title: Daily consumption of ready-to-use peanut-based therapeutic food increased fat free mass, improved anemic status but has no impact on the zinc status of people living with HIV/AIDS: a randomized controlled trial.
abstract: BACKGROUND
  Food insecurity in sub-Saharan Africa and malnutrition constitute the main obstacles for successful treatment of people living with HIV/AIDS (PLWH). The aim of this study was to assess the effect of consuming daily 100 g RUTF (ready-to-use therapeutic food) as supplement, on body composition, anemia and zinc status of hospitalized PLWH in Senegal.
  
  
  METHODS
  A Controlled clinical trial was conducted in 65 PLWH randomly allocated to receive either standard hospital diet alone (Control group: n = 33), or the standard diet supplemented with 100 g RUTF/day (RUTF group: n = 32). Supplementation was continued at home during 9 weeks. Individual dietary intakes were measured and compared to the Recommended Dietary Allowances. Body composition was determined using Bio-Impedance Analysis. Hemoglobin was measured by HemoCue and plasma zinc (PZ) concentration by atomic absorption spectrometry. PZ was adjusted to infection (CRP and α1-AGP). All measures were conducted on admission, discharge and after 9 weeks home-based follow up.
  
  
  RESULTS
  34 and 24% of the patients in RUTF and Control groups were suffering from severe malnutrition (BMI < 16 kg/m(2)), respectively. In both groups, more than 90% were anemic and zinc deficiency affected over 50% of the patients. Food consumed by the Control group represented 75, 14 and 55% of their daily recommended intake (DRI) of energy, iron and zinc, respectively. When 100 g of RUTF was consumed with the standard diet, the DRI of energy and zinc were 100% covered (2147 kcal, 10.4 mg, respectively), but not iron (2.9 mg). After 9 weeks of supplementation, body weight, and fat-free mass increased significantly by +11% (p = 0.033), and +11.8% (p = 0.033) in the RUTF group, but not in the Control group, while percentage body fat was comparable between groups (p = 0.888). In the RUTF group, fat free mass gain is higher in the patients on ART (+11.7%, n = 14; p = 0.0001) than in those without ART (+6.2%, n = 6; p = 0.032). Anemia decreased significantly with the supplementation, but zinc status, measured using plasma zinc concentration, remained unchanged.
  
  
  CONCLUSIONS
  Improving PLWH' diet with 100 g RUTF for a long period has a positive impact on muscle mass and anemia but not on the zinc status of the patients.
  
  
  BACKGROUND
  NCT02433743, registered 29 April 2015.
authors.affiliation: Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Dakar, BP 5005, Dakar - Fann, Sénégal. adama.diouf@ucad.edu.sn.
authors.forename: Adama
authors.initials: A
authors.lastname: Diouf
authors.affiliation: Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Dakar, BP 5005, Dakar - Fann, Sénégal. badiane21@yahoo.fr.
authors.forename: Abdou
authors.initials: A
authors.lastname: Badiane
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal. noelmagloiremanga@yahoo.fr.
authors.forename: Noël Magloire
authors.initials: NM
authors.lastname: Manga
authors.affiliation: Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Dakar, BP 5005, Dakar - Fann, Sénégal. nicole.dossou@ucad.edu.sn.
authors.forename: Nicole
authors.initials: N
authors.lastname: Idohou-Dossou
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier National Universitaire de Fann, Dakar, Sénégal. papasalifsow@gmail.com.
authors.forename: Papa Salif
authors.initials: PS
authors.lastname: Sow
authors.affiliation: Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Dakar, BP 5005, Dakar - Fann, Sénégal. salimata.wade@ucad.edu.sn.
authors.forename: Salimata
authors.initials: S
authors.lastname: Wade
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications; D000328:Adult; D000740:Anemia / Q000178:diet therapy* / Q000453:epidemiology; D010367:Arachis; D001823:Body Composition; D001825:Body Fluid Compartments / Q000378:metabolism; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D005527:Food, Fortified; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D044342:Malnutrition / Q000178:diet therapy / Q000453:epidemiology; D008875:Middle Aged; D009132:Muscles; D009754:Nuts; D064167:Recommended Dietary Allowances; D012675:Senegal / Q000453:epidemiology; D013851:Thinness / Q000178:diet therapy / Q000453:epidemiology; D015032:Zinc / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D015032:Zinc