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Being Alive
Not An Alternative
Jennifer Jensen, MS, RD
May 5, 1995
Being Alive 1995 May 5: 6

Most of us know about "alternative" treatments, even if all we know is that there are alternatives. Some of us choose to use them, some of us don't. I have a huge concern when nutrition is lumped together under the "alternatives" umbrella. This is totally incorrect, and here's why. Nutrition isn't alternative at all. Food and its nutrients have always been absolutely necessary for life, and that is accepted as fact. One time, a group in South America, "breatharians," claimed that simply breathing is all one needs to do for body fuel. Bugs, full of protein, are inhaled from the air (ugh!) and provide plentiful nourishment-eating food is unnecessary (I'm not making this up). But the breatharian leader was "busted" big time some years ago- while raiding a convenience store (stockpiling junk food).

Go figure! Digestion I've said many times that HIV represents a primary disorder of the gastrointestinal system (GI tract or "gut"). The members of this body family include (from the top) the mouth, throat, esophagus, stomach, small intestines, and large intestine (bowel). Also, supportive digestive tract relatives include the liver and the pancreas. Each GI tract member is subject to Opportunistic Infections (OIs). There's no OI that I know of that can't infect the gut.

Among the more common are candida, Kaposi's sarcoma (KS), lymphomas, cytomegalovirus (CMV), MAI/MAC, herpes, cryptosporidium, microsporidium, salmonella, giardia, and the actions of HIV itself. This, in addition to malabsorption, hypermetabolism, depressed appetite and other HIV-related aggravations. One personal annoyance is dry mouth syndrome and it can be brought on by HIV, medications, OIs, or all three.

The mouth is the location of our first digestive task. Nutrition Power says chew your food. We have teeth because chewing is important. Eating is not a race; slow down your BPM (Bites Per Minute). Advisory: count your chews; if you're not to 30, you're not done. This alone could relieve enough intestinal gas to fill an army tank, and "passing wind" (farting) would be very infrequent-but if the occasional gas poops out, those few "events" would smell like rose petals. (I am making that up-it's actually more like gardenias!) Hint: sips of "safe water" or other fluid while chewing can help a lot, but don't forget to count! Constitutional Needs In science, this phrase is used for things we absolutely cannot do without. Absolute needs-it's not negotiable-we have to have them. Food is necessary for life (breatharian wisdom notwithstanding). To think of Nutrition (food) as an "alternative" is unwise in medical or disease circumstances. While there are some fairly alternative-type diets and/or supplements touted as benefitting people living with HIV/AIDS, the proven scientific approach must take top priority; the rest I call "Other." Constitutional needs include "macronutrients"-food parts containing calories. These include carbohydrates, protein, and fat. There are no other calorie containing nutrients. Constitutionals also include "micronutrients"-calorie-free vitamins, minerals and antioxidants. If these needs are not met, any dietary practices and/or food-eating patterns are likely to fail at enhancing health, and may inhibit the potential of medical therapies as well.

Macronutrients Healthy nutrition, regardless of HIV status, begins with emphasis on complex carbohydrates. These foods include grains-cereals, breads, pasta, rice, barley, wheat, crackers-and produce: fruits and vegetables. Simple carbohydrates (e.g., candy, pastries, cakes and cookies) are on the dessert menu.

HIV status does change protein requirements: We need two-to-three times over the levels required for HIV-negative counterparts. High protein foods include meat, fish, poultry, eggs and dairy. Vegetarian food patterns for protein may still allow milk, yogurt and/or eggs, possibly fish, and also tofu, legumes (beans, peas, lentils), grains, nuts and seeds.

And fat-some of our favorite foods. High fat foods contribute caloric density (9 calories per gram vs. 4 for carbs and proteins). Fat adds flavor so fatty foods often taste terrific. Fat also acts to slow down stomach-emptying. For fat, look to butter (not trans-fat margarine), ice cream, cheeses, coconuts, olives, avocadoes, and most "fast foods." Micronutrients (Vitamins, Minerals and Antioxidants) It's always wise to find foods with nutrient density, high in vitamins, minerals and antioxidants. Avocadoes are on the list, along with fruits and vegetables and their juices (antioxidant power-go for color!), meats, whole grains and dairy.

Micronutrient supplementation is recommended for people living with HIV/AIDS and there's almost no agreement among nutritionists on which amounts and forms to take. The best recommendation from this nutritionist includes hearty levels of B-complex vitamins, vitamins A, D, and E, and a balanced multi-mineral. Antioxidant nutrients include beta carotene, vitamin C, vitamin E, selenium and NAC.

Using any supplement concoction is unwise without input from an HIV-savvy, knowledgeable dietitian or nutritionist. Get professional help on this part of your dietary program; you can hurt yourself if you don't.

Alternatives Everything noted so far is among our Constitutional Needs. Before spending time, money, or both on fad-type supplements, or following highly restrictive food regimens including expensive and/or exotic foods, make sure all absolute needs have been met. Any dietary program that doesn't do this can cause health harm by replacing necessary nutrients, and might also cause financial harm from buying expensive foods or supplements. A strong, safe and effective micronutrient supplement program should cost well under $50 per month. Beyond that, you may be dealing with "accessory" products, not necessarily bad on their own, but if they replace constitutional needs products, it may break the bank, and again, could cause physical harm. Get advice; ask an expert! Co-Therapies Nothing works alone. Medicine does not, and nutrition does not. Together, however, the combination can be awesome! Living happier, better and longer, and in that order.

Nutrition, including what you eat (diet) and what you take (supplements), must be considered as a co-therapy with medicine; not in any wayan "alternative." This kind of plan maximizes overall health so that medical remedies can achieve maximum health benefits. "Alternative nutrition"-going beyond constitutional (and financially-friendly) needs may be nice, but not essential. We're talking absolute requirements here.

Bottom Line Use medical resources when necessary. Ask your doctor. Use nutritional strategies always; these are, after all, requirements. Ask your dietitian/nutritionist. Please do not, under any circumstances, think of nutrition as an "alternative" form of care or treatment. And always have a good food day, no matter what anyone else says about nutrition or alternatives.

First do no harm: If this advice is, or seems to be connected to adverse consequences, consult with your doctor or dietitian/nutritionist. (Jennifer Jensen, MS, RD, CNSD is in private practice. In recognition of the financial frailties that often accompany HIV/AIDS, she has always offered a sliding scale for people living with HIV. She always welcomes your call at 310.450.5581. It's your life, and alternative living is not about nutrition.)