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Outsmarting HIV With Healthy Eating

January/February 2012

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Miscellaneous Nutrition Tips

  • If diet, weight loss, and exercise fail to lower your LDL cholesterol and triglycerides, ask your doctor for a prescription for lipid-lowering agents (statins, fibrates, etc.) or to switch your meds to a more lipid-friendly HIV medication combination.
  • For your food, shop mostly in the outer part of the grocery store where the fresh produce, meats, and milk products/eggs are. Avoid overly processed canned or packaged foods, except for frozen vegetables. Read the labels and avoid products with many preservatives and additives. Trans-fats and hydrogenated oils, high fructose corn syrup, and high sugar should be on your radar when reading labels. Watch this funny video for more details on healthy eating.
  • Try to eat several smaller balanced (protein + good carbs + good fats) meals or snacks instead of two to three large ones. Smaller meals/snacks are more easily digestible, keep blood sugar and insulin more constant through the day, and keep you from binge eating late at night.
  • Eat more almonds, walnuts, pecans and pistachios (good cholesterol-lowering fats). Twice a day, snack on such nuts to get your good fats and fiber. If you wish, mix them with some dried fruit. Research has shown that people who eat nuts tend to have lower LDL cholesterol.
  • Avoid junk and fast food. The best way to do this is to have enough food at home and to bring lunch to work. Cook a lot of food on weekends and freeze meals in small containers you can heat up later.
  • Do not sabotage yourself by bringing sweets and junk into your home. Watch your cravings at night, when most people find it the most difficult to avoid overdrinking alcohol or eating ice cream, cookies, and comfort foods.
  • Eat a large breakfast, a moderate lunch, and a small dinner. Skipping breakfast makes you more prone to overcompensate by eating more calories late in the day. Your body has spent several hours without food and is starved for nutrients in the morning. Do not feed it sugar and white flour products at this important time. Eggs, oatmeal (the type that has no added sugar, and you can add whey protein powder to it!), Greek-style yogurt with nuts and fiber supplements, low-fat cottage cheese with fruit, almond butter on multigrain (high-fiber) bread, and fruit are all good choices for breakfast.
  • For lunch have some soup and a glass of water first and wait 10 minutes to trick your body into feeling full faster. Grilled chicken with vegetables, tuna salad over greens and nuts, a Greek salad with sliced steak, and any Mediterranean food choices are good.
  • For dinner, fill yourself with stir-fried (use olive oil!) vegetables and lean meats. Two hours before bed, you can have half an almond butter sandwich or yogurt with fruit. You will not be hungry and desperate with this diet!
  • Eat fruits and vegetables of all colors. Each has a different antioxidant profile. The produce section of the market is basically a fresh vitamin department and a medicine chest. Some foods like garlic, onions, and ginger have genuine therapeutic effects. Eating the widest variety of fresh produce on a daily basis assures you of getting all the ingredients that nature provides that can help keep your body strong enough to handle bacteria and viruses so that you stay healthy.
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  • Avoid sodas, sweet drinks, and fruit juices (fruit sounds healthy, but juice contains too much sugar and no fiber to slow down its absorption into the blood).16 Consuming sugar daily can affect your metabolism, create insulin resistance, make you fat, and have all kinds of negative health consequences. The suggested pecking order of carbohydrate food sources that support your health without increasing insulin resistance follows. Best are vegetables in their many forms. Next are beans and peas. These deliver more calories than vegetables, but the carbohydrates release much more slowly than grains. Next are whole grains, which are calorie-dense but contain carbohydrates that, in general, release somewhat slowly. At the bottom, and the most likely to promote body fat problems, are carbohydrates from milled grains, like wheat and corn. Whole grains are marginally better than processed grains, but when they are milled into flour the difference is not that great. The very worst carbohydrate sources are sweets, like candies, which can deliver as many as 2,000 calories per pound. Try to eat from the first group of slow-release carbohydrate sources most of the time, and if you are relatively healthy, you can have small amounts of milled wheat products or sweets once in awhile.
  • Drink lots of water. Six to eight glasses a day is a good goal. If you get thirsty, you are already dehydrated!
  • Eat a high-protein, complex carbohydrate-rich meal after workouts. Examples: chicken salad with nuts, cottage cheese or yogurt and nuts/fruit, celery sticks and hummus (chickpea butter), etc.
  • Manage your intake of caffeine (it reduces appetite but can increase anxiety). Do not have any caffeine after 4 p.m., since it can impair your sleep.
  • Minimize hidden sugars like high fructose corn syrup. Read the labels of food you buy. Diet sodas tend to make your brain crave sweets in general, so they are not good substitutes for sugary drinks. Water, water, water!
  • If you do not consume at least 20 grams of fiber a day, add to your intake supplements like Citrucell or Benefiber, purchased in any grocery store. Fiber improves insulin sensitivity, makes you feel full longer, keeps your gut healthy (friendly gut bacteria that produce vitamins love fiber), keeps you regular and reduces diarrhea, and can lower the chances of getting colon cancer.17
  • Eating healthy is eating smart, and it does not mean that you should starve yourself. Hopefully, this information has shed some light on healthy food sources and how they can affect health and the body. Now that we are living longer, food choices can determine how well we do as we age with HIV. So, take charge of your health and take care of your body. It is the only one you have.


Healthy Eating Shopping List

1. Produce

  • Spinach and other green leafy vegetables
  • Broccoli and cabbage
  • Green beans
  • Avocados
  • Raspberries and all berries. You can buy frozen ones and add to whey protein shakes
  • Whole fruits (remember no juices).
  • Sweet potatoes, carrots
  • Hummus
  • Beans and other legumes (you can buy canned or frozen ones)

2. Nuts, Grains, Oil

  • Mix of almonds and other nuts
  • Peanut, almond, and cashew butters without hydrogenated oil (the healthy nut butters show oil and butter separated since the lack of hydrogenated oils prevents emulsification)
  • Pumpkin and sunflower seeds
  • Wild rice (the darker the rice, the better)
  • Whole grain breads and pasta
  • High fiber crackers
  • Oatmeal (not the little packets; those are loaded with sugars)
  • Olive oil

3. Dairy

  • Low fat milk, cheese
  • Yogurt (Greek style, no sugar added)
  • Eggs (free range or Omega 3 enriched if possible)

4. Meat

  • Lean meats
  • Salmon, sardines and tuna
  • Occasional glass of red wine per day (optional)

5. Supplements

  • Whey protein (I like the Isopure brand since it does not give me gut problems and it is very light)
  • Vitamin D

Nelson Vergel, a chemical engineer from Venezuela, has been HIV-positive since 1983, and is a leading treatment advocate on HIV disease. He created the Program for Wellness Restoration (PoWeR) and founded the Body Positive Wellness Center in Houston. Nelson has lectured extensively around the country and overseas, and with his research partner, Michael Mooney, co-authored the book Built to Survive. In 2010, he wrote and published Testosterone: A Man's Guide -- Practical Tips for Boosting Physical, Mental and Sexual Vitality. He is currently a member of the DHHS Panel on Antiretroviral Guidelines, the AIDS Treatment Activists Coalition, and moderates PozHealth, one of the largest HIV health discussion listservs online.

Read posts from Nelson's blog, "Surviving HIV."
Read Nelson's blog, "Outsmarting HIV: A Survivor's Perspective."


References

  1. Wanke, C. et al. Pathogenesis and Consequences of HIV-Associated Wasting. Journal of Acquired Immune Deficiency Syndromes. December 2004, Volume 37, pp S277-S279.
  2. Brad M. Dworkin, M.D. Dietary Intake in Patients with Acquired Immunodeficiency Syndrome (AIDS), Patients with AIDS-Related Complex, and Serologically Positive Human Immunodeficiency Virus Patients: Correlations with Nutritional Status. J Parenter Enteral Nutr, November 1990, vol. 14, no. 6 605-609.
  3. Shah, M et al. The role of diet, exercise and smoking in dyslipidaemia in HIV-infected patients with lipodystrophy. HIV Medicine, Volume 6, Issue 4, pages 291-298, July 2005.
  4. Batterham, M. et al. Dietary intake, serum lipids, insulin resistance and body composition in the era of highly active antiretroviral therapy 'Diet FRS Study'. AIDS, 18 August 2000, Volume 14, Issue 12, pp 1839-1843.
  5. Williams, B. Protein Intake Is Positively Associated with Body Cell Mass in Weight-Stable HIV-Infected Men. The American Society for Nutritional Sciences. J. Nutr. 133:1143-1146, April 2003.
  6. Mayere, K. et al. Modifiable Dietary Habits and Their Relation to Metabolic Abnormalities in Men and Women with Human Immunodeficiency Virus Infection and Fat Redistribution. Clin Infect Dis, 2001, 33 (5): 710-717.
  7. Sanchez A, et al. Role of sugars in human neutrophilic phagocytosis. Am J Clin Nutr, 1973, 26: 1180-84.
  8. Mynarcik, D. et al. Association of Severe Insulin Resistance With Both Loss of Limb Fat and Elevated Serum Tumor Necrosis Factor Receptor Levels in HIV Lipodystrophy. Journal of Acquired Immune Deficiency Syndromes, 1 December 2000, Volume 25, Issue 4, pp 312-321.
  9. Carr, Andrew. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS, 7 May 1998, Volume 12, Issue 7, p F51-F58.
  10. Eizirik, D. et al. Prolonged exposure of human pancreatic islets to high glucose concentrations in vitro impairs the beta-cell function. J Clin Invest, 1992 October, 90(4): 1263-1268.
  11. Carr, Andrew. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS, 7 May 1998, Volume 12, Issue 7, p F51-F58.
  12. Hendricks, K. et al. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition American Journal of Clinical Nutrition, Vol. 78, No. 4, 790-795, October 2003.
  13. Tishaa, j. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS, 31 July 2007, Volume 21, Issue 12, p 1591-1600.
  14. O'Keefe, J. et al. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J Am Coll Cardiol, 2008; 51:249-255, doi:10.1016/j.jacc.2007.10.016.
  15. Giuglian, D. The Effects of Diet on Inflammation: Emphasis on the Metabolic Syndrome. Journal of the American College of Cardiology, Volume 48, Issue 4, 15 August 2006, Pages 677-685.
  16. Bolton, R. et al. The role of dietary fiber in satiety, glucose, and insulin: studies with fruit and fruit juice. American Journal of Clinical Nutrition, Vol 34, 211-217.
  17. Bolton, R. et al. The role of dietary fiber in satiety, glucose, and insulin: studies with fruit and fruit juice. American Journal of Clinical Nutrition, Vol 34, 211-217.
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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 TheBody.com'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 EDT
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.
Reply to this comment


Comment by: Anthony B. (Salt Lake City, UT) Thu., Oct. 18, 2012 at 7:50 pm EDT
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.

Anthony.
Reply to this comment


Comment by: Jeanne B. (Milwaukee, WI) Thu., Mar. 8, 2012 at 5:11 pm EST
Excellent article
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Comment by: mary (dar es salaam) Mon., Mar. 5, 2012 at 10:40 pm EST
thanks for ur news im the one who have HIV from 1999 i use HIV drug from2007
Reply to this comment


Comment by: Peter (San Francisco) Fri., Mar. 2, 2012 at 12:40 am EST
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.
Reply to this comment


Comment by: Ellen Levine (New York) Fri., Feb. 24, 2012 at 12:14 pm EST
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 EST
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.
Reply to this comment


Comment by: kim (Florida) Thu., Feb. 23, 2012 at 2:19 pm EST
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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