Diet in HIV / AIDS patients

DIETARY  RECOMMENDATIONS  FOR  PATIENTS  OF  HUMAN  IMMUNODEFICIENCY  VIRUS (HIV)  AND ACQUIRED IMMUNO-DEFICIENCY SYNDROME (AIDS)

 

The symptoms  or complications  associated with HIV/AIDS  or their medication  may include nausea, vomiting, diarrhea, decreased appetite, oral thrush, dysphagia, weight loss, weight gain, dyslipidemia, insulin resistance, fat accumulation, opportunistic  infections, dehydration, micronutrient deficiencies, malabsorption, and taste changes.

The attendant or the patient is advised to follow the dietary changes according to the problem he/she faces.

 

NAUSEA

Take small, frequent meals.

Try bland foods (for example, potatoes, rice, canned fruits, dry crackers, or toast).

Notice patterns of when nausea occurs and avoid offering food at these times.

Position the patient at meals sitting up instead of lying down.

Suggest eating in a cool environment, eating slower, and providing foods at room temperature.

Don’t provide drinks during mealtime; separate liquids from solids.

Don’t serve high-fat, greasy foods or strong- odor foods, such as ripe cheese and fish.

 

VOMITING

Suggest small, frequent meals. Provide clear, cool liquids between meals.

Try bland foods (for example, potatoes, rice, canned fruits,).

Patient should eat slowly.

Don’t serve high-fat, greasy foods or strong- odor foods, such as ripe cheese and fish.

 

DIARRHEA

Provide high soluble fiber (for example, rice, oatmeal, and white bread, potatoes without skin, bananas, peeled apples/applesauce, and mangoes).

Eliminate foods that exacerbate these symptoms, such as high-fat dairy.

Provide electrolyte- replacing fluids (for example, broths, fruit juices, and oral hydration drinks).

Suggest small, frequent meals.

Try offering yogurt with active cultures or acidophilus.

Don’t give high-dose vitamin C supplements, laxative teas, foods containing sorbitol (sugar-free candy and gums), lactose-rich dairy, caffeine, and high-fat foods.

 

DECREASED APPETITE

Suggest small, frequent meals.

Provide nutrient-dense foods (for example, milk shakes, lean meats/poultry/fish, eggs, nut butters, vegetables, fruits, and whole grains).

Don’t recommend large meals.

 

ORAL THRUSH

Serve softer, colder foods and fluids with meals.

Encourage good oral hygiene.

Don’t serve salty, hot, spicy, or acidic foods (citrus fruits, tomato-based products, vinegar/ vinegar-based products).

 

DYSPHAGIA

Moisten foods with sauces and serve softer foods (for example, oatmeal, mashed potatoes, pudding, scrambled eggs, milk shakes, and yogurt).

Provide liquids with meals.

Try dry foods (for example, toast, crackers, and chips).

Don’t provide sticky foods that are difficult to swallow.

 

WEIGHT LOSS

Provide small, frequent nutrient-dense meals.

Serve high-protein foods (for example, lean meats, poultry, fish, eggs, milk, yogurt, cheese, legumes, tofu, and nut butters like peanut butter).

Serve high-calorie foods such as milk shakes, trail mixes with fruit and nuts, and cheese and crackers. Add rice, barley, and legumes to soups.

Add dry milk powder or protein powder to casseroles, hot cereals, milks shakes, etc. to increase calories and protein content.

Use oral supplement such as Boost, and Ensure.

If a patient infected with HIV has a decreased dietary intake, asses if nutrition supplements are appropriate.

 

WEIGHT GAIN

Use traditional dietary approaches to weight management to achieve healthy weight, including adequate caloric intake, warranted caloric reduction, adequate protein intake, or low/ moderate fat intake.

Prepare food with less fat by steaming, grilling, baking, broiling, or microwaving instead of frying.

Incorporate physical activity. See the table on weight control.

Don’t serve simple sugars such as candy, soda, jelly or other high- sugar foods such as cookies.

Don’t provide excessive dietary fat, especially trans and saturated.

 

DYSLIPIDEMIA

Try low/moderate fat diets (about 30% or less of total calories from fat).

Decrease saturated and Trans fat intake (to less than 10% of total calorie intake).

Increase monounsaturated fats (for example, olive, sesame, and canola oils, and nuts) to 10-15% of total calorie intake.

Incorporate omega-3 fatty acids, such as fatty fish (for example, salmon, sardines) and certain nuts/ seeds (for example, walnuts, and flaxseeds).

Prepare food with less fat by steaming, grilling, baking, broiling, or microwaving instead of frying.

Incorporate physical activity.

Don’t serve simple sugars (for example, candy, soda, and other high- sugar foods such as cookies).

 

INSULUN RESISTANCE

Serve high-fiber foods (frits, vegetables, legumes, and whole grains).

Provide low glycemic index foods (for example, whole grains, fruits, vegetables, and legumes).

Don’t prepare a low- fiber diet.

 

FAT ACCUMULATION

Recommend adequate fiber (20-35 gm per day), adequate calories, and adequate protein.

Don’t provide a low- fiber diet.

 

OPPORTUNISTIC INFECTIONS

Wash hands with soap and warm water often.

Wash all fresh fruits and vegetables.

Avoid cross contamination of raw and cooked foods.

Refrigerate foods to less than 41*F.

Don’t serve raw or undercooked meats, poultry, fish, shellfish, and eggs.

Don’t purchase unpasteurized dairy products.

 

DEBYDRATION

Suggest electrolyte-repleting fluids (for example, broths, fruits juices, and oral hydration drinks).

Limit foods high in sodium. Limit caffeine.

 

TASTE  CHANGES

Separate medications that cause taste changes from mealtime (if possible).

Add spices and herbs to foods.

Don’t use oral supplements in metallic cans.