Human Immunodeficiency Virus infection causes Acquired Immune Deficiency Syndrome, which
has caused millions of deaths, with more expected, particularly in developing countries like South
Africa, where poverty is a critical factor.
The intake, digestion, absorption and metabolism of food and nutrients emerge as a vicious cycle.
The undernourished HIV-infected individual develops micronutrient deficiencies,
immunosuppression and oxidative stress, thereby accelerating disease progression. Symptoms
include weight loss and wasting, with increased risk of secondary infections.
A representative sample of 500 African women (25-34 and 35-44 years) from Mangaung in South
Africaâs Free State Province participated in the study.
Socio-demographic composition and physical activity levels were determined by questionnaire.
Weight, height, circumference (waist and hip) and bioimpedance measurements were used to
calculate body mass index and fat distribution and percentage. Dietary intake was determined
using a food frequency questionnaire, and nutrient intake was analysed. Biochemical nutritional
status was determined through blood samples.
Socio-demographic characteristics indicated high unemployment rates. Significantly more HIV
positive than HIV negative young women had lived in urban areas for over ten years, and smoked
and/or used nasal snuff. Few young women had no education, while more older women had only
a primary school or Grade 8-10 education. Significantly more younger and older HIV positive
women headed their own households. No significant differences were found in housing conditions,
room density and household facilities of younger and older HIV positive and HIV negative women.
Anthropometric results showed that approximately 50% of all women were overweight/obese.
Most women had a gynoid fat distribution and were fat/obese according to fat percentage.
However, young HIV positive women had significantly lower body mass index and fat percentage
than young HIV negative women. The entire sample had low physical activity levels.
Median dietary intakes of energy, macronutrients and cholesterol were high, with young HIV
positive women having a significantly higher median energy intake than young HIV negative
women. Low median intakes of calcium, total iron, selenium, fat-soluble vitamins, folate and
vitamin C, but high median intakes of the B vitamins, were reported overall. Younger women with
HIV had significantly higher intakes of calcium, phosphorus, potassium, and vitamins B12, D and E
than young HIV negative women. Older HIV positive women had significantly lower intakes of
haem iron, nonhaem iron and selenium than older HIV negative women.
Although median values for most biochemical parameters were normal, younger HIV positive
women had significantly lower median haemoglobin and haematocrit levels, while older HIV
positive women had significantly higher serum ferritin and lower transferrin values than their HIV
negative counterparts. Significantly more HIV positive younger and older women had low
haematocrit values, while significantly more HIV negative older women had low serum iron and
high transferrin concentrations. Compared to HIV negative women, younger and older HIV positive
women had significantly lower median blood values for total lymphocytes and serum albumin, but
significantly higher median blood levels of total serum protein. Plasma fibrinogen and serum
insulin concentrations were significantly reduced in young HIV positive women. Older HIV positive
women had significantly lower total serum cholesterol values than older HIV negative women.
Serum glucose and serum triglycerides did not differ significantly between HIV positive and HIV
negative women within both age groups.
In younger and older women, increased serum total protein and decreased serum albumin were
associated with HIV infection. In younger women, smoking and being unmarried increase the odds
of HIV infection, while in older women a higher education level and a decreased non-haem iron
intake are associated with HIV infection.
An adequate diet, nutritional counselling and active physical activity can improve immune function,
quality of life and biochemical nutritional status. Dietary intake alone, however, may be insufficient
to correct nutritional deficiencies in this poor community, and the role of food-based approaches
and micronutrient supplementation merits further attention.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ufs/oai:etd.uovs.ac.za:etd-09302005-090104 |
| Date | 30 September 2005 |
| Creators | Hattingh, Zorada |
| Contributors | Prof A Dannhauser, Prof FJ Veldman, Dr CM Walsh |
| Publisher | University of the Free State |
| Source Sets | South African National ETD Portal |
| Language | en-uk |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.uovs.ac.za//theses/available/etd-09302005-090104/restricted/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University Free State or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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