Abstract:
Background. Preliminary evidence suggests that
improved nutrition early in HIV infection may delay
progression to AIDS and delay the initiation or improve
the effectiveness of antiretroviral drug therapy. There
are few studies that evaluate food-based interventions
in drug-naïve, HIV-infected women and their children.
Meat provides several nutrients identified as important
in maintaining immune function and lean body mass.
Objective. To design supplemental meat and soybean
biscuits for use in a randomized trial examining the
effect of meat in the diet of drug-naïve, HIV-infected
rural Kenyan women on changes in weight, lean body
mass, morbidity, nutritional status, and activities of
daily living of the women and growth and development
of their children.
Methods. We designed three supplemental biscuits:
one with added dried beef, another with added soybean
flour, and a wheat biscuit to serve as a control biscuit to
be used in a randomized feeding intervention in drug-
naïve, HIV-infected rural Kenyan women and their
children. The nutritional contents of the different types
of biscuit were examined and compared.
Results. The three biscuits were isocaloric. Meat bis-
cuits provided more lysine, vitamin B 12 , and bioavailable
zinc. Soybean biscuits provided more total and absorb-
able iron; however, higher fiber and phytate contents may
inhibit nutrient absorption. Data analysis for clinical
outcomes of the trial is ongoing.
Conclusions. The “biscuit model” is useful for nutri-tion supplementation studies because it can be provided
in a blinded and randomized fashion, safely and pri-
vately in a home under directly observed consumption
by a highly stigmatized population. It is well received by
adults and children, and the biscuits can be produced
locally with available, simple, affordable technology.
