Effect of nutritional education and dietary counselling on body weight in HIV-seropositive South Africans not receiving antiretroviral therapy

Background Unintentional weight loss of >10% contributes to morbidity and mortality in HIV-infected patients. In poorer developing countries, cost-effective options to promote weight gain are extremely limited. Methods We conducted a pilot study of the effect of nutritional education and dietary counselling on body weight in 90 HIV/AIDS patients. Education entailed principles of healthy eating, socioeconomics of nutrition, food safety, and symptom-related dietary guidelines, Other clinical parameters examined for potential impact on body weight included age, sex, CD4+ lymphocyte count, presence of complicating infections, concomitant medications, vitamin use, and nutritional supplementation. No patients received antiretroviral therapy. Results At study end (mean follow-up, 4.2 months) body weight compared to baseline was greater in study subjects than in controls (P < 0.01); stable or increasing weight was seen in 73% of study patients. Weight gain (1 kg) occurred in 53% of counselled patients (mean = 3.5 kg; range 1-11 kg) vs. 21% of matched controls (mean = 2.0 kg; range 1-3 kg) (P < 0.03). Nutritional counselling was found to offset the adverse effects of gastrointestinal tract or systemic infection (especially in patients with CD4+ counts <200 cells mm(-3)). Conclusion In low-resource areas, culturally and economically relevant nutritional education and dietary counselling are simple yet effective means of stabilizing or increasing body weight in HIV-infected patients.