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Nutrition and Eating Problems

By Peggy A. Wickwire, MS, RD, LD/N

Being infected with HIV can make it hard for you to eat sometimes. This is very common. You may be unable to digest certain foods that you used to eat all the time. The medicines you take may make you feel sick to your stomach. You may have infections in your mouth which hurt when you swallow. You may just feel too tired to eat. And you may worry a lot because you know you should eat, no matter how you feel!

The good news is that there are certain foods that can help you feel better when you are having these problems. The next several pages have lists of ideas on what to eat when you are having problems with:

Caution: Some of the eating hints that are given for one of these problems may conflict with hints that are given for another of the problems. For example, one hint for gaining weight is to put gravy, butter or creamy sauces on your food. If you have diarrhea, however, the gravy, butter or sauce could make it worse!

If you are having more than one of the individual problems listed above, be sure to read the information in all of the sections that apply. Avoid eating foods which either section tells you might be harmful. Your doctor or dietitian can also help you sort out the differences.


Diarrhea

Infections, medicines and emotional stress can all cause diarrhea. it can make you feel weak and become dehydrated. If you have problems with diarrhea, these ideas may help.


Lactose Intolerance
(milk sugar)

Sometimes HIV can give you such bad diarrhea that you won't be able to digest a certain sugar in milk which is called "lactose." This may last for a few weeks, a few months or even longer. Your doctor may tell you to stay away from foods which contain lactose. lactose is mostly found in milk and in many dairy products.

You should not eat these foods:

Regular (whole) milk, Skim milk, Low fat milk, Evaporated milk, Powdered milk, Goat milk, Cheese (unless the label says it has been aged 90 days), Instant coffee, Cocoa or other chocolate beverages, Whipping cream, Sour cream, Pudding and pudding pies, Custard and custard pies, Ice cream or ice milk, Gravy made with milk or cream, Soups made with milk or cream, Party dips made with sour cream, Cream sauce on meats or vegetables.

You might be able to use these foods instead. They have less lactose:


Low Fat Foods

Fat can be hard for your body to digest when you are sick. It can cause diarrhea, nausea, gas and bloating. Here are a list of foods to eat if your doctor says to stay away from fat.


Nausea/Vomiting

Nausea may be caused by the medicines you are taking or by infections in your body. These are some ideas to try when you have nausea:


All About Fluids

When you have diarrhea or are vomiting, you are losing a lot of fluids from your body. You must replace it or you can become dehydrated. Here are some hints about getting the fluids you need.


Ulcers/Pain in Swallowing

Your mouth and throat are some of the most sensitive areas of your body. An HIV infection can allow sores to develop there. These sores can make it hurt to chew or swallow and that makes it hard to eat. Here are some tips to make eating easier for you.


Dry Mouth

Some of the medicines you take may cause you to have a dry mouth. Here are some ideas for moistening a dry mouth and a list of foods that are easy to swallow.


Weight Loss

HIV infection often causes problems with weight loss. Here is a list of eating hints to help you gain weight.

Gaining Weight With Extra Milk and Dairy Products

Gaining Weight With Extra Cheese

Gaining Weight With Extra Meat

Gaining Weight With Peanut Butter

Snacking On Healthy Foods Makes A Difference

Who says snacks have to be potato chips and cola? Make your snack count! Eat healthy foods like these between meals. They will give you protein, vitamins, minerals and the calories you need.

Frozen pizza, fish sticks, sandwiches, tacos, canned spaghetti, crackers and cheese, crackers and peanut butter, hamburger, cottage cheese and fruit, peanut butter on apples, baby food fruits & desserts, ice cream, pudding, grilled cheese, yogurt, milkshake, nuts, boiled eggs, cereal and milk, creamed soups, dried fruit, sliced meats.

Gaining Weight With Extra Fat

Adding fat to your food can increase calories a lot! It can be hard to digest sometimes, though. Use these tips when you feel well. If you begin to have diarrhea or nausea stop adding so much fat.

Foods Which Will Not Help You Gain Weight

When you are trying to gain weight you must think about eating a lot of calories. The more calories you eat, the more weight you can gain. You should realize that your goal of eating more calories and gaining weight is exactly the opposite of what many people in our country are trying to do.

Many, many Americans are too fat. For this reason, the articles about nutrition that may see in magazines, newspapers and television are often full of ideas about how to reduce calories and lose weight. These articles often have titles like "good nutrition" or "how to eat right." In this country, "good nutrition" has come to mean the same thing as "low in calories."

This can be very confusing for you. Up until now, many of your ideas about good nutrition may have had to do with limiting calories. Without realizing it, your family and friends may also have been giving you advice about eating foods and beverages which are low in calories.

When people become infected with HIV they often decide to make the most of their health. They may begin to pay more attention to nutrition. But if they follow what friends and family and the media say is good nutrition, they may lose weight. And that's not what they need!

Statements which follow are generally considered to be good nutrition advice for people in this country. They are bad ideas for you, though, because they can cause you to lose weight or make it hard for you to gain. A statement is made below each which tells you what you should do instead of following this advice.

Good Advice For Some...
But Not For You!

Number 1: Drink a lot of plain water.

Water may not be the best choice for you now. It has no calories. It would be better if you drank things that can help you gain weight. Good choices are milk, egg nog, cocoa, juice, and punch.

Number 2: Eat a lot of fruits and vegetables.

Fruits and vegetables won't help you gain weight. They re very low in calories. When you are trying to gain weight, limit yourself to 4 servings per day of fruits and vegetables. Eat more protein foods like meats, eggs, cheese and peanut butter. And eat more starchy foods like bread, cereal and macaroni instead.

Number 3: Hot soups are especially good for you.

In fact, soup may be a problem for you. Soups are mostly water, and water has no calories. In most cases, solid foods have more calories than liquid foods. If you like soup, consider making it from milk instead of water. Also, try adding extra meat, noodles, cheese or chopped eggs to it to increase the calories.

Number 4: Snack on raw vegetables, salad and fruit.

You could find better snacks that fruits and vegetables right now. They are too low in calories. You could get more calories at snack time if you ate sandwiches, pizza, cereal, ice cream or the other foods mentioned in the section, "Snacking On Healthy Foods Makes A Difference."

Number 5: Have sugar-free drinks instead of regular drinks.

Go for the sugar! It has the calories you need right now. You should have regular soft drinks, not "diet" soft drinks. Add extra sugar to them if you wish. And you might add a scoop or two of ice cream to your glass to give you even more calories.

Number 6: Sugar is bad for you. Don't eat it.

Sugar is your friend! Sugar not only has calories itself, but it makes food taste good. You may be able to eat a bit more if you sweeten your food with sugar, jelly, syrup or honey. Put extra sugar in your cereal. Don't be afraid to eat candy bars, cakes and cookies in addition to your healthy food.

Number 7: Fried food is bad for you. Don't eat it.

You need calories and fat has more calories in it than any other food. When you fry foods you just about double the number of calories in them. Unless you are unable to digest a lot of fat, eat fried foods instead of baked, roasted or boiled.

Number 8: Eggs are bad for you. Don't eat them.

On the contrary, eggs are very good for you right now. They have a lot of protein and you need that to keep up your fight with HIV. Forget about cholesterol! If you want to have a half dozen eggs every day for breakfast, lunch and supper, that would be fine!

Number 9: Don't eat between meals.

Eat whenever you can! You may never get in all the calories that you need in 3 meals per day. You need snacks two, three or more times every day. Look at the section, "Snacking On Healthy Foods Makes A Difference" for some ideas on what to eat for snacks.

Number 10: Don't put butter on your food.

Butter and margarine can help you gain weight. They are very high in calories. So are mayonnaise, sour cream and salad dressing. Look at the section, "Gaining Weight With Extra Fat" for some ideas on ways to put more calories in your food using these foods.

Number 11: Drink skim milk and low fat milk instead of regular milk.

Drink the type of milk which has the most calories. Skim milk and low fat milk have too few calories. Drink regular milk, also called "whole milk," instead. And add chocolate or strawberry powder to it if you wish to vary the flavor!


Poor Appetite

Some days you just may not feel like eating. It can be caused by many different things -- pain, illness, tiredness, worry. It is important to eat well even on days like this. You'll find it helps your mood as well as your body. These ideas should help.

Note: Additional sample menus can be found in the section, "Planning Your Meals."


Feeling Tired

Feeling tired is normal when you are sick. It is a sign that your body is working hard to fight off germs. Your body needs rest, but it also needs good food. Since it is hard to cook when you are tired, try these simple ideas.


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This article was provided by Tennessee Department of Health AIDS Support Services. It is a part of the publication Nutrition and HIV: Your Choices Make a Difference. You can find this article online by typing this address into your Web browser:
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