American Society for Nutrition
J. Nutr. First published November 25, 2009; doi:10.3945/jn.109.110569
 Journal of Nutrition, doi:10.3945/jn.109.110569
Vol. 140, No. 1, 213S-223S, January 2010
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© 2010 American Society for Nutrition

Supplement: The Impact of Climate Change, The Economic Crisis, and the Increase in Food Prices on Malnutrition

Macronutrient Supplementation and Food Prices in HIV Treatment1,2

Kevin A. Sztam3,*, Wafaie W. Fawzi4 and Christopher Duggan3,4

3 Children's Hospital Boston, Division of Pediatric Gastroenterology and Nutrition, Boston, MA 02115 and; 4 Harvard School of Public Health, Department of Nutrition, Boston, MA 02115

Infection caused by HIV and malnutrition have a complex interaction and often coexist geographically. Malnutrition has synergistic immune effects and HIV affects nutritional status. HIV care and treatment programs are compelled to confront this dual burden to optimize HIV outcomes. In this article, we review the published literature concerning intervention studies in adults and children and the effect of food prices on HIV treatment programs. While the evidence base is relatively incomplete for specific macronutrient interventions in the context of HIV treatment, it is clear that a new standard of care is needed, guided by experience, rationale, and existing data, in which malnourished patients may easily access nutritional therapies within HIV treatment. From this clinical foundation, we may both treat patients and evaluate novel therapies. Some HIV care and treatment programs provide food-based supplements; however, rising food costs and economic instability may jeopardize the success of these programs. HIV treatment programs may struggle to meet the needs of patients with potential increased rates of malnutrition and food insecurity in the setting of high food prices.

* To whom correspondence should be addressed. E-mail: kevin.sztam{at}childrens.harvard.edu.

Published online 25 November 2009.