1. Alaine Mills, Dietetic Intern
HIV & Nutrition
Alaine Mills, Dietetic Intern

2. Outline Why is it important to have a healthy diet?
What is a healthy diet?
Possible co-morbidities
Managing side effects
Food Safety
Questions

3. Why is it important to have a healthy diet?
Maintaining/Restoring Body Weight
Managing Side Effects
Eating Enough
Exercise
Marinating body weight helps keeps us strong, healthy, and able to fight off infection.
energy

4. Why do I have increased energy needs?
Fever
Infections

5. What is a healthy diet?
Balanced; whole grains, protein, fruits and veg and dairy products; variety

6. What foods should I focus on?
Protein
Fruits & Vegetables
Protein for building and maintaining body mass
Fruits and vegetables

7. Why Protein?
Helps maintain and build body mass, including muscles, and a strong immune system

8. What foods are high in protein?

9. Why fruits & vegetables?
Antioxidants

10. Immune Supporting Nutrients
Omega-3
Salmon, almonds, walnuts
Vitamin C
Citrus fruits
Vitamin A
Carrots, sweet potatoes
Vitamin E
Spinach, sunflower seeds,
almonds
Zinc
Protein, legumes,
oatmeal

11. Possible Co-Morbidities with Nutritional Implications
Hyperglycemia
Kidney & liver disease
Hypertension
Hypothyroidism
Hyperlipidemia
Osteopenia
Changes in body composition
Malnutrition
Pancreatitis
Wasting

12. Hyperglycemia What is it?
High blood sugar
Symptoms: excessive thirst & hunger, frequent urination, weight loss
Why does it matter?
Can lead to vascular diseases affecting the eyes, heart, kidney, nerves, and limbs

13. Nutritional Management of Hyperglycemia
Avoid concentrated sweets (candy, soda, baked goods, etc)
Whole Grains
Protein with all meals and snacks

14. Hypertension What is it? What does it matter?
Persistent high blood pressure
What does it matter?
It is associated with increased incidence of heart & kidney disease

15. Nutritional Management of Hypertension
Increase fruits, vegetables, and low fat dairy
Reduce sodium intake
Moderation of alcohol consumption

16. Hyperlipidemia What is it? Cannot be identified without a lab test
Abnormal amounts of lipids in the blood
Cholesterol & triglycerides
Cannot be identified without a lab test
Can result from some drugs
What does it matter?
Can lead to serious health problems, such as heart disease
Cholesterol can build up in the arteries and form plaque
Pancreatitis
Painful inflammation of the pancreas
Total cholesterol – less than 200
Low-density lipoproteins (LDL) – less than 100
High-density lipoproteins (HDL) – 60 or higher
Triglycerides – less than 150

17. Nutritional management of hyperlipidemia
Reduced intake of saturated fats
Red meats, butter, baked and fried foods
Increase intake of mono- and poly- unsaturated fats
Fish & seafood, nuts & seeds, soy, vegetable and canola oil
Increase fiber intake
Whole grains, veggies
Limit alcohol
<2 glasses per day
Exercise!

18. Osteopenia What is it? What causes it? Low bone mineral density
Inadequate calcium and vitamin D intake or status
Low body weight
Certain medications
Lack of physical activity

19. Nutrition for Osteopenia
Adequate Calcium (Milk, cheese, yogurt, pudding, dark green veggies)
Adequate vitamin D intake (fish, milk, supplements, and from the sun)
Balanced diet

20. Nutrition Related Complications
Nausea
Mouth or throat sores
Dry mouth
Loss of taste
Fatigue
Diarrhea
Constipation
Not eating enough
Weight loss

21. Nausea Cause: Why is it important? Management: Medications
May cause you to not eat as much as you should
Management:
Small, frequent meals
Avoid high-fat, greasy foods
Cool or room temperature foods
Avoid lying down after eating
Take medications after the meal or with food

22. Mouth or Throat Sores Causes: Why is it important? Management:
Bacteria, virus, or fungus
Why is it important?
May cause you to not eat as much as you should
Management:
Soft, moist food
Avoid spicy or acidic foods
Cool or room-temperature foods
Nutrient and energy dense foods
Medicated mouthwash

23. Dry Mouth (Xerostomia)
Cause:
Medications
Why is it important?
May cause you to not eat as much as you should
Management:
Moist foods
Drink lots of fluids
Good oral hygiene
Use artificial saliva
Sour or tart foods
Chew gum
Suck on hard candy or ice
Avoid alcohol (check your mouthwash)

24. Loss of Taste (Dysguesia)
Causes
Why is it important?
Management:
Avoid red meat
Avoid metal utensils
Use marinades/seasonings

25. Fatigue Causes: Why is it important? Management: Medications, anemia
May cause you to not eat as much as you should
Management:
Get enough sleep
Exercise
Make sure you are eating enough
Avoid alcohol & tobacco
Seek treatment for anxiety or depression
Avoid stress
Ready to eat foods or foods that require little preparation

26. Diarrhea Causes: Why is it important? Management:
Numerous- medications, bacteria, fungi, disease, diet
Why is it important?
May cause malabsorption of nutrients and dehydration
Management:
Drink plenty of fluids (water)
Electrolytes (salt, bananas, potatoes, sports drinks)
Limit dairy
Avoid gas causing foods and beverages
Avoid greasy and spicy foods
Take medications after meals
Soluble fiber (white bread, bananas)
Anti-diarrheal medication

27. Constipation Causes: Why is it important? Management:
Medications, diet
Why is it important?
May cause you to not eat as much as you should
Management:
Drink more fluids
Eat more fiber (whole grains, fruits, vegetables, legumes)

28. Not Eating Enough (Inadequate Food Consumption)
Causes:
Medications, increased energy needs
Why is it important?
Good nutrition improves the quality of life and may prolong it
Management:
Nutrient and energy dense foods
Small, frequent, meals and snacks
Nutrition supplements
Appetite stimulants

29. Weight Loss Causes: Why it matters? Management:
Not eating enough, increased energy needs, medications, hormone imbalances
Why it matters?
Management:
Eat more (especially protein)
Manage eating associated ‘
symptoms
Resistance exercise
Steroids

30. Food Safety
Wash your hands with soap and warm water before you eat or prepare food
Wash all fruits and vegetables with soap and warm water
Make sure your refrigerator is less then 41 degrees F
Keep cold foods cold and hot foods hot
Only keep leftovers for 24 hours
Cook meats well done
Avoid: sushi, raw eggs, raw oysters,
buffets

31. Questions?