H/A: Assess Food/Nutrition-Related History 2010
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
HIV/AIDS: Assess Food/Nutrition-Related History
The registered dietitian (RD) should assess the food and nutrition-related history of people with HIV infection, including but not limited to:
- Food and nutrient intake, focusing on energy, protein, fat, fiber, sodium, calcium and vitamin D
- Medications/drugs, herbal/dietary supplements and their potential negative interactions
- Knowledge, beliefs and attitudes
- Factors affecting access to food and food and nutrition-related supplies
- Physical activity and function
- Nutrition-related patient and client-centered measures
Several studies report variations in energy and nutrient intake in people with HIV infection, some were under- and over-estimated requirements. A clear understanding of food and nutrient intake will form the basis for the nutrition diagnosis, prescription and intervention.
Risks/Harms of Implementing This Recommendation
Conditions of Application
Potential Costs Associated with Application
Costs of medical nutrition therapy (MNT) sessions and reimbursement vary; however, MNT sessions are essential for improved outcomes.
- 15 articles were reviewed to evaluate the monitoring of food intake in people with HIV infection
- Several studies report variations in energy and nutrient intake and weight changes (Chlebowski et al, 1995; Luder et al, 1995; Woods et al, 2002; Hendricks et al, 2006)
- Special considerations are needed for children (Henderson et al, 1997; Melvin et al, 1997; Heller et al, 2000), as well as individuals with fat deposition (Hendricks et al, 2003; Dong et al, 2006), those taking protease inhibitors (Woods et al, 2003; Shah et al, 2005), those with a history of drug abuse (Forrester et al, 2000; Forrester et al, 2004) and those with metabolic abnormalities (Joy et al, 2007)
- One study reported that three-day food records may be more valid than food frequency questionnaires when reporting food intake in the HIV-infected population (Hendricks et al, 2005)
- Further research is needed regarding frequency of food intake monitoring.
Recommendation Strength Rationale
Conclusion statement received Grade II.
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Chlebowski RT, Grosvenor M, Lillington L, Sayre J, Beall G. Dietary intake and counseling, weight maintenance, and the course of HIV infection. J Am Diet Assoc 1995; 95(4): 428-435.
Dong KR, Wanke CA, Tang AM, Ding B, Hendricks KM. Dietary glycemic index of human immunodeficiency virus-positive men with and without fat deposition. J Am Diet Assoc. 2006; 106: 728-732.
Forrester JE, Tucker KL, Gorbach SL. Dietary intake and body mass index in HIV-positive and HIV-negative drug abusers of Hispanic ethnicity. Public Health Nutrition. 2004; 7(7): 863-870.
Forrester JE, Woods MN, Knox TA, Spiegelman D, Skinner SC, Gorbach SL. Body composition and dietary intake in relation to drug abuse in a cohort of HIV-positive persons. J Acquir Immune Defic Syndr. 2000; 25 Suppl 1: S43-S48.
Heller L, Fox S, Hell KJ, Church JA. Development of an instrument to assess nutritional risk factors for children infected with human immunodeficiency virus. J Am Diet Assoc. 2000;100(3): 323-329.
Henderson RA, Talusan K, Hutton N, Yolken RH, Caballero B. Serum and plasma markers of nutritional status in children infected with the human immunodeficiency virus. J Am Diet Assoc. 1997; 97: 1,377-1,381.
Hendricks K, Tang A, Spiegelman D, Skinner S, Woods M. Dietary intake in human immunodeficiency virus-infected adults: a comparison of dietary assessment methods. J Am Diet Assoc. 2005; 105: 532-540.
Hendricks KM, Willis K, Houser R, Jones CY. Obesity in HIV-infection: dietary correlates. J Am Coll Nutr. 2006; 25 (4): 321-331.
Hendricks KM, Dong KR, Tang AM, Ding B, Spiegelman D, Woods MN, Wanke CA. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition. Am J Clin Nutr, 2003; 78: 790-795.
Joy T, Keogh HM, Hadigan C, Lee H, Dolan SE, Fitch K, Liebau J, Lo J, Johnsen S, Hubbard J, Anderson EJ, Grinspoon S. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS. 2007; 21: 1591-1600.
Luder E, Godfrey E, Godbold J, Simpson DM. Assessment of nutritional, clinical, and immunologic status of HIV-infected, inner-city patients with multiple risk factors. J Am Diet Assoc. 1995; 95: 655-660.
Melvin D, Wright C, Goddard S. Incidence and nature of feeding problems in young children referred to a paediatric HIV service in London: FEAD screening. Child Care Health Dev 1997; 23 (4): 297-313.
Shah M, Tierney K, Adams-Huet B, Boonyavarakul A, Jacob K, Quittner C, Dinges WL, Peterson D, Garg A. The role of diet, exercise and smoking in dyslipidemia in HIV-infected patients with lipodystrophy. HIV Medicine. 2005; 6: 291-298.
Woods MN, Spiegelman D, Knox TA, Forrester JE, Connors JL, Skinner SC, Siva M, Kim JH, Gorbach SL. Nutrient intake and body weight in a large HIV cohort that included women and minorities. J Am Diet Assoc. 2002; 102: 203-211.
Woods MN, Tang AM, Forrester J, Jones C, Hendricks K, Ding B, Knox TA. Effect of dietary intake and protease inhibitors on serum vitamin B12 levels in a cohort of human immunodeficiency virus-positive patients. Clin Infect Dis. 2003; 37(Suppl 2): S124-S131.
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
Hendricks KM, Dong KR, Gerrior JL, eds. Nutrition Management of HIV and AIDS. Chicago, Illinois: American Dietetic Association; 2009.