Good nutrition is a key part of living healthily. It can help you maintain a healthy bodyweight and reduce the risk of diabetes, stroke, heart disease, cancer and osteoporosis.

For people with HIV, as for anyone, food provides the fuel for the body. But as infections and illnesses can interfere with the way we use food and energy, people with HIV sometimes need more food than other people. Low levels of vitamins and minerals can weaken the immune system, which protects the body against infections.

Low levels of nutrients are a common problem for people with HIV, because side effects and infections make it more difficult for the body to absorb nutrients.

If lipodystrophy means you have raised blood fats and blood sugars, a balanced diet is important. It should lower the risk of cardiovascular disease.

People with HIV can usually follow the same healthy eating advice as everyone else. Eating a balanced diet from a variety of food groups should mean that you get the full range of energy, fibre and nutrients that you need.

As a general rule, it’s best to get most of your nutrients from food.

Nonetheless, in addition to a balanced diet, a daily tablet with several vitamins and minerals could top up what you get from food. But having more than the recommended dose can be dangerous.

Most HIV clinics have a specialist dietitian who you can see. This is someone trained to give advice about nutrition. They can give you detailed advice based on your situation:

• You may need to lose weight
• You may need to put on weight
• You may not be getting enough nutrients
• You may be concerned about lipodystrophy
• You may have trouble eating because of nausea, diarrhoea or illness
• You may need help with the food restrictions of your anti-HIV drugs.

If a dietitian measures your body composition regularly, they may spot problems early on.

Even if you don’t see a dietitian, it’s important to measure your weight regularly. Weight loss is often a sign of an infection or illness, and being overweight increases the risk of cardiovascular disease. 

Food and taking medicines

A few anti-HIV drugs have to be taken on an empty stomach, or with food, or only with a low fat meal. If you’re not sure, check with your clinic.

If you are ill or have an infection, you may need more calories than usual to maintain your normal body functions. If you’re not able to eat enough, you may have problems with weight loss, involving the loss of both fat and muscle.

It’s worth speaking to your doctor or an HIV dietitian if you’re experiencing unwanted weight loss, which is also known as wasting.

If weight loss is a problem, the aim should be to eat more. This may be easier if you have several small meals or snacks in the day, rather than two or three larger meals. It’ll also help to always have food that you like in the house. Frozen food, ready meals and canned food can be useful, although these foods are not always the healthiest. You should still aim to eat a balanced diet, from the food groups listed in the table above.

Weight loss is more likely during illness. A dietitian can give you specific advice about dealing with problems like having a sore or dry mouth, and on finding  foods that are easier to eat. They can also advise you on dealing with drug side effects like vomiting and diarrhoea.

1. Eat lots of fruit and veg.
2. Eat lots of bread, cereals etc.
3. Eat more fish.
4. Cut down on saturated fat.
5. Try to eat less sugar and salt.
6. Drink plenty of water.
7. Don't skip breakfast.

If you want to lose weight it’s recommended to reduce the overall amount you eat, but still eat a balanced diet. You’ll also need to get more exercise at the same time.

If you need to lose weight because of problems with lipodystrophy, it’s worth seeing a specialist dietitian. You will probably need to cut back on saturated fats, and eat at least five portions of fruit and vegetables a day.

Five portions?

This may not be as hard as it seems, especially if you know that a ‘portion’ is equivalent to three heaped table spoonfuls of vegetables, or a fruit the size of an apple.

So if you can imagine in one day eating some carrots, frozen peas, some lettuce, an orange and a glass of 100% fruit juice, then it may be possible to reach the target.

Fats can be confusing.

BAD - Saturated fats

These are bad for the heart. Fatty meat, butter, cheese, cakes, biscuits, pastries, pies, coconut cream, palm oil etc.

OK - Unsaturated oils

These are healthier alternatives, but are best consumed in moderation. Olive oil, corn oil, rapeseed oil, and spreads based on these.

GOOD - Fish oil

It’s good for the heart; we’re recommended to eat oily fish twice a week. Sardines, mackerel, salmon etc.

• Social services, your HIV clinic or an HIV organisation may be able to help.

• Carbohydrates like bread, pasta and rice are good for you and relatively cheap.

• Nutritious but cheaper foods include eggs, beans and pulses.

• Frozen and canned fruit, vegetables and fish are less expensive than fresh.

• Cooking foods from basic ingredients costs less than buying ready meals.

• Cooking double quantities and keeping half for the next day works out cheaper.

• A meat stew will cost less if you use less meat, and add extra beans and vegetables.

• Larger supermarkets and local markets are cheaper than corner shops.

• Supermarkets often have less expensive ‘value’ ranges.

• Fresh foods are often discounted on the last day of their shelf life, but must be eaten the same day.