A. Schwenk et al., Oral supplements as adjunctive treatment to nutritional counseling in malnourished HIV-infected patients: randomized controlled trial, CLIN NUTR, 18(6), 1999, pp. 371-374
Aims: To compare nutritional counseling with and without oral supplements i
n HIV-infected patients with recent weight loss.
Design: Randomized non-blinded controlled trial, stratified for change in a
ntiretroviral treatment at baseline.
Patients: HIV-infected patients with recent weight loss (> 5% of total, and
>3% in the last month).
intervention: Nutritional counseling to increase dietary intake by 600 kcal
/day over 8 weeks; in group A (n=24) by normal food, and in group B (n=26)
by a range of fortified drink supplements with a calorific value of 0.6 to
1.5 kcal/ml.
Methods: Body composition by bioelectrical impedance analysis, dietary inta
ke by 24 h recall.
Results: Fat free mass increased from baseline to week 8 (P < 0.05) with no
difference between groups A and B (P = 0.97). Body cell mass and weight ga
in were not significant and equal between groups. Assessed at weeks 2 and 4
, group B patients consumed 11 +/- 6 kcal/kg als supplements, and their tot
al energy intake was 6 kcal/kg higher than in group A (P < 0.01). Total ene
rgy intake was not different between groups at weeks 6 and 8.
Discussion: Nutritional counseling and oral supplements are both feasible m
ethods to restore food energy intake in malnourished HIV-infected patients.
Although normal food intake is partially replaced, oral supplements may im
prove the adherence to a weight gain regimen. (C) 1999 Harcourt Publishers
Ltd.