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Nutritional interventions for reducing morbidity and mortality in people with HIV

  1. Liesl Grobler1,2,*,
  2. Nandi Siegfried3,4,
  3. Marianne E Visser5,
  4. Sarah SN Mahlungulu6,
  5. Jimmy Volmink1,7

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 22 MAY 2012

DOI: 10.1002/14651858.CD004536.pub3

How to Cite

Grobler L, Siegfried N, Visser ME, Mahlungulu SSN, Volmink J. Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD004536. DOI: 10.1002/14651858.CD004536.pub3.

Author Information

  1. 1

    South African Medical Research Council, South African Cochrane Centre, Tygerberg, Western Cape, South Africa

  2. 2

    Stellenbosch University, Centre for Evidence-based Health Care, Cape Town, Western Cape, South Africa

  3. 3

    University of Cape Town, Department of Psychiatry and Mental Health, Faculty of Health Sciences, Cape Town, South Africa

  4. 4

    University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, California, USA

  5. 5

    Stellenbosch University, Division of Human Nutrition, Faculty of Medicine and Health Sciences, Tygerberg, South Africa

  6. 6

    Eastern Cape Department of Health, Lilitha College of Nursing, Lusikisiki, Eastern Cape, South Africa

  7. 7

    Stellenbosch University, Faculty of Medicine and Health Sciences, Tygerberg, South Africa

*Liesl Grobler, liesl.nicol@gmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 28 FEB 2013

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[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 3]
Figure 3. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 4]
Figure 4. GRADE Summary of Findings Table for balanced macronutrient supplements versus counselling
[Analysis 1.1]
Analysis 1.1. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 1 Energy intake (kcal/day).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 2 Protein intake (g/day).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 3 Body weight.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 4 Fat mass measured in % of TBW.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 5 Fat free mass.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 6 CD4.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Balanced macronutrient formulas plus nutrition counselling vs nutrition counselling in participants with weight loss, Outcome 7 Viral load (log10 copies/ml).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Supplementary food plus nutrition counselling vs nutrition counselling in malnourished adults on ART and pre-ART, Outcome 1 Body weight.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Supplementary food plus nutrition counselling vs nutrition counselling in malnourished adults on ART and pre-ART, Outcome 2 Change in body weight (kg).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Supplementary food plus nutrition counselling vs nutrition counselling in malnourished adults on ART and pre-ART, Outcome 3 Body mass index (BMI).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Supplementary food plus nutrition counselling vs nutrition counselling in malnourished adults on ART and pre-ART, Outcome 4 % lean body mass.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Arginine rich supplements versus nutritional placebo or arginine-free supplements, Outcome 1 Mean change in body weight baseline to 8 weeks.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Arginine rich supplements versus nutritional placebo or arginine-free supplements, Outcome 2 Change in fat mass measured in kg.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Arginine rich supplements versus nutritional placebo or arginine-free supplements, Outcome 3 Change in fat free mass.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 1 Mean daily energy intake at study endpoint.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 2 Mean daily protein intake in kcal at study endpoint.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 3 Mean fat mass in kg at study endpoint.
[Analysis 4.4]
Analysis 4.4. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 4 Mean weight in kg at study endpoint.
[Analysis 4.5]
Analysis 4.5. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 5 Mean fat-free mass in kg at study endpoint.
[Analysis 4.6]
Analysis 4.6. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 6 Mean CD4 count in cells/mm3 at study endpoint.
[Analysis 4.7]
Analysis 4.7. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 7 Mean viral load in log10 at study endpoint.
[Analysis 4.8]
Analysis 4.8. Comparison 4 Ornithine alpha-ketoglutarate (OKG) versus placebo, Outcome 8 Proportion with gastrointestinal event (at least one).
[Analysis 5.1]
Analysis 5.1. Comparison 5 L-glutamine (GLN) versus placebo, Outcome 1 Mean weight in kg at study endpoint.
[Analysis 5.2]
Analysis 5.2. Comparison 5 L-glutamine (GLN) versus placebo, Outcome 2 Mean fat mass in kg at study endpoint.
[Analysis 5.3]
Analysis 5.3. Comparison 5 L-glutamine (GLN) versus placebo, Outcome 3 Mean CD4 count in cells/mm3 at study endpoint.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Enhanced nutritional support vs std nutritional support in children, Outcome 1 Death at 8 weeks.
[Analysis 6.2]
Analysis 6.2. Comparison 6 Enhanced nutritional support vs std nutritional support in children, Outcome 2 Death at 26 weeks.
[Analysis 7.1]
Analysis 7.1. Comparison 7 Spirulina versus traditional meals in children, Outcome 1 Weight for height z score (WHZ).
[Analysis 7.2]
Analysis 7.2. Comparison 7 Spirulina versus traditional meals in children, Outcome 2 Weight for age z score (WAZ).