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There is no cure for AIDS
(acquired immune deficiency syndrome), nor is there a special diet for
people infected with HIV, the human immunodeficiency virus that causes
the disease. But good nutrition can prevent or delay weight loss and
other complications.
Asymptomatic HIV-infected
individuals should follow the same dietary practices recommended for
healthy people, but with added precautions. Because the HIV organism
attacks the immune system, it makes a person more vulnerable to
infections, including food poisoning from salmonella, shigella,
campylobacter, and other bacteria. Such food borne infections occur
more frequently and are more severe in people with reduced immunity.
Consume plenty of:
1. Meat,
poultry, liver, eggs, milk, nuts, and other high calorie, high protein
foods to prevent weight and muscle loss.
2. Pasta,
rice and other starchy foods, cooked vegetables, juices, and canned or
stewed fruits for essential vitamins and minerals.
3. Small
meals/snacks through the day.
Limit:
1. Fatty
foods and whole grain products if they cause diarrhoea.
2. Coffee,
tea, and other caffeinated drinks that can cause diarrhoea and reduce
absorption of some nutrients.
Avoid:
1. Raw
or undercooked foods, especially shell fish, eggs, and meats.
2. Alcohol,
which can worsen diarrhoea and interact with AIDS medications.
Keep up your
food intake: AIDS is a wasting disease, and death is often
due to starvation rather than to other HIV complications. A patient
should eat as much as possible and, unless markedly obese, not worry
about gaining weight. The extra weight can be critical in seeing a
patient through a crisis where he can’t eat.
Unfortunately,
maintaining good nutrition is complicated by the ways in which AIDS
affects the digestive system. It reduces absorption of nutrients,
especially folate, riboflavin, thiamine, and vitamins B6 and B12; it
often causes intractable diarrhoea, which causes further nutritional
loss; and it increases the risk of intestinal infections. Many AIDS
patients also suffer appetite loss and bouts of nausea, either from the
disease or from medications.
If rapid weight loss
occurs, the patient may require artificial (hyper alimentation)
feeding; this is generally administered through a gastric feeding tube
inserted into the stomach or an intravenous line that pumps
pre-digested nutrients into the bloodstream. Some AIDS specialists
advise artificial feeding if nutrients are not being absorbed properly.
Food Safety:
Anyone who is HIV positive or a person who prepares food for an AIDS
patient, must pay special attention to food safety. Wash hands before
handling food, during its preparation and after. Keep hot food hot and
cold foods cold. Avoid contact between raw and cooked foods. Eggs
should be boiled for at least 7 minutes; meats and fish should be well
cooked, with an internal temperature of 165º F to 212º F (74º C to 100º
C). Raw shellfish, sushi, steak tartare, rare hamburgers, as well as
homemade mayonnaise and ice cream made with raw eggs must be avoided.
Commercial mayonnaise and hard ice cream are safe.
Wash fruits and
vegetables well: They are not as likely to cause problems as
animal products, but they should be washed thoroughly. Many doctors
advise following the same precautions as when travelling abroad; eat
only cooked vegetables, and eat fruits that are peeled, stewed, or
canned. Some feel salads and raw fruits and vegetables are safe but may
be difficult to digest.
Use of
Supplements: Nutritionists often recommend that HIV positive
people take a multiple vitamin and mineral pill to prevent nutritional
deficiencies; however, supplements with more than 100% of the
Recommended Dietary Allowance (RDS) should be used only if prescribed
by a doctor. Many patients self treat with high dose supplements, a
course that can lead to serious problems. High doses of vitamin C, for
example, can worsen diarrhoea.
Avoid harmful
dietary approaches: Some self help groups advocate taking
high doses of zinc and selenium to bolster the immune system. There is
no proof that supplements of these nutrients protect against AIDS
related infections; in fact, studies show that taking 200 mg to 300mg
of zinc a day for 6 weeks actually lowers immunity. Excessive selenium
can also cause vomiting and diarrhoea.
Another dangerous dietary
approach entails following a macrobiotic regimen, especially one
restricted to brown rice and a few vegetables. Such a diet can actually
worsen AIDS because it fails to provide adequate nutrition;
additionally, the excessive fibre can exacerbate diarrhoea.
Herbal medicine is a
popular self care approach, though there is no evidence for efficacy.
Caution is needed as some herbal preparations contain substances that
can cause serious side effects or interact with medications. Check with
a doctor before taking any herbal or other preparation or engaging in
self treatment or alternative medicine.
Practical hints:
1. When
mouth or throat infections, such as thrush or ulcers, make eating
uncomfortable, try soft, moist foods that are easy to swallow, like
mashed potatoes and gravy. Use a straw for liquids. Keep food at room
temperature as hot foods can add to discomfort. Drink low acid
beverages such as milk or apple juice. Avoid foods and juices with high
acid content.
2. When
you suffer from nausea or diarrhoea-common side effects of many HIV
medications: Drink plenty of fluids to replace what you have lost, such
as water, broth, or flat ginger ale, or eat popsicles. When you are
ready to eat, start with bland foods such as toast or crackers. Try
small snacks through the day. Eat slowly and chew food well. If the
smell of food bothers you, let someone else prepare it and stay away
from the kitchen. As the diarrhoea improves, try non irritating foods
such as chicken, eggs, fish, apple sauce, and peanut butter.
3. When
you suffer from frequent bouts of diarrhoea: Avoid raw fruits and
vegetables and high fibre foods such as whole grain breads and cereals.
Also avoid gassy foods such as onions, beans, cabbage, spicy foods, and
carbonated beverages. Stay away from rich, fatty foods, caffeine,
alcohol, and chocolate.
4. Many
nutritionists consider fungi to be champions in the fight against
disease and, shiitake mushrooms in particular, are known to stave off
infection. Lentinan, a compound found in shiitakes, is thought to have
immune enhancing properties and therefore beneficial to AIDS sufferers.
Note: While
every care is taken to provide medically accurate and up to date
information in this web site, it is to be noted that this advice is not
intended to replace the advice of your physician. Before undertaking
the advice contained in this web site, you should consult a medical
professional.
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