What to do, of course,
depends not just on personal preferences, but on what you are trying to
accomplish. Many joggers and gym goers would cite losing weight as
their top goal. Some HIV-positive people need to lose weight too (I do – ed.). For others, widespread
lipodystrophy and HIV-related metabolic problems are causing unhealthy fat
Other HIV-positive people, though, most decidedly do
not. Ongoing HIV infection causes many people to lose weight (particularly lean
body mass: that is, muscle) involuntarily. This condition, called wasting,
can be very serious if not addressed.
Exercise can help, whether you aim to lose or gain –
but it’s important to choose the right kind or you may even make matters worse.
A person experiencing involuntary weight loss probably shouldn’t be training
for marathons. Equally, a person who needs to lose weight may be risking their
health if all they concentrate on is resistance training.
There are three main components to exercise:
resistance training, aerobics, and flexibility training.
Flexibility training should be part of any routine:
stretching and loosening your muscles and joints protects them against injury,
especially before and after weight lifting or other heavy-duty forms of
exercise. It also makes you supple. A number of complementary health
disciplines concentrate on flexibility, both active (most forms of yoga) and
passive (shiatsu or Thai massage).
training means putting your muscles to work against weights or
weight machines. This form of training builds muscle mass and muscle strength,
and is often recommended for people with HIV who have difficulty maintaining
enough body weight. Studies have found that properly designed resistance
training routines safely help HIV-positive people build strength and lean body
mass.1,2 Note that when trying to build muscle, it’s crucial to have
an adequate, healthy diet: your body needs enough protein and other essential
nutrients from which to build new muscle.
High-intensity exercise may be safe
for many otherwise fit and healthy HIV-positive people.
Aerobic exercise is the sweaty stuff that gets your heart and lungs going:
cycling, running, spinning and the like. Aerobic exercise can accomplish two
things: it burns off calories, helping you to lose extra body fat. It also
forces your heart and lungs to work harder, keeping them healthier, hence its
other name, ‘cardio’. Although HIV-specific studies are relatively scarce,
there is a great deal of evidence that regular exercise reduces the risk of
adult onset diabetes, high blood pressure (hypertension), and coronary artery
disease in the population at large and in those with other chronic illnesses.3,4
Improving cardiovascular health is especially
important for people at risk of heart disease. This includes people with HIV,
especially with other risks such as high cholesterol levels. People at risk of
heart disease are encouraged to get regular, moderate amounts of aerobic
exercise. Aerobics can lower the levels of “bad” LDL cholesterol and increase “good”
HDL cholesterol levels in the blood and it’s having a high HDL-to-LDL
cholesterol ratio that’s the key to reducing heart disease risk. While you may
not be able to change your genetics (cardiac risk tends to run in families),
you can change how much you exercise.