Edwin is a 42-year-old male who has been HIV1 for 20 years. His viral load is undetectable and his CD41 count is 643. His current HIV antiretroviral regimen is raltegravir (Isentress), atazanavir (Reyataz), ritonavir (Norvir), and emtricitabine (Emtriva); he also takes atorvastatin (Lipitor) and ranitidine (Zantac). His height is 5990 and his weight is 188 lb. His fasting lipid profile shows a total cholesterol 184 mg/dl, triglycerides 304 mg/dl, high-density lipoprotein 25 mg/dl, and low-density lipoprotein 96 mg/dl. Since his last visit 6 months ago, he has noticed changes in his body composition including loss of buccal fat and increasing abdominal girth. Edwin lives by himself and doesn’t like to cook; he also receives one meal per day from a community program. He walks for 30 minutes daily. Upon taking a 24-hour recall, you find his caloric intake to be 2700 kcal/day’
Nutrition Care Statements
Excessive dietary intake caused by frequent intake of prepackaged meals as evidenced by diet history. NB-1.7. Altered nutrition laboratory values as evidenced by results of lipid profile assessment. NC-2.2 Unintended body composition change of increased adiposity as evidenced by increased abdominal girth. NC-3.4
Nutrition Care Questions
1. What factors may be contributing to the body shape changes that Edwin is experiencing?
2. What nutrition and lifestyle interventions would you recommend to address his nutrition diagnoses?
3. What are some biochemical and nutritional parameters you would monitor to determine whether the nutrition interventions are effective?
4. How would you evaluate the desired nutrition outcomes to determine whether they have been met?
5. Edwin has also been complaining of nausea and diarrhea. What recommendations do you suggest for these symptoms? Are there any drug-nutrient interactions of which you need to be aware?