Dr. MJ Bazos MD, Patient Handout

HIV: Nutrition and Exercise When You Have HIV

Even though you have HIV, you don't have to lose weight. Good nutrition and exercise can improve your health and slow down your HIV infection.

What problems could make it hard for me to eat a healthy diet?

You might have trouble eating if you have sores in your mouth, diarrhea, nausea or just a poor appetite. If you have trouble eating and exercising, talk to your doctor.

What are some good tips for eating right?

A few simple steps can help you make sure your food is healthy and safe:

• Wash your hands with soap and water before you eat so you won't get an infection from germs on your hands.
• Wash fruits and vegetables before you eat them or cook them.
• Wash your hands with soap and water after you touch raw fish, chicken or meat so you won't get an infection from germs on your hands.
• Be sure that meat, eggs and fish are well cooked before you eat them.

Here are some ways to put good nutrition into your diet:

• Have high-calorie drinks like milkshakes. Adding powdered milk can increase the nutrition in other drinks.
• Drink 8 to 10 glasses of filtered water each day.
• Keep nutritious snacks on hand.
• Eat high-calorie foods if you're losing weight.
• Call your doctor if you lose 5 pounds or more when you didn't want to.
• Talk to your doctor about taking a multivitamin every day. Take your multivitamin with a meal so your stomach won't get upset.

What can I do if I'm having trouble eating?

• If you don't have an appetite--Try to eat your favorite foods. Instead of eating 3 big meals each day, eat 6 to 8 small meals. Drink high-calorie protein shakes with your meals or between meals.
• If you have diarrhea--Don't eat fried foods and other high-fat foods like potato chips. Don't eat high-fiber foods. Instead, eat bland foods like bread, rice and applesauce. Ask your doctor about taking nutritional supplements, like Ensure.
• If you have mouth sores--Avoid citrus fruits like oranges and grapefruit. Avoid very hot or cold foods. Don't eat spicy foods. Try not to eat hard foods like chips and pretzels. Use a straw to drink liquids.
• If you have nausea and vomiting--Avoid drinking any liquid with your meals. Eat 6 to 8 small meals each day instead of 3 large meals. Eat foods with a mild flavor. Eat foods at a medium temperature, not hot or cold. Drink nutritional supplements and sports drinks. Sit and relax for 30 minutes after you eat.

How can I increase my strength?

An aerobic exercise like walking will help make you stronger. It's good to begin exercising slowly. Little by little, increase the amount of exercise. For example, you might start walking for 20 minutes 3 times a week. Then, after you get a little stronger, you can increase the walking time to 30 minutes 4 times a week. Talk with your doctor before you start.

Weight lifting is also a good way to increase your strength. The pictures below show several basic exercises. Start by trying to do a weight lifting exercise with a weight light enough that you can lift it 10 times. Lifting it once is called a "repetition." More than one repetition is called a "set." Try to do 2 sets of 10 repetitions. Rest for 90 seconds between each set.

You don't need to have fancy exercise equipment to do weight lifting. You can use soup or juice cans, books and other objects you have in the house. Start by lifting a weight that's comfortable for you and doesn't cause too much strain.

In the first week, do 1 or 2 different weight lifting exercises for each body part once or twice in the week. Start with a small weight in each hand, like 10 to 15 ounces (a can of soup or a can of beans), depending on the exercise. Each week increase the number of exercises you do and the number of times you exercise. Rest for 1 to 2 days between exercise sessions. When you're feeling sick, either exercise less or stop for a while.

Dumbbell bench press (for your chest, shoulders and the back of your arms)

Lie on a bench on your back. Hold a dumbbell in each hand, with your hands lined up with your shoulders. Have the palms of your hands facing down (toward your toes). Lower the dumbbells until your elbows are below the bench (left picture). Don't relax your arms at the bottom of this movement. As soon as your elbows are as low as they can go, move your arms up again to the starting position. Don't "lock" your elbows at the top of the movement (right picture). (This means, don't make your arms be exactly straight--leave a tiny little bend in your elbows.)

Remember: You can use cans of soup instead of dumbbells in these exercises.

Crunches (for your abdomen)

Lie on your back on the floor. Keep your feet on the floor and your knees bent. Fold your arms across your chest. Now raise just your head and shoulders from the floor. This is a small and slow movement, like a curl. Your back stays on the floor. Slowly lower your head and shoulders back to the floor. When you are curling your head up, keep your chin up and your eyes looking at the ceiling. You can add resistance to this exercise by holding a weight on your chest.

Upright row (for your shoulders, upper back and the front of your arms)

Hold a dumbbell in each hand. Let your arms be almost straight and resting on the front of your thighs. Your palms should face toward your legs. Now pull the dumbbells up to the level of your shoulders. Your elbows should go up first. When your elbows are about even with your ears, lower the dumbbells to your thighs again. Keep your knees bent just a tiny bit. Don't let yourself lean backwards.

Lunge (for the front and back of your legs and your buttocks)

Hold a dumbbell in each hand. Keep your arms down at your sides. Your palms should face your legs. Your feet should be even with your shoulders. Take a large step forward with your left leg. Lower your right knee until it's 1 inch above the floor. Now straighten your left leg and step back to the starting position. Repeat on the other leg. Remember that the movement is up and down, not really forward. Keep your back straight and your head up. Don't let yourself lean forward.