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Nutrition and Weight Maintenance for the HIV-Positive Woman

July 2001

Good nutrition, combined with exercise, strengthens the body and mind. It relieves stress and optimizes the most out of HIV-related therapies. The building blocks of good nutrition include an appreciation of the basic food groups and principals of a well-balanced diet.

When making a nutrition and exercise plan, it's probably best to start with small improvements over what you already do. Do you eat three healthy meals a day? If not, try to incorporate that third (or even second) meal into your day. Do you exercise? If not routinely, then commit to walking around the block or stretching in your home each day.

Once you've made these small changes, then try another set of healthful new activities. The key to success is not to create unrealistic goals and expectations, but rather real and do-able goals that you find enjoyable and fit within your lifestyle. And like any basic program, periodically check and adapt your strategy to your changing needs.


Women, HIV, and Weight Loss

Society's glamorizing of thin women might lead doctors -- and some women with HIV -- not to be alarmed by unplanned weight loss. Any weight loss that is unplanned and can't be explained should be cause for alarm. Your weight should be monitored with the same watchful eye as your lab results.

Malnutrition and weight loss are common problems with HIV disease. Malnutrition can result from loss of appetite and food intake due to depression, fatigue, illness or side effects from therapy. Without monitoring, it can persist undetected for a long time.

Weight loss is an obvious sign of malnutrition. It can begin and become severe anywhere in the course of HIV infection, though it's an increasing threat when CD4+ cell counts fall below 100. Wasting is an extreme type of weight loss and is an unexplained loss of 10% or more of a person's normal weight.


Consider Supplements

Vitamin graphicMany people attempt to give their bodies an edge over HIV with vitamins and nutritional supplements. Although a healthy diet is the best source of most vitamins and nutrients, supplements may help correct minor deficiencies. Much research still needs to be done to document nutritional deficiencies of HIV disease and how supplements may correct them. Still, taking a reasonable level of supplements makes common sense.

For some people, supplements are often too expensive. Some counties and states have programs that help cover the cost of nutritional supplements. To find out if programs exist in your area, call your local health department.

However, supplements should not replace food. Whenever possible, increasing vitamins through better eating habits is preferable.

Lastly, the vitamins and supplements industry is entirely unregulated. This means that a product may not contain what the bottle label advertises, and there's no guarantee that it will do what its promoters say. One source that might be useful in evaluating different brands of vitamins is www.consumerlabs.com.


Brown Bag It!

A brown bag medical check-up is an important part of health monitoring. Each time you visit your doctor, put all the therapies you take into a bag. Include vitamins, herbs, nutritional supplements and all prescribed meds. Ask your doctor or pharmacist to review your therapies for their safety and instructions for use. This will help avoid drug, vitamin, and herb interactions and may help diagnose symptoms caused by side effects of therapies.


Treat the Causes

HIV and related conditions can cause weight loss, fatigue, loss of muscle mass and chronic diarrhea. The gut, where your body absorbs nutrients, is a major reservoir of HIV infection. Also, many other infections grow unchecked there once the immune system is weakened. All these factors can contribute to weight loss and poor nutrition.

It is important to identify the cause of weight loss and diarrhea. Often, multiple causes occur at the same time. Also, some wasting is due to malabsorption, when the tissue and cells lining the intestines can no longer properly transfer nutrients.

Finding the cause(s) of weight loss and/or diarrhea is always critical to finding the right solution. Treating symptoms, without understanding the underlying causes, can sometimes do more harm than good.


A Final Word

When correcting nutrition and wasting problems, there's no guaranteed solution for every situation. What works for one person in one situation may not work for the next. The best solution is to form your own opinions after collecting as much information as possible.

Of all the options out there, enhancing and maintaining a well-balanced diet is likely the best cornerstone of a nutrition and weight maintenance program. For more information, read Project Inform's publications, "Nutrition and Weight Maintenance," "Drug Interactions Fact Sheet," and "Herbs, Supplements, and HIV," available from the hotline.


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