Controlling AIDS and HIV complications through diet

There is still no cure for AIDS (acquired immune deficiency syndrome), nor is there a special diet for people infected with HIV, the human immunodeficiency virus that causes the disease. But good nutrition can ­prevent or delay weight loss and other complications. Here are some tips to get you started.

Asymptomatic HIV-infected individuals should follow the dietary practices recommended for healthy people, but with added precautions because food-borne infections occur more frequently and are more severe in people with reduced immunity.

• Keep up your food intake: AIDS is a wasting disease, and death is often due to starvation rather than to other HIV complications. A patient should eat as much as possible and not worry about gaining weight. The extra weight can be critical in seeing a patient through a crisis when he can't eat.
• Maintaining good nutrition is complicated by the ways in which AIDS affects the digestive system. It reduces absorption of nutrients, especially folate, riboflavin, thiamine and vitamins B6 and B12; it often causes diarrhea; and it increases the risk of intestinal infections. Many AIDS patients suffer appetite loss and bouts of nausea, either from the disease or from medications.
• If rapid weight loss occurs, the patient may require artificial feeding through a gastric feeding tube inserted into the stomach or an intravenous line that pumps pre-digested nutrients into the bloodstream.

Anyone who is HIV-positive or prepares food for an AIDS patient must be extra food-safe.

• Wash hands before handling food, during preparation and after.
• Keep hot foods hot and cold foods cold.
• Avoid contact between raw and cooked foods.
• Boil eggs for at least seven minutes; meat and fish should be cooked to an internal temperature of 74°C to 100°C (165°F to 212°F).
• Avoid raw shellfish, sushi, steak tartare, rare hamburgers and ice cream made with raw eggs.
• Hard ice cream is safe.
• Fruits and vegetables should be washed thoroughly.
• Follow the same precautions as when travelling: eat only cooked vegetables, and eat fruits that are peeled, stewed or canned.
• Some feel salads and raw fruits and vegetables are safe, but they may be difficult to digest.

• Nu­tri­tion­ists often recommend that HIV-positive people take a multivitamin and mineral pill to prevent nutritional deficiencies; however, supplements with more than 100 percent of the Recommended Dietary Allowance should be used only if prescribed by a doctor.
• Avoid harmful dietary approaches. Some self-help groups advocate taking high doses of zinc and selenium to bolster the immune system. There is no proof that supplements of these nutrients protect against AIDS-related infections; in fact, studies show that taking 200 milligrams to 300 milligrams of zinc a day for six weeks actually lowers immunity. Excessive selenium can also cause vomiting and diarrhea.
• A macrobiotic regimen can also be dangerous: such a diet can actually worsen AIDS, because it fails to provide adequate nutrition. Additionally, the excessive fibre can exacerbate diarrhea.
• Herbal medicine is popular, though there is no evidence for its efficacy. Plus, some herbal preparations contain substances that can cause serious side effects or interact with medications. Check with a doctor before engaging in self-treatment or alternative medicine.

Consume plenty of:

• Meat, poultry, eggs, nuts and other high-calorie, high-protein foods.
• Pasta, rice and other starchy foods; cooked vegetables; juices and canned or stewed fruits.
• Small meals/snacks through the day.

Limit:

• Fatty foods and whole-grain products if they cause diarrhea.
• Coffee, tea and other caffeinated drinks that can cause diarrhea and reduce absorption of some nutrients.

Avoid:

• Raw or undercooked foods, especially shellfish, eggs and meats.
• Alcohol, which can worsen diarrhea and interact with AIDS medications.

Keep these healthy dietary tips in mind and be sure to consult your doctor for more information.