Group-based intervention in a primary healthcare setting was more effective for weight loss than usual care

Background: Literature and practice recommendations for lifestyle interventions to treat the increasing number of obese patients with non-communicable diseases (NCDs) or risk factors for NCDs attending resource-constrained public healthcare facilities in South Africa are scarce. Aim: To compare the impact of a facility-based therapeutic group (FBTG) intervention with usual care on weight in obese participants, with NCDs or risk factors for NCDs. Setting: Public healthcare facility providing primary healthcare services in Cape Town, SouthAfrica. Methods: A quasi-experimental study design was used where participants chose to receive weight loss treatment with either the FBTG or usual care interventions. Both interventions involved a one-on-one medical and dietetic consultation, while FBTG participants had six additional group sessions. Follow-up assessments took place 6 months after baseline. Socio demographic variables, blood pressure, smoking status, weight, height, waist circumference, dietary intake, physical activity and stage of change were measured. Results: Of the 193 obese adults enrolled, 96 selected the FBTG and 97 selected usual care. There were no significant differences at baseline between the two groups. Weight loss over 6 months was greater (p < 0.001) in FBTG (median [IQR] of -2.9 [-5.1; -0.3] kg) than usual care (-0.9 [-0.9; 0.6] kg) participants. At 6 months, more FBTG completers reached the weekly target of 150 min (p = 0.009), while both groups showed improvements in dietary intake. More FBTG (74%) than usual care (49%) participants were in the action stage of change by 6 months (p=0.010). Conclusions: The group-based intervention was more effective than usual care in weight reduction as well as improvements in physical activity and stage of change

Nutrition in HIV: a Review

Knowledge about the relationship between the human immunodeficiency virus (HIV); nutritional status; treatment; food and nutrition interventions continues to accumulate. This article provides an overview of the main nutrition related issues for people living with HIV (PLHIV) and a review of the potential benefits of nutrition interventions for people affected by HIV. Nutrition plays a vital role in the immune system of all people; including (PLHIV). Good nutrition strengthens the immune system; while HIV infection and poor nutrition have a cumulative effect in damaging it. PLHIV are more vulnerable to malnutrition than the general population and nutritional status is a good predictor of their mortality risk. Malnutrition in PLHIV often occurs in a background of poverty and lack of access to food. It is not always possible toidentify one single cause as the main contributor to declining nutritional status or malnutrition in HIV. Inadequate food intake; increased requirements and malabsorption are the main reasons for weight loss in PLHIV. Asymptomatic adults with HIV infection have a 10higher energy requirement and symptomatic PLHIVhave 20-30higher energy requirements than the general population. Kilojoule/kilocalorie requirements increase by 50-100in children experiencing weight loss. Evidence for increasing protein and micronutrient intake in healthy PLHIV is inadequate. Nutritional education should be an essential component of HIV care and treatment; as it can help PLHIV cope with symptoms of disease; prevent weight loss and manage side effects of medication. In resource limited settings; food support programs may be required in addition to nutrition support to optimise nutritional status and health outcomes in PLHIV who are food insecure.higher energy requirement and symptomatic PLHIVhave 20-30higher energy requirements than the general population. Kilojoule/kilocalorie requirements increase by 50-100in children experiencing weight loss. Evidence for increasing protein and micronutrient intake in healthy PLHIV is inadequate. Nutritional education should be an essential component of HIV care and treatment; as it can help PLHIV cope with symptoms of disease; prevent weight loss and manage side effects of medication. In resource limited settings; food support programs may be required in addition to nutrition support to optimise nutritional status and health outcomes in PLHIV who are food insecure

Onchocerciasis in Malawi. 2. Subjective complaints and decreased weight in persons infected with Onchocerca volvulus in the Thyolo highlands

In the course of an onchocerciasis survey in southern Malawi; body weight was recorded for 10;335 persons aged 20 years and older; and the body mass index was calculated for 5572. A history of symptomatic complaints was elicited from 5653 persons 20 years of age and older. Persons with microfilariae in the skin snips weighed significantly less than persons with negative skin snips. Symptomatic complaints of musculoskeletal pains; itching; dizziness and poor vision were reported more commonly in the group with microfilariae. These findings suggest that onchocerciasis should no longer be considered a disease affecting the eye and skin only but an infection which produces systemic effects as well. Systemic effects of onchocerciasis may lessen productivity of an endemic region by a process distinct from the effects of visual impairment