Healthy eating v

Please be aware that the information in this section of the Tagadere websiteis not intended to replace or conflict with advice given to you by your doctoror healthcare professionals about your HIV treatment and care.
It is a brief outline of how to eat well to enable you to stay well and also willcover some of the changes to your diet which may be needed to maximisethe absorption of anti-HIV drugs if you are on medications.
If you are in any doubt, please refer to you doctor or healthcare specialist.
An important factor of everyone’s health is good nutrition, which is vital inthe health of the immune system and its ability to fight infection.
Eating healthily will also help you to become a healthy wait and remain so.
It also can help towards reducing the risk of heart disease, cancer, diabetesand osteoporosis.
Being HIV positive doesn’t necessarily mean that you have to make drasticchanges to your diet, but you do need to receive enough nutrients to helpyou to keep healthy. Before you begin HIV treatment it is important toalready have a good, healthy diet. This is also important to assist anti-HIVdrugs to work efficiently once you begin taking them.
If you are talking anti-HIV drugs then it is vital to eat a healthy, balanced dietas HIV medication can change the way the body metabolises some sugarsand fats.
A good, balanced diet should consist of the following types of food: Starchy food
Bread, potatoes, cereals, pasta, rice, green banana, millet, cassava, maizemeal and yam. These are examples of starchy foods which should form thebasis of your diet; around a third of your daily food intake. These foods willprovide carbohydrates for energy and also minerals, vitamins and fibre.
Wholegrain types of bread, rice and pasta contain more fibre and very oftenmore vitamins and minerals.
Fruit and vegetables
These provide essential vitamins, minerals and fibre. Try to eat your ‘five aday’ portions of fruit or vegetables each day. A portion is 80g and roughlyequal to: ● Medium sized piece of fruit (apple, orange, pear) ● Two small pieces of fruit (Satsuma, plum) ● Three heaped tablespoons of beans or pulses. Only one portion will ● A handful of dried fruit or a small glass of fresh fruit juice. As with beans and pulses, fresh fruit juice only counts as one portion even ifyou drink more.
● Three heaped tablespoons of vegetables which can be fresh, frozen or from a tin. Vegetables such as potatoes and yams are counted asstarchy food and therefore do not count towards your five-a-dayfruit and vegetable intake.
In a healthy eating regime, fruit and vegetables can help to protect againstcertain cancers and heart disease. As they are low in fat, increasing theproportion your diet is made up from them is advantageous if you are tryingto lose weight.
Dairy products
Milk, cheese and yoghurt provide vitamins and minerals, especially calcium.
Some dairy produce is high in saturated fats and should only be eaten insmall quantities. Instead, you could eat lower-fat versions of them. If youcannot tolerate milk, a good alternative source of calcium are fortified soya,rice or oat milk, dark green leafed vegetables, apricots, dried figs and nuts.
Meat, poultry, fish, eggs, nuts and beans
These provide protein, minerals and vitamins. In particular, you can obtainB12 from meat. Protein-rich food should form around 15% of your foodintake, or two portions per day. Attempt to eat two portions of fish eachweek, including at least one portion of oily fish.
Butter, margarine, cooking oils, meat and other protein-based foods willprovide energy, essential fatty acids and fat-soluble vitamins such as A, D, Eand K. Attempt to eat ‘unsaturated’ fats such as those found in oily fish,seeds, nuts, avocados, vegetable oils and olive oils. The ‘saturated’ fatswhich are found in cheese, meat, butter and many processed foods canraise cholesterol and should only be eaten in small amounts.
Food and drinks with high fat or sugar content
These should only be a small part of your diet and too much can lead to un-healthy weight gain.
Salt and salty foods
These can lead to high blood pressure if eaten in large quantities which canlead to the possibility of having a stroke or developing heart disease. Chil-dren above the age of eleven and adults should eat no more than 6g of saltper day; younger children should intake even less. Some foods have a highsalt content (for example bacon, cheese, stock cubes, gravy granules, ham,prawns, anchovies, salami, smoked fish and meat, salt fish, olives, soysauce, yeast extract and both salted and dry-roasted nuts. Eat these insmaller amounts or less often.
Breakfast cereals and bread
These can add a lot of salt to your diet, more so when you eat a lot of them.
Check the labels of foods such as breakfast cereals, crisps, sauces anddressings for their salt content and buy varieties with a lower level of saltand sugar. Traditionally salt has been used in cooking for flavour; instead,try alternatives such as fresh herbs, spices and garlic to flavour food.
Convenience food
These can often have a high salt, sugar and fat content. It is hard to have abalanced diet if you are eating convenience food regularly.
VITAMINS AND MINERALS
The human body needs vitamins and minerals to make them work correctly.
These nutrients are found naturally in food. Eating a varied and balanced
diet which includes plenty of fruit and vegetables can provide you with these
nutrients.
PREGNANCY AND BREASTFEEDING: There are different nutritional needs
for women who are pregnant and breastfeeding. Your healthcare team can
advise you about these and a dietician can advise on food safety and weight
management during pregnancy.
SUPPLEMENTS: In the hope of strengthening or protecting their immune
system, many people with HIV will consider dietary supplements such as
vitamins, nutrients and herbal remedies. HIV specialists advise that a bal-
anced and healthy diet is sufficient as there is limited evidence that many of
these supplements have any effect. Taking excessive doses of any nutrition-
al supplement is not recommended.
Many people with HIV have low Vitamin D levels and this has been associat-ed with increased risks of some health problems such as osteoporosis. Yourvitamin D levels should be monitored as a part of your HIV care; your doctormay prescribe supplements if your levels are very low. Vitamin D is found infood, however you receive the most from sunlight on skin. This means thatlevels can vary at different times of the year and your skin colour. A dieticiancan advise on dietary sources of vitamin D and safe levels of exposure to sun.
TAKING HIGH DOSES OF VITAMINS AND MINERALS
Believing that high doses of certain vitamins and minerals may boost theirimmune system, some people will take more than is necessary. Researchhas shown that large doses of some can be harmful. The following vitaminsand minerals are all important in maintaining your immune system buttaking too many can cause further health problems.
Vitamin A (also known as beta carotene)
Having large amounts can cause liver and bone damage, headaches andvomiting. Taking doses above 0.7mg for men and 0.6mg for women may beharmful and doses above 1.5mg may increase the risk of osteoporosis.
Supplements containing Vitamin A should not be taken by pregnant womenwithout first consulting their doctor as a high intake can be harmful to thedeveloping baby.
Vitamin C (ascorbic acid)
Does exceeding 1000mg per day may lead to diarrhoea, kidney stones andhardening of the arteries. Large doses of Vitamin C have been shown toreduce concentrations of indinavir (Crixivan) in the blood. There is apossibility that there may be similar interactions between high-dose VitaminC and other protease inhibitors.
Vitamin E
Doses exceeding 800mg per day are associated with adverse effects; if youare taking an anticoagulant or have haemophilia you should take special care.
Vitamin B6 (pyridoxine)
More than 2g per day has been associated with nerve damage. Lower,long-term daily dose (from 500mg to 50mg) has been linked to neuropathy,although Vitamin B6 is also used to treat or prevent neuropathy in somesituations.
A daily dose of 25mg per day as a supplement is considered to be the safeupper level for long-term use as high doses have been linked to copperdeficiency, changes in LDL:HDL cholesterol ratios, anaemia (low red bloodcells) and neutropenia (low white blood cells).
HERBAL REMEDIES
Many people will use herbal remedies as a supplement to their diet. It isimportant to approach this with caution and to inform your doctor and/oryour HIV pharmacist what herbal remedies you are taking as some supple-ments can stop anti-HIV drugs working correctly.
Garlic capsules
The HIV drug saquinavir (Invirase) is stopped from working properly by
taking garlic capsules. Saquinavir is a type of HIV drug known as a protease
inhibitor and it is thought that taking garlic capsules may have a similar
effect on other protease inhibitors. Garlic capsules are often taken because
they are believed to protect the heart. Garlic in food does not have this
adverse effect.
St. John’s Wort
This herbal antidepressant has been shown to be inappropriate for peopletaking protease inhibitors and another type of HIV drug called NNRTIs (whichstands for non-nucleoside reverse transcriptase inhibitors). St. John’s Worthas been shown to lower the levels of the protease inhibitor indinavir(Crixivan); researchers have concluded that is should not be taken with anyother protease inhibitors, NNRTIs or maraviroc (Celsentri) as they are allprocessed in the same way by the body. Commonly prescribed NNRTIsinclude efavirenz (Sustiva, also in the combination pill Atripla) and nevirap-ine (Viramune).
African Potato & Sutherlandia
Two herbs which are sometimes used to treat HIV in Africa have been foundto interfere with the body’s ability to process protease inhibitors and NNRTIswhen subjected to test-tube studies. There is a theoretical risk of an inter-action between anti-HIV drugs and many other herbal preparations including:Borage Oil, DHEA, Ginkgo Bilboa, Liquorice, Milk Thistle, Valerian.
Specific advice about the potential interactions between your anti-HIV drugsand herbal remedies can be found from your HIV pharmacist. It is extremelyimportant to tell your doctor, pharmacist and dietician precisely whichsupplements you are actually taking or considering taking.

Source: http://www.tagadere.org.uk/pdfs/nutrition-healthy-eating-for-people-living-with-hiv.pdf