Study Of Bioavailability Of Trace Elements In Selected Indigenous Foods And Their Potential Use On Management Of Hiv And Aids

ABSTRACT

HIV infection increases nutritional demands and vulnerability to malnutrition. Malnutrition worsens the effects of HIV infection by weakening further the body’s immune system, resulting in earlier and faster progression to the end stage of AIDS. Food supplementation especially with essential elements improves nutritional and clinical status of PLWHA and may delay early use of ARVs. Although high levels of essential elements have been recorded in some indigenous foods, translating physiological requirements of PLWHA into amount of these foods that can deliver the RDA is still a challenge due to lack of information on the bioavailability of the elements in the foods. The purpose of this study was to determine bioavailability of the trace elements in selected indigenous foods and their potential use on the management of HIV and AIDS. This was a pre-intervention study on consenting PLWHA in Butula Division, Western Kenya. Pre-ART subjects aged 19 to 49 years in clinical stages 1 and 2 of HIV and AIDS were sequentially recruited from PLWHA visiting the local VCT centre. Socio-economic, clinical and nutritional status were determined using a questionnaire, whereas haematological and T- lymphocytes subsets were determined by flow cytometer. Levels of trace elements in serum: Fe, Zn, Cr and Se of the subjects and selected indigenous foods were estimated using atomic absorption spectroscopy. Indigenous foods found to contain high levels of the elements were used to make food supplement. Bioavailability of the trace elements in the food formulation was estimated using in vitro digestion procedure and results compared with algorithm estimates. Most PLWHA (77.3 %) had normal weight (Body Mass Index = 18.5 to 24.9) and 63.3 % had anaemia (Haemoglobin < 12 g/dL and Red Blood Cell Distribution Width < 15.2 %). Only few subjects (4.2 %) had low levels of serum zinc indicative of zinc deficiency (< 70 g/dL). Low levels of CD4+ cells was associated with low levels of Mean Corpuscular Haemoglobin Concentration (r = 0.243, p > 0.05) and high levels of serum zinc (p = -0.195, p = 0.055). Incidence of Herpes zooster was associated with high levels of Red Blood Cells (r = 0.212, p = 0.017) and Haemocrit (r = 0.184, p = 0.039). Whereas low serum zinc level was negatively associated with fever (r = -0.195, p = 0.035), headache (r = -0.18, p = 0.017) and loss of appetite (r = -0.245, p = 0.007). Starch, protein, animal and plants food sources accounted for 45.17 %, 21.9 %, 17.48 % and 73, % respectively of total foods consumed by PLWHA in the division. Mean contents of trace elements analysed in the foods were in the range of 10.7 to 6.8 mg 100g-1 for iron, 3.5 to 0.56 mg 100g-1 for zinc, 0.3 to 0.17 mg 100g-1 for chromium and 0.05 to 0.015 mg 100g-1 for selenium. Levels of bioavailable elements predicted by algorithms zinc (13.9 %) and iron (1.2 %), were generally lower than the levels of dialyzable zinc (34.4 %) and iron (24.2 %) obtained in vitro digestion procedure. On average indigenous foods in the study area had adequate levels of iron, selenium and chromium, which are moderately bioavailable but very low levels of zinc. Indigenous foods consumed in this division, if mixed in good proportion can provide RDA for trace elements that boost immunity of PLWHA.