Submitted to: American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/1/2004
Publication Date: 1/1/2004
Citation: Kruzich, L.A., Marquis, G.S., Carriquirry, A.L., Wilson, C.M., Stephensen, C.B. 2004. U.S. youth in the early stage of hiv disease have low intakes of some micronutrients important for optimal immune function. American Dietetic Association. 104(7): 1095-1101. Interpretive Summary: Given the increased micronutrient requirements, nutrition counseling with HIV-infected youth should focus on early increase of intake of foods rich in micronutrients to improve growth, slow disease progression, and increase survival.
Technical Abstract: Objective: We examined the association between micronutrient intakes and HIV infection in youth who were at increased nutritional risk because of the demands of growth and disease as well as poor dietary habits. Design: This was a cross-sectional study to collect dietary intake data using the Block Food Frequency Questionnaire (98.2). Anthropometric, biochemical, clinical, and sociodemographic data were available. Subjects/setting: Participants included 264 HIV-infected and 127 HIV-uninfected adolescents and young adults from the REACH network, a multi-site observational study on HIV progression. Statistical Analyses performed: CD4+ T-cells were stratified for HIV-infected youth: 500, 200-499, and <200 cells/ L. Micronutrient intakes were compared by presence of HIV infection, using two-sample Student's t-tests. Categorical analyses used Chi-square test. Generalized linear regression determined predictors of vitamins A, C, and E, iron, and zinc intakes. Results: Almost half (49.0%) of the HIV-infected participants had CD4+ T-cells 500 cells/ L. After controlling for other factors, HIV-infected participants with CD4+ T-cells 500 had decreased iron intake (p<0.05) and tended to be associated with lower intakes of vitamins C and E (p<0.10) compared to those with more advanced disease and HIV-uninfected youth. Among those youth with CD4+ T-cells between 200-499 cells/ L, a high anxiety score was associated with a 6-fold increase in vitamin A intake as compared to those with a low score. Applications/Conclusions: Given the increased micronutrient requirements, nutrition counseling with HIV-infected youth should focus on early increase of intake of foods rich in micronutrients to improve growth, slow disease progression, and increase survival.