[pronut-hiv] The efficacy of Plumpynut

["George Carter" <fiar@verizon.net>]

I think Dr. Mwadime's suggestions are excellent.

Due to a change in my original post, my comment was about ENSURE, not  
Plumpynut. The more recent post underscores this.

The efficacy of Plumpynut is not clear to me--I haven't looked at the  
data. It includes peanut paste, vegetable oil, milk powder, powdered  
sugar, vitamins and minerals. There was an interesting article on  
peanut allergy suggesting that peanut consumption may not be such a  
bad idea in terms of allergic response, as opposed to early and  
complete avoidance. See Science 2 November 2007 318: 740-741 [DOI:  
10.1126/science.318.5851.740] (in News Focus)  - I can get a pdf if  
anyone wants a copy....of course, the risks of peanut allergy should  
NOT be ignored!

Regarding Ensure, I don't know that there are data showing an  
increase in diarrhea or thrush/candidiasis among HIV+ users of the  
product. However, looking at the ingredients, it is mostly bad fats  
(corn oil) and high in sugar content while being minimal on vitamins  
and minerals. Indeed, the first listed ingredients are water, sugar,  
corn syrup (more sugar), corn maltodextrin, milk protein concentrate,  
soy oil, cocoa powder (I doubt fairly traded cocoa either)...and it  
deteriorates from there. In short, I think it is a crap formula.

Sugar and HIV are probably a bad mix, as an old dear and now departed  
friend, Chester Myers pointed out:
http://www.geocities.com/~jenniferjensen/QUESTIONS/sugarhiv.htm

See also this study underscoring a role for dental hygiene and the  
risk of a high sugar diet:
http://www.blackwell-synergy.com/doi/abs/10.1111/j. 
1600-0528.2004.00154.x?cookieSet=1&journalCode=com

I'm not suggesting no sugar for people with HIV - but an over-priced  
supplement which is MOSTLY sugar is contraindicated. And this from a  
company castigated worldwide by physicians, activists, people with  
HIV for its 500% increase in the price of ritonavir purely for profit  
motivations: a useful drug but I think there are other ways to boost  
PI levels... Yet, indeed, Abbott is REWARDED for their aggressive  
greed and they continue to push a really lousy product.

A rat study below underscores that any weight gain is fat, mostly not  
useful in HIV infection (where loss of lean tissue is the more  
dangerous situation; this may be somewhat different for women).
George M. Carter

**
www.elsevier.com/homepage/sah/spd/2007sample_pdfs/abst/02phys.pdf
603. Effect of flavour of liquid Ensure diet supplement on energy
intake in male SD rats - Archer Z.A., Brown Y.A., Rayner D.V.
et al. [Z.A. Archer, Division of Obesity and Metabolic Health,
Rowett Research Institute, Aberdeen Centre for Energy Regulation
and Obesity (ACERO), Bucksburn, Aberdeen, AB21 9SB Scotland,
United Kingdom] - PHYSIOL. BEHAV. 2006 89/3 (414-419) - summ
in ENGL
Outbred male Sprague-Dawley rats were provided with one of the
four flavours of the liquid diet, Ensure, in addition to chow pellets,
to examine whether differences in flavour lead to differences in en-
ergy intake i.e. degree of over-consumption. For half the rats, the
Ensure supplement was provided for 14 days and then withdrawn
for the final 8 days of the study, whereas the remaining animals
were allowed to consume Ensure for 22 days. All four flavours
of Ensure, chocolate, vanilla, coffee and asparagus, induced a sus-
tained increase in daily energy intake of approximately 15%. There
was an effect of flavour on initial consumption of the Ensure diet,
with coffee and asparagus flavours being consumed less avidly than
vanilla or chocolate. However, this effect was short-lived. Overall,
there was no effect of flavour on body weight gain, energy intake
from Ensure, total energy intake, body composition, or measured
blood hormones and metabolites. Withdrawal of Ensure resulted
in reductions in body weight gain, total energy intake, fat but not
lean tissue mass, and concentrations of blood leptin, non-esterified
fatty acids and triglycerides, but there was no effect of the flavour of
Ensure previously supplied on any of these parameters. The ability
of the liquid diet, Ensure, to stimulate long-term caloric over-con-
sumption is not due to its flavouring. Rather, other attributes of
Ensure must be more important, such as its intrinsic flavour, liq-
uid formulation, macronutrient composition, and ease of ingestion,
digestion and absorption. © 2006 Elsevier Inc. All rights reserved.