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

  1. Berneis,
  2. Battegay,
  3. Bassetti,
  4. Nuesch,
  5. Leisibach,
  6. Bilz,
  7. Keller

Article first published online: 24 DEC 2001

DOI: 10.1046/j.1365-2362.2000.00591.x

Issue

European Journal of Clinical Investigation

European Journal of Clinical Investigation

Volume 30, Issue 1, pages 87–94, January 2000

Additional Information

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

Author Information

  1. University Hospital Basel, Switzerland

* Ulrich Keller MD Department of Internal Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. Tel.: +41 61 265 50 73; fax: +41 61 265 51 00; e-mail: ukeller@uhbs.ch

Publication History

  1. Issue published online: 24 DEC 2001
  2. Article first published online: 24 DEC 2001

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Keywords:

  • AIDS;
  • bioelectrical impedance analysis;
  • enteral nutrition;
  • HIV-infection;
  • protein metabolism;
  • stable isotopes

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 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.

Results

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.

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).

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