Muscle-Wasting Effects of Low-Carb Diets on People With HIV

It is not hard to go into any grocery store these days and see at least one product that advertises low or no carbohydrates on the package. The world seems to have embraced the idea that no or low-carbohydrate diets are good for us. It is a common misconception that carbohydrates are fattening. Because of this misconception the dieter may begin to avoid carbohydrates, leaving protein and fat for calorie intake. Remember that fat, carbohydrates, and protein are the only sources of calories in the diet.

The most popular diets today are high in protein and low in carbohydrates. These diets do work. However, the danger of having a high-protein, and low-carb diet is that when the source of the protein is meat, the meat is usually also high in fat and has higher calories per mouthful than a high-carb diet. One of the reasons that a high-protein, low-carb diet works is that the fat in the food slows down digestion quite a bit, so you feel satisfied with less food.

Another reason for the seeming effectiveness is that high-protein consumption tends to cause loss of body water. If you lose 10 pounds on a high-protein diet, two to three of those pounds may be by dehydration. Later your body reabsorbs the water and you regain that portion of your weight, making the diet less effective than it seems.

But this is not the major criticism of a high-protein, high-fat, and low-carb diet. The big danger is that this diet is conducive to muscle loss and degeneration of muscle tone and efficiency. In a well-balanced diet, the carbs in the meal are used for glucose production, leaving the protein available for muscle repair. The net result of a high-protein, low-carb diet is that the muscles break down and are not repaired, with a consequent loss of lean body mass. It is possible to lose as much as one pound of muscle for every pound of fat lost on one of these diets.

Wasting syndrome, also referred to as loss of body mass or lean body mass, is an AIDS-related complication and can be life threatening. If this kind of diet produces muscle loss among non-HIV-positive people, there is all the more reason for HIV-positive people to pay attention to a balanced diet.

What Happens When You Eat Too Much Protein?

When there is protein (amino acid) in excess of the body's requirements for it, it is sent to the liver and converted to fat. This process is called deamination and can be stressful if your body has to do a lot of it. During the deamination process, the nitrogen that is released from the amino acid is converted into ammonia, which is then changed to urea. Urea is very toxic, but to a lesser extent than ammonia. To be eliminated from the body, it must be diluted in the urine. In a normal balanced diet your body can very easily rid itself of urea. Yet, when you increase your intake of protein you increase the need to rid your body of urea and more fluids are required to dilute it. You may drink a lot more water but it won't necessarily be enough to adequately hydrate your body, and your body will inevitably take water from its own tissues. You now have suddenly put a very stressful burden on your kidneys, which are working overtime to get rid of the urea. Some HIV medications are hard on the kidneys and double taxing is not a good idea.

How Can You Be Sure You're Getting Enough Protein in the Diet While Also Getting a Good Balance of Carbohydrates and Vitamins?

A reasonable rule of thumb is to eat two servings daily of three ounces of a meat product or a meat substitute, like tofu for example. In addition, have two servings, one cup each, of nonfat or low-fat milk or milk substitute such as yogurt. Balance these high-protein foods with carbohydrates by eating four servings of fruits or vegetables each day and four servings of high-fiber breads and cereals, which are grain products.

While it's important to balance your diet with adequate amounts of protein and carbohydrates, you do not have to worry about getting enough fat. It is almost impossible not to get fat in the foods you eat. Even if you decided to eliminate all products that are high in fat, you would still get fat in nuts and other seeds, including wheat germ.

It is important to remember that before trying any new fad diet to talk to your healthcare provider and find out if the diet is right for you before ever beginning.

The bottom line is BALANCE.

Shelley is a treatment educator at Babes Network in Seattle, Washington.