Masters Degrees (Nutrition and Dietetics)

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Browsing Masters Degrees (Nutrition and Dietetics) by Author "Cox, Cindy Deborah"

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    Supplement consumption and energy intake of HIV+ children receiving an enzyme-modified, enriched maize supplement
    (University of the Free State, 2005-05) Cox, Cindy Deborah; Dannhauser, A.
    English: Protein-energy malnutrition (PEM) is an important clinical manifestation of human immunodeficiency virus (HIV) infection in children and have immunosuppressive effects. Reduced energy and oral intake are the most prominent contributing factors leading to malnutrition. Several studies have proven that addition of amylase to bulky cereals decreases the viscosity of cereals and increases children’s dietary intake. However, the impact of amylase modified supplements (AMS) on actual AMS consumption and energy intake from AMS by HIV-infected children is unknown. The main objective of this study was to determine the actual supplement consumption and energy intake from a supplement by HIV-infected children. The study design was a double-blinded, randomized, clinical controlled prospective trial, and included 16 HIV-infected children resident in Lebone House. Children were stratified according to baseline age, CD4+ counts and weight-for-age, and randomly placed into an experimental (E-) group and a control (C-) group. The E-group received an enzyme-modified, enriched maize supplement (E-supplement) and the C-group received an enriched maize supplement (C-supplement). The supplements were served as a breakfast replacement on 4 days per week, for a total period of 16 weeks. The actual supplement consumption was determined by subtracting the amount of leftover supplement from the amount of supplement served. The energy intake from the supplements was calculated by the Department of Biostatistics, University of Free State. The actual supplement consumption was expressed as the mean amount of supplement consumed, the mean percentage of the served supplement consumed, and the percentage of days the participants consumed the entire supplement. The data on the actual supplement consumption demonstrated that the participants consumed large amounts (E-group 489g; C-group 490g) of supplements, which accounted to 98.1 percent and 98.6 percent of the E- and C-supplements served. The median of the percentage of times the E-group consumed the entire served supplement was 94.4 percent and 92.9 percent for the C-group. No statistical significant difference was established between mean amount of supplement consumed (p=0.83), mean percentage of supplement consumed (p=0.67) and the percentage of times the entire served supplement was consumed (p=0.83). The actual supplement consumption was influenced by the viscosities of the supplements and cultural acceptability. The mean energy intake from the supplement for both groups were high (E-group 2540.4 kJ; C-group 2553.2 kJ). The mean percentage of energy consumed from the supplement served was identical to the percentage of the served supplement consumed. No significant difference was observed for the energy intake between the two groups in terms of mean energy intake (p=0.67) and the mean percentage of energy consumed from the portion served (p=0.67). The energy intake of these HIV-infected children was increased with approximately 2000 kJ per day with the addition of a single portion of either supplement, even when the supplements were served as a replacement for their usual breakfast. In conclusion, this study demonstrated that reducing the viscosity of the experimental supplement with amylase did not significantly increase the consumption or the energy intake. Both supplements were palatable and acceptable for these HIV-infected children and also increased the total daily energy intake of the children. Both supplements can therefore be used in the rehabilitation of HIV-infected children in South Africa. Future research should evaluate whether the addition of amylase to an enriched soy-maize supplement would have a positive effect on the weight, immune status and health status of HIV-infected children in comparison to the control supplement without the added amylase. Future research should address the limitations mentioned in this study. Future application of the research if proven to have a significant benefit may include the use of the supplement as part of existing or new feeding schemes to improve the nutritional status of HIV-infected children.