| Nutrition and Exercise |
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Nutrition
Nutrition and HIV Good nutrition is critical for long-term health and survival. Studies have found that HIV+ people with a healthy diet and good nutritional status can better tolerate HIV drugs, maintain weight and muscle mass more easily, and feel better overall. Nutrients are things like fats, protein, carbohydrates, vitamins, minerals, and other important chemicals. You need proper levels of different nutrients in order to build and repair cells, keep hormones regulated, fight infection, and maintain energy levels. For the most part, we can’t make nutrients. We get what we need from food and (when that’s not possible) dietary supplements. Good nutrition depends on many things, including:
HIV-related changes in any of these factors can affect your nutritional status. Over time, this can lead to a variety of nutritional problems, including:
Many of these HIV-related problems can be avoided, or partially managed, using nutritional strategies. How is Nutrition Measured? Nutritional status can be assessed in many ways, including:
Diet and HIV A healthy diet is a key part of any HIV treatment plan. Your diet should give you the nutrients you need to:
What kind of diet you should follow depends on your weight and your nutritional status (cholesterol, blood sugar, vitamin levels, etc). A nutritionist or registered dietician can help figure out which diet plan makes the most sense for you. AIDS service organizations and health-care clinics sometimes have nutritionists on staff. HIV+ Women and Nutrition Nutritional guidelines such as the Recommended Dietary Allowance (RDA) are set by the government to let people know how much of each nutrient they need each day to maintain good health. However, the RDA does not take into account that HIV infection increases these needs. One study showed that HIV+ people needed between 6 and 25 times the RDA of some nutrients. Due to dieting, eating unhealthy foods, lack of time, or other pressures, half of all women in the U.S. do not eat what they need to meet even the basic RDA requirements for many nutrients. This puts women, especially HIV+ women, at particular risk for nutrient deficiencies. Ways to Improve Nutritional Status Eat to Maintain Your Weight In a chronic infection like HIV, your body burns more energy (calories). If you’re using more than you’re bringing in, you may lose weight. Over time, too much weight loss can lead to malnutrition. HIV+ people often need a higher daily calorie intake to prevent weight loss. Hunger isn’t always a reliable guide, because you can feel nauseous or turned off by food, even when you need it most. If this is case, speak to your doctor about interventions such as appetite stimulants or medications to control nausea. Carbohydrates are a good source of energy, but can be a problem if you have diabetes. They are found in foods like:
Eat More Protein to Fight Muscle Loss Protein (along with exercise) helps your body build and maintain muscles. During times of infection, protein stored in muscles, cells, and hormones can get burned as a fuel source. This can lead to muscle wasting. HIV+ people may need 1.5 to 2 times as much protein as HIV- people. You should try to eat at least three serving of protein each day. Foods high in protein include:
Animal sources of protein are high in saturated fats, and should be used in moderation―especially if you have elevated cholesterol or you’re at risk for heart disease. Fiber, Water, Fruits, and Vegetables for Gut Health A healthy intestinal tract is necessary in order for your body to get what it needs from foods, supplements, and medications. Foods high in fiber can help regulate bowel movements and support your gut. These include:
Water (9?11 8 oz cups a day), juices, fresh fruits, and vegetables can help you digest and eliminate waste. Animal fat, especially dairy, can aggravate diarrhea. If diarrhea’s a problem, you may need to cut back on animal fat, fried foods, and sugary foods. Supplements HIV+ people need more vitamins to build and repair tissue. It isn’t always possible to get all the micronutrients (vitamins and minerals) from foods you eat. Vitamins deficiencies can cause problems such as anemia. While supplements do not replace a well-balanced diet, they can help you get the additional micronutrients you need. Most nutritionists treating HIV+ people recommend at a minimum:
Speak to your doctor and see a registered dietician for a nutritional evaluation. They can help you determine what combination of diet changes and supplementation can correct any micronutrient deficiencies you have. Practice Food Safety It's very important to protect yourself against infections that can be carried by food or water:
Taking Care of Yourself It’s not easy to stick to a well-balanced and healthy diet. But the benefits of good nutrition are clear. Well-nourished people have a healthier immune system and are better prepared to fight off infections. In addition, many HIV+ people use food and supplements to manage a variety of complications and side effects. Think of your diet and supplements as part of your total strategy to fight HIV and stay healthy. Although research has yet to identify specific recommendations for HIV+ people, a well-balanced and varied diet that includes all vitamins and minerals seems to be the best way to go. Work with your doctor and a dietician or nutritionist on a regular basis to develop the best plan for you. |
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Exercise
What is Exercise? Exercise is activity that you do on a regular basis (every day, or several times a week) for the purpose of improving your health. Keep in mind that if it’s something you do every day as part of your job, it’s probably not exercise. Exercise needs to be outside of your daily routine. That doesn’t mean that increasing your normal activities during the day can’t be helpful. Some studies have shown that adding small amounts of activity throughout the day can improve your health. This might mean taking the stairs instead of the elevator, parking farther back in the parking lot, or walking to places less than a mile or two away. Benefits of Exercise Everyone knows that exercise can make you stronger, give you endurance, and strengthen your heart. But there are many benefits of exercise that are especially helpful for HIV+ people. An exercise routine can:
Exercise and the Immune System There is as strong connection between muscle mass and immunity. By increasing the size of your muscles, you may be able to slow the progression of your HIV. People who exercise often have higher CD4 cell counts and fewer side effects from HIV and HIV drugs. Types of Exercise Aerobic exercise uses oxygen to burn fat in your body. This is why people who are trying to lose weight often do lots of aerobic exercise. It is also called cardiovascular exercise, because it raises your heart rate and makes your heart stronger. Besides burning fat, it can increase your endurance, meaning that you don’t get tired as quickly when you use energy. Weight-bearing exercise (also called resistance or strength training) is when you move weight with your muscles. When you do this your muscles tear, but when they heal they are bigger and stronger. It is important that when you do weight-bearing exercise, you wait until that part of the body is not sore anymore before you exercise it again. Your body needs plenty of time to heal the muscles. What Type of Exercise Should I Do? Aerobic exercises are good for people who want to lose weight, burn fat, increase endurance, lower cholesterol and triglycerides, or lower blood sugars. (In some HIV+ people, exercise may not lower cholesterol and triglycerides enough. If this is the case, speak to your doctor about lipid-lowering drugs.) Some HIV+ people should not do aerobic exercise, such as those who are wasting or have very little body fat. Make sure that you ask your doctor if you have any conditions that keep you from doing aerobic exercise. Weight-bearing exercise can be helpful for most HIV+ people. This type of exercise strengthens muscles and makes them bigger, which can help prevent or fight wasting. If you have had muscle loss, weight-bearing exercise is probably good for you. However, if you have osteoporosis (bone disease) or if you have been hurt recently, weight-bearing exercise could be dangerous, and you may need a physical therapist. Ask your doctor if weight-bearing exercise is okay for you. Good Aerobic Exercises:
Good Weight-bearing Exercises:
How do I Start an Exercise Routine? First of all, ask your doctor what types of exercise are okay for you. Then start slowly. Do what you can, but don’t overdo it. Be patient with your body and your workout. Before you start your exercise program record your weight and the measurements of your arms, legs, chest, stomach, and hips. If possible, also check your body composition with a Bio-electrical Impedance Analysis (BIA). A BIA can be given in a doctor's office and takes only a few minutes. The test determines your body composition by calculating the amount of fat, muscle, and water in the body according to height, weight, sex, and age. It may be helpful to set goals for yourself, such as increasing or decreasing some of your body measurements. If you are new to exercise, set simple goals for the frequency and duration of your workouts and increase them over time. Make sure your goals are realistic. When doing aerobic exercise, walk at a pace where you could answer a question in a few words but you aren’t gasping for air. Try to work up to at least 30 minutes three times a week. If you have to start out with 10 minutes, that’s fine. Walk for 10 minutes, and in a couple of weeks add five minutes to your workout. Continue doing this until you are up to 30 minutes or more at least three times a week. When doing weight-bearing exercise be sure to use slow, controlled movements. Don’t slam the weights down or drop them quickly on the way down. This is not helpful when trying to put on muscle and it can be dangerous. Try to work up to weight-bearing exercise at least three times a week for 30 minutes or more. Most importantly, drink lots of water before, during, and after your workout. When you're feeling sick, either exercise less or stop for a while. Starting an exercise routine requires commitment. It may take a while for you to get used to your routine, but don’t give up! If you are able, try hiring or talking to a certified fitness trainer to help you develop a good routine. Make sure to talk to your doctor about any exercise you are doing. |