Effect of amaranthe grain (A. cruentus) on nutrition and health status of adults living with HIV in Mweiga, Nyeri-County
Ndung'u, Zipporah Wanjiru
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People living with HIV (PLHIV) are at greater risk of under nutrition and micronutrient deficiency compared with those who are HIV negative. The main challenge is to meet the increased nutrient needs especially for PLHIV in food insecure areas. This calls for use of nutrient dense foods. There is scarce information on how use of locally nutrient dense foods like amaranth grain can meet the increased nutrient needs among PLHIV. This study aimed to assess effect of amaranth grain consumption on nutrition and health status among PLHIV in Mweiga Home-Based Care Group in Nyeri County. The study adopted a one group pre-test post-test experimental design. A sample of 69 PLHIV not on ART was used. The respondents were provided with 100 grams of amaranth grain flour per day for consumption in form of porridge for six months. Dietary practices, nutrition status and morbidity patterns were monitored monthly. CD4 cell count was monitored after every three months. Statistical package for social sciences software version 16 (SPSS) was used to analyse quantitative data. Data from 24 hour recall were analysed by use of Nutri- survey computer software. Nutrition status was analysed using body mass index (BMI) software. Pearson product moment correlation was used to determine the relationship for non-categorical variables while Chi-square was used for categorical variables. t-test for non-independent samples was used to determine the differences between the variables for the pre-test and post-test. Simple and multiple regression were used to determine the effect of dietary intake to health and nutrition status. Qualitative data were summarized to establish the emerging themes. From the results, the mean number of meals consumed per day increased significantly (P=0.042) from baseline (3.2 ± 0.4 SD) to month six (4.1 ± 0.6 SD) due to amaranth grain porridge consumption which provided additional snacks in between the meals. At baseline, the mean kilocalorie intake was below the RDA (3139 ± 365 SD for males and 2479 ± 312 SD for females). With consumption of amaranth grain, the mean kilocalorie intake increased to 3549 ± 386 SD and 2892 ± 330 SD for males and females, respectively which was significant (P= 0.039) at month one. The proportion of the respondents who met the RDA for selected micronutrients namely zinc, iron, magnesium, calcium and vitamin E increased from below 36% to over 77% after adding amaranth grain to the diet. The proportion of underweight respondents reduced from 67.7% to 9.1% and 74.3% to 5.7% from baseline to month six for males and females, respectively. The mean weight gain for the study population was 3.35 kg ± 1.5 SD. The most common illnesses noted were upper respiratory tract infections, pneumonia, malaria and diarrhoea. The proportion of those with illness at baseline reduced significantly (P< 0.05) at month six from 60.6% to 28.8%. The mean CD4 cell count increased significantly (P=0.041) by 105 ± 16.3SD mm3 from baseline to month six. The amount of kilocalorie consumed and presence of illness correlated significantly with BMI (P<0.05). . Intake of zinc, magnesium, iron, calcium, selenium, vitamin A and vitamin E had a significant relationship (P<0.05) with presence of illness and CD4 cell count. Consumption of 100 grams of amaranth grain porridge supplemented the diet of PLHIV in Mweiga and enabled them to meet the RDA for energy, protein, zinc, magnesium, iron, calcium and vitamin E, which was associated to the observed increase in weight and improved health status. This study recommends use of amaranth grain by PLHIV both at community and hospital level for improved health and nutrition status.