Nutritional Management

Nutritional management goals are listed in Table 18-3. Energy, protein, and micronutrient requirements for sustaining lean body mass and supporting normal growth and development in the AIDS setting are not well defined. Infectious diseases characteristically increase energy requirements, and HIV infection itself may increase basal metabolic rate.8 Since weight loss or gain is the ultimate measure of energy needs, calorie requirements should be calculated according to the general guidelines in Chapter 5 with allowance made for energy needs of opportunistic infections or malabsorption.9 Micronutrient deficiencies may be prevented by providing vitamin/mineral supplements at doses equal to one to two times the Recommended Dietary Allowance.'1 Strategies for nutritional management of the symptomatic HIV-infected child are summarized in Table 18-4.

Table 18-3. Goals of Nutritional Management in Pediatric HIV

Preserve lean body mass Promote normal growth and development Provide adequate levels of all nutrients Minimize symptoms of malabsorption

Adapted from Task Force on Nutrition Support in AIDS. Guidelines for nutritional support in AIDS. Nutrition 1989:5:39-46.

Table 18-4. Nutritional Management in Pediatric AIDS

Problem

Intervention

Anorexia

Increase nutrient density ot foods

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