Nutritional supplements combined with dietary counselling diminish whole body protein catabolism in HIV-infected patients.

Abstract

BACKGROUND:

Weight loss and protein malnutrition are frequent complications in HIV-infected patients. The effect of an oral nutritional supplement combined with nutritional counselling on whole body protein metabolism was assessed.

MATERIALS AND METHODS:

HIV-infected individuals with a body mass index < 21 kg m-2 or CD4-T cells < 500 micro L-1 in stable clinical condition were randomly allocated to [1] receive either oral nutritional supplements (containing 2510 kJ, complete macro- and micronutrients) and dietary counselling (n = 8), or [2] identical monitoring but no supplements or specific nutritional advice (controls, n = 7). Whole body leucine kinetics and leucine oxidation rate were determined by [1-13C]-leucine infusions and lean and fat mass were measured before and 12 weeks after intervention.

RESULTS:

Leucine oxidation (protein catabolism) decreased in the group receiving nutritional intervention from 0.33 +/- 0.02 to 0.26 +/- 0.02 micromol kg-1 min-1 after 12 weeks (P < 0.05; P < 0.05 vs. control group) but remained unchanged in the control group. Whole body leucine flux showed a tendency to decrease in the intervention group from 1.92 +/- 0.19 to 1.73 +/- 0.14 micromol kg-1 min-1 (P = 0.07) and remained unchanged in the control group (2.21 +/- 0.16 and 2.27 +/- 0.14 micromol kg-1 min-1, respectively). Lean body mass determined by bioelectrical impedance analysis increased in the nutritional intervention group from 84 +/- 2 to 86 +/- 2 per cent (P < 0.05) and fat mass decreased from 17 +/- 2 to 14 +/- 2 per cent (P < 0.05) of total body weight whereas neither mass changed in the control group. Nutritional intervention had no significant effect on lymphocyte CD4 counts, on plasma TNFR 55, TNFR 75 and ILR 2 concentrations and on quality of life.

CONCLUSIONS:

The data demonstrate an anticatabolic effect of nutritional supplements combined with dietary counselling in HIV-infected subjects. They suggest that diminished whole body protein catabolism resulted in a change of body composition (increased lean mass, decreased fat mass).

• Authors: K Berneis, M Battegay, S Bassetti, R Nuesch, A Leisibach, S Bilz, U Keller
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 30 Issue 1 Pg. 87-94 (Jan 2000) ISSN: 0014-2972 [Print] England
• PMID: 10620007 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Insulin
• Proteins
• Receptors, Tumor Necrosis Factor
• Glucagon
• Leucine

Topics

• Body Composition
• Body Weight
• Counseling
• Energy Metabolism
• Female
• Glucagon (blood)
• HIV Infections (metabolism, therapy)
• Humans
• Insulin (blood)
• Leucine (metabolism)
• Male
• Nutritional Support
• Proteins (metabolism)
• Receptors, Tumor Necrosis Factor (analysis)