ABCNews.com/Healthology Press (12.14.01) - Wednesday, December 19, 2001
Meredith Liss, MA, RD, CDN, New York Presbyterian Hospital, Weill Cornell

People with HIV must contend with body composition changes that include wasting syndrome and fat redistribution syndrome as well as metabolic changes such as elevated levels of cholesterol, triglycerides and blood sugars. While many of these conditions require medication, developing a healthy diet and exercise program can make a great difference in longevity and the quality of life.

Good nutrition should be taken seriously as co-therapy for HIV. Diet recommendations include a high protein diet to fight wasting syndrome; a heart healthy, low saturated fat diet to keep cholesterol levels within proper limits; and a diet high in whole grains and low in sugar to maintain adequate blood sugar and triglyceride levels. Also included should be 1-2 multi-vitamins with minerals to insure that micronutrient needs are met.

Good nutrition can be followed by setting up a modified Food Guide Pyramid like the one established by the US Department of Agriculture. The pyramid contains a list of different food groups, the recommended number of daily servings of each group, and examples of the amount of food that constitutes a serving. -Bread, cereal, rice, and pasta (6-11 servings per day) 1 slice of bread or bagel or English muffin cup of cooked pasta, rice, or hot cereal 1 ounce of ready-to-eat cereal (choose whole grains, brown rice and high fiber cereals -Vegetables (at least 3 servings per day) cup of chopped raw or cooked vegetables 1 cup of leafy raw vegetables (choose dark green leafy vegetables; choose a variety of vegetables with a variety of colors) -Fruits (at least 2 servings per day) 1 piece of fruit or melon cup of juice cup of canned fruit cup of dried fruit (choose fresh fruits more often than juices) -Milk, yogurt, and cheese (at least 2 servings per day) 1 cup of milk, soy milk or yogurt 1 to 2 ounces of cheese (choose skim or 1% milk, low fat yogurt, low fat cheese. Soy milk does not have to be low fat because it contains healthy fat) -Meat, poultry, fish, beans, eggs, and nuts (at least 3 servings per day) 2-3 ounces of cooked lean meat, poultry or fish. The following foods are equivalent to one ounce of meat: 1 egg or cup of fat free, cholesterol free egg alternative; or one third cup of nuts; or 2 tablespoons of peanut butter; or cup of beans. (To prevent or reverse muscle wasting, try to include a source of protein with each meal or snack.)

To reduce cholesterol levels, decrease intake of foods high in saturated fat like red meat, poultry skin, whole and 2 percent milk, cheese, butter, coconut and palm oils.

One of the causes of weight loss in HIV infection is not being able to eat enough calories. You may find that you get hungry and when you sit down to eat, you become full too fast. There are some medical causes of early fullness but a pattern of small, frequent meals of six or more a day will probably help a great deal. Also, high calorie, high protein shakes of ice cream, yogurt, milk, fruits, peanut butter, wheat germ and fruit nectars or canned supplements that can be purchased at local drug stores and supermarkets are highly recommended as meal alternatives.

Exercise is safe and does not weaken the immune system. It is important to prevent or fight the loss of muscle mass and to offset the effects of the fat redistribution syndrome.
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