Nutritional supplements combined with dietary counselling diminish whole body protein catabolism in HIV-infected patients
Article first published online: 24 DEC 2001
Blackwell Science Ltd, Oxford
European Journal of Clinical Investigation
Volume 30, Issue 1, pages 87–94, January 2000
How to Cite
Berneis, Battegay, Bassetti, Nuesch, Leisibach, Bilz and Keller (2000), Nutritional supplements combined with dietary counselling diminish whole body protein catabolism in HIV-infected patients. European Journal of Clinical Investigation, 30: 87–94. doi: 10.1046/j.1365-2362.2000.00591.x
- Issue published online: 24 DEC 2001
- Article first published online: 24 DEC 2001
- Cited By
- bioelectrical impedance analysis;
- enteral nutrition;
- protein metabolism;
- stable isotopes
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 μ 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.
Leucine oxidation (protein catabolism) decreased in the group receiving nutritional intervention from 0.33 ± 0.02 to 0.26 ± 0.02 μmol 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 μmol kg−1 min−1 (P = 0.07) and remained unchanged in the control group (2.21 ± 0.16 and 2.27 ± 0.14 μmol 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.
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).