Case Study #3

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Feb 20, 2024

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CASE STUDY #3 BY: Riya Patel Date: November 10, 2023 CLASS: NUTR 4050 Body Weight and Lipids in HIV Infection In HIV infection, body weight and lipid levels can be affected. Some individuals may experience weight loss due to factors like decreased appetite, malabsorption, or increased metabolism. On the other hand, some people may experience weight gain due to factors like changes in body composition or certain medications.

If Mr. J’s current weight is 60 kg and his desired weight is 68 kg, we can calculate the BMI for both scenarios. For the current weight of 60 kg: BMI = 60 kg / (1.68 m)^2 = 21.26. For the desired weight of 68 kg: BMI = 68 kg / (1.68 m)^2 = 24.10. According to the World Health Organization (WHO) classification, a BMI between 18.5 and 24.9 is considered within the healthy weight range. Based on the calculations, Mr. J’s current weight of 60 kg falls within the healthy BMI range, and his desired weight of 68 kg would still be within the healthy range. Therefore, gaining weight to 68 kg would not put him in the overweight range but would still keep them in the healthy BMI range. According to the reading, I believe the patient’s body weight would increase. However, looking through his 24-hour dietary recall, he is eating non-nutritious foods which is causing him to gain weight. The foods he is consuming is high in calorie and high in sugar. For example, the full Snickers bar he consumes is not necessary to eat, and this is just putting extra sugar into the body causing weight gain. As a result, this quote from Cancer Council states, “ Sugar is a type of carbohydrate which provides energy to the body. However, eating too much sugar over time can lead to weight gain.” The food that Mr. J eats while prescribed this medication is not a great way to improve its function. Mr. J takes the pills, atazanavir and ritonavir, when he eats his after-dinner snack, which is not the best meal he eats out the day. These medications are most likely instructed to take when consumed with light meals. Understandable, that Mr. J’s after-dinner snack is not considered a big meal, but it does not have the nutritious quality that is needed for the pills to work their function. A diet high in saturated fat, sugar, and simple carbohydrates can lead to increased lipid levels, especially triglycerides. Having increased belly fat is associated with 2

elevated levels of LDL cholesterol, as well as high blood pressure and the risk of developing diabetes. People with diabetes, especially those who are sedentary, can also have disorders in which triglycerides accumulate in muscles or the liver, rather than being used as energy, which removes them from the body. Taking certain medications, such as steroids, estrogen used in birth control pills, and certain medications to treat high blood pressure and psychiatric conditions, can increase lipid levels. However, Mr. J’s lipid levels should be around: total cholesterol below 200 mg/dL, LDL cholesterol below 130 mg/dL, HDL cholesterol above 60 mg/dL, triglycerides below 150 mg/dL, and non- HDL cholesterol below 160 mg/dL. Overall, Mr. J's desire to gain weight to 68 kg would keep him in the healthy BMI range. After becoming sober and starting HAART for HIV, an increase in body weight was expected. HAART and the end of drug use can lead to an increase in appetite and BMI. The initiation of HAART and the reversal of HIV-associated wasting can lead to weight gain. Eating foods with anti-inflammatory properties can support a strong immune system in HIV patients. His 24-hour dietary recall reveals the following: Breakfast - 2 eggs fried in butter - 1 strip fried bacon - 1 cream cheese pastry - 12 oz. of 2% milk - Orange juice - Coffee Snack - None Lunch - 2 whole sandwiches made of white bread, ham, lettuce, mustard, mayo, and cheese - One 1 oz. bag of regular potato chips - One regular size Snickers bar 3

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- 12 oz. of 2% milk Snack - None Dinner - Two pieces of fried chicken with the skin on - 2 cups of green salad - 3 tablespoons of regular Ranch dressing - 12 oz. of 2% milk After-Dinner snack - Two whole English muffins with 1 tablespoon of butter each - 6 oz. of plain tea His most recent lipid labs are listed below: Total Cholesterol 236 mg/dL Triglycerides 512 mg/dL LDL Cholesterol unable to calculate HDL Cholesterol 25 mg/dL Non-HDL Cholesterol 211 mg/dL 4

Works Cited Cancer Council Victoria. (1899, December 31). Sugar . https://www.cancervic.org.au/about/careers Dr. Alex Anderson NUTR 4050 Lecture World Health Organization. (n.d.). World Health Organization (WHO) . World Health Organization. https://www.who.int/ 5

Case Study #3

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