Effects on body composition and handgrip strength of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy: A randomised controlled trial
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Effects on body composition and handgrip strength of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy : A randomised controlled trial. / PrayGod, George; Rehman, Andrea M; Wells, Jonathan C. K.; Chisenga, Molly; Siame, Joshua; Jeremiah, Kidola; Kasonka, Lackson; Woodd, Susannah; Changalucha, John; Kelly, Paul; Koethe, John R; Heimburger, Douglas C; Friis, Henrik; Filteau, Suzanne.
In: Journal of Nutritional Science, Vol. 8, e19, 2019.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effects on body composition and handgrip strength of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy
T2 - A randomised controlled trial
AU - PrayGod, George
AU - Rehman, Andrea M
AU - Wells, Jonathan C. K.
AU - Chisenga, Molly
AU - Siame, Joshua
AU - Jeremiah, Kidola
AU - Kasonka, Lackson
AU - Woodd, Susannah
AU - Changalucha, John
AU - Kelly, Paul
AU - Koethe, John R
AU - Heimburger, Douglas C
AU - Friis, Henrik
AU - Filteau, Suzanne
N1 - CURIS 2019 NEXS 181
PY - 2019
Y1 - 2019
N2 - Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m 2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium ( 2 H) diluted water (D 2 O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D 2 O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D 2 O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI -0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D 2 O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.
AB - Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m 2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium ( 2 H) diluted water (D 2 O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D 2 O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D 2 O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI -0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D 2 O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.
KW - Antiretroviral therapy
KW - Body composition
KW - Handgrip strength
KW - Malnutrition
KW - Minerals
KW - Vitamins
U2 - 10.1017/jns.2019.15
DO - 10.1017/jns.2019.15
M3 - Journal article
C2 - 31143445
AN - SCOPUS:85065853464
VL - 8
JO - Journal of Nutritional Science
JF - Journal of Nutritional Science
SN - 2048-6790
M1 - e19
ER -
ID: 218653549