FOR THE PAST 10 YEARS, AS Dr. Catherine Carpenter (PhD ’96) has traveled to India as part of an international research team focused on nutrition and women’s health, she has seen the transformation of many Indian cities into globalized urban areas. “There’s a lot of new construction, a lot of new buildings, especially in Chennai,” explains Carpenter, a UCLA Fielding School professor of epidemiology with joint appointments in the schools of nursing and medicine. “Every time I travel to Chennai, there are new additions — to the airport, to the city — and it’s busy. Then, traveling into the rural areas, one often sees extreme poverty.”
Carpenter’s work in India focuses on the benefits of protein for recovery from malnutrition; the joint Indian-American research team she is part of has worked since 2012 on a variety of randomized nutritional intervention trials seeking to find ways to improve the health of Indian women in rural areas — especially those living with HIV/AIDS.
“Somebody who has HIV/AIDS, who has progressed in terms of the disease, often gets what is called muscle wasting,” Carpenter says. “The disease places a strain on the immune system, and in the context of malnutrition, the body turns to the muscle to supply it with enough protein to support an immune response and you see the characteristic signs of muscle wasting — people with very thin upper arms.”
People living with HIV/AIDS, especially in a setting of widespread malnutrition, are at a high risk of nutritional deficiency and poor nutritional status leading to a weakening of the immune response and worsening recovery, Carpenter explains. Malnourished individuals who start antiretroviral therapy are generally at a higher risk of mortality. In addition, nutrient deficiencies increase the person’s susceptibility to infection from opportunistic diseases (such as human papillomavirus, or HPV; salmonella; and candidiasis, or thrush), which occur more frequently and are more severe in people with compromised immune systems.