Nutritional Care
One area that is often overlooked is the nutritional state of the person who is HIV/AIDS positive. Nutritional care is a vital, integral, and cost effective way to improve the overall health status of a person who is HIV/AIDS positive.
HIV/AIDS positive person can be empowered to manage the nutritional aspect of self-care. Malnutrition is often associated with HIV/AIDS disease.
Malnutrition develops because the body has a greater need for calories, protein, vitamins and minerals. These increasing nutritional demands can be due to pregnancy or fever. Many people who are suffering from malnutrition have a decreased desire or tolerance for healthy foods due to the following:
- Pain (sore mouth) due to Opportunistic Infections, Thrush, and Poor Dentition.
- Decreased Appetite due to illness, drug related anorexia, nausea and vomiting, and taste changes.
- Neurological Complications due to dysphasia, dementia, and lack of coordination.
- Financial barriers due to homelessness, jobless, and lack of insurance
- Problems with Food Access due to fatigue, disability, lack of social support, and lack of transportation
- Malabsorption due to HIV related changes in the GI tract, HIV drugs with side effects of diarrhea, nausea, and vomiting
- Substance Abuse
The standard of care for the HIV/AIDS person is that nutrition should be guided by a registered dietician.
The Dietician does a baseline nutritional assessment, dietary counseling, on-going assessments, counseling and aggressive interventions as indicated. The dietician also provides diet-drug counseling, like timing of medications versus food intake and symptom management.
The following are brief dietary guidelines that the dietician considers in providing care to the HIV/AIDS client.
- To decrease cholesterol a standard heart healthy diet can be followed. Listed is what is suggested to be generally effective:
<30% of calories from fat
- Limit saturated fats,
- High fiber diet,
- Possible use of lipid lowering agents, and caution with exercise with very high lipids due to possible infarcts occurring.
To achieve or maintain glycemic control the following has been recommended:
- Low fat diet,
- No concentrated sweets, and
- Consistency in amount and timing of carbohydrates.
To lower triglycerides the following is recommended:
- Increase fiber,
- 20-25% of calories as fat,
- No alcohol,
- Exercise,
- L-carnitine,
- Monosaturates (olive oil and canola), and
- A handful of nuts (walnuts, hazelnuts) every day.
Doctors may also prescribe appetite stimulating and anabolic agents. Exercise should be encouraged to increase the patient's strength/muscle mass and referral to a physical therapist may be necessary.
Social workers can assist to ensure that the client has access to a safe and nutritious supply of food and that the members of the healthcare team continue to work together to improve the quality of life of the person who is HIV/AIDS positive.
Nutritional Information
