Alaine Mills, Dietetic Intern

HIV & NUTRITION

Why is it important to have a healthy diet?What is a healthy diet?Possible co-morbiditiesManaging side eff ectsFood SafetyQuestions

OUTLINE

Maintaining/Restoring Body Weight

Managing Side Effects

Eating EnoughExercise

WHY IS IT IMPORTANT TO HAVE A HEALTHY DIET?

Fever Infections

WHY DO I HAVE INCREASED ENERGY NEEDS?

WHAT IS A HEALTHY DIET?

ProteinFruits & Vegetables

WHAT FOODS SHOULD I FOCUS ON?

WHY PROTEIN?

WHAT FOODS ARE HIGH IN PROTEIN?

Antioxidants

WHY FRUITS & VEGETABLES?

Omega-3 Salmon, almonds, walnuts

Vitamin C Citrus fruits

Vitamin A Carrots, sweet potatoes

Vitamin E Spinach, sunflower seeds, almonds

Zinc Protein, legumes, oatmeal

IMMUNE SUPPORTING NUTRIENTS

HyperglycemiaHypertensionHyperlipidemiaChanges in body

compositionPancreatitis

Kidney & liver diseaseHypothyroidismOsteopeniaMalnutritionWasting

POSSIBLE CO-MORBIDITIES WITH NUTRITIONAL IMPLICATIONS

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

HYPERGLYCEMIA

Avoid concentrated sweets (candy, soda, baked goods, etc)

Whole Grains Protein with all meals and snacks

NUTRITIONAL MANAGEMENT OF HYPERGLYCEMIA

Hypertension

What is it? Persistent high blood pressure

What does it matter? It is associated with increased incidence of heart & kidney

disease

Nutritional Management of Hypertension

Increase fruits, vegetables, and low fat dairyReduce sodium intakeModeration of alcohol consumption

Hyperlipidemia

What is it? 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

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!

NUTRITIONAL MANAGEMENT OF HYPERLIPIDEMIA

Osteopenia

What is it? Low bone mineral density

What causes it? Inadequate calcium and vitamin D intake or status Low body weight Certain medications Lack of physical activity

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

NauseaMouth or throat soresDry mouthLoss of tasteFatigueDiarrheaConstipationNot eating enoughWeight loss

NUTRITION RELATED COMPLICATIONS

Cause: Medications

Why is it important? 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

NAUSEA

Causes: 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

MOUTH OR THROAT SORES

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)

DRY MOUTH (XEROSTOMIA)

CausesWhy is it important?Management:

Avoid red meat Avoid metal utensils Use marinades/seasonings

LOSS OF TASTE(DYSGUESIA)

Causes: Medications, anemia

Why is it important? 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

FATIGUE

Causes: 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

DIARRHEA

Causes: 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)

CONSTIPATION

Causes: Medications, increased energy needs

Why is it important? Good nutrition improves the quality of life and may prolong

itManagement:

Nutrient and energy dense foods Small, frequent, meals and snacks Nutrition supplements Appetite stimulants

NOT EATING ENOUGH(INADEQUATE FOOD CONSUMPTION)

Causes: Not eating enough, increased energy needs, medications,

hormone imbalancesWhy it matters?Management:

Eat more (especially protein) Manage eating associated ‘ symptoms Resistance exercise Steroids

WEIGHT LOSS

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 FKeep cold foods cold and hot foods hotOnly keep leftovers for 24 hoursCook meats well doneAvoid: sushi, raw eggs, raw oysters, buff ets

FOOD SAFETY

QUESTIONS?