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Nutrition and ExerciseNutrition and Exercise
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May 25, 2013

Hello. I am 35 years of age and my CD4 is 350 and my viral load is undetected. My current regimen since 04/2012 is Prezista, Norvir, and Truvada. I workout 4 days a week and I am having trouble trimming off the fat and toning up muscle. I lift weights and do intense cardio each day I workout yet I am still not seeing my mid-section trim-up nor am I seeing any definition in my muscles. I need help. What supplements can i take to help? Of course that will not interfer with my regimen.

Response from Mr. Vergel

Concentrate on minimizing your sugar and processed (low fiber) carbohydrate intake. Many HIV+ people, specially those on boosted protease inhibitors with family history of metabolic issues, have insulin resistance which interferes with the proper use of glucose for energy. Signs are elevated lipids, higher than normal fasting glucose and insulin levels, and higher body fat. So we have to be very aware of the intake of foods that can worsen insulin response.

Try to follow a diet high in fiber, protein, good fats and be aware of hidden sugars and processed carbohydrates. You do not and should not be hungry when you increase your fiber intake. I have written an article on this type of diet with details: Outsmarting HIV With Healthy Eating

Keep exercising like you are making sure that you sweat for at least 10 minutes. That will raise your metabolic rate. Also, some studies have shown that those who take 10,000 steps a day tend to lose weight and keep it off more effectively. That usually means 3 miles per day (walking and adding steps at the gym on elliptical trainers or treadmills). I downloaded a free step counter app to my phone for that purpose. It sounds like a lot of steps but you would be surprised to find out how easy it is to reach that goal, specially if you live in a walking city like New York, San Francisco or others (I live in Houston where we hardly walk!).

I am an advocate of having a hormone panel done on those of us who are older at least every two years specially if we have symptoms of fatigue, lack of sex drive, and difficulty losing weight even when we follow a good diet and exercise program. Thyroid function and testosterone (free and total) blood levels are part of that panel. But keep in mind this is not part of standard of care for aging HIV positive people, so some physicians may not be willing to do this specially in public clinic settings where funds are limited.

As far as supplements go, green tea has been shown to increase energy expenditure and may also have some beneficial antioxidants. Just make sure that you do not take green tea capsules after 3 pm or so since they have caffeine that may disrupt sleep. Be careful with all the bogus supplements out there that promise fat burning since they can have cause cardiovascular issues.

I hope this information helps you! As we get older, the key is to be consistent and not fall for our own inner voices that give us excuses not to eat well and exercise. I have those voices in my head frequently even after all these years. The important thing is to be aware of them and not allow them to rule your life. In my case, fear of falling apart and not feeling my best are my greatest motivators!

More on fat loss here: Nelson's Top 10 Tricks for Fat Loss

In health,

Nelson Vergel

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