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Chester Myers' Nutrition Series primum non nocere - first do no harm The information in this monograph is intended mainly for people living with HIV, and their caregivers. Be careful of nutritional supplements that contain high levels of corn and soy oils which are major sources of PUFAs/linoleic acid, so avoid these products, or use only occasionally. Those with some MCT may be the best. More on Fats "An increase in either saturated or polyunsaturated fatty acids to >16% of calories results in decreased cell-mediated immunity, including cytotoxic function, delayed cutaneous hyper-sensitivity, lymphocyte response to mitogen stimulation, and natural-killer-cell activity." Chandra, 1991 This comment is relevant especially to corn and soy oils. There are data (reviewed by Kinsella et al, 1990) that indicate flax and fish oils help the immune system, and it is now believed that olive, canola and animal fats are neutral with respect to immunity (S. Bell, 1995). MCTs (medium chain length fatty acids) are okay sources of fat. One study indicates coconut fat (contains high levels of MCTs) may help the immune system. Boost, Resource and Ensure are some products that contain higher levels of fat than Chandra referred to as being immunosuppressive already at >16% of calories, so avoid these products, or use only occasionally. Better products include Peptamen, Nutren, Advera, Vivonex, .... or even IsoSource, IsoCal, ... Why play Russian Roullette with our lives? Yet more on Fats Many North Americans, including many PHAs, eat too high levels of fat in their diet. This may not be so for all. Michèle Cossette, a Montreal dietitian experienced in issues regarding HIV, notes that many PHAs may be getting too little fat in their diet. This can have extremely serious consequences - indeed there are essential fatty acids which we must have - the body cannot make them. The linolenic (n-3) and linoleic (n-6) fatty acid families are considered essential for humans - i.e., we must have them in our diet. Low levels can be sources of skin, neurological and other problems including suppressed immunity. Thus either too low or too high levels are bad. 2-4 g/day of linoleic acid (1.5% of calories) has been suggested necessary (Kinsella et al, 1990). About 2 teaspoons of soy oil or 1½ teaspoons of corn oil contains about this amount, so it doesn't take much. Other oils also contain this fatty acid. Gamma-linolenic acid (GLA), which is high in evening primrose, borage and blackcurrent oils, has also been shown in studies to have a number of health benefits. Sources of these fatty acids are corn, soy, sunflower, safflower, & peanut oils. Although the profile of the fatty acids in corn and soy oils, and regular sunflower and safflower is skewed towards those associated with immune suppression, we still need to get some of these oils with other dietary fats. Fish, flax, olive &/or canola, butter and coconut fat can form the most part of our dietary fat. Olive oil makes a good salad dressing oil, and coconut fat is excellent for cooking. Coconut fat also is unlikely to be associated with problems of high levels of blood triglycerides (hypertri-glyceridemia). It may be a good source of energy (calories). Fats On a Priority Basis Choose your profile of fats to minimize those that may be immune suppressive. Get a variety of types of fats. Make sure you are taking enough vitamin E. The more of the PUFA oils you eat, the more vitamin E you need. If you are taking 200-400 IU/day of a natural source vitamin E, this should be enough. The number of stars (*) indicates a suggested priority in choice. If serum triglycerides are very high, then you may need to reduce those that are indicated as high in LCFA (long chain fatty acids) - but only if your serum triglycerides are very high. May be Immune enhancing
"Oral 100-g portions of carbohydrate from glucose, fructose, sucrose, honey, or orange juice all significantly decreased the capacity of neutrophils to engulf bacteria as measured by the slide technique. Starch ingestion did not have this effect. ... The greatest effects occurred between 1 and 2 hr [after eating], but the values were still significantly below the fasting control values 5 hr after feeding. ... These data suggest that the function and not the number of phagocytes was altered by ingestion of sugars." "oral administration of increasing amounts of glucose progressively lowered the phagocytic capacity of neutrophils in normal subjects or patients..."Sanchez et al, Am J Clin Nutr 26:1973:1180-1184 (italics added for emphasis) Products with high levels of sugar include Boost, Resource, Ensure, NuBasics and Sustacal, so avoid these products, or use only occasionally. Better products inlude Peptamen, Nutren, Advera, Vivonex, or even IsoSource, IsoCal. Why play Russian Roulette with our lives? More on Sugars "Because it is a monosaccharide, [glucose] is unsurpassed as the carbohydrate source for yeast and other organisms." monograph, CPC International Inc. ".. the data provide an experimental rationale for clinical trials to decrease the intake of glucose or its utilization by C. albicans in immunocompromised patients." Vargas et al, 1993 Other published studies also indicate C. albicans, the yeast responsible for thrush and oesophageal candidiasis, grows well on simple sugars, and sucrose. The bread baker and the brewer know what yeast grow on best, i.e., the simple sugars. It's the same for C. albicans as for baker's and brewer's yeast when it comes to what they grow on well. There is no evidence that, when in the human body, these yeast change their dietary preferences away from simple sugars. C. Myers Products with high levels of sugar include Boost, Resource, Ensure, NuBasics and Sustacal, so avoid these products, or use only occasionally. Better products inlude Peptamen, Nutren, Advera, Vivonex, .... or even IsoSource, IsoCal, ... Why play Russian Roulette with our lives? Liquid Food Supplements On a Priority Basis At the best of times, why use poor quality components? When you are NOT in your best of health, then, even more so, why gamble with your life? GO FOR QUALITY!! For criteria in choosing other liquid nutritional supplements, see HIV & Liquid Food Supplements monograph (also by Chester Myers) Excellent *********** - Peptamen, Nutren, Vivonex Plus, Advera ********* - Vivonex, Nutren ******* ***** - Iso Source, IsoCal **** *** Very Occasionally ** - NuBasics Very occasionally or Avoid * - Boost, Resource, Ensure Author, Chester Myers, holds both honours B.Sc. and M.Sc. (1969) degrees in physical chemistry from Dalhousie University, and a Ph.D. (1975) from the University of Toronto (biophysical chemistry) where he investigated the mechanism of action of one of the digestive enzymes. In addition to publishing in the scientific literature and having authored several patents, he has written extensively on topics regarding health and HIV. The latter include articles in The Positive Side, Canadian AIDS News, and monographs available from the AIDS Committee of Toronto (ACT), the Community AIDS Treatment Information Exchange (CATIE), and various other organizations. Disclaimer: The material in this publication is for information purposes only. It does not endorse any particular treatment program nor strategy; neither is it intended as medical advice nor as a replacement for medical advice. ©This document is copyrighted by Chester Myers. All materials may be reprinted and/or distributed without prior permission. However, reprints may not be edited. |
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February 1997 | |
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Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner who is knowledgeable about HIV-related illness and the treatments in question. MORE | |