HIV+ people are at higher risk of developing three kinds of bone disease: osteoporosis, osteopenia and avascular necrosis. Osteoporosis and osteopenia make your bones weak so they can break easier. In avascular necrosis, blood vessels in your bones are damaged, causing part of the bone to die.
Many different things can put you at risk for bone disease such as being a woman, being older, being white, low body weight and low levels of the hormone estrogen. Smoking and drinking alcohol and caffeine can also make you more likely to get bone disease.
To find out if you have bone disease, doctors can either remove a small piece of the bone (bone biopsy) or do a DEXA scan to measure your bone density. DEXA is an easy and painless test that people at risk for bone disease should have done.
Even though you cannot control some of the things that lead to bone disease, your diet may help keep your bones strong. The minerals calcium and phosphorus make up most of your bone. If you do not get enough calcium or phosphorus in your diet, your bones may get weaker.
You can get calcium from dairy products like milk, yogurt and cheese. Some products have calcium added, such as fortified orange juice. Most HIV+ people should take calcium pills every day even if they eat dairy products. Make sure your calcium pills also contain vitamin D. Most people should take no more than 1000 mg (milligrams) of calcium and 400 IU (international units) of vitamin D. Speak to your doctor about the right dosing for you.
Phosphorus is found in dairy products, beans and peanuts. Most people do not need to take extra phosphorus.
It is also important to exercise on a regular basis. When you exercise your muscles pull against your bones, which helps keep them healthy and strong. The best kind of exercise uses weight. Walking, stair climbing, hiking, aerobics and jogging make your muscles work by using your own body weight. Working out with weights is also a very good exercise for your bones. The more often you exercise the better. Start slowly and increase your exercise routine five minutes every two weeks. In the end, you should be working out 3-7 times a week, about 20-60 minutes each time.
Discuss your exercise routine with your doctor to make sure it is safe for you. You should also talk to a registered dietitian (RD) and your doctor before you start a new diet. Your doctor may suggest hormones (like estrogen or testosterone) to take along with your diet and exercise. In some cases your doctor may also suggest that you take a prescription medicine like Fosamax or Citracal.
To learn more about HIV, nutrition and exercise, try these websites:
Kelly Williams is a registered dietitian at AIDS Treatment Initiatives in Atlanta, GA.