Central fat accumulation

Doing lots of sit-ups will not reduce central fat. The most efficient way of using up your central fat is with progressive resistance training. By increasing your total percentage of muscle, you burn off more fat even at rest. You will lose more central fat than peripheral fat when larger muscles begin to burn fat.

Peripheral fat loss (arms, legs)

Weight training may lead to slightly less peripheral fat. However by building up more muscle you can balance changes in the appearance of your limbs. If you feel you are losing too much fat reduce your exercise regime slightly.

Blood fat and sugar control

Improving your heart’s fitness tends to reduce your blood fats. However this depends on consistent regular exercise. By reducing central fat and increasing muscle you are able to control your blood sugar levels more efficiently.

Plan for exercise

• Build up your exercise regime gradually; if you haven’t exercised for years, don’t expect to reach all the targets described here in the first few weeks or even months.

• Find somewhere to exercise where you feel comfortable. Your HIV clinic or local voluntary organisation may be able to recommend somewhere, and some clinics are able to provide access to free facilities.

• Warm up (10 mins of aerobic activity at a low level below your training range to warm your muscles).

• 20 to 30 minutes of aerobic activity keeping heart rate in the range described.

• Progressive resistance exercise at an appropriate level.

• Warm down (same as warm up).

• Stretch all muscles trained (this reduces muscle tears and injuries).

• Have 3-4 aerobic sessions and 2-3 progressive resistance sessions per week. Most people will have to build up gradually to this amount of exercise. You can vary your programme, for example, by doing two gym sessions with both aerobic and resistance components and one swimming or cycling or yoga session per week.

Cautions

• Always consult your doctor before starting a new exercise programme.

• Ensure you have an appropriate orientation to any gym – make sure that you know what you are doing, or you risk injuring yourself.

• Do not exercise if you have a temperature as this can cause significant stress on your heart.

• If you have high blood pressure, care should be taken when weight training not to hold your breath and further increase your blood pressure.

• Free weights require much more strength and stability, so starting on weight machines may reduce injuries.

• For further information contact your local gym or physiotherapist, and also contact your local authority for schemes for people on low incomes.

The YMCA has launched a scheme called Positive Health to provide gym access for people with HIV.

Call 020 7343 1720/21 to see if there is a centre near you.