Nutrition of HIV positive persons

Nutrition affects the quality of life of a person with HIV infection . A poor diet can accelerate the development of the disease. HIV infection and its treatment affects the organism of the HIV+ patient and his health condition. The influence does not only concern immune functions, but also the overall energy requirement and the need for nutrients , vitamins and minerals .

The greatest contribution to the development of malnutrition in HIV+ persons is the increased need for energy of the affected organism, insufficient energy intake, diarrheal diseases and so-called opportunistic (waiting for weakening) infections . Inadequate food intake is often caused by loss of appetite , a feeling of a full stomach , nausea, vomiting or depression . HIV infection increases the energy requirement in asymptomatic individuals by about 10%. The consequence of malnutrition is mainly the deterioration of the body’s immune defenses and the associated higher risk of developing other infections.

The prevalence of overweight and obesity among HIV positive people in developed countries is around 40-50%.

HIV – positive people who are overweight or obese are more likely to suffer from high blood pressure , high blood sugar and high cholesterol . These symptoms subsequently lead to the development of chronic non-infectious diseases, so-called diseases of civilization, which include diabetes , cardiovascular disease , stroke, etc.

The causes of overweight and obesity in HIV+ people are the same as in the rest of the population – low physical activity , unbalanced diet and excessive energy intake.

Nutritional recommendations

Most HIV-positive people do not need to fundamentally change their eating habits. However, it is advisable that their eating habits correspond to the recommendations for proper nutrition .

Weight control

Regular weight control plays a big role in maintaining proper nutritional status . This means weighing yourself once every 14 days to 3 weeks, preferably in the morning on an empty stomach. More frequent weighing makes no sense. Only by regularly checking our weight can we find out whether our weight is staying at the value we are used to.

The optimal body mass index ( BMI ) value is 18.5–25.

Energy and nutrient intake

For proper nutrition, we should eat regularly, variedly, adequately and not forget to drink fluids.

The regular diet includes 5 daily meals at 2.5- to 3-hour intervals.

The variety of the diet consists in the fact that we do not avoid any foods or, on the contrary, do not consume some in excessive quantities, and we also take care of the intake of all basic nutrients: fats , carbohydrates and proteins . Carbohydrates make up 50-60% of a person’s total energy intake and are contained in the following foods (cereals, rice, bread, pasta, fruit, vegetables). Fats make up 25-30% of a person’s total energy intake. We should prioritize those beneficial to our health. These are mainly found in fish, nuts and seeds and in vegetable oils (rapeseed, olive, linseed, sunflower, etc.). We should pay attention to the excessive intake of animal fats (lard, crackers, sausages, creams, etc.). When choosing food, we monitor the type of fats used and limit foods with palm and coconut fat, which has a negative effect on blood lipid levels . Proteins make up 12-15% of a person’s total energy intake. Proteins are mainly found in animal products (eggs, milk and milk products, meat). From vegetable sources, proteins are mainly contained in legumes, here their better use is helped by the combination of legumes with cereals (e.g. lentils with bread).

Adequacy lies in a reasonable portion size. Although there is an increase in the energy needs of HIV+ people by about 10%, this amount means an increase in intake by about 260 kcal, which is, for example, 100 g of bread. Adequacy and variety can help us fulfill the so-called food pyramid . It tells us how many portions we should eat from individual food groups in one day so that our diet is balanced and varied. For breakfast, lunch and dinner, we consume foods from all levels of the food pyramid. For snacks, it is sufficient to select only individual layers (e.g. fruit or dairy product).

When it comes to drinking , we prefer unsweetened drinks. We should drink approximately 1.5 to 2 liters of fluids per day. However, the need for fluids is increased by hot weather, excessive sports load or an outbreak of fever or diarrheal disease.

Vitamin intake

HIV-positive people are particularly at risk of a lack of B vitamins (especially B ₆ , B ₁₂ , B ₁ and B ₂ ), folic acid , vitamin C and also a lack of vitamins A, D, E.

B vitamins are generally important for the proper functioning of the immune and nervous systems . Their food sources are milk, meat and eggs, whole grains, legumes and yeast. Vitamin C has important antioxidant effects and is important for the immune system and for the production of antibodies . Its source is mainly fresh vegetables and fruits.

Vitamins A, D and E belong to the fat-soluble vitamins. Vitamin A supports vision , especially in the dark. Its source is mainly red and yellow colored vegetables and fruits, as well as egg yolk, liver , dairy products and fish. Vitamin D affects the immune system, but also the body’s proper management of calcium . It is formed in the skin by the action of UV radiation . Fish and fish oil are important dietary sources. Vitamin E is also important for its antioxidant action. Its sources are primarily vegetable oils, nuts and seeds.

Intake of minerals

For HIV+ people, attention is mainly focused on the quality of bone mass , but also on the level of iron , zinc and selenium in the blood. Bone density can be affected by antiretroviral drugs used, but low physical activity and lack of vitamin D and calcium can also contribute to its development. Well-absorbable sources of calcium are especially milk and milk products. From non-dairy sources, it is worth mentioning sardines with bones , hard drinking water and cruciferous vegetables (broccoli, cabbage, kohlrabi). Iron is an important part of the blood as an oxygen carrier . Its easily absorbable food sources are primarily red meat (game, beef and pork), offal, fish and egg yolk. From plant sources, iron is mainly found in legumes (peas, lentils, beans, soy) and also in nuts and seeds (pumpkin, sunflower). Zinc is involved in wound healing and supports cellular immunity . Zinc deficiency reduces appetite . Its sources are mainly red meat, dairy products, eggs, nuts and seeds. Selenium participates in antioxidant processes in the body and is important for cellular immunity. The source of selenium in food is mainly meat and offal, as well as mushrooms, cheeses and nuts and seeds. To ensure all important vitamins and minerals, it is very important to have a varied diet and, if necessary, on the basis of a doctor’s recommendation, the use of dietary supplements .