons and several studies were launched worldwide to investigate the feasibility of food assistance and nutrient supplementation. Nutritional supplementation has been advocated in HIV-infected persons especially in lowincome countries such as South Africa. Therefore, a study to evaluate the role of nutritional supplementation in HIV-positive patients becomes necessary, especially in a developing country such as South Africa. It is against this background that the present research was initiated to examine the influence of a nutritional supplement on the immune status and health status of HIVpositive/ AIDS adult individuals. The aim of the investigation was to determine if supplementation with a mixture comprised from specific minerals, vitamins and herbs over a period of one year, affected the haematological status, immune status, viral load and pulmonary function in forty (40) HIV-infected individuals living in the Mangaung Metropolitan, RSA. viii A quantitative, open-labeled, before-after clinical trial was conducted at the Central University of Technology, in Bloemfontein, Free State Province in the RSA. Socio-demographic and dietary intake questionnaires were completed. All data pertaining to anthropometric measurements, haematological status, immune status, viral load and pulmonary function were obtained my means of using standard procedures and technological equipment. The data were subjected to parametric and non-parametric statistical analysis. The results of the present investigation show that the eating pattern of this urbanized group of individuals reflects high energy (KJ) and macronutrient intakes coinciding with sub-optimal intake of Vitamin D and iodine. Of all the haematological variables the only statistical significant changes observed were increases in the median erythrocyte sedimentation rate (ESR) (p=0.0219) and mean cell haemoglobin concentration (MCHC) (p=0.0245) after six months of nutritional supplementation. At 12 months a statistical significant decrease in the median CD/CD8 ratio (p<0.0048), median Hematocrit concentration (p<0.0312), median mean cell volume (MCV) (p<0.0359), and median RDW (p<0.0273) accompanied a statistically significant increase in the MCHC (p<0.0003) at 12 months after supplementation. At 6 months 89% (CI95%: 73%; 96%) of the individuals showed a decline in viral load counts with a median percentage decline of 34% (CI95%: 73%; 96%). At 12 months 85% [CI95%: 68%; 94%] of the individuals show a decrease in viral load counts with a median percentage decline of 62.9% (CI95%: 50%; 78.6%) following the intake of the supplement. The main findings of the present investigation reveal that 68% (50%-81%) of the individuals show a statistical median increase (p=0.0302) of 16.9% (11.5%; ix 36.1%) in the Peak Expiratory Flow (PEF) at six months. A significant decrease (p=0.0484) in the median FEF75 of 28.1% (14%; 35.3%) is observed in 70% (53%-83%) of the individuals after 12 months of exposure to the supplement. No statistical significant changes are observed for FVC, FEV1, FEV1/FVC and FEF50 over the entire trial period. The present results suggest that a significant measurable decrease in viral load in HIV-infected individuals can be obtained by means of subjecting individuals to a nutritional fortification supplement strategy for 6 months or more

Effects of environmental enrichment on cognitive performance of pigs in a spatial holeboard discrimination task

This study investigated the effects of environmental enrichment on the cognitive performance of female conventional farm (growing) pigs in a spatial holeboard task. Ten pairs of littermates matched for weight were used. From each litter, one piglet was randomly assigned to a barren environment; the other was assigned to an enriched environment from 4 weeks of age. The enriched environment was double the size of the barren environment, had a floor covered with straw, a rooting area filled with peat, and one of the four different enrichment toys which were exchanged daily. Starting at 11 weeks of age, all pigs were tested in a spatial holeboard discrimination task in which 4 out of 16 holes were baited. Furthermore, basal salivary cortisol levels of all pigs were determined after the end of all testing. All pigs were able to acquire the pattern of baited holes (acquisition phase, 40 trials) and the diagonally mirrored pattern (reversal phase, 20 trials). During the acquisition phase, the reference memory performance of the enriched-housed pigs was better than that of their barren-housed littermates, i.e. they reduced visits to the unbaited set of holes. During the reversal phase, enriched-housed pigs had a better general working memory performance than the barren-housed pigs as indicated by reduced revisits to holes already visited during a trial, irrespective of whether they were of the baited or the unbaited set. The enriched-housed pigs also searched for the hidden bait faster during both phases. The environments did not affect basal salivary cortisol levels. In conclusion, environmental enrichment slightly improved the cognitive performance of pigs in a spatial learning task. We hypothesise that the long period of habituation to and testing in the holeboard acted as enrichment that partially reduced the effects of barren housing