Nutrition and Health

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Part I: Identification of Nutrient

In the case of an Asian female, she is 35 years old, 5’2” and 95 pounds. She is HIV/AIDs positive, single and does very light activities. She has poor dentition and has poor malnutrition.

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She is currently under the National Institute of Health which provide her 1200 calorie diet. She takes the antiretroviral drug which includes the one-day tablet containing 150mg and 800mg, 1000mg calcium daily. The diet that the patient is taking has a deficiency of CHO, PRO and fat since the patient’s weight is meager that is 43kg. This value is small for an adult with 35yrs. This means that the diet is deficient of protein for bodybuilding and carbohydrate.

The diet does not meet the Recommended Dietary Allowance (RDA) since the patient seems to have insufficient calcium in her body. This is indicated by the poor dentition conditions that she has. The 5 nutrients that are recommended for the patient with a deficiency in macronutrient are the calcium, vitamin A, potassium, vitamin C and Iron. Calcium is a very essential mineral in the body because it helps in the development of the teeth and also strong bones. The patient is associated with performing a light activity which indicate that the patient’s bones are weak due to deficiency of calcium. Vitamin A is another essential nutrient which is highly recommended by the people living with HIV/AIDs because the diet with vitamin A has a very vital role in improving the immune system of the patient. The people living with HIV/AIDs has very low immunity and it is essential for them to boost their diet with vitamin A (Hummelen et al, 2011). Poor dentition of the patient show that she lacks a diet with enough vitamin A because vitamin A contributes in the development of bones and teeth.

Part II(Disease &Nutrient)

The patient with HIV/AIDS should have a much-planned diet because if the diet lack some important nutrient or vitamin may cause a lot of complication and cause the health of the person to deteriorate. The victims are associated with diarrhoea which is caused by malabsorption as a result of the gut not able to uptake in the appropriate manner which causes loss of protein in the patient’s body. The patient with diarrhoea symptoms needs to take diet which is rich in protein to build up all the muscle tissue that breakdown. The patient whose diet does not have some certain nutrients which do not boost the immune system may cause the patient’s disease symptom to increase because the patients are associated with high-stress levels which has an adverse effect to the immune system. The patient may be eating a lot of food but the disease symptoms progress meaning that the diet that the person is undertaking does not help to boost the immune system.

The patient should avoid food with a lot of sugar and salt since they have high chances of getting the cardiovascular disease because the ARV drugs the patient is taking makes them prone to heart diseases. The patient should limit the consumption of sugar to evade diseases such as diabetes and blood pressure. The patient should avoid drinking alcohol because it will deteriorate their health since it causes loss of water from the body. Water is essential in the body because it helps in the transportation of the important nutrient to all parts of the body.

The HIV patient needs to eat foods that have high energy such as the sweet potatoes, cereals, rice, and the bread which enables the body to keep their bodies stable. To boost their immune system, the patients need to take fruits and vegetables which strengthen the immune system. Vitamin C is very important and can be obtained from citrus fruits like lemon, oranges, grapefruit and other fruits like tomatoes and mangoes. Vitamin A is also important in their body which can be obtained from red fruits, green fruits and also from green vegetables like spinach, kales, broccoli leaves from pumpkin and others. The patients are supposed to eat the fresh fruits and vegetables and they need not be over-cooked because they lose the nutrient in them. The vegetables are supposed to be cooked with moderate heat. Dairy products, meat, pork, milk which are food that is rich in protein which is an important diet in building body tissue and to strengthen the immune system of the patient (Liu, 2011). Even though the HIV patient should limit the levels of sugar and salt, it is important to take moderate sugar. These sugars can be obtained from biscuits, desserts, and cakes.

The other nutrients which the HIV patient need to eat are flavonoid and phytosterols which are the nutrient from the fruits which helps to strengthen the immune system. Flavonoids nutrient can be obtained from fruits such as the carrots, apples, strawberries, and peppers. The phytosterols nutrients are obtained from whole grains such as the nuts, sunflower seeds, seafood, and peas.

When the food and the drugs are consumed, they interact differently, and it is essential to consider how the nutrient is absorbed and whether medicine has a side effect. People living with HIV need to utilize the nutritionist, in case there is a side effect of the medicine and food the nutritionist can advise the patient on the alternative way to supplement the food to get the same health benefit without causing any side effect. There is some food which affects the action of the drug-modifying conjugase and systems of MFO. For instance, some substances are found in some foods such as charcoal roasted meat, cabbage that influences the action of the MFO system through the induction of the enzyme (Willby, 2012).

There is some herbal dietary supplement which has negative effects when they interact with therapeutic drugs like the ARV. These supplements have a potential threat to the drugs because of the stimulation of the enzyme and affect some categories of the medication (Wilby, 2012). There are some studies which show that the nutrient found in garlic has been reported to minimize the concentration of plasma of saquinavir to the human health. The nutrient restriction that has been made for the patient with HIV/AIDs taking ARV are, food rich in calcium should be separated from dosing by 2hours because affect the action of integrase. When using the capsules medication, the garlic consumption should be avoided by the patient (Bayan et al, 2014). Food which has vitamin E should be evaded to prevent the danger of bleeding which is caused by TPV. It is recommended that the patient should observe those restriction to avoid the nutrient-drug side effects which affect the health of the patient.

Part III: Patient Education.

Calculation of the patient, BMI, BMR, CHO, and PRO

Parameters: age-35yrs, weight-95lb or 43kg, Height-5’2.

BMI

95/61.5 X61.5 (4225) X0.703=15.8

The value of BMI of the Asian Woman is below the healthy weight standard which ranges from 18.5 to 24.9; this indicates that the lady is underweight.

BMR

BMR is the amount of calorific need that the patient needs in her diet

BMR=[{(950X0.2 (activity)) + 950 }x0.1}+1140 =1254calories per day

CHO

The amount of carbohydrate she needs should be determined to restrict the amount she feeds because she does light activity.

(1254X0.45 Calories=565)/4calories /gram =141grams/day

( 1254 X 0.65=815)/4 Calories/gram=204

Dairy range 565-825 calories per day from 141-204 grams per day

PRO

The intake of protein recommended is approximately 1.5 to 2.0 times and the recommended protein for adults is 0.8g/kg (Dudek, 2014)

95lb/2.2kg/lb =43.8kgX0.8=34.5 grams protein daily

34.5grams X 1.5 times =51.8grams per day x 4calories/gram= 207calories per day

34.5grams X 2 times as much required for an adult =69 grams per day X 4 calories per gram= 276carories/day

Dairy range 207-276 calories per day or 34.5-51.8 grams per day.

FAT

The recommended fat for the patent is 35% to 40 % (Dudek, 2014)

Part III. Smart Goals and Patient Care Plan

In the SMART goals, the patient needs to eat at least three meals per day which are rich in protein so that she will be able to build all the worn out tissues in the body. She needs to eat a special diet because of the underweight levels she is of 15.8. The patient needs to work hard and increase the more foods which are rich in protein and also more calories which are in the form of fats and carbohydrates. The patient should add protein to her diets such as eating hard boiled eggs, eating more legumes such as nuts and beans, chopped meals and soups. To add the Calories she needs to take foods like rice, potatoes, and crackers. The patient should try to limit the number of sugary drinks and spicy foods. This is to prevent diarrhea.

References

Bayan, L., Koulivand, P. H., & Gorji, A. (2014). Garlic: a review of potential therapeutic effects. Avicenna journal of phytomedicine, 4(1), 1.

Dudek, S. G. (2014). Nutrition essentials for nursing practice (7th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Hummelen, R., Hemsworth, J., Changalucha, J., Butamanya, N. L., Hekmat, S., Habbema, J. D. F., & Reid, G. (2011). Effect of micronutrient and probiotic fortified yogurt on immune-function of anti-retroviral therapy naive HIV patients. Nutrients, 3(10), 897-909.

Liu, E., Spiegelman, D., Semu, H., Hawkins, C., Chalamilla, G., Aveika, A.,& Fawzi, W. (2011). Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania. Journal of Infectious Diseases, 204(2), 282-290.

Wilby, K. J., Greanya, E. D., Ford, J. A. E., Yoshida, E. M., & Partovi, N. (2012). A review of drug interactions with boceprevir and telaprevir: implications for HIV and transplant patients. Annals of Hepatology, 11(2), 179-185.

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