A Practical Guide to Nutrition for People Living with HIV


1.1 Appetizer – You, Food and HIV

Why this guide is important for you

The saying goes: You are what you eat. The good news is that nutrition is in your hands—and in your mouth. Good nutrition can keep you healthy and decrease your chances of getting other chronic diseases. People with HIV who get the nutrients they need get sick less often, are stronger and have improved quality of life. With good nutrition and medical care you can not only live longer with HIV… you can live better.

Nutrition in HIV/AIDS

Nutrition and your immune system

Your immune system needs good nutrition to function well.

We have known for decades that nutrition plays a major role in immunity and the ability of the immune system to respond to infection. The nutrients our bodies derive from food keep the immune system strong in countless ways. For example, the skin and linings of the lungs and gut provide the first line of defence by acting as physical barriers to invaders such as viruses and bacteria. These barriers are very sensitive to nutrition, especially vitamin A, and deteriorate when people don’t get proper nutrition. When this happens, viruses and bacteria have easier access into the body.

As another example, the body mounts a defence against invaders by using different types of immune cells and chemicals. This defence requires energy, proteins, vitamins and minerals—all of which are supplied by food. A lack of any of the key nutrients can weaken the body’s ability to fight infection.

How HIV affects nutrition

Nutritional issues are common in HIV disease. At some point, almost everyone living with HIV will face challenges in maintaining good nutrition. Problems can be related to HIV infection itself and to the effects of anti-HIV therapy, also called HAART (highly active antiretroviral therapy). For example, the virus can infect some of the immune cells in the intestines, causing local inflammation and making it more difficult to absorb nutrients and medicines. This can result in weight loss or vitamin and mineral deficiencies.

Also, the nutritional needs of people with HIV are greater because the body has to work overtime to deal with a chronic viral infection and to fight off opportunistic infections. People co-infected with hepatitis C, which attacks the liver, are even more at risk of nutritional problems because the liver has a central role in processing all nutrients and most drugs. Finally, poor appetite, fatigue, nausea and other side effects of medications can make it hard to eat well.

Nutrition as part of your HIV care plan

Good nutrition is an important part of your HIV care plan.

Although there is still no cure for HIV, HAART has given many people with HIV hope and renewed health. While nutritional strategies cannot replace HAART, good nutrition can be an important part of your overall HIV care plan. In the time before you start HAART—which might last from a few weeks to many years after your diagnosis—good nutrition and a healthy lifestyle are two important strategies to maintain good health and quality of life. And once you start HAART, nutrition is still an important component of your plan to keep yourself healthy and your body’s immune system strong.

Nutrition’s role in other chronic diseases

In recent years a great deal of attention has been paid to the role of nutrition in preventing illnesses like heart disease, diabetes and certain cancers—conditions that are thought to be influenced by nutrition and lifestyle. People with HIV are at increased risk of developing these conditions due to the virus itself or to the side effects of HAART. People with HIV are also living longer and getting older, which incurs a whole range of health concerns that can be influenced by nutrition and lifestyle. All this to say that by reading this book you are taking care of much more than just HIV.

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How this book can help you

This practical guide is divided into two parts. This first part is an overview of nutrition basics and suggestions for designing a healthier diet. While you are free to read only bits and pieces, this section is meant to be consumed like a meal, with appetizers first and dessert last. The second part is more like snacks—browse through and take only what you need. In this section you will find tips on vitamin and mineral supplementation and how to deal with more specific issues, such as symptoms and side effects. There is also lots of information on nutrition and HIV on the Web. Check out Appendix D for a list of reliable sites.

One of the biggest barriers to good nutrition faced by people living with HIV, in Canada and around the world, is not being able to get the food they need in order to have healthy, active lives. This guide will attempt to address this issue by including strategies for more affordable grocery shopping.

This practical guide is part of a series and is meant to be used in conjunction with the other guides. The other titles are:

All Practical Guides are available at www.catie.ca or by calling us at 1-800-263-1638.

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Finding a nutrition professional

Accredited nutrition professionals include dietitians and naturopathic doctors.

This guide is meant to help you make informed decisions about your nutrition care plan, but you may decide to look to a nutrition professional for more advice. In fact, before making any significant changes in your nutrition, you should talk with a nutrition professional. They will take into consideration your unique health situation and needs and provide the best care and advice.

When choosing a nutrition professional, there are some things you should know about their qualifications. Registered dietitians have years of education and training in the science of food and nutrition and are good at translating science into real-life food choices. The term dietitian is protected and can only be used by a person with the right qualifications. Dietitians can be found at hospitals, some HIV clinics and community agencies. To find a dietitian in your area, ask your healthcare team to refer you. Or check the Dietitians of Canada Web site at www.dietitians.ca.

Naturopathic doctors have four years of pre-medical training and four years of full-time naturopathic medical training; they must pass licensing examinations and carry malpractice insurance before entering practice. They are very well trained in the nutritional use of foods for various conditions. Their training also includes nutritional supplementation and botanical and homeopathic medicine. To find a qualified naturopathic doctor near you, call the Canadian Association of Naturopathic Doctors (CAND) at 1-800-551-4381 or visit them online at www.cand.ca.

The term nutritionist is generic and can be used by anyone regardless of education or training. When getting advice it is important to find out more about the nutritionist’s qualifications. You might also get nutritional information from people at stores that sell vitamins and other health products, but remember that they are in the business of selling.

Unfortunately, not every person with HIV has easy access to a dietitian or naturopathic doctor. Your doctor and other members of your healthcare team may also be able to help. Doctors can answer questions related to treatment, while nurses, pharmacists and other members of your healthcare team can provide practical tips about dealing with side effects.