Daily consumption of ready-to-use peanut-based therapeutic food increased fat free mass, improved anemic status but has no impact on the zinc status of people living with HIV/AIDS: a randomized controlled trial

BMC Public Health. 2016 Jan 4:16:1. doi: 10.1186/s12889-015-2639-8.

Abstract

Background: Food insecurity in sub-Saharan Africa and malnutrition constitute the main obstacles for successful treatment of people living with HIV/AIDS (PLWH). The aim of this study was to assess the effect of consuming daily 100 g RUTF (ready-to-use therapeutic food) as supplement, on body composition, anemia and zinc status of hospitalized PLWH in Senegal.

Methods: A Controlled clinical trial was conducted in 65 PLWH randomly allocated to receive either standard hospital diet alone (Control group: n = 33), or the standard diet supplemented with 100 g RUTF/day (RUTF group: n = 32). Supplementation was continued at home during 9 weeks. Individual dietary intakes were measured and compared to the Recommended Dietary Allowances. Body composition was determined using Bio-Impedance Analysis. Hemoglobin was measured by HemoCue and plasma zinc (PZ) concentration by atomic absorption spectrometry. PZ was adjusted to infection (CRP and α1-AGP). All measures were conducted on admission, discharge and after 9 weeks home-based follow up.

Results: 34 and 24% of the patients in RUTF and Control groups were suffering from severe malnutrition (BMI < 16 kg/m(2)), respectively. In both groups, more than 90% were anemic and zinc deficiency affected over 50% of the patients. Food consumed by the Control group represented 75, 14 and 55% of their daily recommended intake (DRI) of energy, iron and zinc, respectively. When 100 g of RUTF was consumed with the standard diet, the DRI of energy and zinc were 100% covered (2147 kcal, 10.4 mg, respectively), but not iron (2.9 mg). After 9 weeks of supplementation, body weight, and fat-free mass increased significantly by +11% (p = 0.033), and +11.8% (p = 0.033) in the RUTF group, but not in the Control group, while percentage body fat was comparable between groups (p = 0.888). In the RUTF group, fat free mass gain is higher in the patients on ART (+11.7%, n = 14; p = 0.0001) than in those without ART (+6.2%, n = 6; p = 0.032). Anemia decreased significantly with the supplementation, but zinc status, measured using plasma zinc concentration, remained unchanged.

Conclusion: Improving PLWH' diet with 100 g RUTF for a long period has a positive impact on muscle mass and anemia but not on the zinc status of the patients.

Trial number: NCT02433743, registered 29 April 2015.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / blood
  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • Anemia / diet therapy*
  • Anemia / epidemiology
  • Arachis*
  • Body Composition
  • Body Fluid Compartments / metabolism
  • Dietary Supplements
  • Energy Intake*
  • Female
  • Food, Fortified*
  • HIV Infections / blood
  • HIV Infections / complications*
  • Hemoglobins / metabolism
  • Humans
  • Iron, Dietary / administration & dosage
  • Iron, Dietary / pharmacology
  • Male
  • Malnutrition / diet therapy
  • Malnutrition / epidemiology
  • Middle Aged
  • Muscles*
  • Nuts
  • Recommended Dietary Allowances
  • Senegal / epidemiology
  • Thinness / diet therapy
  • Thinness / epidemiology
  • Zinc / administration & dosage
  • Zinc / blood
  • Zinc / pharmacology*

Substances

  • Hemoglobins
  • Iron, Dietary
  • Zinc

Associated data

  • ClinicalTrials.gov/NCT02433743