STAYING HEALTHY WITH AIDS/HIV

 

A FEW REASONS WHY NUTRITION IS SO IMPORTANT

Good nutrition is important to all people — whether or not they are living with HIV. But some conditions related to HIV/AIDS and its treatment (including, wasting, diarrhea, and lipid abnormalities), mean that proper nutrition is really important to people with HIV. Eating well is key to maintaining strength, energy, and a healthy immune system. In addition, because HIV can lead to immune suppression, food safety and proper hygiene is a concern to prevent infections.

GOOD HEALTH STARTS WITH A HEALTHY DIET

A healthy diet is essential to maintaining good health across your life span. The U.S. Food and Drug Administration defines a healthy diet as one that provides enough of each essential nutrient, contains a variety of foods from all of the basic food groups, provides adequate energy to maintain a healthy weight, and does not contain excess fat, sugar, salt or alcohol. There are six essential nutrients:

  • Protein builds muscles and a strong immune system.

  • Carbohydrates (including starches and sugars) give you energy.

  • Fat gives you extra energy.

  • Vitamins regulate body processes.

  • Minerals regulate body processes and also make up body tissues.

  • Water gives cells shape and acts as a medium in which body processes can occur.

Before you make major changes in your diet, however, contact your primary care provider, or a registered dietician who specializes in HIV care, to get a better assessment of your nutritional needs.

THE CONNECTION BETWEEN HIV AND YOUR DIET

HIV and many of its treatments can change your body’s metabolism — or the way your body processes nutrients and other substances (like body fat). Some of these metabolic changes can lead to lipodystrophy, insulin resistance, andwasting syndrome, and can affect the way you look and feel.

In addition, nausea, vomiting, and diarrhea are common conditions associated with HIV and its treatments. These side effects can keep you from eating or cause you to lose essential nutrients. They can also cause you to be dehydrated.

Because HIV progression is often slow, changes in your metabolism and physical appearance may be slow as well. That’s why it’s so important to pay attention to your diet and eat properly on a daily basis — it will help you in the long-run.

If you are experiencing metabolic changes, or vomiting and diarrhea, don’t be afraid or embarrassed to discuss these important issues with your healthcare provider. Your provider will need to know what’s happening with your body in order to decide the best way of supporting your nutritional needs. While some of these issues can’t be prevented or treated with dietary modifications alone, healthy eating and proper nutrition are critical parts of the process.

SAFETY FIRST

Because HIV affects your immune system, you may be at greater risk for food-borne illness. So in addition to eating well, you need to eat safely. By following a few basic safety rules when you prepare and eat your meals, you can protect yourself from food-related illness:

  • Avoid eating raw eggs, meats, or seafood (including sushi and oysters/shellfish).

  • Wash fruits and vegetables thoroughly.

  • Use a separate cutting board for raw meats.

  • Wash hands, utensils, and cutting boards with soap and water after each use.

  • Water safety is extremely important, as water can carry a variety of parasites, bacteria, and viruses. To protect yourself against these infections, here are some helpful hints:

    • Do not drink water from lakes, ponds, rivers, or streams.

    • You may choose to use a store-bought water filter at home for your drinking water.

    • You can significantly reduce your risk of water-borne illness by using only boiled water for drinking and cooking.

    • When traveling abroad in areas where sanitation is poor or water safety is questionable, drink only bottled water and avoid ice or unpasteurized juices and drinks.

Do I need supplements?

Our bodies need vitamins and minerals, in small amounts, to keep our cells working properly. They are essential to our staying healthy. People with HIV need extra vitamins and minerals to help repair and heal cells that have been damaged.

Even though vitamins and minerals are present in many foods, your health care provider may recommend a vitamin and mineral supplement (a pill or other form of concentrated vitamins and minerals). While vitamin and mineral supplements can be useful, they can’t replace eating a healthy diet.

If you are taking a supplement, here are some things to remember:

  • Always take vitamin pills on a full stomach. Take them regularly.

  • Some vitamins and minerals, if taken in high doses, can be harmful. Talk with your VA health care provider before taking high doses of any supplement.

How much water do I need?

Drinking enough liquids is very important when you have HIV. Fluids transport the nutrients you need through your body.

Extra water can:

  • reduce the side effects of medications

  • help flush out the medicines that have already been used by your body

  • help you avoid dehydration (fluid loss), dry mouth, and constipation

  • make you feel less tired

Many of us don’t drink enough water every day. You should be getting at least 8-10 glasses of water (or other fluids, such as juices or soups) a day.

Here are some tips on getting the extra fluids you need:

  • Drink more water than usual. Try other fluids, too, like Gatorade or Sprite.

  • Avoid colas, coffee, tea, and cocoa. These may contain caffeine and can actually dehydrate you. Read the labels on drinks to see if they have caffeine in them.

  • Avoid alcohol.

  • Begin and end each day by drinking a glass of water.

  • Suck on ice cubes and popsicles.

Note: If you have diarrhea or are vomiting, you will lose a lot of fluids and will need to drink more than usual.

WHY IS EXERCISE IMPORTANT?

Exercise cannot control or fight HIV disease, but it may help you feel better and fight many of the side effects of HIV disease and HIV medications. It can also help you live healthier while ageing with HIV.

WHAT ARE THE ADVANTAGES OF EXERCISE?

Regular, moderate exercise has many of the same advantages for people with HIV disease as it does for most people. Exercise can:

  • Improve muscle mass, strength and endurance

  • Improve heart and lung endurance

  • Improve your energy level so you feel less tired

  • Reduce stress

  • Enhance your sense of well-being.

  • Increase bone strength

  • Decrease LDL cholesterol and triglycerides

  • Increase good (HDL) cholesterol

  • Decrease fat in the abdomen

  • Improve appetite

  • Improve sleep

  • Improve the way the body uses and controls blood sugar (glucose) which reduced the risk of Type II diabetes

WHAT ARE THE RISKS OF EXERCISE?

  • You can get dehydrated (lose too much water) if you do not drink enough liquids to keep up your fluid levels.

  • Injuries may take more time to heal.

  • You can lose lean body mass if you exercise too much.

  • You can injure yourself if you use the wrong “form” in exercises.

  • Exercise can help those with heart disease, but talk to your doctor to make sure that you are able to exercise safely!

EXERCISE GUIDELINES FOR PEOPLE WITH HIV

Don’t Overdo It!

A moderate exercise program will improve your body composition and minimize health risks. At first, go slow and schedule exercise into your daily activities.

Work up to a schedule of at least 20 minutes, at least three times per week to the best of your abilities. This can lead to significant improvements in your fitness level and you may feel better. As your strength and energy increase, try to aim at 45 minutes to an hour, three to four times a week.

People with HIV can improve their fitness levels through training like those who do not have HIV. However, people with HIV may find it harder to continue with a training program because of fatigue and pain in the feet (neuropathy, see Fact Sheet 555). These issues are not seen less often with new HIV medications, however.

Vary your exercise routine so that you do not get bored. Find new ways to keep yourself motivated to maintain your exercise program. Find a friend who can become your “exercise buddy.”

Your fitness level may be different than it used to be. It is very important that you work your way into an exercise program to avoid injury. Starting with 10 minute sessions is good enough until you build up to an hour.

Eat and Drink Correctly

Drinking enough liquids is very important when you exercise. Extra water can help you replace the fluids you lose. Remember that drinking tea, coffee, colas, chocolate, or alcohol can actually make you lose body liquid.

Don’t eat a big meal before you exercise (snacking is OK). Try to eat during the first hour after the exercise session to replenish your body’s energy storage. Having a small snack like an apple or small peanut butter sandwich on multigrain bread before working out can provide you with a boost in energy.

Proper nutrition is also important. With increased activity, you may need to eat more calories to avoid losing weigh, unless weight loss is your goal.

Choose Something You Enjoy

Choose activities that you like. Whether it is yoga, running, bicycling, or another sport, doing something you like will encourage you to maintain your program. Try not to sit for over 2 hours. Take breaks and walk around. Don’t get into a rut! Change your activities if you need to so that you stay motivated.

If your fitness level is good, you can compete in competitive sports. Taking part in competitive or team sports does not pose a risk of spreading HIV to other athletes or coaches. Keeping your HIV viral load undetectable protects you and other around you, and may prevent you from losing lean body mass.

Exercise with Weights

Weight training (resistance exercise) is one of the best ways to increase lean body mass and bone density that may be lost through HIV disease and aging. Working out three times a week for an hour should be enough if done well. Doing weight training followed by 30 minutes of cardiovascular exercise may be the best way to improve body composition and keep your blood lipids and sugar down. Cardiovascular exercise means increasing oxygenation and heart rate while moving large muscle groups continuously for at least 30 minutes. Activities such as brisk walking, jogging, dancing, bicycling or swimming can be considered cardiovascular exercise. Walk your dog, park your car far, use the stairs, and get creative about ways not to remain sedentary. The quality of your old age depends on this!

THE BOTTOM LINE

Exercise can improve lean body mass, decrease fat, stress, fatigue and depression; improve strength, improve strength, endurance, and cardiovascular fitness, It may also help the immune system work better.

FOR MORE INFORMATION

You can get more information on exercise and HIV from the following:

Exercise: The Best Therapy for Managing Side Effects, at http://positivelyaware.com/2009/09_05/exercise.shtml

HIV and Exercise: http://www.thebody.com/tpan/julaug_02/exercise.html

Medibolics web site: http://www.medibolics.com/exercise.html

Ten Things You Can Do to Improve Your Physical Fitness: http://www.thebody.com/bp/10things/fitness.html

From: http://www.aidsinfonet.org/fact_sheets/view/802

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