The relationship between healthy eating and a healthy life is often overlooked by people living with HIV. Between concerns about getting case management, health care, and medicine, nutrition gets placed on the back burner. In addition, the cost of buying healthy food can be hard to justify when you are scraping by to afford health insurance, prescriptions, rent, and utilities.
That’s where ASA’s Medical Nutrition Therapy (MNT) Program comes in. About one-third of our food bank clients use the MNT program to establish realistic goals for their nutritional health. Our registered dietitian (RD) Christine Marquette works with more than 80 clients yearly.
“Some clients are homeless and therefore very food insecure which has caused many health problems,” Christine explains. “So our program is helping to meet their basic needs. Others may just have had a setback and need some help getting their nutritional health back on track.”
Before clients can access MNT services, they must complete a nutritional risk screen (which looks at their medical history, current medical needs, and current eating habits), and they must have received an AIDS diagnosis or be showing symptoms. Christine helps clients with issues ranging from weight-loss or weight-gain to managing other medical needs such as diabetes.
“Once the client is scheduled for an initial MNT appointment,” Christine describes, “We go through a detailed assessment including a measurements of body fat, hydration, and muscle mass; questions about the client’s medical history, medications, recent lab work, social history; and understanding their access to food, what they eat, and how often they eat.”
After this initial 90 minute assessment, Christine determines if the client needs supplemental nutrition, and if so, what type is most appropriate. The client can then pick up these supplements with every food bank visit, which includes a weigh-in to monitor their nutritional status. In order to continue receiving supplements, MNT clients must attend follow-up appointments.
“Our goal has been to have a show rate of more than 75%,” Christine explains. “Historically we have been in the 70 – 80% range, but for three months this year, we have achieved a show rate (or “retention in care”) of over 90%!” In addition, Christine has recently seen two elderly clients (in their 70s) graduate from the MNT program.
Interacting with clients is Christine’s favorite part of working in the MNT program at ASA. “They are all such unique individuals and many have overcome so many challenges & obstacles, both in life in general and in their health, it really makes me appreciate my own life circumstances and health. My goal with each client is to do the best assessment I can to help them set their own realistic goals regarding their nutritional health. I am very happy when clients graduate from the program and feel a sense of accomplishment that they can handle their nutritional needs without me.”
Christine recently had a client re-enroll in the MNT program after being released from prison. In addition to a history of drug and substance abuse, this particular client had a history of missing appointments. Unfortunately, due to the high demand among clients, the program has a strict three strikes rule: Three missed appointments means being unable to continue receiving MNT services at ASA.
“When the client re-enrolled, his weight was at 88% of his ideal body weight,” Christine recalls. “He kept his initial appointment and started coming to food bank every two weeks for his supplements and to get his weight check. He managed to stay sober for 5 straight months and got his weight up to 90% of his ideal body weight! Although he did have a small relapse with drugs and alcohol, causing him to miss one food bank week, he made his follow-up MNT appointment and has gotten back on track with sobriety. He has also joined a gym and is doing yoga and swimming twice a week, in addition to following a healthy eating plan.”
Since our registered dietician is only available part-time for the MNT program, we also strive to provide nutritional education classes once a quarter, which are open to all ASA clients. “Topics we have covered in the past include what to eat if you have high blood pressure, portion sizes/how to serve a healthy plate, as well as cooking demos with various foods (grains, proteins, etc.).”
Learn more about these demos in our blog post: CAFB Class Builds Cooking Skills