Mealtimes provide a great opportunity for
HIV positive people to boost their immune system, yet there are still some
surprising perils on the most appealing platters
Words Tim Benzie
Image Russell Plows
Living with a virus that sits poised to attack the immune system, most sensible
punters want to nurture the T-cells they’ve got and keep them happily
reproducing as the years glide by. Among other things, this means watching
what you eat.
Even with the best will in the world and a talented chef in the kitchen, med
side effects like nausea can often stop us feeling hungry or eating properly.
Diarrhoea can also prevent us absorbing nutrients and calories. This is even
more reason to make meals appealing, bug-free and nutrient-rich. It is often
recommended that people with HIV should eat more calories, especially to counter
HIV-related wasting and make up for nutrients lost through diarrhoea. But
avoid boosting your calorie intake with deep-fried Mars bars and other high-fat,
low-nutrient foods as this may raise levels of fats in the blood.We must also
be mindful of certain foods that might interfere with our medications or provide
too much risk of opportunistic infections if our immune system is low. Here’s
a quick guide to the dos and don’ts of positive dining. Bon appétit.
What to eat every day
Fresh
fruit and veg
Research indicates broccoli is especially good for the immune system, as are
berries and shiitake mushrooms. Sweet potato rates highly, as do green beans,
carrots, tomatoes, courgettes, celery, bok choy, papaya, asparagus and cantaloupe
melons. Eat at least five portions a day.
If your immune system is compromised, take extra care to wash veggies thoroughly
and preferably at least parboil them, just to be safe. This is also a good
idea if you
suffer with diarrhoea.
Carbs
Carbs give you energy and, like people, come in simple and complex varieties.
Complex carbs in grains, cereals, vegetables and fruits give you a slow, steady
release of energy and provide fibre and nutrients. Simple carbs or sugars
give you quick energy.
Good fats, bad fats
Fats are essential and provide extra energy, but don’t overdo them.
Also, like people, they come in good and bad varieties. Monounsaturated fats
in nuts, seeds, canola and olive oils, and omega-3 fats in oily fish, are
considered ‘good’ while ‘saturated’ fats in butter
and animal products are ‘bad’ fats. Cut back on these if you have
high lipids.
Protein
Good for the immune
system, gaining muscle mass and an energy boost. Think meat, eggs and milk
but don’t overdo it as they are high in saturated fats. Fish such as
salmon (see recipe, page 66), sardines and tuna are excellent sources of protein,
as are beans and legumes.
Whole grains
A great source of zinc and vitamin E (both pluses for the immune system),
whole grains include oats, barley, brown rice, millet and buckwheat.
Water
Our bodies are around two-thirds water. Kidneys, liver, stomach, everything
needs water to function effectively. It is recommended that we drink eight
250ml glasses per day, more in hot weather, when exercising or suffering from
diarrhoea or night sweats. Bottled, filtered and tap water can all contain
bugs such as cryptosporidium, so boil it if your CD4 count is below 200.
Supplements
A little of everything, but not a lot, is especially true for people living
with HIV, when an excess of even the most benign herb or vitamin can bite
back. Selenium for instance, found in huge amounts in foods like Brazil nuts,
is necessary in small quantities for proper immune function, but controversy
still rages over whether, in larger doses, it speeds up HIV progression. The
bottom line is, a multivitamin can’t hurt, but mustn’t be seen
as a substitute for fresh fruit and vegetables.
Best avoided
Raw
food
If your immune system is within a normal range, an occasional snack of sashimi
or a rare steak shouldn’t hurt, but doctors still recommend avoiding
these if you have a low T-cell count. Undercooked eggs, such as the raw egg
cracked over rice or noodles in dishes like yaki soba are a no-no, as are,
sadly, oysters and clams. Even raw alfalfa and bean sprouts can contain E.
coli.
Garlic
Garlic in your pasta isn’t going to hurt and is a proven way of lowering
cholesterol. Yet people taking saquinavir are warned to avoid taking garlic
supplements because they may block the drug’s
effectiveness. There are also claims garlic heightens the side effects of
drugs like ritonavir. Check with your doctor.
Grapefruit juice
Grapefruit juice can interact with a range of drugs, including Valium, methadone,
allergy medications, statins and certain HIV meds, but the odd glass isn’t
going to kill you. Ask your doctor if you’re worried. There is another
reason not to drink grapefruit juice: personally, I think it tastes vile.
St. John’s Wort
Not a food, but this herbal therapy and mild anti-depressant reduces levels
of some HIV medications, specifically the protease inhibitors and NNRTIs.
Avoid if this is part of your combo.
The important rule with food, for everybody, is moderation and balance. If
you are concerned about any possible problems with food, ask to speak to the
nutritionist at your clinic.
• Visit www.thebody.com/pinf/herbs.html
for
a more detailed examination into possible drug interactions, herbal side effects
and toxicity
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