I am doing a research paper on AIDS wasting and I was going to address using two different meal plans for patients who are experience wasting. I was wondering if you have any advise on how I should hypothetical plan meals for my patients.

First, I would make sure that HIV viral load is controlled and undectectable, and that diarrhea is treated if present. Issues like lack of appetite, nausea, depression, fatigue, and mouth ulcers can also get in the way of gaining needed lean body mass critical to survival and quality of life.

1- Provide at least 17 Kcal per Kg per day 2- Determine if the patient is lactose intolerant 3- Use Calory-dense foods (cheese, peanut butter, creams, nuts, lean meats,etc). Some patients deal better with snacks than with full meals. Snacking every 2-3 hours can provide caloric needs when a patient cannot handle 500+ calorie meals. 4- Ensure that free testosterone and thyroid function are normal, and if not, supplement. 5- If appetite and/or nausea are an issue, smaller meals and the use of Marinol may be useful 6- Oxandrin, an oral mild anabolic, can also increase appetite and help to increase lean body mass more effectively 7- Supplements like whey protein shakes and JUVEN, an aminoacid mix, can also be added to the diet. 8- Limit sugar intake and "empty calories" 9- Megace, a progesterone-based drug, increases appetite and weight, but the gains are mostly fat and it decreases testosterone levels. This drug can be used in extreme cases of wasting, though. 10- Resistance training, even if light and only twice a week, can help increase lean body mass when proper nutrition is in place. 11- Have the patient seek counseling and treatment if depression is a barrier to eating.

You can look at our web site wwww.medibolics.com for more info.

There are very good resources listed here: http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=2&tax_subject=278&topic_id=1380