Dietary and Lifestyle Considerations
Optimal nutrition is important for maintaining a healthy immune system and preserving overall general health. However, several factors make this a challenge for people with HIV. Weight loss and malnutrition are common due to complications such as anorexia, changes in metabolism, malabsorption, and chronic diarrhea.117 HIV-related factors such as depression, loss of appetite, impaired taste or smell, or stomach upset (from treatment or from co-infections) may prevent affected individuals from eating enough.117,118 Even people with HIV who consume adequate diets may experience chronic diarrhea and/or vomiting from drug treatments or opportunistic infections, leading to nutrient loss.117 Combined, these factors can lead to nutrient deficiency, which can impair immune function and lower the body's resistance to infection.118,119 New infections, in turn, can further impair nutritional status, creating a vicious cycle that promotes the progression of the disease.118 Moreover, some individuals with HIV may have increased nutrient requirements for other reasons, including pregnancy, or because they are infants or growing children. These issues underscore the importance of ensuring adequate intake of vitamins and other nutrients to maintain health.
Other steps toward optimal health include maintaining a healthy lifestyle—avoiding the use of illicit drugs, alcohol, and tobacco, as well as engaging in moderate physical activity. In moderation, being active has been found to support immune function, reduce the potential for metabolic abnormalities, and decrease the risk of acute infection. It can also boost muscle mass, which may be useful for countering HIV-related lipodystrophy.118 Regular physical activity is associated with decreased levels of skeletal muscle inflammatory proteins, as well as reductions in several other important markers of inflammation. These markers bear strong correlations with adverse conditions such as cardiovascular and metabolic diseases (eg, insulin resistance), underscoring the value of moderate physical activity. Moderate activity can also eliminate obesity. This presents additional health-related benefits, particularly since obesity is associated with impaired immune function, along with a host of other health problems.120 Prolonged (more than 1.5 hours), high-intensity exercise is not recommended for people with HIV, as it may have an immune-suppressing effect.121