Daily consumption of ready-to-use peanut-based therapeutic food increased fat freemass, improved anemic status but has noimpact on the zinc status of people livingwith hiv/aids: a randomized controlled triall

Abstract

Background:Food insecurity in sub-Saharan Africa and malnutrition constitute the main obstacles for successfultreatment of people living with HIV/AIDS (PLWH). The aim of this study was to assess the effect of consuming daily100 g RUTF (ready-to-use therapeutic food) as supplement, on body composition, anemia and zinc status ofhospitalized PLWH in Senegal. Methods:A Controlled clinical trial was conducted in 65 PLWH randomly allocated to receive either standard hospitaldiet alone (Control group:n=33),orthestandarddietsupplementedwith100gRUTF/day(RUTFgroup:n=32).Supplementation was continued at home during 9 weeks. Individual dietary intakes were measured and compared tothe Recommended Dietary Allowances. Body composition was determined using Bio-Impedance Analysis. Hemoglobinwas measured by HemoCue and plasma zinc (PZ) concentration by atomic absorption spectrometry. PZ was adjustedto infection (CRP andα1-AGP). All measures were conducted on admission, discharge and after 9 weeks home-basedfollow up. Results:34 and 24 % of the patients in RUTF and Control groups were suffering from severe malnutrition(BMI < 16 kg/m2), respectively. In both groups, more than 90 % were anemic and zinc deficiency affected over 50 % ofthe patients. Food consumed by the Control group represented 75, 14 and 55 % of their daily recommendedintake (DRI) of energy, iron and zinc, respectively. When 100 g of RUTF was consumed with the standard diet,the DRI of energy and zinc were 100 % covered (2147 kcal, 10.4 mg, respectively), but not iron (2.9 mg).After 9 weeks of supplementation, body weight, and fat-free mass increased significantly by +11 % (p=0.033),and +11.8 % (p=0.033) in the RUTF group, but not in the Control group, while percentage body fat wascomparable between groups (p = 0.888). In the RUTF group, fat free mass gain is higher in the patients on ART(+11.7 %,n=14;p = 0.0001)than in those without ART (+6.2 %,n=6;p=0.032). Anemia decreased significantlywith the supplementation, but zinc status, measured using plasma zinc concentration, remained unchanged.