Nutrition Care for People Living with HIV (PLHIV) and/or Tuberculosis (TB) Clients in Ghana 1 Introductory Session Nutrition Assessment, Counselling, and Support 2 Training Course Objectives 1. Advocate for and discuss the role of nutrition in care and treatment 2. Assess and classify the nutritional status for PLHIV and/or TB clients 3. Select appropriate care plans based on nutritional status of clients 4. Provide appropriate nutrition counselling to PLHIV and/or TB clients 5. Prescribe and monitor specialised food products for acutely malnourished clients 6. Manage NACS services at the facility and community levels 7. Monitor and report NACS services 3 Module 1 Overview of Nutrition 4 Learning Objectives 1. Define basic nutrition terms 2. Explain the importance of nutrition for good health 3. Explain energy and protein requirements for people in different age groups 4. Explain the additional nutrition requirements for TB clients and PLHIV 5. Describe the interaction between HIV and TB 6. Describe the clinical symptoms, signs, and consequences of malnutrition 7. Describe the Critical Nutrition Actions (CNAs) 5 Definitions of Basic Nutrition Terms • Food is anything that provides the body with nutrients. • Nutrition is the body’s process of taking in and digesting food; using it for growth, reproduction, immunity, breathing, work, and health; and storing nutrients and energy in appropriate parts of the body. 6 • Nutrients are chemical substances in food that can be metabolised to provide energy to maintain, repair, or build body tissues. They include macronutrients and micronutrients. • Macronutrients = carbohydrates, protein, and fat (needed in large amounts) • Micronutrients = vitamins and minerals (needed only in small amounts) 7 Definition of Malnutrition • Malnutrition is an imbalance in nutritional status. A malnourished person can have either undernutrition or overnutrition. – Undernutrition is the result of taking in an inadequate amount or combination of nutrients to carry out needed body functions. – Overnutrition is the result of taking in more nutrients than the body needs over time. 8 Types of Undernutrition • Acute malnutrition is caused by a decrease in food consumption and/or illness, resulting in bilateral pitting oedema or wasting (low Mid-Upper Arm Circumference [MUAC]) — Severe Acute Malnutrition (SAM) — Moderate Acute Malnutrition (MAM) • Chronic malnutrition is caused by prolonged or repeated episodes of undernutrition starting before birth, resulting in stunting. Stunting is defined by low height- for-age. • Underweight is a composite form of undernutrition which includes elements of stunting and wasting. Underweight is defined by low weight-for-age. • Micronutrient deficiencies are a result of reduced micronutrient intake and/or absorption. The most common forms of micronutrient deficiencies are related to iron, vitamin A, and iodine. 9 Food Groups People should eat a variety of foods from all the food groups to get all the nutrients the body needs. 1. Energy-giving foods: Foods rich in carbohydrates and fat, e.g., cereals, plantains, bananas, roots, tubers, honey, sugar, fats, and oils. Important for giving the body energy. 2. Body-building foods: Foods rich in protein, e.g., pulses and nuts. Important for growth and repair. 3. Protective foods: Foods rich in vitamins and minerals, e.g., fruits and vegetables. Important 10 for the body’s protection.