Nutrition Guidelines & Diets for AIDS/HIV  

The best way for a person to meet his or her nutritional needs is to eat a wide and balanced variety of foods. When the body’s immune system is weakened, however, as it is in people with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection, maintaining good nutrition and healthful eating habits may pose a constant challenge. Owing to their susceptibility to infectious bacteria, people with AIDS/HIV must take special precautions when purchasing and preparing food, being sure to avoid eating raw fish (sushi) and raw eggs, to consume only pasteurized dairy products, to wash all fruits and vegetables thoroughly, and to cook all meat and poultry well. Sometimes the medical conditions of people with AIDS/HIV -- or the therapies used to address those conditions -- interfere with the ability or willingness to eat. Malnutrition is therefore a common complication of AIDS/HIV.   

The following sections, intended for people with AIDS/HIV and for their caregivers, provide dietary guidelines for managing common AIDS/HIV-related conditions -- including side effects of medications and treatments -- and for meeting general nutrition requirements safely, effectively, and consistently.  Information about alternative therapy for AIDS/HIV, including specific herbal/natural remedies and recommended nutritional supplements, is also provided.

 

Managing Common AIDS/HIV-Related Conditions & Side Effects

Nutrition Tips for Treatment Days

Boosting Calorie & Protein Intake for People With AIDS/HIV

Nutritious Snacks

Alternative Therapy for AIDS/HIV

Herbal/Natural Products for AIDS/HIV

Alternative Dietary Recommendations for AIDS/HIV

Nutritional Supplements for AIDS/HIV

Managing Common AIDS/HIV-Related Conditions & Side Effects 

If you are a person with AIDS/HIV, you may experience a range of specific eating problems, including nausea and vomiting, owing to certain opportunistic infections and/or to side effects of medications and treatments.  Many dietary and behavioral tips are available to help you maintain a nutritional diet while lessening the side effects of treatment and the most common discomforts caused by your illness.  Consult the following links for specific information:    

            Appetite Loss

Bloating

Constipation

Fatigue  

Lactose Tolerance

Mouth & Throat Discomfort

Nausea & Vomiting

 

Nutrition Tips for Treatment Days 

If you are a person with AIDS/HIV, you may eventually undergo treatment, such as surgery, chemotherapy, and/or radiation, that will affect your eating habits and possibly the level of your nutritional intake. At the start of a course of treatment, you may encounter little, if any, discomfort and may be able to follow a normal pattern of eating. As your treatment continues, however, some side effects may prevent you from getting the nutrients that your body needs.    

The following guidelines may help you to maintain proper nutritional intake during the course of your treatment:  

·         Instead of eating three large meals daily, try smaller, more-frequent meals; this will help to minimize nausea. 

·         Avoid foods that are high in fat, which tend to remain in the stomach longer than other foods and may cause nausea. Limit your intake of bacon, bologna, butter, chips, cream, cream sauces, donuts, fried foods, gravies, hot dogs, ice cream, margarine, mayonnaise, peanuts, sausage, whole milk, and other high-fat foods.  

·         On treatment days, eat a small meal two hours before treatment and take a snack with you to treatment. Also try to have some of the following food and drink, which require little or no preparation, available throughout the day: broth-based soups, canned fruit, crackers, fruit juice, fruit sorbet, gelatin, popsicles, soda (regular, not diet), and tea.

 

Boosting Calorie & Protein Intake for People With AIDS/HIV 

The first priority of any diet should be to meet the body’s calorie and protein needs. If a person does not eat enough food to meet these needs, he or she will start to lose weight, muscle mass, strength, and physical stamina.   

If you are a person with AIDS/HIV, your illness may make it difficult for you to follow a regular diet and, in turn, may hinder your body’s ability to fight infection. You will need to make greater efforts to ensure that you are getting enough protein and calories (as well as vitamins and minerals) in your diet. A common problem among people with AIDS/HIV is wasting syndrome, unintended and progressive weight loss owing to inadequate dietary intake, malabsorption of nutrients, abnormalities in metabolism and energy expenditure, and/or HIV-related infections. A fundamental aim of therapy for wasting syndrome is to boost calorie and protein intake, in order to increase both body weight and lean body mass.

Beware of fad diets and products that promise to “cure” your illness. Special diets or fad regimens rarely provide the adequate calories, protein, vitamins, and minerals required by your body. Even if you are overweight, your primary goal should be to maintain your weight by improving your dietary habits. Try weighing yourself weekly, on the same day and at the same time of day, using the same scale. If you find that you are losing weight, adjust your diet to include more calories. A first step is to be sure that you eat breakfast every day; because you may become progressively tired as the day passes (in some cases owing to medication), a healthful meal at the start of the day will help you to keep your strength and energy levels up.  Once you are familiar with ways to adjust your diet, you will be better able to maintain a nutritional balance in your daily eating and, in turn, to promote overall good health.

Many simple and safe food-preparation strategies are available to help you increase both your calorie and your protein consumption.  Information about recipes and about a specific diet and menu is available as well. Consult the following links: 

Guidelines for Boosting Calorie & Protein Intake

High-Calorie/High-Protein Recipes

High-Calorie/High-Protein Diet

            High-Calorie/High-Protein Menu

 

Nutritious Snacks 

If you are a person with AIDS/HIV and are having difficulties eating well at meals, you may need to eat plenty of snacks between meals.  You should, in fact, consider nutritious snacks an integral part of your daily diet.                        

Alternative Therapy for AIDS/HIV 

Complementary and alternative therapy comprise a wide variety of practices and treatments, including the use of herbal preparations and of vitamin and mineral supplements. Whether you are a patient or a caregiver, you should be aware that many treat­ments have not been thoroughly re­searched and scrutinized for safety and efficacy and may not be approved by the U.S. Food and Drug Administration (FDA).  Although some complementary therapies (acupuncture for nausea, for example) have been shown to be safe and efficacious, others (the use of some individual herbs and supple­ments, high‑dose vitamin and mineral regimens, and radical diets) have brought about toxic side ef­fects.  If you prefer alternative therapies, or if you believe that you have exhausted the available therapies of conventional medicine, the information that follows may be helpful to you. The therapies presented here, however, are by no means intended to replace standard, appropriate medical attention and treatment.             

 

Herbal/Natural Products for AIDS/HIV 

The table below provides information about the potential benefits of specific  herbal/natural products that have been used in the treatment of people with AIDS/HIV.   

Note: You should use alternative therapies to treat a specific health condition only after you have received an accurate diagnosis from a qualified doctor or other medical professional. Be cautious of anyone called an “herbalist,” an “herb doctor,” or a “health counselor”; these job titles are not regulated. Remember that good health depends on proper medical care. 

Caution: In some cases herbal/natural products may interact negatively with other medications. Such interactions can be dangerous. Herbal/natural remedies are not regulated and their quality is not controlled. Moreover, although an abundant supply of information about alternative treatments and remedies is currently circulating, little of it has been scientifically validated. Consult your doctor before using any herbal/natural remedy, and remember always to make your doctor and pharmacist aware of any therapeutic products you are using. Your doctor and pharmacist can assist you in determining which herbal/natural products are safe to use with the drugs you are taking.  

Do not use herbal/natural products if you are pregnant or breastfeeding, and do not treat infants or children with herbal/natural remedies without a qualified doctor’s approval and guidance. 

Table 1. Herbal/natural products commonly used in the treatment of AIDS/HIV. 

Herbal/Natural Products

Enhances Immune System

Purifies Blood

Fights

Infection

Comments & Cautions

 

Aloe Vera Juice

 

 

 

 

Astragalus

 

 

 

 

Blue-Green Algae

 

Contains a high level of chlorophyll, a detoxicant.

 

Brown Algae

 

 

 

 

Burdock Root

 

 

Cat's Claw

 

 

 

Caution: Do not take if you have hemophilia or are pregnant.  May cause headaches, stomachaches, or difficulty with breathing; also has contraceptive properties.

 

Chlorella

 

Contains a high level of chlorophyll, a detoxicant.

 

Dong Quai

 

 

 

 

Echinacea

Caution: The use of echinacea to treat AIDS/HIV is controversial. Some reputable health-information sources recommend echinacea therapy, but other sources recommend avoiding this herbal/natural product. Consult with a qualified medical practitioner before initiating echinacea therapy.

 

Evening Primrose Oil

 

Has antioxidant  properties.

 

Garlic

 

 

 

 

Ginger Root

 

 

Effective against nausea and vomiting caused by medications and/or chemotherapy and radiation treatment. Also antioxidant properties.

 

Goldenseal

 

Used to treat depressed white-blood-cell counts following chemotherapy and radiation treatment. Also used to treat mouth sores.

Caution: Do not take on a daily basis for longer than one week at a time, and do not use if you are pregnant or have high blood pressure or any chronic disease of the gastrointestinal tract, such as stomach or duodenal ulcers, esophageal reflux (reflux esophagitis), ulcerative colitis, spastic colitis, diverticulosis, and diverticulitis. May cause gastrointestinal distress and may be harmful to the nervous system. If you have a history of cardiovascular disease, diabetes, or glaucoma, use only under a doctor's supervision.

Irish Moss

 

 

 

 

Licorice

 

 

 

 

 

May slow the progression of HIV to AIDS. 

Caution: Do not use on a daily basis for longer than one week at a time, and avoid completely if you have high blood pressure, kidney failure, heart disease, or you are using digitalis preparations. Glycyrrhizin, the major active ingredient in licorice, may cause sodium and water retention, high blood pressure, and/or low potassium levels (hypokalemia).

Maitake Mushroom

 

 

May help to protect “T-helper” cells from destruction by HIV.

 

Mullein

 

 

 

 

Pau d'Arco

 

Enhances the functioning of the liver and may aid digestion. Also recommended during periods of chemotherapy or radiation treatment to reduce pain.

Caution: Very high doses may cause nausea, vomiting, anemia, and slower blood-clotting.

 

Quercetin

 

 

 

 

Red Clover

 

May act as an antibiotic and may help to prevent cancer.

Reishi Mushroom

 

 

The polysaccharides in this type of mushroom are thought to boost the immune system and to protect against cancer.

 

St. John’s Wort

 

 

Used to treat mild to moderate depression and may slow the progression of HIV to AIDS.

Caution: St. John’s Wort should not be taken with antiretrovirals because it could hinder the activity of those medications.

Shiitake Mushroom

 

 

Lentinan, a polysaccharide in this type of mushroom, may boost the immune system.

 

Siberian Ginseng

 

 

 

Used to slow the spread of HIV, bolster tolerance to chemo-therapy, and increase energy.

Caution: Do not use if you have hypoglycemia, high blood pressure, or a heart disorder.  People with these conditions have reported pericardial pain, palpitations, headaches, and elevated blood pressure after taking Siberian ginseng.

  

Alternative Dietary Recommendations for AIDS/HIV 

The following recommendations and lists of foods, intended for people with AIDS/HIV, are shaped by four main dietary goals: bolstering the immune system; supplying the body with essential nutrients; ridding the body of potentially harmful substances; and avoiding harmful substances.  

Bolster Your Immune System  

Foods that are known to bolster the immune system include avocados, Brazil nuts, carrots, garlic, kiwi, omega-3 fatty fish (such as mackerel, salmon, and tuna), pumpkin seeds, sesame seeds, shellfish, shrimp, and sweet peppers. 

Note: Foods and beverages that are high in salt and/or fat (bacon, hot dogs, lunch meats, pickled products, snack chips), concentrated sugars (bakery goods, candy, sodas), or caffeine should be avoided; they may hinder the functioning of the immune system.  

Supply Your Body With Essential Nutrients  

To help supply your body with essential nutrients and the elements required to turn food into energy effectively and efficiently, follow these guidelines: 

·         Get Your Vitamins and Minerals

Your body requires supplies of more than 40 vitamins and minerals every day. Some, such as selenium and vitamins A, C, and E, help to keep your immune system strong. Others, such as thiamin and zinc, provide energy.  

The following foods are good sources of nutrients that either enhance the functioning of the immune system or provide the body with energy: beans, cruciferous vegetables (such as broccoli, cabbage, cauliflower, collard greens, radishes, rutabagas, and turnips), fresh fruits, lentils, nuts, seeds, yellow and deep-orange vegetables (such as carrots, pumpkin, squash, and yams), and whole grains (including brown rice and millet). 

Note: For help in planning a diet complete with the essential nutrients, consult the food pyramids.  

·         Get Your Protein

Your body needs high-quality proteins, such as whey protein, soy protein isolate, and egg protein. Protein provides the amino acids that help your body to build, maintain, and repair cells and muscle tissue, to heal wounds, and to support the immune system. The best protein sources are beans, cheese, eggs, fish, lean meat, milk, nuts, poultry, tofu, and yogurt. 

·         Get Your Enzymes

Eat unripened papaya and fresh pineapple frequently. These fruits are good sources of proteolytic enzymes, which are crucial for proper digestion of foods and assimilation of nutrients. Without enzymes, the body cannot be supplied with the energy it needs for its activities.  (Eaten as solid foods or consumed in juice form, these fruits may also be used to soothe an upset stomach.) 

·         Replenish Your Good Bacteria

Acidophilus, which replenishes “friendly” intestinal bacteria that is destroyed by antibiotic therapy, can be found in acidophilus milk, kefir (fermented or cultured cow’s milk), and yogurt that contains live cultures of Lactobacillus acidophilus. (Most but not all yogurts contain live cultures of Lactobacillus acidophilus; consult food labels to be certain.)  

Note: Many people with AIDS/HIV cannot tolerate dairy products. If you have an allergy or food sensitivity to milk and/or dairy products, try milk-free acidophilus supplements, which are available in a variety of forms. 

Rid Your Body of Potentially Harmful Substances  

Follow the guidelines below for help in ridding your body of potentially harmful toxins and bacteria: 

·         Purify Your Blood

Consume plenty of fresh fruit and vegetable juices. The chlorophyll provided by "green drinks," made from leafy greens such as beet greens, kale, and spinach, works to purify the blood, eliminating toxins produced by invading pathogenic organisms. Carrot and beet-root juices have also been used to purify the blood, and fresh garlic and onions have been shown to have effective antiviral qualities.  

·         Hydrate Your Organs

Drink steam-distilled water only (avoid tap water), and lots of it -- eight or more 8-ounce glasses daily -- to flush toxins from the body. All cells and organ systems need water. Drink plenty, even if you are not thirsty: Bodily organs -- especially the brain -- can become dehydrated long before thirst develops.  

Avoid Ingesting Harmful Substances  

Follow the guidelines below to minimize your exposure to harmful bacteria and other hazardous substances: 

·         Beware of Bad Bacteria

Avoid all foods that carry the risk of exposure to potentially poisonous pathogens (bacteria, parasites, and viruses). People with AIDS/HIV may be especially susceptible to contracting an illness from foodborne pathogens.  Once contracted, such an illness, often causing severe vomiting and diarrhea, can be difficult to treat and may return repeatedly, further weakening the immune system and possibly hastening the progression of HIV to AIDS.  For people with AIDS, an illness from a foodborne pathogen can be fatal.   

For information about illnesses caused by specific foodborne pathogens (including salmonella and escherichia coli bacteria), lists of foods to avoid, and the necessary precautions to take, see foodborne pathogens. 

·         Beware of Pesticides

Pesticide residues are present at minimum levels on many of the fruits and vegetables you buy, but the health benefits of eating plenty of fruits and vegetables far outweigh the potential harm caused by exposure to such residues.  You can add to your safety by using special care when handling and preparing food.  Be sure to wash produce thoroughly with soap and water and to remove the outer leaves on leafy greens.  

 Nutritional Supplements for AIDS/HIV 

If you are a person with AIDS/HIV, you may experience a decrease in your appetite.  As a result, you may not be able to provide your body with the necessary levels of vitamins, minerals, and trace elements to keep your immune system functioning optimally. In addition, your illness may hamper your body’s ability to absorb nutrients effectively.

Nutritional therapy is not a cure for AIDS/HIV, but certain vitamin and mineral supplements may help to bolster your immune system, preventing further deterioration of your health and possibly retarding the progression of HIV to AIDS. Medical experts therefore suggest that, in addition to striving to maintain a healthful diet of natural foods, you take vitamin and mineral supplements daily. (Nutritionally complete products, which are available in a variety of flavors and forms -- bars, beverages, puddings, soups -- may also be helpful; most provide the calories, protein, fat, vitamins, and minerals that you normally obtain through a diet of natural foods.) Even if you believe that your diet is providing you with enough of the essential nutrients, taking supplements can help you to be certain.

The following tables provide guidelines for daily nutritional supplementation.  

        Vitamins & Minerals  

The daily doses provided in the table below for vitamins and minerals are recommended specifically for people with AIDS/HIV. For detailed information about a particular vitamin or mineral, simply click on the vitamin or mineral name in the left-hand column. 

Note: Units for nutritional supplements may be given by weight -- generally in milligrams (mg) or micrograms (mcg) -- or by biological activity, which is measured in international units (IU).  Use care when comparing products to ensure that the units are identical. 

Table 2. Vitamins & minerals commonly used in the treatment of AIDS/HIV. 

Vitamins & Minerals

Daily Dose & Dosage Information

Comments & Cautions

Vitamin A

5,000-7,500 IU

Helps to keep the immune system functioning optimally.

Vitamin B12

(Cobalamin)

2 mg

A deficiency in Vitamin B12 has been linked to a faster progression of HIV to AIDS. 

Vitamin C With Bioflavonoids

500-1,000 mg 3 times daily, 30 minutes before or after meals

 

Enhances the functioning of the immune system and has been shown to slow the progression of HIV to AIDS. Also has antioxidant properties. 

Caution: A daily dose of vitamin C larger than 1,200 milligrams can cause diarrhea in some people.

Vitamin E

400-800 IU

Has been shown to have the greatest and most consistent effects of antioxidant nutrients in slowing the progression of HIV to AIDS. 

Caution: If you are taking anticoagulants (blood thinners), do not take vitamin E supplements. Vitamin E may interfere with the blood-clotting effect of vitamin K, potentially causing prolonged clotting time and bleeding after injury.

Beta-carotene

(a precursor of Vitamin A)

6 mg

Has aantioxidant properties and enhances the functioning of the immune system. Recent studies have cast doubt on the benefits of using beta-carotene supplements, however. The best way to provide your body with the required level of this nutrient is to rely on food sources, such as apricots, cantaloupe, carrots, mango, papaya, and sweet potatoes. 

Caution: If you are a smoker, do not take beta-carotene supplements. Studies have shown that beta-carotene supplementation may increase the risk of lung cancer in smokers.

Selenium

200-400 mcg

Has antioxidant properties and enhances the functioning of the immune system.

 Note:  mg = milligrams, mcg = micrograms, IU = international units 

Additional Supplements  

The table below lists additional nutritional supplements, with daily doses, that have been recommended in the treatment of people with AIDS/HIV. For detailed information about a particular supplement, simply click on the supplement name in the left-hand column. 

Note: Units for nutritional supplements may be given by weight -- generally in milligrams (mg) or micrograms (mcg) -- or by biological activity, which is measured in international units (IU).  Use care when comparing products to ensure that the units are identical. 

Table 3. Additional supplements commonly used in the treatment of AIDS/HIV.   

Additional Recommended Supplements

Daily Dose & Dosage Information

Comments & Cautions

Milk-free acidophilus

 

Dose according to the manufacturer’s label.

 

 

Replenishes “friendly” intestinal bacteria that is destroyed by antibiotic therapy and helps to fight against Candida albicans, a fungus that is often associated with HIV (see Candidiasis ). Many people with AIDS/HIV cannot tolerate dairy products. A soy protein is used in place of milk in this supplement.

Bromelain and papain enzymes

Chewable mixture before each meal (dose according to the manufacturer’s label)

Help the body to digest proteins.

Lipoic acid

150 mg

Has powerful antioxidant properties.

  Note:  mg = milligrams

 

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