Good Nutrition for the HIV/AIDS Patient

There is still no cure for AIDS, nor is there a special diet for people infected with HIV, the human immune-deficiency virus that causes the disease. But good nutrition can help prevent or delay weight loss and other AIDS complications. Doctors often advise HIV-positive patients to consult a qualifed clinical dietitian, preferably while still healthy, to learn about sound nutrition.

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.

AIDS is a wasting disease, and death is often due to starvation rather than other HIV complications. An AIDS patient should eat as much as possible and, unless markedly obese, not worry about gaining a few kgs.

The extra weight can be critical in seeing a patient through a crisis when 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, thiamme, and vitamins B6 and B12. It often causes intractable diarrhoea, which causes further nutritional loss and it also 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 feeding; this is generally administered through a gastric feeding tube inserted into the stomach or an intravenous line that pumps predigested nutrients into the bloodstream.

Some AIDS specialists advise starting artificial feeding even before there is rapid weight loss, especially if nutrients are not being absorbed properly.

Anyone who is HIV-positive, or a person who prepares food for an AIDS patient, must pay special attention to food safety.

Eggs should be boiled for at least seven minutes or cooked until hard. Meat and fish should be cooked until well done. In our country this is the practice, unlike in advanced countries where meat and fish are also eaten raw, rare or medium done.

Fruits and vegetables are not as likely to cause problems as animal products. Even so, they should be washed carefully in soapy water and rinsed thoroughly. Salads and some raw fruits and vegetables may be safe but may be difficult for an AIDS patient to digest.

Nutritionists generally recommend that HIV-positive people take a multiple vitamin and mineral pill to prevent nutritional deficiencies.

However, supplements with more than 100 per cent of the Recommended Nutrient Intakes (RNIs) 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. There is no proof that high doses of zinc and selenium protect against AIDS-related infections.

In fact, studies show that taking 200 mg to 300 mg of zinc a day for 6 weeks actually lowers immunity. Excessive does of selenium can also cause nausea, vomiting and diarrhoea.

Another dangerous dietary approach entails following a macrobiotic regimen, especially one that is 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 its 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.

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