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Calculating energy requirements for men with HIV/AIDS in the era of highly active antiretroviral therapy

European Journal of Clinical Nutrition volume 57, pages 209–217 (2003)Cite this article

Abstract

Objective: 1. To determine if resting energy expenditure (REE) adjusted for body composition is elevated in HIV-positive males when compared with healthy controls in the era of highly active antiretroviral therapy. 2. To examine the accuracy of prediction equations for estimating REE in people with HIV. 3. To determine if REE adjusting for body composition is significantly different between those HIV-positive subjects reporting lipodystrophy (LD) or weight loss (≥5%) and those who are weight stable when compared to controls.

Design: Cross-sectional study.

Setting: Tertiary referral hospital HIV unit and an outpatient clinic specializing in HIV care.

Subjects: HIV-positive males (n=70) and healthy male controls (n=16).

Methods: REE was measured using indirect calorimetry. Body composition was assessed using bioelectrical impedance analysis.

Results: 1. REE when adjusted for fat-free mass and fat mass using the general linear model (analysis of covariance) was greater in HIV-positive subjects than controls (7258±810 kJ, n=70 vs 6615±695 kJ, n=16, P<0.05). 2. The Harris and Benedict, Schofield, Cunningham and the two equations previously published by Melchior and colleagues in HIV-positive subjects all gave an estimate of REE significantly different from the measured REE in the HIV-positive subjects, therefore a new prediction equation was developed. The inability of the published equations to predict REE in the different HIV-positive subgroups reflected the heterogeneity in body composition. 3. REE adjusted for fat-free and fat mass was significantly greater in the both the HIV patients who were weight stable and those with lipodystrophy compared with the healthy controls.

Conclusion: REE is significantly higher in HIV-positive males when compared with healthy controls. Body composition abnormalities common in HIV render the use of standard prediction equations for estimating REE invalid. When measuring REE in HIV-positive males adjustment steps should include fat-free and fat mass.

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Author notes

  1. M J Batterham: Guarantor: MJ Batterham.

  2. M J Batterham, J Morgan-Jones, P Greenop, R Garsia, J Gold and I Caterson: Contributors: MJB conceptualized the study, designed the study, collected and analysed the data, drafted the paper. JM-J assisted with the study design, collected the data and reviewed the paper. PG collected the data and reviewed the paper. RG assisted with study design and reviewed the paper. JG assisted with study design and reviewed the paper. IC assisted with study design and reviewed the paper.

Authors and Affiliations

  1. Smart Foods Centre, University of Wollongong, Wollongong, NSW, Australia

    M J Batterham

  2. The Albion Street Centre, Surry Hills, NSW, Australia

    J Morgan-Jones & J Gold

  3. Department of Nutrition, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

    P Greenop

  4. Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

    R Garsia

  5. Human Nutrition Unit, University of Sydney, NSW, Australia

    I Caterson

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Batterham, M., Morgan-Jones, J., Greenop, P. et al. Calculating energy requirements for men with HIV/AIDS in the era of highly active antiretroviral therapy. Eur J Clin Nutr 57, 209–217 (2003). https://doi.org/10.1038/sj.ejcn.1601536

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