{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:40:48Z","timestamp":1760236848180,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["NIMH098729"],"award-info":[{"award-number":["NIMH098729"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Loss of lean muscle mass impairs immunity and increases mortality risk among individuals with HIV\/AIDS. We evaluated the relative contributions of protein supplementation and nutrition education on body composition among 600 women living with HIV\/AIDS in rural Andhra Pradesh, India. We conducted a cluster randomized controlled 2 \u00d7 2 factorial trial lasting six months with follow up at twelve and eighteen months. Interventions occurred in the Nellore and Prakasam regions of Andhra Pradesh by trained village women, ASHA (Accredited Social Health Activists), and included: (1) the usual supportive care from ASHA (UC); (2) UC plus nutrition education (NE); (3) UC plus nutritional protein supplementation (NS); (4) combined UC plus NE plus NS. A Bioimpedance Analyzer Model 310e measured body composition. SAS 9.4 analyzed all data. Mixed models using repeated measures evaluated lean mass change from baseline as primary and fat weight and total weight as secondary outcomes. Lean mass change was significantly associated with NS (p = 0.0001), NE (p = 0.0001), and combined NS plus NE (p = 0.0001), with similar associations for secondary outcomes. Stronger associations for total weight were observed with greater ART adherence. Nutritional interventions may improve physiologic response to HIV. Significant increases in lean mass resulted from independent and combined protein supplementation and nutrition education.<\/jats:p>","DOI":"10.3390\/nu14010179","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T23:29:07Z","timestamp":1640906947000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lean Mass Improvement from Nutrition Education and Protein Supplementation among Rural Indian Women Living with HIV\/AIDS: Results from Cluster Randomized Factorial Trial at 18-Month Follow-Up"],"prefix":"10.3390","volume":"14","author":[{"given":"Catherine L.","family":"Carpenter","sequence":"first","affiliation":[{"name":"Center for Human Nutrition, University of California, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavita","family":"Kapur","sequence":"additional","affiliation":[{"name":"Whitefield, Bangalore 560066, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Padma","family":"Ramakrishna","sequence":"additional","affiliation":[{"name":"People\u2019s Health Society, Nellore 524137, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Pamujula","sequence":"additional","affiliation":[{"name":"People\u2019s Health Society, Nellore 524137, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-2808","authenticated-orcid":false,"given":"Kartik","family":"Yadav","sequence":"additional","affiliation":[{"name":"Sue & Bill Gross School of Nursing, University of California, Irvine, CA 92697, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E.","family":"Giovanni","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, University of California, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Julian","sequence":"additional","affiliation":[{"name":"College of Medicine, Drexel University, Philadelphia, PA 19129, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria L.","family":"Ekstrand","sequence":"additional","affiliation":[{"name":"Center for AIDS Prevention, Department of Medicine, University of California, San Francisco, CA 94158, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Sinha","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-6620","authenticated-orcid":false,"given":"Adeline M.","family":"Nyamathi","sequence":"additional","affiliation":[{"name":"Sue & Bill Gross School of Nursing, University of California, Irvine, CA 92697, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.jaci.2005.04.036","article-title":"Mechanisms of nutrient modulation of the immune response","volume":"115","author":"McNeeley","year":"2005","journal-title":"J. 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