Canadian AIDS Treatment Information Exchange (CATIE) TreatmentUpdate48, Vol. 4, No. 8 - March 1994
Sean Hosein

As explained in the section above, weight loss can occur for several reasons. If weight loss continues unchecked, patients eventually may experience reduced quality of life and survival. Although doctors can order many laboratory tests when investigating weight loss, they may not always find the cause. These patents can try to maintain or increase their weight by a programme of "aggressive nutritional supplementation", increasing their intake of:

- Protein. Proteins from eggs and milk care easier to digest than soy proteins. Some patients blend protein powders in milk or juices adding flavours (vanilla, almond, chocolate) and spices (allspice, cinnamon, mace or nutmeg) or sweeteners that do not have much sugar such as barley malt or even artificial sweeteners such as NutraSweet. As well, some patients eat more eggs and beef and take about 1 gram/day of the amino acid carnitine. See TreatmentUpdate46 for details on carnitine.

- Exercise. Another source of protein for the body is muscle tissue. Patients who have the energy to exercise by lifting weights can build up a potential source of good quality protein muscle tissue. During times of stress and infections, muscle tissue can be converted into protein. Not all patients can exercise because they may be too tired but regular forms of exercise, even if it is just walking, can help maintain some muscles and perhaps quality of life. - Essential fatty acids. Some patients supplement their diets with evening primrose oil and/or flax seed oil taking extra beta-carotene and vitamin E as 'preservatives' to protect these oils.

- Certain fats. Creamed coconut and medium-chain triglycerides are fats which the body can easily 'burn' for energy.

- The amino acid carnitine. This substance helps the body convert fats to energy. Red meat is a good source of carnitine.

- An extra meal. Some patients who normally eat 3 meals a day and suffer from weight loss may find that a fourth meal helps to maintain their weight. For other ways to build up muscle mass please see the articles on growth hormone on page 4.

ACKNOWLEDGMENTS:

1. We would like to thank CD Myers, Ph.D. for his review, comments and support on these articles on nutrition.

REFERENCES:

1. Myers CD, Good advice on nutrition helps maintain quality of life. Canadian AIDS News 1993;6(6):10-1 1.

2. Ott M, Lembeke B. Fischer X, et al. Early changes of body composition in human immunodeficiency virus-infected patients: tetrapolar body impedance analysis indicates significant malnutrition. American Journal of Clinical Nutrition 1993;57:15-19.

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