Although everyone can benefit from healthy eating, people with HIV/AIDS have special nutritional needs because the virus weakens their immune system and makes it more susceptible to illnesses if they don’t consume adequate nutrients. Conversely, good nutrition strengthens the body, boosts its resistance to infection and disease and improves energy.
Living with the virus can precipitate a chain reaction of nutritional emergencies that can lead to malnutrition. For example, many individuals with HIV suffer from a loss of appetite and may find it difficult to eat, leading to an inadequate intake of nutrients. “With poor nutrition absorption, individuals may not be able to digest foods efficiently, and therefore, the body may not be able to use the nutrients properly, particularly fats, carbohydrates and proteins,” states HIV/AIDS: A Guide For Nutrition, Care and Support, produced by the Food and Nutrition Technical Assistance Project for program development managers.
What’s more, diarrhea, which sometimes accompanies the virus, can also decrease the body’s ability to fully absorb nourishment and can result in a loss of key minerals, water and nutrients the body needs.
Years ago, after Dawn, a New York resident, learned that she’d acquired HIV, she met with a certified nutritional counselor for advice about what to eat when she didn’t feel good. Side effects from the meds prescribed for Dawn’s antiretroviral (ARV) treatment for HIV sometimes left her feeling nauseous and prompted her stomach to turn flip-flops.
Besides the nausea, Dawn was hit with diarrhea. Her distressing bouts in the bathroom left her feeling weak and wasted and made it difficult to eat. After periodic episodes of poor appetite stripped 30 pounds from her already spare frame, Dawn found herself hiding out at home. She withdrew from family, friends and coworkers, who expressed concern about how ill she looked. To arrest her unwanted weight loss, she stopped taking the medication responsible for her digestive issue and eventually crossed the line into nonadherence. “That’s when my doctor put his foot down and ordered me to get some help,” she says. “He referred me to a team of nutritionists who specialized in dietary counseling and made it clear that he expected me to make an appointment as soon as possible. I didn’t know what else to do, so I did exactly that.”
According to the University of California, San Francisco (UCSF), diarrhea is the most common gastrointestinal issue in people with HIV. If diarrhea is a chronic problem for you while on ARV treatment, besides speaking with your doctor about a change in your regimen or adding a prescription drug for your bathroom troubles, tweak your diet. Drink more clear liquids; avoid caffeine and milk products; add more soluble fiber to your meals; and skip greasy, spicy foods, advise dietary specialists.
“I started eating whole-grain breads—rye, pumpernickel or whole wheat— in the morning before I took my meds,” Dawn says. “I noticed a difference very quickly when I did that. The episodes of diarrhea decreased, and I began putting back on the weight I’d lost, so I felt, and looked, much healthier.”
According to dietitians, for people living with HIV/AIDS, good nutrition must be a part of the plan for living well. These specialists counsel individuals with HIV/AIDS to pick the best choices from each food group.
In addition, when cooking your food, it’s key not to lose vitamins and minerals, so boil, steam and fry veggies for only a short period of time.
If you have diarrhea for more than a few days, nutritionists recommend seeing your doctor and suggest that you choose your meals wisely. For example, use cooking techniques that don’t require you to add fats to a meal. Also, reach for lean cuts of meat, peel the skin off chicken and cook vegetables before eating them. But limit dairy foods, such as milk, ice cream and cheese and oily snack foods, such as French fries and potato chips.
“Eating a well-balanced diet can help you reach a healthy weight, strengthen your immune system, prevent infection and reduce hospital stays,” say authors of Eating Tips: A Nutrition Guide for People Living with HIV/AIDS, by God’s Love We Deliver, a volunteer service that prepares and delivers fresh meals and nutritional counseling to people living with HIV/AIDS and other life-changing illnesses.
“It also helps the body build and keep muscle, allows medications to work better and enables you to handle the effect of medications,” the authors add.
Sometimes, people on antiretroviral treatment experience diarrhea’s evil twin: constipation. When this unpleasant side effect occurs, nutritionists suggest that you incorporate more noncaffeinated beverages and dried fruits, such as prunes or raisins, into your diet and engage in light exercise.
“Unfortunately, research has shown that nutritional problems are among the first negative effects of HIV infection,” explains POZ.com, an HIV website and a sibling publication of Real Health, about how nutrition becomes a problem in the presence of the virus. “These problems—deficiencies in certain nutrients—often get worse over time and contribute to immune dysfunction and disease progression in multiple ways,” explains the site’s HIV and nutrition page.
But findings also show that as people with HIV age, doctors can team therapies that focus on nutrition with medical management of the illness. According to researchers, good nutrition can act to reduce the incidence of complications associated with HIV infection, improve immune function, weaken the progression of the virus and decrease deaths associated with HIV.
In a recent study conducted by UCSF and Project Open Hand, a nonprofit organization that provides nutritious meals to low-income people with type 2 diabetes (some living with HIV), when researchers checked on the role comprehensive nutrition played on their overall health, they found that those living with the virus enjoyed huge and unexpected benefits. Scientists saw significant improvements in health outcomes for all participants.
“For example, we saw dramatic improvements in depression, the distress of having diabetes, self-management of diabetes, trading off between food and health care and HIV medication adherence,” says Kartika Palar, PhD, an assistant professor of medicine at UCSF and a co-author of the study.
Most infectious disease experts agree that the best approaches for individuals with HIV to improve their health involve two parts, so they encourage them to consume the right kinds of foods and drinks and to take the appropriate amount of nutritional supplements, such as vitamins, minerals, amino acids and fatty acids.
But there is one caveat: Don’t substitute supplements for the nutrients you can get from eating healthy foods.
“Gulping down handfuls of pills won’t make up for eating a bad diet, and even the best diet may not provide the level of certain nutrients that may be needed to protect and repair the body and maintain an optimal immune response,” warns POZ.com.
The best tactic is to consistently eat a variety of healthy, nutrient-rich foods.
Findings continue to show us that many beneficial substances, like antioxidants and probiotics, are hidden in common veggies, such as mushrooms, purple potatoes and kale, and in fermented dishes and foods, such as miso, kimchi (made with vegetables such as cabbage, radish, scallion, garlic, ginger or cucumber), olives and pickles, that were not previously known to play potential key roles in immune function and health.
In addition, although scientific studies continue to unpack information that’s pitched at us with intimidating speed and regularity, it’s always best to keep things simple.
“Instead of struggling to follow complex dietary rules, it’s easier for most people to just look at the overall picture and try to always choose healthful foods, while avoiding those that adversely affect health,” say the experts at POZ.com. “The first step in ensuring the presence of all the nutrients required to meet the needs of those living with HIV is making the most of what you eat.”
In simplest terms, this means eating a wide variety of whole foods—as opposed to processed, nutrient-poor foods—every day, along with plenty of water and other healthy beverages that your body needs to function at its best.
What About Nutritional Supplements?
Vitamins, minerals and amino or fatty acids can better the health of people living with HIV.
Even if your diet provides a broad spectrum of the nutrients essential for your body’s health, nutritional supplements can play an important role. This also holds true for those living with HIV and hepatitis C, according to multiple studies that show the value of using supplements to improve the health of these individuals.
According to a full report sourced from POZ.com, both large and small studies have shown slower disease progression, increases in CD4 cell counts and an overall improvement in various symptoms of HIV in people with higher levels of nutrients.
Of particular importance to those living with HIV and hepatitis C are antioxidants.
These substances play a key role in countering oxidative stress, a process triggered by the constant production of free radicals, atoms created during metabolic activities in the body, such as breathing and digesting food, that are associated with disease. As such, antioxidants, which are found in vitamins, minerals, amino acids and fatty acids, help protect cells throughout the body, improve cell function and offer support to the liver as it breaks down toxins.
As its base, an effective nutritional supplement program should contain a potent multivitamin that supplies a balanced basic supply of all the nutrients most important to human function.