Nutrition problems

Problems and possible causes

AIDS almost always causes severe weight loss, even in people who eat good food. There are many reasons for this including:

· not enough nutritious foods available
· painful or difficult swallowing because of:

- oral or esophageal thrush

- mouth sores such as the blisters caused by herpes simplex

- Kaposi sarcoma lesions (purple lesions which can occur on gums or palate)

- inflammation of the gums or infections of the gums and teeth (redness, pus or swelling of the gums); these can be caused by a lack of vitamin C (found primarily in citrus fruits and in dark green leafy vegetables).

· nausea and vomiting
· chronic diarrhoea
· tuberculosis (see Chapter Six)
· depression or anxiety
· fever from any cause.

What to do at home

A sick person has an even greater need for food than a healthy person. People should be encouraged to think about the foods that will help make them healthy, rather than worry about foods that are not considered to be good for them.

All of the foods you are familiar with will fall into one of the following three groups. Everyone should try to eat food from each of these groups at every meal.

1. Body-building foods: These include peas or beans, soya, groundnuts, nuts, eggs, meat, fish and milk.

These foods are rich in protein and contain iron and calcium.

Figure

2. Energy-giving foods: These include potatoes, yams, cassava, taro, plantains, sugar, wheat, rice, millet, maize, animal fats and vegetable oils.

Figure

3. Foods that protect the body from infection (vitamin-rich foods): These include all fruits and vegetables. Dark green leafy vegetables are the most nutritious, then orange-coloured vegetables and fruits. Cooking for too long destroys vitamins so these foods should be cooked or steamed lightly, and the cooking water used as a soup or sauce.

Figure

As mentioned in the section on diarrhoea in this chapter, correct preparation and storage of foods should ensure that they are clean and safe and do not cause disease. This is especially important for infants.

General hints for people who are having trouble eating or maintaining their weight and strength

· Eat small amounts often. Foods that can be eaten with the fingers are easier to manage, particularly if the person is weak.

· To supplement a regular diet of nutritious foods, vegetable oil or groundnut paste can be added to food.

· Raw vegetables are not very digestible and can easily be contaminated, so they are not advisable.

· If someone is experiencing nausea or vomiting, preparing the foods in liquid or semi-liquid form may help.

· If persistent diarrhoea is present, use soft or mashed foods and avoid irritating foods, for example pepper and raw vegetables.

· Drink plenty of fluids and watch for dehydration (see the section on diarrhoea in this chapter).

· Taking vitamin tablets may be helpful although eating good foods is always better (see the section on medicines for nutrition problems in Chapter Six).

· Certain problems that decrease the appetite or the ability to eat, such as thrush or dental problems, can be treated and action should be taken before the problem gets very bad. Refer back to the section on sore mouth and throat in this chapter for more information about this.

· If a person is interested or has more questions, they could try to find reading materials in their own language that give further information. Many health centres have books and pamphlets on nutrition.

Loss of appetite or difficulty in eating can be very distressing for the sick person and their family and might make them feel helpless and ineffective. It may help if they can discuss this with a health care worker. A nutritionist may also be available at the health centre to provide further information.

When sick people and their families must seek help

People should be encouraged to seek help if a sick person:

· becomes dehydrated or very malnourished
· is suddenly unable to eat
· starts to have severe abdominal pain with or without vomiting.

Notes on nutrition problems
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