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Nutrition for the AIDS patient


by Dr Leow Chee Seng, Regional Director of British Institute of Homeopathy From the moment an individual is diagnosed positive for HIV infection, nutritional intervention should be among the highest priority steps to be taken for optimal effectiveness in the fight for life.

cquired immunodeficiency syndrome (AIDS) is a health condition where the immune system is compromised and the patient is unable to flight off infections. AIDS is an extremely complex disorder without any cure currently. While the search for a cure continues, current medical practice aims to reduce the progression of the disease. Some of this may also be possible with nutritional change and supplements recommended by health professionals. In fact, nutrition intervention should take a high priority from the moment an individual receives a positive diagnosis for the human immunodeficiency virus (HIV) infection. The initial nutrition assessment evaluates the individuals current nutrition status and establishes baseline parameters from which to monitor changes. Nutrition therapy may be most effective in the early stage of HIV infection when reduced food intake is more likely to lead to malnutrition rather than in the later stages, when repeated infections and hypermetabolism quickly deplete nutrient stores. Clinicians can begin to encourage gradual improvement in eating habits before the person becomes debilitated and the task of keeping ones self adequately nourished becomes monumental. Weight watch Most AIDS patients lose weight or suffer from diarrhoea which can be severe and unresponsive to drug therapy.
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Weight maintenance is the first strategy in nutrition therapy. A high protein and calorie diet is able to achieve this strategy. Patients should also consume whole foods instead of processed foods as whole foods contain higher quantity of vitamins and minerals. HIV infection patients tend to suffer from multiple nutritional deficiencies. In practice, a 500-calorie per day caloric supplement with fatty acids, multivitamins and minerals was found to be of no help in increasing body weight beyond that offered by a multivitamin-mineral supplement alone. In the early stage of detection, HIV positive patients are suggested to follow immune-enhancing formulas that include omega-3 fatty acids, arginine, and nucleotides. Also, hydrolysed protein and fish oil may help prevent weight lost and reduce the frequency of hospitalisation in the early stages of HIV infection. Some HIV patients undergo enteropathy (protein loss) where the weight loss is due to chronic diarrhoea and abnormal intestine function. Clinically, HIV patients are given gluten-free diets that containing food to reduce the episodes of diarrhoea. With control of chronic diarrhoea, the patients are able to gain weight during the glutenfree periods. Lifestyle change Most HIV patients tend to lose strength and lean body mass. Anabolic steroids are used to address this complication. Hence, in nutrition counselling, we always suggest the patient should undergo progressive resistance training such as weight training to substitute the drug therapy. Patients should have resistance training about three times per week for eight weeks to increase their lean body mass. Not only that, research has proven that such training three to four times per week is able to slow down the progression towards death. Nutritional supplements Generally, AIDS patient often have multiple nutritional deficiencies and as such, a broadspectrum nutritional supplement may be beneficial. It is clinically proven that patients consuming multivitamin-mineral supplements had slower onset of AIDS. Selenium deficiency also increases mortality among HIV-positive people. Selenium supplement is able to reduce rate of infection, allow better intestinal function, improve appetite and heart function. Patients with HIV-related cardiomyopathy (heart abnormalities) should take 800mg of selenium for 15 days, followed by 400mg per day for eight days.

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Besides selenium, the amino acid, N-acetyl cysteine (NAC) is able to inhibit the replication of the HIV virus. One research has found the supplementing of a patients diet with 800mg per day of NAC slowed the rate of decline in immune function in people with HIV infection. Then, the combination of glutamine, arginine and amino acid derivative, hyroxymethylbutyrate has been found to prevent loss of lean body mass in people with AIDS. Further, vitamin A deficiency is common among people with HIV infection. Decrease of blood level vitamin A increases the diseases severity and increases the risk of transmission of the virus from a pregnant mother to her infant. Vitamin A supplements are helpful at halting the disease progression. HIV-positive children given two consecutive oral supplements of vitamin A (20 000 IU), coupled with influenza vaccination are able to display a decrease in their bodies viral load. B-complex vitamin supplements can also help delay progression to death from AIDS. Thiamine (B1) deficiency has been identified in nearly one-quarter of people with AIDS. The deficiency contributes to neurological abnormalities. Vitamin B6 deficiency was associated with decreased immune function among HIV patients. Besides, supplements of vitamin B6, B12 and folic acid are needed among HIV patients. Vitamin C has been proven to inhibit HIV replication and a reduced risk of progression to AIDS. The amount used ranges from 40g to 185g per day and such high dosage supplementation has to be monitored by a medical officer. This amount is used to treat herpes simplex outbreak and Kaposis sarcoma among AIDS patients. Then, vitamin E enhances the effectiveness of the anti-HIV drug zidovudine (AZT) while reducing toxicity. Zinc supplementation can also protect against AZT toxicity. The blood level of the coenzyme Q10 (CoQ10) is low in people with HIV infection. In a clinical trial, people with HIV infection took 200mg per day of CoQ10 and it found that 83% of them experienced no further infection up to seven months and the counts of infection-fighting white blood cells improved in three cases. Also, taking iron supplements can help our body fight against bacterial infection and improve the immune response system. It is important to note that there are many types of herbs which may be helpful to HIVinfected patients. Some of the common herbs include andrographis, St Johns wort, garlic, licorice, turmeric, Asian ginseng, echinacea, maitake, reishim shiitake, tea tree oil and others. OH!

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