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Date: 21 May 2012
Time: 17:24
Dietetic service
A specialist HIV dietician is available in clinic to discuss with you the following:
- Healthy eating
- Food safety
- Healthy weight
- Exercise
- Managing side effects of medication
- Appropriate use of dietary supplements
- Smoking cessation
- Other nutrition related questions
Contact:
Rosaleen McDermott, Senior HIV Dietician: 0121 204 1700
(if you get through to our answer machine, please leave a message)
Good nutrition promotes a strong immune system. Having HIV is unlikely to mean that you have to make any drastic changes to your diet – your existing diet will probably meet all your nutritional needs.
- Healthy eating
- HIV and heart disease
- What can you do to reduce your risk of heart disease?
- Loss of appetite
Healthy eating
A balanced diet includes a variety of foods from each of the four food groups:
Starchy food (energy foods)
E.g. breads, cereals, millet, maize meal, cous cous, potato, pasta, rice and cassava.
- Starchy foods should form the basis of your diet. Eat at each mealtime
- Choose higher fibre options, e.g. wholegrain breads, brown rice
- Aim for four-six portions per day – more if you are very active
One portion ~ one slice bread, half cup cooked rice, one cup cooked pasta or one bowl cereal.
Fruit and vegetables (protective foods)
- These provide vitamins, minerals, fibre and energy
- Aim for five portions per day
One portion ~ one piece of fruit, small bowl of salad or three heaped tablespoons of vegetables.
Meat, poultry, fish, eggs, beans, nuts (building foods)
- These provide protein, minerals and vitamins
- Choose lean cuts of meat or trim the fat before cooking where possible
- Eat oily fish, e.g. sardines, mackerel, tuna, salmon, pilchards
- Try and eat two or three portions per day
One portion ~ two medium-sized eggs, a 100g piece of meat, a 150g piece of fish or a small tin of baked beans.
Dairy products (building foods)
E.g. milk, cheese and yoghurt.
- These provide vitamins, minerals and calcium
- Aim for three portions per day
- Choose low-fat varieties where possible
- Three portions should be eaten per day
One portion ~ third of a pint of milk, a small pot of yoghurt or a matchbox-sized piece of cheese.
Fats, such cooking oils, butter and margarine: eat with care, as too much fat can lead to weight gain and increased fat levels in the blood. This may increase your risk of heart disease. Choose products made from sunflower, soya bean, olive, canola, linseed or nuts instead.
HIV and heart disease
Recent research has shown that those with HIV may be at a higher risk of heart disease.
Someone's risk of heart disease, e.g. heart attack or angina, is determined by the presence of both non-modifiable and modifiable risk factors.
Non-modifiable, those that someone can not do anything about are:
- age
- gender
- family history
- ethnicity
Modifiable risks are:
- smoking status
- being inactive
- poor diet
- high cholesterol
- diabetes
At Selly Oak Hospital we proactively screen and manage cardiovascular risk in our patients. Patients are screened for risk factors for cardiovascular disease every two years and individualised specialist lifestyle advice is provided to reduce an individuals risk.
When lifestyle advice is not enough to reduce someone's risk for cardiovascular disease, referrals are made to either a specialist lipid clinic – last Friday of every month run in conjunction with the HIV clinic, hospital-based Hypertension Service - or where appropriate referred back to the GP for assessment and monitoring.
What can you do to reduce your risk of heart disease?
Stop smoking – stopping smoking is the single biggest thing you can do to reduce your risk of heart disease. A lot of people who try and give up smoking need more than one attempt before successfully quitting. Using nicotine replacement therapy (NRT) can increase your chances of being successful.
Once you have stopped smoking, your risk of heart disease returns to that of a non-smoker after five years.
Healthy eating
See the guidelines above and:
- drink sensibly – men should drink a maximum of three units of alcohol per day and women up to 2 units per day, with some alcohol free days
1 unit ~ 125 ml glass of wine, single measure of spirit or half pint of lager.
Increase activity
Increasing activity can:
- aid weight loss
- reduce blood pressure
- increase high-density lipoproteins or good cholesterol level
- generally improve mood
Aim for 30 minutes four-five times per week. The best exercise is something that you enjoy doing that gets you a little out of breath.
If doing a lot is difficult, try:
- taking the stairs instead of using the lift
- getting off the bus a stop earlier
- parking the car further from your destination
Speak to your GP before starting any new activity, especially if you have not been active recently.
Aim for a healthy weight
Being overweight or obese can put you at risk of heart disease and some cancers. An indicator of a healthy weight is a body mass index (BMI) between 20-25.
To calculate your BMI, please see the external link box.
If you want to lose weight:
- exercise regularly
- reduce fatty foods
- reduce high-calorie foods, e.g. cakes, biscuits, sweets, pastries, puddings, crisps, margarine, butter, oil etc
Loss of appetite
A common problem that people living with HIV may encounter is loss of appetite. This generally only lasts for a short time and, among other reasons, may be due to stress, having another illness or be a side effect of medication.
The following advice may be helpful:
- Eat three small meals per day: try to have something at each meal time, even if it's a much smaller portion than normal
- Eat two-three snacks per day, e.g. nuts, cakes, crisps, pastries, chocolate, biscuits, yoghurt, avocado pears
- Drink nourishing drinks: milky drinks, fizzy drink, tea/coffee made with full fat milk and sugar, or fruit juice are more nourishing than water
- Fortify your food with extra nourishment:
- To milk based sauces, add cream/evaporated milk or grated cheese
- To puddings, add extra cream, custard, jam, ice-cream, honey or dried fruit
- To breakfast cereals, add yoghurt, cream, sugar, honey or dried fruit
- To soup and stews, add grated cheese, oil, cream, dumplings or nuts
- To potato and other vegetables, add cheese, cream, butter, oil or fried onions
If you are concerned that you have lost your appetite and may be losing weight you can book an appointment with the dietician who will be able to advise you.
A good general information sheet on all aspects of HIV and nutrition has been produced by NAM. For more information, please see the downloads box.
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