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Nutritional Assessment in HIV/AIDS Intravenous Drug Users


Ellen Smit, Ph.D., R.D.
Johns Hopkins University, School of Hygiene and Public Health


Lecture Outline

  1. Assessing nutritional status: Review of methods with respect to their use in IDUs/HIV populations.
    Dietary intake assessment
    Body composition
    Biochemical measurements

  2. Methods currently being used: A review of studies reported during the 12th World AIDS Conference.

  3. Current research on methodology: What is being done? Dietary assessment and calibration validation studies Body composition and biochemical methods research

  4. Future research needs in nutrition methodology. Dietary intake assessment, body composition, biochemical measurements

Learning Objectives

  • To increase knowledge of methodological issues related to assessing nutritional status in IDU/ HIV populations.

  • To identify future research needs in nutrition methodology.

Abstract

Assessment of nutritional status may include any combination of biochemical and body composition measurements, dietary intake assessment, and metabolic studies. Each method has its strengths and weaknesses and we may disagree on which tool is best. What we can agree on, however, is that at the moment we do not have a perfect tool. When assessing nutritional status in injection drug users (IDU) and in HIV-infected individuals, the decision in what method(s) to use becomes even more complex. A review of studies reported during the 12th World AIDS Conference reveals that out of 64 abstracts on the topic of nutrition in HIV-infected adults, only 11 assessed diet, with 41 assessing anthropometry and 24 assessing some form of biochemical measurements. The most common methods for dietary intake included 24-hour recalls, food records, and food frequencies. The most common methods for body composition included height, weight, bioimpedance, and DEXA. Biochemical measurements included a variety of blood nutrients, lipids and albumin. Methods varied greatly, and caution should be taken when trying to compare results between studies using different methods. Currently, there are few studies dealing with the development of methods that can be used for research in HIV and IDU populations, especially methods that will allow us to track changes in nutritional status over time. We need to work toward better tools in dietary intake assessment, body composition, and biochemical measurements.

References

Conference Record, Bridging the Gap, 12th World Aids Conference, Geneva, 1998.

Dwyer JT. Dietary assessment. In: Modern Nutrition in Health and Disease, Shils ME, Olson JA, and Shike M (editors), Lea & Febiger, PA, pp. 842-860, 1994.

Forbes GB. Body composition: influence of nutrition, disease, growth and aging. In: Modern Nutrition in Health and Disease, Shils ME, Olson JA, and Shike M (editors), Lea & Febiger, PA, pp. 781-801, 1994.

Heymsfield SB, Tighe A, Wang Z. Nutritional assessment by anthropometric and biochemical methods. In: Modern Nutrition in Health and Disease, Shils ME, Olson JA, and Shike M (editors), Lea & Febiger, PA, pp. 812-841, 1994.

Margetts BM, Nelson M. Design Concepts in Nutritional Epidemiology. Oxford University Press, New York, NY, 1991.

Thompson FE, Byers T. Dietary Assessment Resource Manual. J Nutr 124:supplement, 1994.

Willett W. Nutritional Epidemiology. Oxford University Press, New York, NY, 1990.

Yanovski SZ, Hubbard VS, Heymsfield SB, Lukaski HC. Bioelectrical Impedance Analysis. Am J Clin Nutr 64:supplement, 1996.

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