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. By Tim Benzie
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. e 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, 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. +
