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HIV treatment, metabolic changes and ageing

Anti-HIV drugs can cause changes inside your body, known as metabolic changes. These can include:

  • changes to blood fats (also called lipids), such as having too much low-density (LDL, or ‘bad’) cholesterol; having too little high-density (HDL, or ‘good’) cholesterol; or having high triglycerides
  • a change in the way the body processes sugar, known as insulin resistance.

These sorts of metabolic changes are also caused by lifestyle factors, such as smoking, lack of exercise and being overweight. These changes are associated with an increased risk of diabetes and cardiovascular (heart) disease.

People can have any one of these changes on their own, but there is often a link between them. For example, insulin resistance can lead to diabetes, and both diabetes and weight gain are associated with an increased risk of cardiovascular disease.

You will be monitored for these changes as part of your routine HIV care. If you develop any of these problems, you can talk to your healthcare team about the sort of changes you may need to make to your eating habits and lifestyle to deal with them.

If you have high cholesterol, it is recommended that you cut down on saturated fats. These come from animal products such as red meat (beef, lamb and pork), dairy products such as butter, cream, whole milk, cheese and full-fat yoghurt, and the vegetable fats palm oil and coconut cream or oil (see Healthy eating for more information on a healthy, balanced diet).

Everyone is recommended to eat at least five portions of fruit and vegetables a day, and having plenty of fresh fruit and vegetables is especially important if you need to reduce your weight or high lipid (blood fat) levels.

To help prevent blood clots and reduce triglyceride levels, it’s a good idea to increase your intake of a type of polyunsaturated fat called omega-3 fats. These are found in oily fish like mackerel, herring, salmon and sardines.

Regular exercise can also help reduce levels of blood fats. Resistance training (using muscle strength, such as lifting weights) and aerobic exercise (activities that increase your heart rate and make you breathe faster, such as running, walking and swimming) are particularly effective.

The glycaemic index (GI) is a way of rating foods by how fast they cause a rise in your blood sugar levels. High GI food will produce a sudden rush, while low GI food keeps blood sugar levels more stable. If you are experiencing these metabolic changes, you may be advised to follow a low GI diet. A dietitian can help you with this.

With the right treatment and care, people with HIV can expect to live well into old age. In fact, some doctors think that the life expectancy of many people more recently diagnosed with HIV is now near normal.

However, there is evidence that some of the diseases associated with ageing occur at a younger age in people with HIV compared to the general population. The reasons for this are unclear but, in many cases, could be either because of the effect of HIV itself on the body, or the side-effects of HIV treatment.

Nutrition has an important part to play in both the risk of developing these diseases (and preventing them) and how they can be managed if you have them.


Published August 2011

Last reviewed August 2011

Next review July 2014

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap