- Preventing and Combatting Wasting
Dr. Donald Kotler (in 1989) found that death quickly followed a loss of more than 46 percent of a person's lean tissue or 'body cell mass'(cited in Krales [August, 1999], Weighing in the modern way: Bioelectrical Impedance analysis and body composition, Body Positive XII(8).
This is known as "wasting." Wasting is associated with a decrease in subcutenous fat (the kind of fat that migrating birds and ultra-long-distance runners burn) according to a more recent report by Kotler (2002) from the Barcelona AIDS Conference (cited in Medscape/Reuters Health). Kotler also says in the 2002 report that wasting may be associated with cardiovascular problems. In fact, adipose (see http://en.wikipedia.org/wiki/Adipose_tissue; adipose makes up subcutenous fat that is lost in AIDS wasting)--is the fuel that the heart runs off.
Wasting may be caused by the HIV virus itself, which may cause the destruction of adipose; in addition, wasting may be brought on by anti-HIV drugs, and by diarrhea associated with AIDS-associated illnesses and/or anti-HIV drugs.
The body's fat may provide a reservoir for HIV according to recent research, and, at the same time, AIDS may destroy important fatty insulation.
Like the CD4 T-cells, the body's fat cells "have CCR5 receptors, and now it appears HIV uses these to infect fat cells, Jacques Leibowich and Pietri-Rouxel--of the Institut Cochin in Paris--reported at a meeting of the Institute of Human Virology at the University of Maryland in Baltimore" (November, 2002; AIDS Reader; cited in in Reuters Health/Medscape); similar findings have been reported by others: the HIV virus may possibly target human adipose cells which express the CD4 and other receptors, according to U. Hazan, I. A. Romero, and R. Cancellero (reported in Medscape's Medline [Reuter's Health], August, 2002). (According to some researchers, including Marjolein Visser, Lex M. Bouter, Geraldine M. McQuillan, Mark H. Wener, and Tamara B. Harris. "Elevated C-Reactive Protein Levels in Overweight and Obese Adults," in JAMA, interleukin 6 is one of the proteins associated with inflammation in the adipose tissue--this is associated with obesity in adults, and also with type 2 diabetes; I note that interleukin 6 production is increased in HIV infection, although no studies have been done of its role in inflamming the adipose tissue in HIV.)(Does this mean pump iron and run, run? Who knows? Or maybe consume foods rich in omega 3 fatty acids, the unsaturated fats in fish oils and olive oil? Another option is cinnamon, which seems to help the body to metabolize glucose for type 2 diabetes as well as to reduce cholesterol (see Khan, et. al., "Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes", Amy Campbell's "Can Cinnamon Help You Control Your Diabetes?", and Answers for Your Health.com's "Cinnamon: THe Cure for What Ails You"--but note, counter to what the last study says, all you really need is the water-soluble part of the cinnamon, which is good news for your liver! Garlic may have effects similar to those of cinnamon. Coenzyme Q10 is also associated with cell conversion of food to energy--see the Mayo Clinic's information on "Coenzyme Q10".)
According to Project Inform, "[o]ne interesting but unexplained observation was that people with fat loss in the face, arms or legs (lipoatrophy) had fewer mitochondria--mitochondria are essential to cell metabolism and to cellular energy--while people who developed a buffalo hump had an increased number." Project Inform says that this difference may be the result of the anti-HIV therapy.
As Project Inform has noted, the use of protease inhibitors should be monitored carefully, as these drugs may elevate fat and sugar levels in the blood and reduce protein levels, thereby leading to a decrease in lean tissue. Nucleoside analog reverse transcriptase inhibitors such as AZT may also be associated with wasting.
Diarrhea can be brought on by the use of drugs such as protease inhibitors, as well as by opportunistic infections, and even by HIV itself! Since diarrhea can lead to wasting, it is important to control it! Acidophillus and lactobacillus taken with yogurts or cottage cheese help restore the boyd's natural fauna and flora--which are essential to good digestion, and which are often destroyed by drugs and disease! Also, calcium and natural fibers, among other things, may help to control diarrhea! In addition, IAPAC (the International Association of Physicians in AIDS Care) has looked at controlling diarrhea and wasting with L-glutamine (an amino acid, a major component of muscular tissue; also possibly a digestive enzyme) and human growth hormone.
Always, a diet rich in both protein and fibers, and low in saturated fat, is a good idea, especially when you are sick for a long period, as the cells that make up the immune system require protein to be built and as these cells are used rapidly in long-term illness. (For my kitties with long-term illness, I've had very good luck with seaweed and sea kelp--which is about half protein and has fiber as well. For more on nutrition, see Our "Basic Nutrient Chart".
Sunshine, which converts the body's fats to vitamin D, may be beneficial too--who knows?
Biolectrical Impedance can measure wasting. It involves hooking electrodes to the body. Also, as you lose muscle mass, you may float more readily in water.
* * *