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dc.contributor.advisorDannhauser, A.
dc.contributor.authorCox, Cindy Deborah
dc.date.accessioned2016-06-21T09:06:43Z
dc.date.available2016-06-21T09:06:43Z
dc.date.issued2005-05
dc.identifier.urihttp://hdl.handle.net/11660/3155
dc.description.abstractEnglish: 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.en_ZA
dc.description.abstractAfrikaans: Proteïen-energie-wanvoeding (PEW) is ‘n belangrike kliniese manifestasie van menslike immuniteitsgebrekvirus (MIV) in kinders en beskik oor immuunonderdrukkende effekte. Die oorsake van MIV-geassosieerde PEW is veelvoudig, maar verlaagde voeding- en energie-innames is die belangrikste faktore wat tot PEW kan aanleiding gee. Verskeie studies het bewys dat ‘n verlaging in die viskositeit van graanvoedsel, kinders se dieetinnames kan verhoog. Die invloed van amilase-gewysigde supplemente (AMS) op die werklike supplementinname en energie-inname op MIV-geïnfekteerde kinders is nie bekend nie. Die doelwit van die huidige studie was om die werklike supplement- en energie-inname vanaf die AMS op MIV-geïnfekteerde kinders te bepaal. In die studie is ‘n dubbel-blinde gerandomiseerde, klinies-gekontroleerde, prospektiewe studieontwerp gevolg. Die studiedeelnemers was 16 MIV-geïnfekteerde kinders, wat in Lebone Tehuis woonagtig was. Die studiedeelnemers is volgens hul basislyn-ouderdom, CD4+-tellings en massa-vir-ouderdom-status gestratifiseer en gerandomiseer in twee groepe, naamlik die eksperimentele (E-) en kontrole (C-) groep. Die E-groep het tydens die studie ‘n amilase-gewysigde, verrykte mieliepap (E-supplement) ontvang, terwyl die kinders in die C-groep identiese mieliepap, maar sonder die ensiem amilase (C-supplement), ontvang het. Die E- en C-supplemente is as ‘n ontbytplaasvervanger vier keer ‘n week, oor ‘n totale tydperk van 16 weke bedien. Die navorser het die hoeveelheid supplement wat bedien is, geweeg, asook die oorskiet. Die werklike supplementinname is bereken deur die oorskiet supplement af te trek van die hoeveelheid supplement wat voorgesit is. Die energie-inname van die supplemente is deur Department Biostatistiek bereken. Die werklike supplementinname is uitgedruk as gemiddelde supplementinname, gemiddelde persentasie van die ingeneemde supplement en persentasie van dae wat die deelnemers die volle porsie supplement ingeneem het. Die data vir die gemiddelde supplement-inname dui aan dat die deelnemers groot hoeveelhede (E-groep 489g; C-groep 490.9g) supplemente ingeneem het. Die gemiddelde persentasies van die supplemente wat ingeneem is, was 98.1 persent (E-groep) en 98.6 persent (C-group). Die deelnemers het meestal (E-groep 94.4 persent; C-groep 92.9 persent) die volle supplementporsie wat bedien is, ingeneem. Geen betekenisvolle verskille het voorgekom tussen die E- en C-groep in terme van die gemiddelde supplementinname (p=0.83), gemiddelde persentasie van die supplementinname (p=0.67) en die persentasie van die aantal kere wat die volle supplementporsie ingeneem is (p=0.83). Die werklike supplementinname is beïnvloed deur die viskositeit van die supplemente en die kulturele aanvaarbaarheid. Die gemiddelde energie-inname vanaf die supplemente was hoog (E-groep 2540.4kJ; C-groep 2553.2kJ) vir albei groepe. Die gemiddelde persentasie vir die energie-inname van die supplement was identies aan die persentasies van die supplementinname. Geen betekenisvolle verskille het tussen die E- en die C-groep voorgekom in terme van gemiddelde energie-inname (p=0.67) en gemiddelde persentasie van energie ingeneem van die porsie supplement bedien (p=0.67) nie. Opsommend, in hierdie studie is gedemonstreer dat die verlaging in die viskositeit van die E-supplement met die ensiem, amilase, nie die supplement- of energie-inname van die supplement betekenisvol verhoog het nie. Beide die supplemente was smaaklik en kultureel aanvaarbaar vir hierdie Suid Afrikaanse MIV-geïnfekteerde kinders. Toekomstige navorsing behoort te bepaal of die byvoeging van amilase tot verrykte mieliepap ‘n positiewe effek sal hê op die massa, immuun- en gesondheidstatus van MIV-geïnfekteerde kinders in vergelyking met ‘n kontrole pap, sonder bygevoegde amilase. Die uitgewysde beperkings van hierdie studie sal in hieropvolgende studies in ag geneem moet word. Toekomstige toepassing van hierdie projek, indien daar voordele met die gebruik van amilase ontdek word, sluit die insluiting van die E-supplement by bestaande of nuwe voedingsprogramme in – om sodoende die voedingstatus van MIV-geïnfekteerde kinders te verbeter.af
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.subjectHIV infections -- Nutritional aspectsen_ZA
dc.subjectHIV infections -- Diet therapyen_ZA
dc.subjectAIDS (Disease) -- Nutritional aspectsen_ZA
dc.subjectAIDS (Disease) -- Diet therapyen_ZA
dc.subjectHIV-infected childrenen_ZA
dc.subjectStuntingen_ZA
dc.subjectWastingen_ZA
dc.subjectAmylaseen_ZA
dc.subjectGerminationen_ZA
dc.subjectSupplement consumptionen_ZA
dc.subjectEnergy intakeen_ZA
dc.subjectDissertation (M.Sc. (Dietetics))--University of the Free State, 2005.en_ZA
dc.titleSupplement consumption and energy intake of HIV+ children receiving an enzyme-modified, enriched maize supplementen_ZA
dc.typeDissertationen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA


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