Both central fat deposits and lipid levels in people with HIV have been improved by a programme of resistance exercise and aerobic exercise. Resistance exercise builds muscles which burn triglycerides stored in body fat, and regular exercise of any sort increases levels of HDL cholesterol (the form which protects us from heart disease). People with fat wasting from the arms and legs may find that they lose more fat.

Recommended exercise levels in order to modify fat gains

A combination of both aerobic (oxygen burning) and resistance (weight training) exercise is best for people with HIV and for tackling body fat changes.

Aerobic exercise

Aerobic exercise improves both your heart’s ability to pump and your muscles’ ability to use oxygen. It includes activities like brisk walking, running, swimming, cycling, rowing, vigorous sex and even dancing.

Aerobic exercise should be at a level where you are puffing but could still talk. A total of 30 minutes of any of these activities per day at this level will reduce your risk of heart disease. If you maintain your heart rate within a training range for at least 20 to 30 minutes three times per week you will improve your fitness from your current level. You can calculate your training heart rate range with the following formula:

• You should aim to exercise between 60% - 75% of your maximum heart rate.

• To find out your maximum heart rate subtract your age from 220, e.g. 220 - 39 = maximum heart rate of 181.

• Multiply 181 x 0.6 to get the lower end of your training heart rate and by 0.75 to get the upper end.

• Therefore the training heart rate of a 39 year-old is between 109 beats per minute and 136 beats per minute.

Progressive resistance training

The most efficient way to improve your muscle strength and size is to resistance or weight train. Activities like yoga and swimming do provide some resistance but the most efficient way is to use free weights or weight machines in a gym. You need to work on large muscle groups to gain the most benefit.

To improve muscle strength you need to load your muscles quite heavily. Therefore do a small number of repetitions using relatively heavy weights.

Always do a warm up of ten repetitions on a light weight before starting.

Your training weight needs to be increased as your strength increases to make sure your muscles continue to experience resistance. Do three sets of 8-12 repetitions.