Caring for the Inside: HIV and Nutrition

I don't buy snacks when I shop, because once those snacks get in the house, I'm in trouble!

-- Nancy Santiago, 55
Needle exchange staffer, Philadelphia
Diagnosed with HIV in 2002

Nancy Santiago (Illustration: A.E. Kieren)
Nancy Santiago (Illustration: A.E. Kieren)

Aging brings wear and tear on your heart, liver, and kidneys. HIV adds to it. But medications, diet, and lifestyle can all help fight those trends.

"I'm a mother of five, grandmother of 10, woman, best friend," says spunky Nancy Santiago, 55, of Philadelphia, who works part-time at a needle exchange that helps keep drug users free of HIV and hepatitis C. "HIV doesn't define me!"

Luckily, Santiago's never had many problems with her HIV since she was diagnosed in 2002, after having sex with a boyfriend who didn't tell her he was HIV-positive. What she does she really struggle with?

Her diabetes. "I have to do my insulin five times a day, and I have to be careful with what I eat and how much I eat, because almost everything contains some amount of sugar. I don't buy snacks when I shop, because once those snacks get in the house, I'm in trouble!" she says with a giggle, "Instead, I fantasize that I'm eating it. And I have an orange at night instead."

In some ways, Santiago's scenario is typical, because research shows that even when HIV is well managed, folks with HIV over 50 still have a higher incidence of organ-related complications, such as heart disease, liver disease, diabetes, and high blood pressure (which can damage the kidneys), than their HIV-negative peers. Organ decline appears to happen faster in folks with HIV than other middle-agers and seniors. Often, it's because of a mix of the years-long toll of HIV meds, HIV causing amped-up inflammation in the body, the presence of co-infections like hepatitis B or C, and a history of smoking, alcohol, and/or drug use.

Thankfully, as with all complications of HIV and aging, there are concrete action steps you and your doctor can take to buck this trend. Let's have a look:

Get screened regularly. If you're seeing your HIV doctor every three months or so, make sure they're doing basic screening of your organ functions. This includes testing your cholesterol levels (lipids) as a measure of heart health, blood-sugar levels, liver function tests (ALT, AST, alkaline phosphatase, PT, INR, albumin, and bilirubin) and kidney (renal) function tests (BUN, creatinine, and creatinine clearance). Ask your doctor to go over these results, and what they mean, with you.

Review all your meds. Certain meds are more likely to cause problems with your heart, liver, or kidneys than others. Read up in the POSITIVELY AWARE HIV Drug Guide, or other online resources, and talk to your doctor about the pros and cons of different meds.

Talk to your doctor about organ-protective meds. Drugs called statins (such as Lipitor) can not only bring down your cholesterol level and boost your heart health, they also have a beneficial anti-inflammatory effect. High-blood pressure medication, a daily baby aspirin, turmeric, fish oils -- they can all play a role in keeping your organs healthy. Talk to your doc about them, as well as over-the-counter supplements before starting them.

Tips From the Pros

Nancy Santiago, 55

As for our Philly abuela, what is Santiago doing to stay healthy?

"I don't like to say I'm HIV-positive first. That's not who I am."

"I don't buy snacks when I shop, because once those snacks get in the house, I'm in trouble!" she says with a giggle, "Instead, I fantasize that I'm eating it. And I have an orange at night instead."

"I'm on my feet at my job every day, which keeps me active."

Oh, and she has one more tip for aging healthy with HIV. "Stay stress-free! I try to let most stressful things fly over my head. And I'm only 4'9", so they don't have to go very high!"

Eating Healthy & Cheap

Think you can't eat an anti-inflammation diet on a budget? We checked in with Lisa Zullig, who heads up nutrition at God's Love We Deliver, which delivers home-cooked meals to people with AIDS and other illnesses in New York City. Here are her tips on how to spend and use your dollars wisely at the supermarket.

Count those beans. Dried beans bought in bulk are cheaper than the canned variety -- and they're loaded with nutrients. Soak 'em and boil 'em and you can make all sorts of things with them from puréed dips to soups, chilis, and casseroles.

Buy frozen fish and vegetables. They're flash-frozen so they retain nutrients better than fresh vegetables that sit around for days. Plus you can thaw just as much as you need, thus not wasting anything. And they're economical.

Make chicken soup. Put a chicken (whole or parts), carrots, celery, and onion in a big pot with water and salt and pepper. Boil it until the chicken is done and then remove the bones. Then throw in pasta, rice, or a grain like barley if you wish. Voilà! You've got a super-healthy, delicious meal that'll last for days. Or you can freeze portions for per-meal eating.

Pan-fry salmon burgers. Salmon is so good for you. Buy it canned and crush up the bones -- they're loaded with nutrients. Then mix with diced onions and a red pepper, breadcrumbs, seasoning and an egg. Form into patties, pan-fry them, and serve them topped with salsa, with salad or a vegetable on the side. (You can do the exact same thing with turkey burger.)