You’ve lived with HIV for three months.

Let’s focus on your diet.

Are you adjusting to your HIV treatment?

You’ve made huge strides forward by getting tested, facing the results, and accepting what’s happening in your life. At this point you’ve made it to your third month on ARV treatment. If you’ve collected your medication but you’re scared to start taking it, we encourage you to start as soon as possible. Your fears are real, and they are important. You can speak with your doctor, nurse or clinic team about those at any time, even after you start your treatment.

If you started your treatment immediately, or in your first week after diagnosis, by now any side effects would have faded. You’ve become used to taking your medication every day, and you’re feeling more like yourself. Your confidence is returning, and you’re starting to think more clearly about the future. We’re proud of you, and you should be too.

How else can you support your immune system?

HIV is a virus that depletes your immune system’s ability to function and fend off infections. Supporting your immune system to improve your CD4 count is the primary objective of being on treatment. There are two other ways you can support your health: good nutrition and regular exercise.

Manage your weight

It’s entirely possible that you lost some weight before you were diagnosed with HIV. Alternatively, you may have been overweight when you were diagnosed. Or, while dealing with the common side effects of initiating ARV treatment, you battled nausea, found it difficult to eat, or found certain things absolutely intolerable to consume.

The great news is this: your doctor can help. Aim to eat and exercise towards achieving a healthy weight. Check in with your doctor, ensuring you stick to their plan for eating and exercise, created with your unique physical needs in mind.

Managing your nutrition

Of course, everyone loves to live ‘the good life’, where delicious indulgences are to be enjoyed. Here’s the good news: you don’t need to cut them out entirely, but it is important to eat well. And, by eating well, we mean: don’t overdo it at the dessert table.

Cutting back on your sugar, salt, and sodium intake is important for everyone. This helps to support your immune system, while making your body stronger and healthier. We’re going to take you through the things you should be eating as you continue living with HIV, and highlight the good ways you can support your immune system and embrace the healthy, happy, and long life you’re looking forward to living.

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Your nutritional guidelines

Here’s the even better news: if you already subscribe to a healthy eating plan, and are considerate about the things you consume, you won’t need to change much about your diet when living with HIV. There are some areas of your nutrition that need particular attention, but a generally healthy diet, where fresh fruits and vegetables make up the major portion of your daily food intake, is a very good start indeed.

Fruits and vegetables

Eating fresh fruits and vegetables every day gives your body a boost of antioxidants, that help to protect and support your immune system. You should be eating between 5 to 9 servings of fruits and vegetables a day. Don’t be shy to get creative with your intake here!

Fresh fruit and vegetables provide your body with vitamins, minerals, and fibre. To make sure you get at least 5 to 9 servings of fresh fruits and vegetables into your diet each day, we’ve broken down different ideas on what a single portion looks like. Take your pick from the list below:

  • One medium-sized apple, pear, orange, or banana.
  • One plum, naartjie, or other small fruit.
  • One large slice of pineapple, watermelon, or other larger fruit.
  • Three teaspoons of vegetables: these should be green vegetables, like broccoli, spinach, or kale.
  • Three teaspoons of beans or pulses.
  • One handful of dried fruit.
  • One glass of fresh fruit juice.

Dairy products

Dairy products are notorious for setting off a bout of nausea while you’re adjusting to ARV treatment. They do, however, provide your body with necessary vitamins, calcium, and minerals. You’ll only need to eat a small amount of dairy products every day. Yes, the milk in your coffee does count! But, keep it low on your caffeine intake, and limit your consumption to just two or three cups a day.

You should enjoy fresh milk, yoghurt, cheese, and similar dairy products every day. If you’re avoiding dairy products, or prefer using dairy alternatives, almond milk, soya milk, coconut milk, make for healthy options. Do, however, be sure to check their labels, as many of these dairy alternative products are not fortified with calcium. Calcium is an important mineral for your body, and your body gets all of it from the things you eat. If you find you need to increase your calcium intake, look at adding more beans, pulses, sardines, pilchards, and green, leafy vegetables to your diet.

Protein

You don’t need to eat red meat to get enough protein into your diet. Red meat is often expensive to buy, and consuming too much of it can have a terrible effect on your heart and overall health. It’s doubly important to take extra special care of your heart when you’re on ARV treatment, as this type of treatment can place extra strain on your heart, and elevate your risk of developing heart disease.

That’s why we recommend you cut back on your red meat consumption and choose other sources of protein too. Lean proteins, like fish, eggs, beans, and nuts, are great for ensuring that you eat enough protein every day. Pulses, like beans, lentils, and peas, are also a great source of protein, and they’re relatively inexpensive too.

While you’re planning your weekly meals, don’t forget to include at least two servings of oily fish into your diet too. Oily fish, like sardines, pilchards, salmon, and tuna, are very good sources of Omega-3. Omega-3 is an incredible, natural anti-inflammatory agent.

Starchy foods

Who doesn’t love a potato? We think potatoes are probably right up there on the list of the world’s best foods. They’re versatile, easy to find, and easy to cook. They’re also a great source of starch. Eating enough starchy foods every day helps you to maintain your energy and make sure you get everything done that you need to. You should aim to eat approximately 3 to 5 servings of starchy food per day. We love the following starchy foods, that also provide you with the right kind of fibre and carbohydrates:

  • Potatoes (leave the skin on your potato – it’s filled with vitamins and minerals!)
  • Sweet potatoes
  • Brown rice
  • Whole wheat pasta
  • Maize meal
  • Couscous
  • Whole grain bread
  • Sugar and salt

That’s the good news: you don’t need to ditch your sugar and salt entirely, but you do need to monitor your consumption a little more closely than before. Because being on ARV treatment can raise your risk for heart disease, keeping a close eye on your sugar and salt intake is extremely important. Read every label on the packaging of foodstuffs you consume, and make sure you don’t take in more than 2300 milligrams of sodium every day.

Fats

In the world of food and nutrition, there are ‘good’ fats and ‘bad’ fats. Eating fat helps you to gain weight if you need to, and keep your weight stable if you’re worried about losing weight. Focus on eating enough ‘good’ fats, and you’ll find those in nuts, vegetable oils, and avocados.

Processed foods

A healthy diet can include some processed foods, but never includes a whole lot of them. Processed foods, like takeaways, should not be a major feature of your daily diet. Rather, replace most of your processed food intake with fresh fruits and vegetables. Of course, enjoying a delicious takeout meal once in a while is fine, but aim to keep that for a special treat, once or twice a month.

Water

It’s the most wonderful thing, water. Water lifts your energy levels, keeps your body from becoming dehydrated, and helps to support every single one of your body’s organs. Make sure you drink enough water every day: 8 to 10 glasses of water a day is enough to support your body’s functioning.

Food safety

Because HIV depletes the effectiveness of your immune system, protecting your body from infection is vitally important. That’s why it’s doubly important to take extra special care when you’re preparing meals, and dealing with food. When it comes to food safety, we recommend you:

  • Make sure your kitchen counters are always clean, and use a clean chopping board for preparing your meals.
  • Wash your hands before and after you’ve prepared or eaten a meal.
  • Check the expiry dates on all food items. If it’s past the expiry date, throw it away.
  • Rinse all your fresh fruits and vegetables in clean water, before you eat them.
  • Wash all your dishes, crockery, and cutlery in hot, soapy water, every time you use them.
  • Make sure you cook food thoroughly, especially meat. Chicken should have no pink spots on the inside, and red meat should be thoroughly cooked through.
  • If you’ve made too much of a meal, make sure you store the leftovers in an airtight container in your fridge. But, if you haven’t eaten your leftovers within 2 to 3 days, throw them away.
  • Clean out your fridge once a week: Anything that’s grown mould, smells a little strange, or seems to be wilting, now belongs in the rubbish bin.

Alcohol and smoking

The rules around drinking alcohol and smoking are the same for everyone, no matter if they’re on ARV treatment or not. Drinking alcohol in moderation, and quitting smoking, are two of the most important ways you can preserve your health and extend your lifespan. In fact, we’d recommend ditching alcohol and cigarettes entirely – your body will thank you!

Advice for progressing beyond your first three months of living with HIV

For more advice on how to manage your nutrition while on ARV treatment, talk to your doctor, clinic sister, or nurse. You can also talk to us, or call our 24-hour HIV Helpline. We’re always here to help!

Sources:

Avert. 2020. Taking care of yourself when living with HIV. Web page online. Available at: https://www.avert.org/living-with-hiv/health-wellbeing/taking-care-of-yourself [Accessed 17 April 2020].

HIV Insite. 2017. Diet and nutrition. Web page online. Available at: http://hivinsite.ucsf.edu/insite?page=pb-daily-diet [Accessd 17 April 2020].

Jones, A. 2016. Healthy eating for people living with HIV. Aidsmap. Article online. Available at: https://www.aidsmap.com/about-hiv/healthy-eating-people-living-hiv [Accessed 17 April 2020].

Klemm, S. 2018. Nutrition tips to keep the immune system strong for people with HIV-AIDS. Eat Right Academy of Nutrition and Dietetics. Article online.30 November. Available at: https://www.eatright.org/health/diseases-and-conditions/hiv-aids/nutrition-tips-to-keep-the-immune-system-strong-for-people-with-hiv-aids [Accessed 17 April 2020].

Liao, S. 2017. Eat right when you have HIV. WebMD. Article online. Available at: https://www.webmd.com/hiv-aids/features/hiv-what-to-eat#1 [Accessed 17 April 2020].

Robinson, J. 2019. Nutrition and HIV/AIDS. WebMD. Article online. Available at: https://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-life#1 [Accessed 17 April 2020]

Spar. n.d. Healthy eating for people living with HIV. Web page online. Available at: https://www.spar.co.za/Assets/Tips/View/Health-Tips/HIV [Accessed 17 April 2020].

University of California San Diego School of Medicine. 2020. Diet and exercise for HIV-positive individuals. Web page online. Available at: https://health.ucsd.edu/specialties/hiv/hiv-health/Pages/diet-exercise.aspx [Accessed 17 April 2020].

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