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How To Eat Right While Living With HIV

With all the new diet trends it can be hard to know which is best for your own health and happiness. And people who are HIV-positive need to pay special attention to what they consume because a healthy diet with the right nutrients may be able to repair and heal cells that were damaged from the virus, as well as boost their immune systems.

A new study led by researchers at UC San Francisco shows the transformative power of a healthy diet for People Living With HIV (PLWH). The study found that PLWH who got on a healthy diet for six months were more likely to adhere to their medication regimens, were less likely to become depressed and were less likely to make trade-offs between food and healthcare.

The study, published in the Journal of Urban Health, sought to determine whether comprehensive nutrition could improve the health of those living with HIV and diabetes. The study was a joint effort by researchers from UCSF and from Project Open Hand, a San Francisco Bay Area nonprofit agency that provides over 2,500 nutritious meals each day to low-income people living with HIV and other disabilities.

The program allows registered dietitians to support and counsel PLWH to help them feel better by eating right. While food-oriented medical treatment has been shown to help people in low-resource countries, it has not been well studied in developed countries like the U.S. which is what prompted researches from UCSF to get involved.

About two-thirds of those in the study were male and just over 70 percent were between 50 and 64 years old. About 80 percent were non-white and only about 17 percent were employed. Most were receiving federal disability payments – SSI and/or SSDI – and about 20 percent were receiving food stamps. Compared to participants living with HIV, those with type 2 diabetes were more likely to be older, female, African-American, employed and receiving food stamps.

According to the study, people with diabetes were able to achieve optimal blood sugar control when they were put on a healthier diet. They also had a decrease in hospitalizations and emergency department visits, consumed less sugar and were able to lose weight.

“We saw significant improvements in food security and in outcomes related to all three mechanisms through which we posited food insecurity may affect HIV and diabetes health – nutritional, mental health, and behavioral,” said Kartika Palar, PhD, an assistant professor of medicine at UCSF and co-first author of the study. “For example, we saw dramatic improvements in depression, the distress of having diabetes, diabetes self-management, trading-off between food and health care, and HIV medication adherence.”

After following the participants for six months, researchers determined that they ate more fruits and vegetables and consumed lower amounts of unhealthy fats. Overall, those in the study had fewer symptoms of depression and were less likely to binge drink. For those with HIV, adherence to antiretroviral therapy increased from 47 percent to 70 percent.

The participants ate meals and snacks based on a Mediterranean diet, which emphasizes fruits, vegetables, olive oil instead of butter, beans and cereal grains, such as wheat and rice. Moderate amounts of fish, dairy and wine are included, while red meat and poultry are limited. The Mediterranean diet has also been in the news recently for its benefits related to brain mass retention.

The diet was also low in refined sugars and saturated fats, based on current recommendations from the American Diabetes Association and American Heart Association.

The diet, while healthy, was not about restricting calories. Meals and snacks fulfilled 100 percent of daily caloric requirements. Average energy requirements used to design daily meals were 1,800 to 2,000 kcal for people living with HIV and 1,800 kcal for people with type 2 diabetes.

“This study highlights the vital role that community-based food support organizations can play in supporting health and well-being of chronically ill populations who struggle to afford basic needs,” said Sheri Weiser, MD, associate professor of medicine at UCSF and senior author of the study.

There is also a popular myth that a healthy diet is expensive, but the study found that healthy food may save costs. The cost to feed each participant was $6.58 a day, or $1,184 for the six-month intervention, which is less than half the $2,774 cost per in-patient day in a California hospital.

“Feeding people who are too sick to take care of themselves is at the core of our mission,” said Project Open Hand CEO Mark Ryle.

The team plans to follow up with another six-month study of 200 HIV-positive clients in San Francisco and Alameda counties.



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