Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Support Individualized Meal PlansConsider• Stage of illness and symptoms• Food security (availability and accessibility ofbasic foods)• Resources (money, time, other caretakers)• Food likes and dislikes• Knowledge, attitudes, and practices(especially traditional dietary taboos)Modify Meal Plans to SuitMedication and Health StatusConsider• Flexibility to change depending on client context• Possible food and drug interactions• Changes in medication regimens• Absence of opportunistic infections and otherinfections that may affect food intake orutilization• Changes in food accessibility in terms of qualityand quantity (especially in resource-poor settings)Promote Lifestyle Changes forNutritional Well-being• Eliminate foods and practices that aggravateinfection− Raw eggs and unpasteurized dairy products− Foods not thoroughly cooked, especially meats− Unboiled water or juices made from unboiled water• Avoid foods that may affect food intake− Alcohol and coffee− “Junk” foods with little nutritional value− Foods that aggravate symptoms related to diarrhea, nauseaand vomiting, bloating, loss of appetite, and mouth sores(e.g., expired foods, fatty foods)Recommend Regular ExerciseMuscle loss can be restored by reducingviral load or maintaining physical activityPhysical activity improves• Lean body mass• Body composition• Bone density•Strength• Functional capacity•Quality of life• AppetiteTherapeutic Regimensfor HIV-Related Weight LossTherapyMegestrol acetateParental nutritionrGHNandrolone (hypogonadal)Resistance exercise aloneResistance exercise andoxandroloneNitrogenretention(g/day)NANA4.03.73.85.6Source: Adapted from Hellerstein and Kotler 1998Rate of change in bodycompositionLBM (kg/wk)0.00-0.050.000.250.250.480.86Weight (kg/wk)0.450.300.130.410.530.84ExercisesThat Build Muscle Mass• Weight bearing exercises− Resistance training− Weight training• Exercises generating high force on bone− Aerobics− Jogging− Stair climbing− Hiking− Skipping• Relaxation exercises− Yoga