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).
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
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!
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.
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
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.
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!
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.
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.)