AIDS is really a chronic, intractable condition caused with the Human Immunodeficiency Virus (HIV). With this virus the immune system is targeted and eventually overwhelmed. It is imperative that a holistic therapeutic approach be implemented, involving medication, dietary management and stress management, given the constraints of current therapy.
Increasing appetite, improving digestion and absorption of nutrients, while stopping catablolism ( i.e. the breakdown) of proteins in your body are all techniques within the dietary management of AIDS. Consequently malnutrition and losing weight will be minimized, which in turn enhances the immune system. Proteins play a important role for optimal health particularly in AIDS because it replenishes cells, tissues and muscles, apart from its biological and immunological functions. Enough medical literature exists to counsel that a high protein diet of casein and whey are recommended. Specific amino acids such as glutamine, methionine, arginine, N-acetyl cysteine (NAC) and hydroxymethyl butyrate (HMB) are essential.
Ultimately, the bulk of patients infected with HIV frequently manifest involuntary body weight loss. Wasting might not be an inevitable consequence of HIV infection, but could be a consequence of multiple nutritional insults. Wasting is contributed to by a spread of etiologies to include hypermetabolism, alterations in metabolism, lessend oral intake, malabsorption, immune mechanisms and endocrine dysfunction. A decreased survival rate is related to the wasting of the lean body mass. Furthermorethe immune function is impaired. According to studies, a trend was found towards a decrease in body weight and disease progression. Both HIV positive men and women have significantly lower body weight, fat and body cell mass than that of HIV negative controls.
The quantity of nutrition–related clinical signs and symptoms in every person correlated with the size of weight loss. Within immunocompromised patients an avoidable morbidity is the result of a low energy consumption, deficiency of protein in diet and catabolism of proteins from muscle tissues (Suneeta franklin et al., 1999). Hence it is recommended that a person living with HIV or AIDS consumes between 0.8 g - 1 g of easily digestible and top quality protein per pound of body weight equivalent to 1.8 -2.2 g body weight (Bristol, 1995). Treating AIDS-related wasting syndrome with a whey protein concentrate (WPC) may combat the negative effects of oxidative stress, improve T-cell function and T-cell survival, and aid within the management of HIV replication.
Whey proteins are made of a-lactalbumin and ß-lactoglobulin (defending against infection) serum albumin, the immune globulin, enzymes and protease -- peptones ß-lactoglobulin accounts for about 50% of total whey proteins. It also contains tiny amounts of lactoferrin (iron, containing protein having protecting effects) and serum transferrin. Whey protein consists of a bunch of proteins known to produce a substance (glutathione) that will improve the immune system and in many cases slow the weightloss typically experienced by individuals with AIDS. It's also a diet supplement providing a protein rich energy boost while containing little lactose.
A Partially hydrolyzed whey protein is helpful if digestion is difficult. Because of the presence of casein inside milk proteins they are less difficult to digest (Metcalfe, 1992). Casein is known as a colloidal protein calcium phosphate complex and makes up 80% of total nitrogen in milk. Amino acids like glutamic acid, proline, aspartic, leucine, lysine and valine are also included in casein (Srilakshmi, 1996).
Cystine and methionine content (sulphur-containing amino acids) can be a superb reason to consider proteins. Additionally, low amounts of methionine is common for people with AIDS (Muller, 1996). It causes deterioration that occurs in the nervous system (Revillard, 1992). Likewise some factors of the disease process in AIDS are directly affected (Keating, 1991). Dementia can also be a outcome of a methionine deficiency (Tan, 1998). There is certainly reasons to suspect the HIV myelopathy would possibly be due to a deficiency of the amino acid Methionine (Di Rocco A et al., 1998).
It has also been shown that HIV reproduction is inhibited by the amino acid N-acetyl cysteine (NAC) (Roederes et al., 1990). In order to maintain adequate amounts of glutathione NAC together with glutamine is essential (Noyer et al., 1998). Glutamine is required for the synthesis of glutathione, an important antioxidant inside cells that is frequently depleted in individuals with HIV and AIDS (Robinson et al., 1992).
The combination of glutamine, arginine and amino acid derivative, hydroxy methyl butyrate (HMD), may forestall loss of lean body mass (i.e. wasting) in individuals with AIDS (Clark et al., 2000).
Therefore development of a protein supplement containing casein, whey and amino acid derivative arginine, glutamine, methionine, N-acetyl cysteine and HMB can offer an apt high protein diet for people suffering from HIV or AIDS. Until a cure is found for HIV/AIDS, a change of the attitude with assessment of nutritional status is necessary to curtail the progression of the disease and improve the quality of life.
References
1. Dr Suniti Solomon, AIDs and Nutrition, Second regional workshop on planning diet for health March 1999, pg.347.
2. Suneeta Franklin and Dr. Gomathy shivaji, Nutritional management of HIV/AIDs Patients Second regional workshop on planning diet for health March 1999, pg.350, 351
3. "Good Nutrition for people with HIV/AIDS" - A video distributed by Bristol-Myers Squibb, 1995.
4. POZ Magazine (02/97) p.102; Burroughs, Carola.
5. Metcalfe DD, “The Nature and mechanisms of food allergies and related disease”, Food Technology
6. Srilakshmi B., Food Science, June 1996. New age International Private Limited Publishers, pg. 120-121.
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10. Tan SV, Gssiloff RJ. Hypothesis in the pathogenesis of vacuolar myelopathy, dementia and peripheral neuropathy in AIDS. J. Neural Neurosurg. Psychiat. 1998; 65 : 23-28.
11. Di Rocco A, Tagliati M, Danisi F, Dorfmam D, Moise J, and Simpson DM, A pilot study of L-methionine for the treatment of AIDS-associated myelopathy. Neurology July 1998; Volume 5, pages 266-268
12. Roederes M, Staal FJ, Raju PA, et al. Cytokine stimulated human immuno deficiency virus replication is inhibited by N-acetyl-L-cysteine. Proc. Natl. Acad. Sci. 1990; 87: 4884-4888.
13. Noyar CM, Simon D, Borezub A, et al. A double-blind placebo controlled pilot study of glutamine therapy for abnormal intestinal permeability in patients with AIDS. Am. J. Gastroenterol. 1998; 83: 972-975.
14. Robinson MK, Hong RW, Wilmore DW. Glutathione deficiency and HIV infection. Lancet 1992; 339: 1603-1604.
15. Clark RH, Peleke G, Din M, et al. Nutritional treatment for acquired immuno deficiency virus - associated wasting using beta-hydroxy beta-methylbutyrate, glutamine and arginine- a randomised double-blind, a placebo-controlled study. Jpen J. Parameter Enterol. Nuts. 2000; 24: 133-139.
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