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HIV treatment and nutrition

some medication and some tomatoes on a table

Some medications that you take if you're HIV positive can create physical side-effects. Don't worry there are ways you can redress the balance by altering your nutrition.

  1. Heart disease
  2. Diabetes
  3. Fat
  4. Safety

Heart disease

Fat redistriction is also associated with high blood lipids (fats). The two types of fats that we are the most concerned about are triglyceride and LDL cholesterol. These 'bad' fats accumulate around the walls of blood vessels, eventually clotting them up, causing heart attacks or even a stroke. If triglyceride levels increase then the risk of having a heart attack in the next 10 years is increased too, more so in women.

It is recommended to reduce saturated (bad) fat but increase unsaturated (good) fat in the diet. It is very important that you do not eliminate fat in your diet, but choose the 'good' fat, over the 'bad' ones. For example when you choose fat, avoid the ‘bad’ ones such as butter, lard, suet, coconut oil and palm oil. Go for the ‘good’ ones such as soft margarine and vegetable oil such as olive, corn, sunflower oil.

On the other hand, many ready made meals and processed food contain trans-fat to make them last longer. Trans-fat acts like saturated fat in our body, so it is best to avoid it as well. Choosing lean meat, or cutting skin and fat off the meat where possible can also reduce saturated fat.

Diabetes

Insulin is a hormone produced by the pancreas. Its main function is to allow glucose t be utilised by the body. However the abdominal fat, which may be associated to fat redistribution, releases a protein called ‘TNF alpha’ that causes cells to stop responding to insulin. This is known as insulin resistance. It is the onset of type 2 diabetes, the most common type of diabetes.

At the same time, some drugs also cause high blood sugar levels. Without the help of insulin, the blood sugar remains high. If it is not treated, it may give rise to many long term health effects, such as renal, neural and visual impairment, risk of heart disease and stroke.

The UK recommends having at least five portions of fruit and vegetable per day. Each portion is approximately 80g. Fruit and vegetable contain lots of dietary fibre, vitamins and minerals. Eating plenty of fibre is found to lower the risks of heart disease. If you are not used to eating fruits and vegetables, try to increase a portion gradually until you reach five. It will become achievable once you get into the habit. You could start by making small changes, such as adding a tablespoon of peas in your rice, lettuce leaves in your sandwich or banana slices in your breakfast cereals.

Other sources of fibre that do not count as ‘5 a day’ are those such as whole-grain cereals, nuts and seeds. Additionally, try to reduce simple carbohydrates or use sweeteners as a substitute. Studies have found that in overweight or obese people, weight loss, particularly in the abdomen, can reduce the risks of developing type 2 diabetes and heart disease.

Fat

Fat redistribution is a side effect of some antiretroviral drugs. It describes redistributing fat in the body and hence changing the body shape.

Fat loss often occurs underneath the skin in the cheeks, buttocks, arms, legs and soles of feet. Meanwhile fat accumulates at the back of the neck, abdomen and breasts. The pattern and severity of body fat changes might be different for different people. Fat redistribution is different from muscle loss.

Quite often people with HIV will experience both fat loss and accumulation, so the body weight might not be altered. However, such changes in the body shape might affect people's ability to perform daily activities such as moving around, walking, sitting and sleeping.

Safety

Food and water safety is important if your immune system is weakened, if your CD4 count is below 200. Bacteria and viruses can be passed onto your foods and drinks if they are not handled properly, causing a number of symptoms such as diarrhoea, vomiting, nausea, headache, fever and stomach pain.

You should wash your hands with anti-bacterial soap before handling and eating your food. All the equipment and containers for food should be washed with hot soapy water before and after use. Using different chopping boards and knives for raw and cooked food can prevent cross-contamination. All fruit and vegetables should be washed thoroughly with clean and safe water. All meat must be cooked to a well-done stage, i.e. 75oC. Do not eat any raw food, especially eggs, fish and poultry.

Always keep left-over food in a refrigerator between 2-5oC and eat it within 3 days. Frozen food must be kept in a freezer at -18oC or below. Store cooked food above raw food. If dishes are reheated, they must be heated to 82oC or above.

Do not reheat your food twice. Do not eat any food that is expired. Trust your senses, if they smell bad, taste sour or look abnormal, discard them straight away!

 

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The Information Standard: Certified member

This article was last reviewed on 31/10/2012 by P. Kelly

Date due for the next review: 31/10/2014

Content Author: Food Chain

Current Owner: Katie Smith

More information:

Causes of Atherosclerosis, NHS

Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. Mozaffarian D. et al, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, US 23;7(3):e1000252 (March 2010)

Why obesity gives you diabetes, BBC News (2004)

Diabetes and Obesity Rate Soar, Diabetes UK (2009) 

5 A Day, NHS

Fruit And Veg, Eat Well, Be Well, FSA

Mitri J. et al. Diabetes medications and body weight, University Medical School, Roger Williams Hospital, Providence, USA, 2009, 8(5):573-84 (wt loss)

Temperature Control, House Rules (2005)