Browsing by Author "Neumann, Charlotte G."

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    Effects of Animal Source Food Supplementation on Neurocognitive Outcomes of HIV-Affected Kenyan School-Aged Children: A Randomized, Double-blind, Controlled Intervention Trial
    (2016-10-10) Neumann, Charlotte G.; Loo, Kek Khee; Weiss, Robert E.; Sugar, Catherine; Chen, Qiaolin; Rizzo, Shemra; Ettyang, Grace; Ernst, Judith A.
    Assess the effects of animal source food (ASF) versus soy versus wheat biscuit supplementation on the neurocognitive performance of HIV-affected, nutritionally at-risk school-aged children in rural Kenya.
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    Effects of biscuit-type feeding supplementation on the neurocognitive outcomes of HIV-affected school-age children: a randomized, double-blind, controlled intervention trial in Kenya
    (Compuscript, 2017-12-01) Khee Loo, Kek; Rizzo, Shemra; Chen, Qiaolin; Weiss, Robert E.; Sugar, Catherine A.; Ettyang, Grace; Ernst, Judith; Samari, Goleen; Neumann, Charlotte G.; Health Sciences, School of Health and Rehabilitation Sciences
    Objective: To determine if meat or soy protein dietary supplementation will enhance the neurocognitive performance of HIV-affected children at-risk of malnutrition and food insecurity. Methods: A randomized, double-blind, controlled intervention trial evaluated the effect of nutritional supplementation on the neurocognitive outcomes of 49 HIV-affected school-age children in western Kenya. The intervention consisted in providing the mother, target child, and siblings with one of three isocaloric biscuit-type supplements – soy, wheat, or beef – on 5 days per week for 18 months. Neurocognitive outcomes of the target children were assessed by a battery of eight measures and followed up longitudinally for up to 24 months. Results: Mixed effects modeling demonstrated significant differences in the rates of increase over time among all three groups (F test degrees of freedom of 2, P<0.05) for Raven’s progressive matrices performance, but not for verbal meaning, arithmetic, digit span backward, forward, and total, embedded figure test, and Beery visual–motor integration scores. Conclusion: HIV-affected school-age children provided with soy protein supplementation showed greater improvement in nonverbal cognitive (fluid intelligence) performance compared with peers who received isocaloric beef or wheat biscuits. Soy nutrients may have an enhancing effect on neurocognitive skills in HIV-affected school-age children
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    High-nutrition biscuits to increase animal protein in diets of HIV-infected Kenyan women and their children: A study in progress
    (Food and Nutrition Bulletin, 2014-12-30) Ernst, Judith A.; Ettyang, Grace; Neumann, Charlotte G.
    Background. Preliminary evidence suggests that improved nutrition early in HIV infection may delay progression to AIDS and delay the initiation or improve the effectiveness of antiretroviral drug therapy. There are few studies that evaluate food-based interventions in drug-naïve, HIV-infected women and their children. Meat provides several nutrients identified as important in maintaining immune function and lean body mass. Objective. To design supplemental meat and soybean biscuits for use in a randomized trial examining the effect of meat in the diet of drug-naïve, HIV-infected rural Kenyan women on changes in weight, lean body mass, morbidity, nutritional status, and activities of daily living of the women and growth and development of their children. Methods. We designed three supplemental biscuits: one with added dried beef, another with added soybean flour, and a wheat biscuit to serve as a control biscuit to be used in a randomized feeding intervention in drug-naïve, HIV-infected rural Kenyan women and their children. The nutritional contents of the different types of biscuit were examined and compared. Results. The three biscuits were isocaloric. Meat biscuits provided more lysine, vitamin B12, and bioavailable zinc. Soybean biscuits provided more total and absorbable iron; however, higher fiber and phytate contents may inhibit nutrient absorption. Data analysis for clinical outcomes of the trial is ongoing. Conclusions. The “biscuit model” is useful for nutrition supplementation studies because it can be provided in a blinded and randomized fashion, safely and privately in a home under directly observed consumption by a highly stigmatized population. It is well received by adults and children, and the biscuits can be produced locally with available, simple, affordable technology.
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    Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV
    (Taylor & Francis, 2016) Neumann, Charlotte G.; Nyandiko, Winstone; Siika, Abraham; Drorbaugh, Natalie; Samari, Goleen; Ettyang, Grace; Ernst, Judith A.; Department of Health Sciences, School of Health and Rehabilitation Sciences
    This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week and physical inspection. Blood and urine samples were examined for determination of immune function (CD4, CD8, and total lymphocyte counts), anaemia, malaria, and pregnancy status. Intradermal skin testing with tuberculin (PPD), candida, and tetanus toxoid antigens was also performed to evaluate cell-mediated immunity. Anthropometry was measured, and body mass index (BMI) was calculated. Seventy-six per cent of the women reported being sick on the day of the interview or within the previous week. Illnesses considered serious were reported by 13.7% of women. The most frequent morbidity episodes reported were upper respiratory tract infections (13.3%), suspected malaria (5.85%), skeletal pain (4.87%), and stomach pain (4.42%). The most common morbidity signs on physical inspection were respiratory symptoms, most commonly rhinorrhea and coughing. Confirmed malaria and severe diarrhea were significantly associated with a higher BMI.