Assessment of the effect of a protein calorie supplement on change in CD4 count among art-naïve female TB patients co-infected with HIV in Dar Es Salaam, Tanzania

RATIONALE: Tuberculosis and HIV infection together form a highly mortal combination. Even after the advent of highly active antiretroviral therapy (HAART) medications, management for Tuberculosis and HIV/AIDS still remains a challenge. Poor outcomes (in both morbidity and mortality) are still being witnessed throughout the world, and especially in the poorly developed countries that bear the bulk of the burden of the cases. It is assumed that one of the major contributors to the poor outcomes is poor nutritional status resulting from the disease process itself, poverty and toxicity from medications being used to treat these diseases that substantially reduce appetite. An assessment of the role that nutritional status has on change in CD4 as a surrogate marker of disease progression is therefore of importance. OBJECTIVES: To evaluate the role that nutritional supplementation has on change in CD4 in TB patients co-infected with HIV who are receiving standard care of treatment. METHODS: Data from a randomized controlled trial of a Protein Calorie Supplement (PCS) were used. To assess the effect of randomization to a nutritional supplement, baseline characteristics were compared among the intervention and the control groups and confounder variables, such as age, BMI, baseline CD4, socioeconomic status, previous exposure to TB and compliance with HAART medication were analyzed and adjusted for in a model using multivariate linear regression. RESULTS: 151 HIV-infected women with TB disease were enrolled; 72 received PCS while 79 did not. We found that the PCS intervention had no significant effect on change in CD4 between baseline and 8 months. Average change in CD4 count was similar for intervention and control groups (204 vs. 207 units). This similarity persisted after adjusting for baseline BMI and previous TB disease. CONCLUSION: Randomization (i.e. nutritional supplement) did not have a significant effect on change in CD4 count among study participants. However, an effect could have been masked by high compliance with ART

Value of crops: Quantity, quality and cost price

Possibilities of using algae as a nutritional supplement are examined. The nutritional value and protein content of spirulines of blue algae are discussed. A cost analysis of growing them artificially is presented

Nutritional supplement use among fitness club participants in Tehran, Iran

The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin–mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants

Impact evaluation of a conditional cash transfer program: the Nicaraguan Red de Protección Social

"In 2000, the Nicaraguan government implemented a conditional cash transfer program designed to improve the nutritional, health, and educational status of poor households, and thereby to reduce short- and long-term poverty. Based on the Mexican government's successful PROGRESA program, Nicaragua's Red de Protección Social (RPS) sought to supplement household income, reduce primary school dropout rates, and increase the health care and nutritional status of children under the age of five. This report represents IFPRI's evaluation of phase I of RPS. It shows that the program was effective in low-income areas and particularly effective when addressing health care and education needs. The report offers the first extensive assessment of a Nicaraguan government antipoverty program." Authors' AbstractRed de Protección Social (Nicaragua) Evaluation, Economic assistance, Domestic Nicaragua Evaluation, Public welfare Nicaragua, Child welfare Nicaragua, Poverty Nicaragua,

Nutritional status and nutritional treatment are related to outcomes and mortality in older adults with hip fracture

Malnutrition is very prevalent in geriatric patients with hip fracture. Nevertheless, its importance is not fully recognized. The objective of this paper is to review the impact of malnutrition and of nutritional treatment upon outcomes and mortality in older people with hip fracture. We searched the PubMed database for studies evaluating nutritional aspects in people aged 70 years and over with hip fracture. The total number of studies included in the review was 44, which analyzed 26,281 subjects (73.5% women, 83.6 ± 7.2 years old). Older people with hip fracture presented an inadequate nutrient intake for their requirements, which caused deterioration in their already compromised nutritional status. The prevalence of malnutrition was approximately 18.7% using the Mini-Nutritional Assessment (MNA) (large or short form) as a diagnostic tool, but the prevalence was greater (45.7%) if different criteria were used (such as Body Mass Index (BMI), weight loss, or albumin concentration). Low scores in anthropometric indices were associated with a higher prevalence of complications during hospitalization and with a worse functional recovery. Despite improvements in the treatment of geriatric patients with hip fracture, mortality was still unacceptably high (30% within 1 year and up to 40% within 3 years). Malnutrition was associated with an increase in mortality. Nutritional intervention was cost effective and was associated with an improvement in nutritional status and a greater functional recovery. To conclude, in older people, the prevention of malnutrition and an early nutritional intervention can improve recovery following a hip fracture

Protein and sensory quality of a food supplement formulated for the elderly

This study aimed to evaluate the composition, the protein quality, and the acceptability of a powder dietary supplement formulated for elderly people. The centesimal composition was analysed according to A.O.A.C. methods and the protein quality was assessed in weaning rats, by comparing Protein Efficiency Ratio (PER), Net Protein Ratio (NPR), and True Digestibility (TD) of the supplement with a casein-control based on AIN-93G diet. For the acceptance test samples of four flavours of the supplement dissolved in whole milk were offered to each judge, in monadic form. To assess the overall acceptability a scale of seven points was used. The sensory panel was composed of 121 Brazilian panellists, with mean age of 68.28±5.78 years. The supplement is promising in reaching the nutritional demands of the elderly, providing high content of protein and fibre and low content of fat. The values found for PER and NPR were shown to be superior to the control group of casein (P<0.05) and the digestibility was higher than 90%, showing that the supplement presented characteristics of a high nutritional value protein source. The supplements with banana, vanilla, and strawberry flavour were the most accepted and did not differ significantly for the overall acceptability

Vitamin D supplementation in the pediatric rheumatology clinic.

Vitamin D is capturing the attention of healthy and chronically ill populations for its potential skeletal and nonskeletal benefits. New information suggesting a role in immune modulation has led to a surge of interest among rheumatologists. Although the epidemiologic data are limited, it appears that many children with rheumatic conditions are at risk of vitamin D deficiency. However, understanding this phenomenon requires an appreciation for how vitamin D status is assessed, and options for supplementation. Although a "more-is-better" attitude is tempting when considering the medicinal effects of a nutritional supplement, we suggest a cautious approach and suggest that further studies are needed to clarify the potential benefits and risks among children with rheumatic conditions

Comparison of knowledge, attitude and practice of Urban and rural households toward iron deficiency anemia in three provinces of Iran

Background: Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently improper practice, which can lead to several complications. This study has been designed in order to compare knowledge, attitude and practices of the urban and rural households regarding iron deficiency anemia (IDA) in Boushehr, Golestan and Sistan & Balouchestan provinces in 2004. Methods: The sampling method at household's level in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas were tested by chi square test. Results: A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of households toward IDA were better in urban areas of Sistan & Blouchestan and Golestan provinces. In Sistan & Balouchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The majority of pregnant and lactating mothers (except for rural areas of Bushehr) did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly. Conclusion: Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources

The Pattern of Breastfeeding and Providing Supplement Increase Nutritional Status for 7–24 Month Children

Introduction: Infants grow and develop rapidly therefore they tend to suffer from malnutrition when they couldn't get adequate nutrition. The infant nutrient status is influenced by many factors such as the breastfeeding pattern and the providing supplement meal pattern. The purpose of this study was to analyze correlation between breastfeeding and providing supplement with 7–24 month child nutritional status. Method: This study used cross sectional design. Population was mothers who were breastfeeding and providing supplemental meal to their infants age 7 to12 months at Nuri Posyandu, in Kademangan Puskesmas. Samples consisted of 16 mothers with their infants, enrolled based on inclusion criteria. The independent variables were breastfeeding pattern and providing supplement meal pattern. The dependent variable was the nutritional status of the infant age 7 to 12 month. Data were collected by questionnaire and the infant weight was interpreted using Road to Health Card (KMS) then analyzed by spearman's rank test with significance level ofα ≤ 0.05. Result: Result showed a strong correlation between breastfeeding pattern and nutritional status of the infant age 7 to 12 months (p = 0.001) and adequate correlation was also found between the providing supplement meal pattern and the nutritional status of the infant of 7 to 12 months (p = 0.036). Discussion: In conclusion, both of breastfeeding and providing supplement meal correctly have correlation to the good infant nutritional status. Further studies should use other designs that enable data to be collected more than once to obtain better reliability in accuracy