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Outsmarting HIV With Healthy Eating

January/February 2012

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Fatty Acid Recommendations

EFAs include the omega-3 and omega-6 fatty acids. Most people get an imbalance of these two by consuming too small an amount of omega-3 fats, which have anti-inflammatory properties, and relatively too large an amount of omega-6 fats, which tend to promote inflammation when out of balance.15 To get more omega-3s, eat more fish, including salmon, tuna, sardines, anchovies, mackerel, rainbow trout, and herring. Omega-6s are contained in common vegetable oils, like sunflower, safflower, and corn oils. Try to reduce your intake of these.

Oils and Cooking

Olive oil is one of the best oils to cook with. You can also cook with high-oleic sunflower oil, avocado, canola, macadamia, or any oil that is high in mono-unsaturated fatty acids.

Avoid cooking with oils made from corn and sesame. These oils contain more omega-6 fats, and less mono-unsaturated fats, so they have a higher potential for spoiling and turning to trans-fats, which are bad for the immune system. Try to avoid any intake of these oils when they are not absolutely fresh.

Also, choose oils that are minimally processed. Most of the clear oils in supermarkets are stripped of some of their natural components to make them more suitable for sitting on store shelves for long periods of time without spoiling. Do not use these stripped oils. When you do cook, do not overheat the oil so that it smokes, which causes the formation of carcinogens and destroys the beneficial fatty acids.


Avoid Margarine, Hydrogenated fats or Processed oils

Do your best to avoid processed fats or oils, as they have negative effects on cellular health, overall metabolism, and your immune system. Look out for the words hydrogenated and partially-hydrogenated. These kinds of manipulated fats probably do increase the risk of cancer and heart disease. They also weaken healthy cellular immune metabolism, which means that they might increase HIV progression. Lastly, they are also likely to promote high lipid levels and insulin resistance.

Protein, Food for the Immune System

Dairy protein fractions, such as caseine (contained in milk curd) and whey, are at the top of the list of proteins that optimally feed lean body mass growth. In dairy products, the amino acid balances, insulin-raising potential, and overall growth factor content add up to one thing: milk proteins were created to make mammals grow bigger. While there is a lot of hoopla related to which dairy protein fractions are best, there is more misinformation than reality in this area. Those with lactose intolerance should be careful in their selection of milk-based products. Aged cheeses and yogurt may be more tolerable for those who cannot digest lactose.

Egg Protein

Next on the list are egg proteins. The important thing to remember is that whole egg is probably somewhat better than egg white for lean body mass growth and overall health effect, because the yolk is a rich nutrient source, and its protein content complements the protein in the egg white. Together they are a better source of protein.

Meat Protein

While real food like meat often seems to take a back seat to protein powders because of a mindset created by slick advertising, professional athletes know the value of real food related to lean body mass growth. If you do not make real food and meat fundamentals in your diet, you will not grow lean body mass tissue as well. Fish, chicken, turkey, and beef are vitally important foods, not only because of their protein content, but because they contain numerous other nutritional components that are important for a healthy metabolism. The message is: eat real food, then supplement food with protein powder drinks if you need them.

Lean red meat is a superior source for lean body mass growth and blood-building nutrients. These include creatine, carnitine, phenylalanine, conjugated linoleic acid (CLA), and heme- (blood) iron, the most absorbable form of iron. And meat, in general, is less likely to cause allergic reactions than eggs or dairy proteins, like casein and whey. The only caution about red meat is that the high amount of saturated fat most commercial red meat contains could promote metabolic problems. So be moderate about including it in your diet and choose leaner meats if you do.

Important details on meat: cooking kills bacteria in meats. Stewed meat is better for digestion (chicken soup, beef stew). Roasting is okay. Try not to fry or barbecue with charcoal. Charred foods are associated with increased risk of gastrointestinal system cancers. Any cooking of meat or vegetable protein that causes the formation of a hard outer skin renders the protein that becomes the skin to be much less digestible because it cross-links the protein.

Vegetarian Diets

It is very difficult to gain lean muscle weight on a vegetarian diet. In fact, it is almost impossible for most people, especially when they are fighting infections that burn lean body mass. While I know a very few HIV-positive people who can do well adhering to a vegetarian regime, I find that the vast majority cannot do it and keep their lean body mass. Additionally, vegetarian diets increase the potential for anemia because of a lack of blood-building components such as highly absorbable heme-iron and vitamin B12.

If you do choose a vegetarian diet, your best protein sources are beans, seeds and nuts. Digestion of nuts and seeds will be improved by soaking them overnight to reduce the enzymes they contain that inhibit digestion of proteins. If you can eat them without digestive problems, many nuts and seeds are ideal foods because they contain protein, healthy fat, and complex carbohydrates in a very good balance for overall health. They also make a great snack between meals. However, the amino acid balances in these proteins do not appear to be optimum for lean body mass growth for humans. Again, vegetarian or vegan diets present a challenge to people with HIV or AIDS who need a full spectrum of amino acids and micronutrients. Unless you are vegetarian for ethical reasons, consider eating eggs and fish.


People who are on HIV medications like tenofovir (in Viread, Truvada, Atripla, Complera, and the Quad), which may affect kidney function in some patients, should be careful about increasing their protein intake too high (over 1 gram per pound of body weight per day), as this can increase the potential for kidney problems. Ask your doctor if you are taking kidney burdening medicines, and, if so, only eat a higher protein diet under your doctor's direction. Those who have liver problems need good protein intake for the repair of liver tissue, but should also be careful about higher protein intake, and should also do so only under a doctor's supervision.

Calcium and Vitamin D -- Two Important Micronutrients

Bone loss has been reported in several HIV studies. It seems to be caused by the effect of the virus on the body. Certain medications like tenofovir (Viread) may make this problem worse. We also seem to have a high incidence of vitamin D deficiency due to potential HIV medication effects or metabolism issues. We know that calcium and vitamin D help to strengthen bone. Many of us chose to take calcium plus vitamin D supplements, but there are also foods that are rich in these nutrients. Calcium-rich foods include milk, cheese, spinach, fortified orange juice (be careful with the sugar, though!), fish, eggs, and beans. Vitamin D-rich foods include milk, most fish, and eggs. However, most of us do not consume the 1000 mg and 2000 IU needed per day for calcium and vitamin D, respectively, and need to take over-the-counter supplements. One word of caution: do not take your calcium supplements with your HIV medications since they may interfere with their absorption (at least two hours before or after is okay).

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This article was provided by Positively Aware. It is a part of the publication Positively Aware. Visit Positively Aware's website to find out more about the publication.
See Also
An Introduction to Dietary Supplements for People Living With HIV/AIDS
Ask a Question About Diet or Nutrition at's "Ask the Experts" Forums
More on Diet, Nutrition and HIV/AIDS

Reader Comments:

Comment by: kim (florida) Wed., Aug. 7, 2013 at 3:42 am UTC
The best diet for your health is a vegan diet. Read the China Study by T. Colin Campbell. A vegan diet will not only optimize your health but also the health of the planet and countless animals that share the planet with us.
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Comment by: Anthony B. (Salt Lake City, UT) Thu., Oct. 18, 2012 at 7:50 pm UTC
Hello Mr. Vergel,

Thank you for this great article. I wondered in the "Healthy Eating Shopping List" under the Dairy section, can you suggest another kind of milk other than low fat? I usually drink whole milk, and I don't usually like the taste of the lower kind - 2% etc. Can I substitute this with perhaps soy milk? or another kind of milk?

Thanks again for the great article.

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Comment by: Jeanne B. (Milwaukee, WI) Thu., Mar. 8, 2012 at 5:11 pm UTC
Excellent article
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Comment by: mary (dar es salaam) Mon., Mar. 5, 2012 at 10:40 pm UTC
thanks for ur news im the one who have HIV from 1999 i use HIV drug from2007
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Comment by: Peter (San Francisco) Fri., Mar. 2, 2012 at 12:40 am UTC
Great tips - this pretty much represents my own diet, right down to the almond butter sandwich at night! I did want to note that if one is taking a fiber supplement, precautions regarding timing of the supplement must be observed. Basically one should not take a fiber supplement within a few hours (before or after) of taking medications, because it can interfere with absorption. The labels on most fiber supplements have information regarding timing.
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Comment by: Ellen Levine (New York) Fri., Feb. 24, 2012 at 12:14 pm UTC
Nelson - I am an RD working in HIV nutrition for many years. I find this article just right on. I like your well rounded and well researched approach, and your emphasis on using real foods in the diet, as well as lean meats and eggs, which many people are afraid to eat these days. I also love your emphasis on the vegetables, fruits. You are knowledgeable, and I plan to use this piece as a basis for some of the talks I give. Thanks.
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Comment by: amy (Illinois) Thu., Feb. 23, 2012 at 4:09 pm UTC
Meat and Dairy are not necessary. Many successful athletes from ultramarathon runners to body builders are vegans. I believe people like myself who are living with HIV will feel and stay healthier on a proper vegan or at least a vegetarian diet.
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Comment by: kim (Florida) Thu., Feb. 23, 2012 at 2:19 pm UTC
Dairy and meat are NOT healthy for people, the animals that suffer horrendously or the planet. The number one cause of global warming is animal agriculture. Vegetarians and Vegans are much healthier if they follow a balanced diet of whole grains, unprocessed foods and dark, leafy, green vegetables. Research shows that vegetarians have less cancer and heart disease. Vegans only need to supplement vitamin B12. I have been living with hiv since 1988 and on antivirals since 1998. I have always followed a vegetarian or vegan diet with no loss in lean body mass, lipodystrophy or other physical issues. Please try to consider other sentient beings on this planet. The medication we rely on each day to survive has destroyed billions of precious lives already. Isn't it time to save a few lives in return. And, just think how you and the planet will be healthier for having merely changed your diet.

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