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Evidence Analysis Questions:
 What is the evidence to support a particular dietary intake of energy for people with HIV infection?
Twenty-four studies were evaluated regarding energy intake in people with HIV infection. Eight out of nine studies report increased resting energy expenditure (as much as 5% to 17%) in people with HIV infection, compared to healthy controls. However, total energy expenditure may be similar to that of control subjects. Energy balance deficits result in growth failure in children with HIV infection. Factors related to energy needs in people with HIV infection include stage of disease, opportunistic infections and comorbidities, inflammation and effects of medications. Further research is needed regarding energy requirements in people with HIV infection.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
If a very large meal (>900 kcal) is consumed within 5-hours of a RMR measurement, then a longer time (at least 6 hours) is recommended to reduce diet-induced thermogenesis impact on RMR to clinically insignificant levels (<100 kcals/day) in individuals.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
12 studies were evaluated regarding the association between underweight or weight loss and depression in adults over age 65. Four studies report an association between weight loss or poor nutritional status and depression, while two studies report no association between low BMI and depression. Additional studies report that weight loss may be common in depressed individuals with Alzheimer's disease, individuals who are recently widowed, demented individuals and individuals on antidepressant therapies. Further research is needed in this area.
Grade II
Overall strength of the available supporting evidence: Grade I - good; Grade II - fair; Grade III - limited; Grade IV - expert opinion; Grade V: not assignable
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